Drop-out and therapeutic alliance: a process analysis

Journal title TERAPIA FAMILIARE
Author/s Francesca Balestra, Claudia Zaccaria, Laura Fruggeri
Publishing Year 2022 Issue 2021/127
Language Italian Pages 22 P. 85-106 File size 672 KB
DOI 10.3280/TF2021-127006
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The study aims to investigate the relationship between therapeutic alliance and drop-out to examine which factors in the context of therapeutic sessions may be associated with early termination of therapy by clients. Five therapeutic processes with different outcomes, for a total of 24 sessions, were analyzed through a mixed methodology that included an initial descriptive analysis with SOFTA, followed by a clinical-constructionist-dialogical analysis. The results show a fluctuating trend both in the completed therapeutic processes and in the dropouts and point out the in-session factors linked to the ruptures and failures to repair the alliance.

Keywords: Drop-out, therapeutic alliance, SOFTA, therapeutic relationship, positioning, discourse analysis.

  1. Aronsson K. & Cederborg A.C. (1994). Co-narration and voice in family therapy. Voicing, devoicing, and orchestration. Text, 14: 345-370. DOI: 10.1515/text.1.1994.14.3.345
  2. Bartle-Haring S., Glebova T., Gangamma R., Grafsky E. & Delaney R.O. (2012). Alliance and termination status in couple therapy: A comparison of methods for assessing discrepancies. Psychotherapy Research, 22(5): 502-514. DOI: 10.1080/10503307.2012.676985
  3. Beck M., Friedlander M.L. & Escudero V. (2006). Three perspectives on clients’ experiences of the therapeutic alliance: A discovery-oriented investigation. Journal of Marital and Family Therapy, 32(3): 355-368. DOI: 0.1111/j.1752-0606.2006.tb01612.x
  4. Escudero V., Boogmans E., Loots G. & Friedlander M.L. (2012). Alliance rupture and repair in conjoint family therapy: An exploratory study. Psychotherapy, 49(1): 26-37. DOI: 10.1037/a0026747
  5. Eubanks C.F., Muran J.C. & Safran J.D. (2018). Alliance rupture repair: A etaanalysis. Psychotherapy, 55(4): 508-519. DOI: 10.1037/pst0000185
  6. Friedlander M.L., Escudero V. & Heatherington L. (2006). Therapeutic alliances in couple and family therapy: an empirically informed guide to practice. Washington: American Psychological Association (trad. it.: Alleanze Terapeutiche nella terapia di coppia e della famiglia. Roma: Firera & Liuzzo, 2010).
  7. Fruggeri L., Balestra F. & Venturelli E. (2020). Le competenze psicoterapeutiche. Bologna: il Mulino.
  8. Harré R., Moghaddam F.M., Pilkerton Cairnie T., Rothbart D. & Sabat S.R. (2009). Recent advances in positioning theory. Theory and Psychology, 19: 5-31. DOI: 10.1177/0959354308101417
  9. Horvath A.O. & Bedi R.P. (2002). The alliance. In: Norcross J.C., a cura di, Psychotherapy relationships that work. New York: Oxford University Press.
  10. Johnson L.N., Wright D.W. & Ketring S.A. (2002). The therapeutic alliance in homebased family therapy: is it predictive of outcome? Journal of Marital and Family Therapy, 28: 93-102. DOI: 10.1111/j.1752-0606.2002.tb01177.x
  11. Jones E. (2003). Working with the “Self ” of the therapist in consultation. Human Systems, 14(1): 7-16.
  12. Kivlighan D.M. Jr. & Shaughnessy P. (2000). Patterns of working alliance development: A typology of client’s working alliance ratings. Journal of Counseling Psychology, 47(3): 362-371. DOI: 10.1037/0022-0167.47.3.362
  13. Knobloch-Fedders L.M., Pinsof W.M. & Mann B.J. (2007). Therapeutic alliance and treatment progress in couple psychotherapy. Journal of Marital and Family Therapy, 33: 245-257. DOI: 10.1111/j.1752-0606.2007.00019.x
  14. Kreppner K. (2009). Analizzare le “strutture profonde” dei processi familiari. In: Fruggeri L., a cura di, Osservare le famiglie. Roma: Carocci.
  15. Martin D.J., Garske J.P. & Davis M.K. (2000). Relation of therapeutic alliance with outcome and other variables: a meta-analytic review. Journal of Consulting and Clinical Psychology, 68: 438-450. DOI: 10.1037/0022-006X.68.3.438
  16. Masi M.V., Miller R.B. & Olson M.M. (2003). Differences in dropout rates among individual, couple and family therapy clients. Contemporary Family Therapy, 25(1): 63-75. DOI: 10.1023/A:1022558021512.
  17. Muñiz de la Peña C., Friedlander M. & Escudero V. (2009). Frequency, severity and evolution of split family alliances: How observable are they? Psychotherapy Research, 19(2): 133-142. DOI: 10.1080/10503300802460050
  18. Ochs E. & Taylor C. (1996). The “father knows best” dynamic in dinnertime narratives. In: Hall K., a cura di, Gender articulated: language and the socially constructed Self. London: Routledge.
  19. Robbins M.S., Liddle H.A., Turner C.W., Dakof G.A., Alexander J.F. & Kogan S.M. (2006). Adolescent and parent therapeutic alliances as predictors of dropout in multidimensional family therapy. Journal of Family Psychology, 20(1): 108-116. DOI: 10.1037/0893-3200.20.1.108
  20. 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 Psychology, 17(4): 534-544. DOI: 10.1037/0893-3200.17.4.534
  21. Stiles W.B., Glick M.J., Osatuke K., Hardy G.E., Shapiro D.A., Agnew-Davies R., Rees A. & Barkham M. (2004). Patterns of Alliance Development and the Rupture-Repair Hypothesis: Are Productive Relationships U-Shaped or V-Shaped? Journal of Counseling Psychology, 51(1): 81-92. DOI: 10.1037/0022-0167.51.1.81
  22. Tannen D. (2007). You just don’t understand. Women and men in conversation. New York: Harper & Collins.
  23. Yoo H., Bartle-Haring S. & Gangamma R. (2016). Predicting premature termination with alliance at sessions 1 and 3: An exploratory study. Journal of Family Therapy, 38: 5-17. DOI: 10.1111/1467-6427.12031

Francesca Balestra, Claudia Zaccaria, Laura Fruggeri, Drop-out e alleanza terapeutica: un’analisi processuale in "TERAPIA FAMILIARE" 127/2021, pp 85-106, DOI: 10.3280/TF2021-127006