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Observing the therapeutic alliance in family therapy: associations with participants' perceptions and therapeutic outcomes



Positive and negative alliance-related behaviours of thirty-seven families seen in brief family therapy were rated from videotapes using the System for Observing Family Therapy Alliances (Friedlander et al., 2006b). Positive associations were found between in-session behaviour and participants' perceptions of the alliance and improvement so far both early (session 3) and later in therapy (session 6). Binary logistic regression showed that successful outcomes (defined as consensus by therapist and all family members on general improvement and reduced problem severity) were significantly predicted by positive individual behaviour (Engagement in the Therapeutic Process, Emotional Connection with the Therapist, Safety within the Therapeutic System) in session 3 and productive within-family collaboration (Shared Sense of Purpose within the Family) in session 6. Shared Sense of Purpose was the alliance indicator most consistently associated with clients' and therapists' perceptions of therapeutic progress; moreover, it was the only alliance indicator to improve significantly over time in treatment.