Marianne Welmers

Chapter 3 66 In order to encompass these systemic complexities in a comprehensive model of the alliance in family therapy, Friedlander et al. (2006a) developed the System for Observing Family Therapy Alliances (SOFTA). This assessment system is based on a four domain model of the alliance, with two individual alliance domains reflecting (a) goal and task elements ( Engagement in the Therapeutic Process ), and (b) bond elements of the alliance ( Emotional Connection to the Therapist ), similar to Bordin’s (1979) definition of the alliance for individual psychotherapy. The other two domains concern systemic aspects of the alliance unique to conjoint family treatment, that is, (c) Safety within the Therapeutic System , referring to family members experiencing the therapeutic environment as a safe place where they can take risks, be open and flexible, and handle family conflicts without risking harm, and (d) Shared Sense of Purpose within the Family, which is the agreement and cooperation between family members on shared goals (Friedlander et al., 2006a). Several studies using the SOFTA to observe client behaviors indicate the importance of family members’ sense of safety and their shared sense of purpose in promoting positive outcomes of family therapy (e.g. Escudero et al., 2008; Friedlander et al., 2008b; Isserlin & Couturier, 2012; Sotero et al., 2018). Moreover, results of a recent meta-analysis on the association between alliance and outcome in couple and family therapy indicate that aspects of the alliance typical of systemic treatment, such as safety within the therapeutic system or the family’s shared sense of purpose, are more predictive of outcome as compared to individual alliances with the therapist, even when these individual alliances of multiple family members are averaged to measure a family unit of alliance (Friedlander et al., 2018). This indicates that study findings on therapists’ contributions to alliance in individual therapy cannot simply be generalized to family treatment, which emphasizes the importance of a systemic approach to the alliance in family therapy practice and research. However, studies examining therapists’ contributions to the alliance in systemic family treatment are scarce (Sotero et al., 2017). Therapists’ Alliance Building Behaviors Therapists’ observed in-sessionbehavior couldbean important contributor to thealliance, as has been shown in several studies in individual youth therapy (Creed, & Kendall, 2005; Fjermestad et al., 2020; Ovenstad et al., 2020). For conjoint family treatment however, studiesonalliancebuildingbehaviors are scarce. Diamondet al. (1999) examined tencases of adolescents in Multidimensional Family Therapy (MDFT) with initially poor alliances, and compared five improved cases with five unimproved cases. They found that in the improved cases, therapists more extensively presented themselves as the adolescent’s ally, attended to the adolescent’s experience, and formulated personallymeaningful goals. In a comparable study on the alliance with adolescents in a Spanish setting of brief family therapy, Muñiz de la Peña et al. (2012) found that therapists showed significantly more