Marianne Welmers

Therapists’ Contributions to the Alliance 73 CHAPTER 3 present in the session ( n = 6) and by low variance (range = 0-3). For this scale we therefore additionally analyzed percentage of agreement between coders and found that for 67.7% of the sessions there was 100% agreement on number of observed SSP behaviors, for 16.7% ( n =1) of the sessions the difference between coders was 1, and in the remaining 16.7% the difference was 2. However, preliminary results showed that not only interrater reliability, but also variance was low for observed SSP behaviors. Therefore, we excluded this domain from our main analyses. Procedures Participating families were drawn from four IPT-teams of two Dutch youth care organizations. Each family that started treatment was 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 families were invited to participate by telephone by a research assistant. Participating family members of 12 years and older signed an informed consent letter, and the project was approved by the ethical review board of the university faculty where authors of the study were employed. 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. For each participating family two IPT-sessions at the family’s home were videotaped. 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). The second video- observation (T2) was twomonths later, when treatment was in the phase of active change. Immediately after both video-recorded sessions, the therapist and participating family members were asked to independently fill out theWork Alliance Inventory (WAI). Children who were 8 years or older were asked to complete the Working Alliance Inventory (WAI). In some families, children above 8 did not want to participate in the research, and in other families the therapist saw one or two parents without a child for at least a part of the sessions, including the observed session. Therapists were asked to reflect on alliances with all family members actively involved in treatment, regardless of age. For 9 families there were no T2 measures available because the treatment had already ended ( n = 3), or therapist or clients wished to end their participation after T1 because the situation had changed ( n = 6), and for 1 family there was no T1 measure. Study dropouts were not excluded because this might have decreased the clinical representativeness of our study. We compared all measures at T1 as well as therapist personality measures and clinical experience for dropout and completer cases by performing amultilevel regression