Marianne Welmers

Chapter 4 104 ability to detect differences between family members’ alliances. Notably, our study is probably the first to include observed, self-reported, and therapist-reported measures when investigating alliance discrepancies. More research is needed to build a stronger evidence base on the therapists’ ability to accurately recognize alliance discrepancies. Therapist reports of the alliance weremoderately associated withmothers’ self-reported alliance in the early stage of treatment, but there was no therapist- and self-report correlation for fathers and youths. This indicates that at the beginning of treatment, therapists lack a shared perspective on the alliance with both fathers and youths. It seems that in the early stage of treatment therapists’ perspectives on the alliance are closest to mothers’ perspectives, who in our sample were the most involved party in treatment. These results should, however, be interpretedwith caution, as differences in the therapist- self-report correlation at T1 were only trend significant for the difference between fathers and mothers, and not significant for the differences between parents and youths. It was interesting to find that the association between therapist reports of the alliance with fathers and their self-reports became notably stronger during treatment. At T2 there was a significant and large correlation, which was comparable with the association between therapist- and self-reports of mothers’ alliances at T2. Apparently, when therapists spend more time in treatment with fathers, a more shared perspective on their alliance evolves. In contrast, correlations between therapist- and self-reports of the alliance with youths barely increased during treatment, indicating that even when the treatment process evolves, therapists still lack a shared perspective on the alliance with youths. This finding is in contrast with meta-analytic findings of Roest et al. (2021a), who found a moderate correlation between therapist reported and self-reported alliances with youths in youth psychotherapy. Perhaps our finding on the lack of a shared perspective between therapists and youths is specific to the alliance with youths in conjoint family treatment, where therapists might have a stronger focus on the alliance with parents. It should be noted, however, that in our sample the number of youthswith self-reports of the alliancewas small, and further research is required to draw valid conclusions about the association between therapist- and self-reports of the alliance with youths in family treatment. Limitations, Strengths, and Future Directions Several limitations of this study should be considered when interpreting our study findings. First, we analyzed data froma highly heterogeneous sample in terms of targeted problems, age of referred children, and present family members at observed sessions. Also, only a small number of fathers and youths with self-reports and observer reports of the alliance was included in the sample. Furthermore, in comparing alliance reports of therapists, clients, and observers, it could be that results are to some extent confounded