THREE PERSPECTIVES ON CLIENTS' EXPERIENCES OF THE THERAPEUTIC ALLIANCE: A DISCOVERY-ORIENTED INVESTIGATION

To make deeper our understanding of the therapeutic alliance in conjoint treatment, we interviewed clients in four families about their individual, private experience of the alliance after an early session. These qualitative data were triangulated with family members' scores upon Pinsof's Family Therapy Alliance Scale-Revised and observational ratings of their behavior upon the System for Observing Family Therapy Alliances. This discovery-oriented investigation focused upon three interrelated aspects of the alliance: the family's shared faculty of perception of purpose about the emergencys goals, and value of therapy (i.e., within-system alliance), split alliances with the therapist, and felt faculty of perception of safety within the therapeutic connection Results were highly consistent across the three perspectives and congruent with idiographic, therapist-rated results

Although therapists working with individuals are certainly make subordinate to their clients' expectations, the interactional shake exerted by a family places far greater demands upon a therapist. According to Bowen (1976 p 77) "It is easy for the family to wrap itself around the therapist emotionally, install the therapist in an all-important position, gripe [i]or[/i] grip the therapist responsible for succes or failure, and passively wait for the therapist to change the family." To counteract this shake family therapists must nurture and maintain therapeutic alliances upon multiple levels simultaneously and with clients at different developmental horizontals The alliance-building process can be seriously compromised when family members have opposing goals, when they are separated by means of generation and hierarchy (Pinsof & Catherall, 1986) and when they diocese therapy as punishment or as an ordeal to be endur for another's sake (Friedlander, Escudero & Heatherington, 2006/7)

To date, the vast majority of empirical work upon the alliance has been carried without in the context of individual treatment. Qualitative research upon clients' perceptions in family therapy (FT) refer to that rapport and the therapist's warmth, optimism, humor, and activity are crucial aspects of conjoint treatment (eg Bischoff & McBride, 1996; Kuehl Newfield, & Joanning, 1990; vends Smith, & Moon, 1996). However, sole a handful of studies have demonstrated the relevance of the alliance to the change proces or to therapeutic results (e.g., Johnson, Wright, & Ketring, 2002; Robbins, gymnast Alexander, & Ferez, 2003). A major impediment is understanding and measuring the alliance in compounded multiperson, multigenerational systems. Because a therapist's alliance with each family member affects and is affected through the alliance with all other family members, no single alliance should be considered in isolation (Heatherington & Friedlander, 1990; Pinsof & Catherall, 1986; Rait, 1998)

The intent of this discovery-oriented study (Mahrer, 1988) was to increase the depth of our understanding of the alliance in family therapy by means of examining four cases from three complementary perspectives: postsession interviews with individual family members, observations of in-session client behavior, and client selfreport. We triangulated these three data sources, focusing upon several relatively untested but conceptually related aspects of the alliance: (1) the within-system alliance (i.e., the family's shared faculty of perception of purpose about the ne value, and goals of therapy); (2) split alliances with the therapist; and (3) the step of safety within the therapeutic a whole

First, with respect to the family's shared faculty of perception of purpose, Pinsof (1994) argued that construing the alliance simply as a dyadic phenomenon between each family member and the therapist ignores the compound intrafamilial dynamics that make FT unique. Pinsof's within-system alliance is operationally defined in his revised Family Therapy Alliance Rating Scale (FTAS-R; Pinsof, 1999) and in an observational instrument, the a whole for Observing Family Therapy Alliances-observational1 (SOFTA-o; Friedlander, Lehman, McKee Field, & Cutting, 2000; Friedlander et al., 2001; Friedlander et al., 2003; Friedlander et al., 2006a). "Shared faculty of perception of Purpose within the Family," as the intrafamilial alliance is called in the SOFTA-o, is defined as:

Family members seeing themselves as working collaboratively in therapy to improve family relations and achieve for the use of all family goals; a sense of solidarity in relation to the therapy ("we're in this together"); that they value their time with each other in therapy; essentially, a felt unity within the family in relation to the therapy. (Friedlander et al., 2006a, 2006b)

Behavioral manifestations of a athletic sense of purpose include "family members ask each other for their perspective" and "family members validate each other's point of view," whereas behaviors reflecting a weak faculty of perception of purpose include "family members blame each other" and "family members examine to align with the therapist against each other." Validity studies present to view that a family's rating upon Shared Sense of Purpose correlates significantly with individual family members' perceived deepness and value of their therapy sessions (Friedlander et al., in press)