Using the Therapeutic Alliance to Empower Couples and Families

Abstract

In this introductory chapter we explain the perspective taken in this book, i.e., that regardless of their theoretical orientation, therapists need to purposefully balance their alliances with multiple family members in order to empower individuals, subsystems, and the couple or family unit for therapeutic gain. The more complex and resistant the family, the more essential and decisive it is to create strong alliances. As a theoretical framework we introduce our pan-theoretical, systemic perspective on alliances in couple and family therapy (CFT), the distinguishing feature of which is a primary concern with shifting the interpersonal dynamics that maintain psychosocial problems and family dysfunction. Next, we describe in a very practitioner-friendly language, our System for Observing Family Therapy Alliances (SOFTA; Friedlander, Escudero, & Heatherington, Therapeutic Alliances with Couples and Families: An Empirically-Informed Guide to Practice. Washington, DC: American Psychological Association, 2006), the four-dimension model (Engagement in the Therapeutic Process, Emotional Connection with the Therapist, Safety Within the Therapeutic System, and Shared Sense of Purpose Within the Family), its measures, supporting research, and use in practice, training, and clinical supervision. In doing so, we highlight aspects of the alliance unique to conjoint treatment—the need to ensure safety for family members who are in conflict with one another, who are at different developmental levels, and who may have differing motivations—all of which present specific challenges for effective conjoint CFT. Additionally, we discuss alliance rupture and repair processes, split or unbalanced alliances, individual differences in alliance formation and maintenance, and differences between alliances in challenging and not-so-challenging couple and family cases.