title: Problematic within-family alliances in conjoint family therapy: a close look at five cases.
abstract: We intensively analyzed five sessions in which the within-family alliance was manifestly problematic and family members reported discrepant perceptions of the family's sense of purpose about working together in therapy. Triangulation of observer ratings with (a) session content, (b) participants' post-session perceptions, (c) therapists' alliance-related interventions, and (d) clients' pretreatment target complaints and problem descriptions suggested three essential, interrelated aspects of the within-family alliance: family members (a) agreeing on the problem(s) and goals for treatment, (b) feeling connected in coping with their concerns ("a felt unity"), and (c) seeing conjoint therapy as valuable. Within-family disagreements on any of these aspects seemed to account for the observed in-session struggles. The analysis also suggested several missed opportunities for strengthening the within-family alliance.
authors.affiliation: University of Colorado-Colorado Springs, 1420 Austin Bluffs Pkwy., Colorado Springs, CO 80903, USA. jlamber2@uccs.edu
authors.forename: Jessica E
authors.initials: JE
authors.lastname: Lambert
authors.forename: Alyson H
authors.initials: AH
authors.lastname: Skinner
authors.forename: Micki L
authors.initials: ML
authors.lastname: Friedlander
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003299:Cooperative Behavior; D005195:Family Relations; D005196:Family Therapy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D036301:Qualitative Research