Therapeutic Alliance: A Review of Sampling Strategies Reported in Marital and Family Therapy Studies

Abstract

Therapeutic alliance is considered important for successful counseling. Alliances between a therapist and couples or family members become complicated because of multiple interactions. This literature review examines sample size, participant assignment, and generalizability in 19 marital and family therapy studies on therapeutic alliance published 1989 through 2003. Eleven studies had inadequate sample sizes. Most of the assignment strategies include convenience and purposive samples conducted with YAVIS (young, adult, verbal, intelligent, stable) populations. Studies lacked diversity in participant demographics and treatment sources. None of the studies factor how therapist experience and therapeutic setting affect therapeutic alliances. These studies do support therapeutic alliance as an integral part of marital and family counseling, theory, and assessment.

Keywords

therapeutic alliance family therapeutic alliance marriage therapeutic alliance therapeutic alliance sampling

Get full access to this article

View all access options for this article.

References

Alexander, P.U. (1997). Successful and unsuccessful couples therapy: A grounded theory study of client perspectives . Dissertation Abstracts International-B, 58(05), 2663 . (UMI No. AAT 9734265).

Ary, D. , Jacobs, L.C. , Razavieh, A. (2002). Introduction to research in education (6th ed.). Belmont, CA: Wadsworth Thomson Learning .

Best, J.W. , & Kahn, J.V. (1993). Research in education (7th ed.). Boston: Allyn and Bacon .

Bordin , (1979). The generalizability of the psychoanalytic concept of the working alliance . Psychotherapy: Theory, Research and Practice, 16, 252-260 .

Bourgeois, L. , Saborin, S. , & Wright, J. (1990). Predictive validity of therapeutic alliance in group marital therapy . Journal of Consulting and Clinical Psychology, 58(5), 608-613 .

Cohen, J. (1992). A power primer . Psychological Bulletin, 112(1), 155-159 .

Coupland, S.K. , & Serovich, J.M. (1999). Effects of couples' perceptions of genogram construction on therapeutic alliance and session impact: A growth curve analysis . Contemporary Family Therapy, 21(4), 551-572 .

Davenport, B.R. , & Ratliff, D. (2001). Alliance ratings as a part of trainee evaluations within family therapy training . Contemporary Family Therapy , 23(4), 441-454 .

Diamond, G.M. , Diamond, G.S. , & Liddle, H.A. (2000). The therapist-parent alliance in family-based therapy for adolescents . Psychotherapy in Practice, 56(8), 1037-1050 .

10.

Faloon, I.R.H. (1991). Behavioral family therapy. In A. S. Gurman & D. P. Kniskern (Eds.), Handbook of family therapy (Vol. 2, pp. 65-95). New York: Brunner/Mazel , Inc.

11.

Garfield, S. L. , & Bergin, A. E. (Eds). (1986). Handbook of psychotherapy and behavior change. New York: John Wiley & Sons .

12.

Glass, G.V. , & Hopkins, K.D. (1984). Statistical methods in education and psychology (2nd ed.). Englewood Cliffs, NJ: Prentice-Hall, Inc.

13.

Glueckauf, R.L. , Liss, H.J. , McQuillen, D.E. , Webb, P.M. , Dairaghi, J. , & Carter, C.B. (2002). Therapeutic alliance in family therapy for adolescents with epilepsy: An exploratory study . The American Journal of Family Therapy, 30, 125-139 .

14.

Gravetter, F.J. , & Wallnau, L.B. (2004). Statistics for the behavioral sciences (6th ed.). Belmont, CA: Wadsworth Thomson Learning .

15.

Gurman, A.S. , & Jacobson, N.S. (1995). Therapy with couples: A coming of age. In N. S. Jacobson & A. S. Gurman (Eds.), Clinical handbook of couple therapy. New York: Guilford Press .

16.

Gurman, A.S. , Kniskern, D.P. , & Pinsof, W.M. (1986). Research on the process and outcome of marital and family therapy. In S. L. Garfield & A. E. Bergin (Eds.), Handbook of psychotherapy and behavior change (pp. 565-624). New York: John Wiley & Sons .

17.

Hampson, R.B. , Prince, C.C. , & Beavers, W.R. (1999). Marital therapy: Qualities of couples who fare better or worse in treatment . Journal of Marital and Family Therapy, 25(4), 411-424 .

18.

Haslam-Hopwood, G.T.G. (2003). The role of the primary clinician in the multidisciplinary team . Bulletin of the Menninger Clinic, 67(1), 5-17 .

19.

Heatherington, L. , & Friedlander, M.L. (1990). Complementarity and symmetry in family therapy communication . Journal of Counseling Psychology , 37(3), 261-268 .

20.

Hight, C.T. (1997). The effects of the perceived therapeutic alliance on outcome in couples therapy . Dissertation Abstracts International-B , 58(08), 4451 . (UMI No. AAT 9807112).

21.

Holtzworth-Munroe, A. , Jacobson, N.S. , DeKlyen, M. , & Whisman, M.A. (1989). Relationship between behavioral marital therapy outcome and process variables . Journal of Consulting and Clinical Psychology, 57(5), 658-662 .

22.

Horvath, A.O. , & Bedi, R.P. (2002). The alliance. In J. C. Norcross (Ed.), Psychotherapy relationships that work: Therapist contributions and responsiveness to patients (pp. 37-69). New York: Oxford University Press .

23.

Horvath, A. O. , & Greenberg, L. S. (Eds.). (1994). The working alliance: Theory, research, and practice. New York: John Wiley & Sons, Inc.

24.

Horvath, A.O. , & Luborsky, L. (1993). The role of the therapeutic alliance in psychotherapy . Journal of Consulting and Clinical Psychology, 61(4), 561-573 .

25.

Johnson, L.N. , Wright, D.W. , & Ketring, S.A. (2002). The therapeutic alliance in home-based family therapy: Is it predictive of outcome? Journal of Marital and Family Therapy, 28(1), 93-102 .

26.

Kaplan, H.I. , & Sadock, B.J. (1998). Kaplan & Sadock's synopsis of psychiatry: Behavioral sciences/clinical psychiatry (8th ed.). Baltimore, MD: Lippincott, Williams & Wilkins .

27.

Levy, S.T. (2000). The therapeutic alliance. Madison, CT: International Universities Press .

28.

Luborsky, L. (1994). Therapeutic alliances as predictors of psychotherapy outcomes: Factors explaining the predictive success. In A. O. Horvath & L. S. Greenberg (Eds.), The working alliance: Theory, research, and practice (pp. 38-50). New York: John Wiley & Sons, Inc .

29.

Martin, D.J. , Garske, J.P. , & Davis, M.K. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review . Journal of Consulting and Clinical Psychology, 68(3), 438-450 .

30.

Miller, T.M. (2003). The impact of specific support-focused marital therapy interventions on marital satisfaction and related variables . Dissertation Abstracts International-B, 64(02), 970 . (UMI No. AAT 3079326).

31.

Neufeldt, S.A. (2004). Critical factors in supervision: the patient, the therapist, and the supervisor. In D. P. Charman (Ed.), Core processes in brief psychodynamic psychotherapy: Advancing effective practice (pp. 325-342). Mahwah, NJ: Lawrence Erlbaum Associates .

32.

Norcross, J.C. (2002). Psychotherapy relationships that work: Therapist contributions and responsiveness to patients. New York , Oxford University Press .

33.

Patalano, F. (1997). Developing the working alliance in marital therapy: A psychodynamic perspective . Contemporary Family Therapy, 19(4), 497-505 .

34.

Pinsof, W.M. (1988). Strategies for the study of family therapy. In L. C. Wynne (Ed.), The state of the art in family therapy research: Controversies and recommendations (pp. 159-174). New York: Family Process Press .

35.

Pinsof, W.M. (1994). An integrated systems perspective on the therapeutic alliance: Theoretical, clinical, and research implications. In A. O. Horvath and L. S. Greenberg (Eds.), The working alliance: Theory, research, and practice (pp. 173-195). New York: John Wiley & Sons, Inc.

36.

Pinsof, W.M. , & Catherall, D.R. (1986). The integrative psychotherapy alliance: Family, couple, and individual scales . Journal of Marital and Family Therapy, 12, 137-151 .

37.

Rait, D.S. (2000). The therapeutic alliance in couples and family therapy . Psychotherapy in Practice, 56(2), 211-224 .

38.

Raytek, H.S. , McGrady, B.S. , Epstein, E.E. , & Hirsch, L.S. (1999). Therapeutic alliance and the retention of couples in conjoint alcoholism treatment . Addictive Behaviors, 24(3), 317-330 .

39.

Reif, C.L. (1997). Therapeutic alliance in marital therapy . Dissertation Abstracts International-B, 58(10), 5653 . (UMI No. AAT 9812052).

40.

Reimers, S. (2001). Understanding alliances: How can research inform user-friendly practice ? Journal of Family Therapy, 23, 46-62 .

41.

Robbins, M.S. , Turner, C.W. , Alexander, J.F. , & Perez, G.A. (2003). Alliance and dropout in family therapy for adolescents with behavior problems: Individual and systemic effects . Journal of Family Psychotherapy, 17(4), 534-544 .

42.

Rugel, R.P. (1997) Husband-focused marital therapy: An approach to dealing with marital distress. Springfield, IL: Charles C Thomas Publisher , Ltd.

43.

Safron, J. D. , & Muran, J. C. (Eds.). (1998). The therapeutic alliance in brief psychotherapy. Washington, DC: American Psychological Association .

44.

Satir, V. (1967). Conjoint family therapy. Palo Alto, CA: Science and Behavioral Books .

45.

Terry, D.S. (2002). The multiple therapeutic alliances in family therapy . Dissertation Abstracts International-B, 63(05), 2607 . (UMI No. AAT 3053018).

46.

Tolan, P.H. , Hanish, L.D. , McKay, M.N. , & Dickey, M.H. (2002). Evaluating process in child and family interventions: Aggression prevention as an example . Journal of Family Psychology , 16(2), 220-236 .

47.

Van Roosmalen, M.J. (2001). Therapist intervention factors that influence therapeutic alliance events in family therapy with multi-problem families: A qualitative study (Doctoral dissertation, Open University , United Kingdom, 2001). Dissertation Abstracts International-C, 63(04), 873 .

48.

Werner-Wilson, R.J. , Michaels, M.L. , Thomas, S.G. , & Thiesen, A.M. (2003). Influence of therapist behaviors on therapeutic alliance . Contemporary Family Therapy, 25(4), 381-390 .

49.

Wynne, L.C. (1988). The state of the art in family therapy research: Controversies and recommendations. New York: Family Process Press .