chapter  Four
27 Pages

Alliance and Assessment of Family Patterns

WithJames L. Furrow, Gail Palmer, Susan M. Johnson, George Faller, Lisa Palmer-Olsen

This chapter reviews the emotionally focused family therapy (EFFT) steps used to move a family toward stabilization and de-escalation. De-escalation is the first change event in EFFT treatment. It examines how relational blocks disrupt the family’s attachment and caregiving process and describe the therapist’s use of emotionally focused therapy interventions to access and explore these relational blocks. Increasing vulnerability in the family requires the safety of the therapist alliance with family members and greater focus on mirroring the present process and assembling affect in family interactions occurring during the clinical session. Conjoint couple sessions are used to address relational blocks in the couple relationship and caregiving alliance. The therapist’s working alliance with individual family members and assessment of safety guide the use of conjoint and individual sessions in family treatment. George and Sarah affirmed their commitment to a strong caregiving alliance but George’s physical absence and his anxious support for Sarah indicated ongoing assessment of the caregiving alliance was necessary.