Therapist intervention factors that influence therapeutic alliance events in family therapy with multi-problem families : a qualitative study

van Roosmalen, Marc J. (2001). Therapist intervention factors that influence therapeutic alliance events in family therapy with multi-problem families : a qualitative study. PhD thesis The Open University.

DOI: https://doi.org/10.21954/ou.ro.0000e7d6

Abstract

Background and Aims. The study investigates the therapist factors that influence the therapeutic alliance in family therapy with multi-problem families, from the perspectives of the child and family and structured commentary of the therapist. Due to the lack of research done with this client group and the adapted use of qualitative approaches applied, the methodology is also subject to scrutiny.

Design and Participants. A qualitative small-case design is used, to enable the collation of rich and detailed data of the meanings and experiences of the participants to emerge. Four family therapy cases at a child clinic are followed, using therapeutic alliance events as the units of investigation.

Measures. Interpersonal Process Recall, an interview method developed by Elliott (1984), gains the views of the participants, with Interpretative Phenomenological Analysis as the method of transcript analysis. The dual role of researcher and therapist is studied reflexively on various levels. An adapted Family Therapy Alliance Scale is also administered.

Results. A number of prominent themes emerged, namely, child therapy stance and technique, the children's communication style and a shift from an individual to systemic meaning of the difficulties. Others were being heard and listened to versus the experience of not being heard, working alongside the family, benefits and motivation in therapy and the experience of safety.

Implications. The study gives a useful account of the participants' views of which therapist intervention factors influenced the alliance and links with current research and theory. Prominent implications were the full participation of children, shifts in the meanings families ascribe to their difficulties and ways for therapists to collaborate with them. Evidence of the viability and limitations of the method used is provided. Directions of further research are suggested.