Marianne Welmers

A Systemic Perspective on Alliances and their Relation to Outcome 115 CHAPTER 5 as financial problems, parental psychopathology or lack of a supporting social network. The treatment has an empowering, solution-focused and systemic approach, focusing on improving parenting skills and enhancing social support (Van der Steege, 2007). During treatment, an IPT-worker visits the family once or twice a week or once every two weeks, depending on the families’ needs and stage of treatment. Families in this study received IPT for an average period of 47 weeks ( SD = 25.3; range 12-109). Procedures Participating families were drawn from four teams specialized in IPT of two Dutch providers of specialized youth care. When a family started treatment with an IPT-worker of a participating team, they were informed about the research project by the IPT-worker or institution and received a letter with information. In one team, all IPT-workers directly asked their clients to participate. In the remaining three teams a member of the research team called the family to ask them to participate. Children aged 8 years or older were asked to complete theWorking Alliance Inventory (WAI) and were included in coding observations using the System for Observing Family Therapy Alliances (SOFTA). Therapists were asked to reflect on alliances with all family members involved in treatment, regardless of age. Participating family members between 12 and 16 years gave assent, and older participants gave informed consent. The project was approved by the ethical board of the Faculty of Social and Behavioral Science of the University of Amsterdam. All participating families received a €10,- gift card and by draw, two families received a voucher for visiting a zoo or fun park of their own choice. As a standard treatment procedure in all participating teams, parents filled out the Child Behavior Checklist (CBCL) at the start and end of treatment. Because the response rate at the end of treatment was very low, the research team carried out a follow-up telephone interview to gather CBCL data 18 months after the family had ended the treatment. Thirty-two participating families were excluded from the present study sample, because they had missing CBCL data on either the start of treatment or at follow-up. We compared family members of included and excluded families for therapist-, self- and observer reported alliances at T1 and T2, families’ SSP scores and CBCL measures at T1 and T2 and CBCL at baseline and follow-up by performing an independent samples t-test. Results indicated that families included in the present study sample had slightly higher self-reports of the alliance at T1 (t(88) = -.884, p = .020) and slightly lower self-reports of alliance at T2 (t(67) = .013, p = .028). Furthermore, total youth problems at baseline were lower for included families as compared to excluded families (t(43) = .541, p = .015). There were no significant differences between included and excluded families for any other measures.