The creation and maintenance of a strong therapeutic alliance is one of the most robust predictors of successful treatment for adult (Horvath & Bedi, 2002) and adolescent (Karver, Handelsman, Fields, & Bickman, 2006) clients across diverse therapy formats and presenting problems. However, research on the alliance with adolescents lags far behind research with adults, particularly in the context of family therapy. Because of the supported efficacy of family therapy for diverse adolescent problems (Shelef et al., 2005), the present study examined the association between observed therapist-adolescent alliances and relational control communication in the context of conjoint family therapy. Relational control refers to how people use language in order to influence others, reflecting the implicit hierarchical and relational structure of messages people exchange with one another (Rogers & Escudero, 2004).
Specifically, two interpersonal control patterns (competitive symmetry and complementarity) were compared, in sessions where the adolescent’s alliance was positive (“good”) to sessions where the alliance was negative (“bad”). Competitive symmetry reflects a struggle for control, whereas complementarity reflects a mutual understanding of the relationship. Additionally, the likelihood of competitive symmetry and complementarity were compared in cases in which the adolescent’s observed alliance with the therapist deteriorated over time to cases in which the alliance remained stable and positive.
Ten family cases seen at a university family therapy clinic in Spain were selected based on adolescent alliance scores observed using the SOFTA (Friedlander, Escudero, & Heatherington, 2006). Sequential lag analyses were used to obtain contingency tables for therapist-adolescent relational control interactions, which were coded using the Family Relational Communication Control Coding System (FRCCCS; Friedlander & Heatherington, 1989). Results provided some support for the hypothesized differences in that there was relatively more competitive symmetry and relatively less complementarity in the bad alliance sessions. Moreover, in the deteriorating alliance cases, competitive symmetry increased and complementarity decreased from session 1 to 3, whereas in the stable-positive alliance cases, complementarity remained relatively unchanged and competitive symmetry decreased. Results highlight the importance of promoting cooperation and avoiding competition with the adolescent in order to develop and maintain a strong alliance in conjoint therapy.
|Advisor:||Friedlander, Myrna L., Escudero, Valentin|
|School:||State University of New York at Albany|
|School Location:||United States -- New York|
|Source:||DAI-B 72/02, Dissertation Abstracts International|
|Keywords:||Adolescence, Adolescent psychotherapy, Communication, Family therapy, Interaction analysis, Relational control, Therapeutic alliance|
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