Marianne Welmers

Chapter 5 116 When a family participated, two sessions with an IPT-worker at the family’s home were videotaped, and all family members involved in the videotaped session as well as the therapist were asked to independently complete the WAI-s right after the session. For T1—in the early treatment phase—the third session (and by exception the fourth or fifth) was filmed. We chose the third session because families were informed about the research and asked to consider participation in the first session. By choosing the third session they had some time to consider participation, but treatment was still in its starting phase, which lasts about six weeks (Van der Steege, 2007). Measurements Working Alliance Inventory – Short Form (WAI-s) To assess the alliance as perceived by therapists and family members, we used the Working Alliance Inventory, Short Form (WAI-s; Horvath & Greenberg, 1989; Killian, Forrester, Westlake, & Antonopoulou, 2017). The questionnaire consists of 12 items (e.g. “My family counselor and I agree upon what I should do in order to improve the way things are going in my family” for the client version or “This client agrees upon what family members should do in order to improve the way things are going in the family” for the therapist version) and measures task-, goal- and bond-elements of the alliance on a 5 point Likert scale ranging from 1 ( never ) to 5 ( always ). In the current sample, Cronbach’s alpha for the therapists’ version was .86 at T1 and .87 at T2, and for the clients’ version .84 at T1 and .92 at T2. System for Observing Family Therapy Alliances (SOFTA-o). The SOFTA-o (Friedlander, Escudero, & Heatherington, 2006b) was developed to asses four dimensions of alliance-related behavior from videotaped family or couple therapy sessions. Two dimensions reflect the individual alliance between a family member and the professional based on Bordin’s (1979) classical definition of the alliance, i.e., Engagement in the Therapeutic Process, representing task and goal elements of the alliance, and Emotional Connection. The two other dimensions, Safety within the Therapeutic System, and Shared Sense of Purpose within the Family, reflect aspects of the alliance that are unique to conjoint family treatment. For the purpose of this study, we used the Shared Sense of Purpose scale, and an average of Engagement and Emotional Connection to reflect the individual alliance between a family member and the therapist. Scores of these two subscales were significantly correlated (T1: r = .292, p = .034, T2: r = .422, p = .007). When using the SOFTA-o, a trained coder observes a session and notes the frequency of specific positive and negative alliance-related behaviors along the four dimensions. After observing the session, based on the frequency, intensity and clinical meaningfulness of the marked behaviors, coders assign global ratings on