ABSTRACT
What we have been describing in the last few points has been variously labelled the `common skills' or `common factors' of all therapies as they are applied to family therapy (Hubble et al. 2000; Safran and Muran 2000; Friedlander et al. 2006). Research con®rms that these factors account for a large element of the success of therapy (Hubble et al. 2000). When these factors are not rated highly by families, moreover, they account for high dropout rates (Friedlander et al. 2006). A number of theoreticians and researchers have termed these factors the `therapeutic alliance' (Flaskas and Perlesz 1996). This is de®ned as the relationship between the client(s) and the therapist in relation to the therapy that needs to be undertaken. In studies of individual therapy this construct has been divided into a number of elements that usually include the `bond' between therapist and client(s), the level of agreement about the tasks of the therapy and a willingness to work towards the goals of the therapy. In family therapy, the therapeutic alliance is clearly more complicated than the alliance in individual therapy. For instance, in family therapy, the alliance needs to be understood as relating to both the whole family in relation to the therapist as well as in relation to each individual family member relating to the therapist. A further complexity is that each family member will almost certainly vary in their commitment, understanding and willingness to change, in relation to the therapeutic task. Family therapists (Friedlander et al. 2006) currently describe this concept as consisting of four dimensions: (a) the emotional connection with the therapist, (b) engagement in the therapeutic process, (c) safety within the therapeutic system and (d) a shared sense of purpose within the family. Of these four dimensions, two (emotional connection and engagement in therapy) are shared with all other therapeutic interventions. The other two are unique to family therapy as this form of therapy elicits the need for family
therapeutic the kinds of alliance between therapist and family. The developers of the current alliance research (Friedlander et al. 2006) suggest that certain therapist behaviour is more likely to increase the alliance whilst others are likely to diminish it. In the previous points we have described a number of therapist behaviours that will increase the therapeutic alliance, such as listening carefully to each family member (increases emotional bond to therapist), explaining what family therapy is about (increases shared sense of purpose) and capturing everybody's perspective (increases sense of safety). It equally gives ideas about what behaviours might not be so helpful, therefore, a therapist should be mindful that too much negative discussion might make family members feel less safe and therefore not want to come to therapy. If we return to an example we used in an earlier point, an open, respectful response will allow Mr Jones to air his views but in a safe way.
