Using SOFTA-o Alliance Activity to Examine Systemic Dimensions of Multiple Alliances in Home-Based Family Treatment

Autor: Hendricx-Riem, Madelon, Hasselman, Fred, Scholte, Ron, Van Hattum, Marion, Bunge, Andrea
Rok vydání: 2023
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ISSN: 0022-0167
DOI: 10.17605/osf.io/4jcn9
Popis: This is the preregistration of my planned paper "Using SOFTA-o Alliance Activity to Examine Systemic Dimensions of Multiple Alliances in Home-Based Family Treatment". For this paper, I am making use of an existing dataset which details the results of the System for Observing Family Therapy Alliances (SOFTA; Friedlander et al., 2006) which was used to capture observations of alliances occurring in home-based family treatment sessions. The resulting SOFTA-o sheets contain information about the occurrence of alliance behaviors across the four alliance dimensions "Engagement", "Emotional Bond", "Safety in the Therapeutic Context", and "Shared Sense of Purpose", and per family treatment unit (therapist(s) and clients). Thus far, research using SOFTA-o has focused primarily on alliance formation and maintenance by viewing aggregated scores per dimension. Namely, SOFTA-o deduces global scores ranging between -3 and +3 which reveal the strength of the alliance for each of the four SOFTA alliance dimensions per person and session. In contrast, this study explores the non-aggregated information SOFTA-o reveals about the multiple alliances. Instead of viewing the aggregated global scores alone, this study explores the role of what we will call alliance activity. An individual’s activity on the alliance dimension is represented by the amount of alliance behaviors a person has contributed to this dimension throughout the session. In other words, while the global score is determined by aggregating the positive and negative alliance behaviors to quantify the quality and strength of an alliance dimension, the activity on a dimension reveals how many contributions a person has made to the dimension. This distinction between activity and strength of alliance becomes especially interesting when viewing the global scores between -1 and +1. This is due to the fact that the global scores -1, 0, and +1 are given when both positive and negative behaviors have occurred throughout the session which may effectively cancel each other out. A global score of 0 therefore does not reveal how fixated persons have been on forming the alliance dimension, but only that the accumulated efforts resulted in an overall neutral alliance on the dimension. This is where attention to the alliance activity comes in. The goal of this study is to explore the potential added value of this non-aggregated information SOFTA-o provides. By viewing a person's alliance activity in combination with the alliance dimension's strength, it can help individuals assess the effectiveness of their alliance behaviors. For example, a professional may decide to adjust their interventions if the sessions repeatedly result in low global scores despite high activity by the therapist and clients on this same alliance dimension throughout the sessions. It may mean that it is not a lack of attention to the dimensions per se which is causing the unsatisfactory scores, suggesting that a closer look at the individual alliance behaviors and dynamics throughout the sessions may be warranted. This proposed paper will have a strong methodological focus, expanding the range of applicable analyses in SOFTA's repertoire. To the author's knowledge, there is no other paper looking at alliance activity in combination with SOFTA’s global scores in this way. In order to connect our findings to prior research, we will explore the relationship between a person's role in the family treatment unit and their behavior on the alliance dimensions. Prior studies suggest that a person’s role in the FTU may be related to the strength of the person’s alliance, with for example stronger alliances observed between therapists and parents versus with youth (Welmers-van de Poll et al., 2021a; Wong et al., 2022). We are interested to see whether we find this phenomenon repeated in our dataset as well. More specifically, we will use the proposed methodology to analyze the therapist’s and clients’ systemic alliance behaviors in particular. Despite prior research pointing to the systemic dimensions specifically as predictors of therapy outcome (Friedlander et al., 2018), it seems that alliances are still created largely in a dyadic manner rather than with the group as a whole (Welmers-van de Poll et al., 2021b). This is surprising considering that conjoint family treatment aims to tackle the group’s issues systemically by working with the family unit / system versus the individual. A study by Welmers-van de Poll (2021b) points to especially low contributions of the therapist on the systemic alliance dimensions “Safety in the Therapeutic Context” and “Shared Sense of Purpose” in comparison to the dyadic dimensions. This specific study is, to the author’s knowledge, the only SOFTA-related research to use the number of alliance behavior occurrences (alliance activity) rather than the global scores. Furthermore, findings by Benítez et al. (2020) point out an unequal distribution of contributions by therapist and clients to the strength of the systemic alliance dimensions, with higher global scores on “Shared Sense of Purpose” for the clients than the therapist. This is interesting considering that we generally assume the therapist to play a leading role in managing therapy and shaping alliances (Hartmann et al., 2015). We are interested to see whether looking at the alliance activity can help shed further light on these alliance dynamics at hand. The analyses will be performed primarily by the first author, Andrea Bunge. She has thus far briefly viewed the dataset in order to choose appropriate methods for the analyses. No analyses have been performed at the time of this registration. Literature: Benítez, J. L., Abascal, A., Garrido, M., & Escudero, V. (2020). Building an Expanded Therapeutic Alliance: A Task Analysis with Families Trapped in Parental‐Adolescent Conflict. Family Process, 59(2), Article 2. https://doi.org/10.1111/famp.12435 Friedlander, M. L., Escudero, V., Horvath, A. O., Heatherington, L., Cabero, A., & Martens, M. P. (2006). System for observing family therapy alliances: A tool for research and practice. Journal of Counseling Psychology, 53, 214–225. https://doi.org/10.1037/0022-0167.53.2.214 Friedlander, M. L., Escudero, V., Welmers-van de Poll, M. J., & Heatherington, L. (2018). Meta-analysis of the alliance-outcome relation in couple and family therapy. Psychotherapy (Chicago, Ill.), 55(4), 356–371. https://doi.org/10.1037/pst0000161 Hartmann, A., Joos, A., Orlinsky, D. E., & Zeeck, A. (2015). Accuracy of therapist perceptions of patients’ alliance: Exploring the divergence. Psychotherapy Research, 25(4), 408–419. https://doi.org/10.1080/10503307.2014.927601 Welmers-van de Poll, M. j., Stams, G. j. j. m., van den Akker, A., & Overbeek, G. (2021a). Alliance discrepancies in home-based family treatment: Occurrence, development and the therapist’s perspective. Journal of Family Therapy, 43(4), 642–664. https://doi.org/10.1111/1467-6427.12309 Welmers-van de Poll, M., Stams, G., van den Akker, A., & Overbeek, G. (2021b). Therapists’ Contributions to the Alliance in Home-Based Family Treatment: The Role of Alliance Building Behaviors, Personality, and Clinical Experience. Contemporary Family Therapy, 43, 1–14. https://doi.org/10.1007/s10591-021-09597-3 Wong, N. R., Carta, K. E., Weintraub, M. J., & Miklowitz, D. J. (2022). Therapeutic alliance in family therapy and clinical outcomes among adolescents at risk for mood disorders. Journal of Affective Disorders, 300, 66–70. https://doi.org/10.1016/j.jad.2021.12.088
Databáze: OpenAIRE
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