Marianne Welmers

Therapists’ Contributions to the Alliance 69 CHAPTER 3 Although therapists’ personality traits might help or hamper bonding and collaborating effectively with clients, clinical experience might help therapists to enhance those interpersonal skills that do not come naturally. Especially in family therapy, skills required for balancingmultiplealliancesandenhancingsystemicaspectsof thealliancearecomplex, and thusmight benefit fromextensive clinical experience. Toour knowledge, there are no studies available examining the effect of the therapist’s clinical experience on alliances in conjoint family treatment. Previous studiesof other formsof therapy showmixed results. For example, Mallinckrodt andNelson (1991) foundthatexperiencedpost-graduatetherapistshadstronger allianceswith their clientsascompared tobothnoviceandadvancedpsychotherapy trainees. Hersoug et al. (2009) found that in long-term psychotherapy more experienced therapists rated the alliance to be lower. However, in another study, with a larger sample of therapists, no effect was found for years of clinical experience on alliance (Dunkle & Friedlander, 1996). These equivocal results underline the relevance of further investigating the role of the therapists’ clinical experience in building alliances. Present Study This study aimed to examine the contribution of therapists’ observed alliance building behaviors, personality, and clinical experience to the alliance in a home-based family treatment for youth problems. Empirical evidence suggests that the client’s perspective on the alliance seemsmost predictive of outcome (Horvath et al., 2011). However, several studies support the predictive value of therapist reports as well (Flückiger et al., 2018; De Greef et al., 2018b; Zilcha-Mano et al., 2015). Also, it is the therapist who is responsible for managing the therapeutic process, including the process of building alliances and repairing problematic alliances if they occur (Hartmann et al., 2015). In this study we thus focused on predicting both family members’ and therapists’ experiences of the alliance. Because we were interested in alliance as a dynamic process that develops over time (Horvath, 2006; Welmers-van de Poll et al., 2018), we investigatedmid-treatment alliance, taking into account the possible effects of early treatment therapist behavior and alliance. We hypothesized that the therapist’s personality, clinical experience, and observed alliance building behaviors would be significantly associated with mid-treatment alliance as reported by family members and therapists. More specifically, we expected that therapists’ extraversion, openness to experience, and agreeableness would positively, and neuroticism would negatively predict quality of the alliance. As previous findings regarding conscientiousness (-related traits) as well as years of clinical experience were inconsistent, we did not formulate hypotheses for the direction of the association with the alliance for these characteristics. Finally, we expected that therapists’ observed engagement, emotional connection, safety, and shared sense of purpose behaviors would predict more positive mid-treatment alliance reports.