Alliance rupture and repair in conjoint family therapy: an exploratory study

In this article, we introduce a methodology for studying alliance rupture and repair in conjoint family therapy. Using the System for Observing Family Therapy Alliances (Friedlander, Escudero, & Heatherington, 2006), we identified rupture markers and repair interventions in a session with a single mother and her 16-year-old "rebellious" daughter. The session was selected for analysis because a severe rupture was clinically evident; however, by the end of the session, there was an emotional turnaround, which was sustained in the following session and continued until the successful, mutually agreed upon termination. The first rupture occurred when the psychotherapist suggested that the mother explore, in an individual session, how her "personal stress" may be affecting her daughter. The observational analysis showed repeated rupture markers, that is, confrontation and withdrawal behavior, hostile within-family interactions, and a seriously "split" alliance in family members' expressed feelings toward the psychotherapist. The time-stamped behavioral stream showed that the psychotherapist focused first on safety, then on enhancing his emotional connection with each client, and finally on helping mother and daughter understand each other's behavior and recognize their shared isolation.