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Alliance and adherence in a systemic therapy.

Aurelie M C Lange1,2, Rachel E A van der Rijken1,3, Marc J M H Delsing4

  • 1Viersprong Institute for Studies on Personality Disorders, P.O. Box 7, 4660 AA, Halsteren, The Netherlands.

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PubMed
Summary
This summary is machine-generated.

The client-therapist alliance and therapist adherence mutually reinforce each other throughout therapy. Early alliance predicts later adherence, while adherence strengthens the alliance during the mid-treatment phase.

Keywords:
Adolescenceantisocial behaviourdelinquencyfamily therapystructural equation modelling

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Area of Science:

  • Psychology
  • Family Therapy
  • Psychotherapy Research

Background:

  • The client-therapist working alliance is crucial for adult psychotherapy effectiveness.
  • Its role in family and systemic therapy, and its longitudinal interplay with therapist adherence, remain understudied.
  • Therapist adherence involves fidelity to treatment protocols or manuals.

Purpose of the Study:

  • To investigate the bidirectional associations between working alliance and therapist adherence in family therapy.
  • To examine how these variables interrelate longitudinally over the course of treatment.
  • To explore potential moderating effects of client characteristics on these associations.

Main Methods:

  • Cross-lagged panel analyses were employed.
  • Data from 1970 adolescents and their families in Multisystemic Therapy (MST) were analyzed.
  • Primary caregivers reported on alliance and adherence via monthly telephone interviews.

Main Results:

  • Client-therapist alliance in one month predicted therapist adherence in the subsequent month.
  • Therapist adherence predicted subsequent alliance only during the middle phase of treatment.
  • No client characteristics moderated the observed associations between alliance and adherence.

Conclusions:

  • Alliance and therapist adherence appear to mutually reinforce each other during therapy.
  • The client-therapist alliance may foster therapist adherence.
  • Therapist adherence may, in turn, deepen and consolidate the client-therapist alliance, independent of client factors.