Therapeutic alliances with families : empowering clients in challenging cases

This practical breakthrough introduces a robust framework for family and couples therapy specifically designed for working with difficult, entrenched, and court-mandated situations. Using an original model (the System for Observing Family Therapy Alliances, or SOFTA) suitable to therapists across theoretical lines, the authors detail special challenges, empirically-supported strategies, and alliance-building interventions organized around common types of ongoing couple and family conflicts. Copious case examples illustrate how therapists can empower family members to discover their agency, find resources to address tough challenges, and especially repair their damaged relationships. These guidelines also show how to work effectively within multiple relationships in a family without compromising therapist focus, client individuality, or client safety. Read more... Abstract: This practical breakthrough introduces a robust framework for family and couples therapy specifically designed for working with difficult, entrenched, and court-mandated situations. Using an original model (the System for Observing Family Therapy Alliances, or SOFTA) suitable to therapists across theoretical lines, the authors detail special challenges, empirically-supported strategies, and alliance-building interventions organized around common types of ongoing couple and family conflicts. Copious case examples illustrate how therapists can empower family members to discover their agency, find resources to address tough challenges, and especially repair their damaged relationships. These guidelines also show how to work effectively within multiple relationships in a family without compromising therapist focus, client individuality, or client safety Dedication Foreword About the Authors Acknowledgments Contents Chapter 1: Using the Therapeutic Alliance to Empower Couples and Families Alliances in Couple and Family Therapy The SOFTA Model and Measures Description of the SOFTA Dimensions and Behaviors Using the SOFTA-o and SOFTA-s in Practice and Training Alliance and Individual Differences Building Alliances in Not-so-Challenging Cases Alliance Rupture and Repair Poor Engagement in the Process: Safety First Problematic Within-Family Alliances Split Alliances: Emotional Bonds in Disarray Moving Forward References Chapter 2: Couples’ Cross Complaints: “I Want... but She/He Doesn’t Want to...” Unique Challenges “I Will...But S/he Won’t Come to Therapy” “I Feel Comfortable Here, but S/he Doesn’t” “I Want This, but S/he Wants That” “I Think the Problem Is This, but S/he Thinks the Problem Is That” Recommendations from the Literature Not All Conflicts Are the Same Individual Differences Matter Conflict and the Within-Couple Alliance Alliance-Empowering Strategies Managing Cross Complaints Managing Zero-Sum Conflicts Case Example: The Singh-Whalens Final Thoughts References Chapter 3: Engaging Reluctant Adolescents and Their Parents Unique Challenges “Clearly, He Is the Problem” “No, No ... I Don’t Have Any Problems” “If You Really Want to Help, Why Are You Forcing Therapy on Me?” “We Have Already Done Everything Possible, So Why Should We Go to Therapy?” “It’s Just What Kids Do Nowadays” Rebellion Can Trap an Adolescent Recommendations from the Literature Engagement Is Key A Different Kind of Therapeutic Relationship Factors that Matter Split Alliances Toward an Empirical Process Model of Engaging Reluctant Adolescents Alliance-Empowering Strategies Roll with Initial Resistance Foster Autonomy and Individuation Validate the Adolescent’s Subjective Experience Reframe the Problem Systemically Empower the Parental System: Three Layers of the Onion Case Example: What’s on Marta’s Smartphone? Final Thoughts References Chapter 4: Parenting in Isolation, Without or With a Partner Unique Challenges Recommendations from the Literature One-Parent Families Two-Parent Families Alliance Empowering Strategies Flying Solo: Families with a Physically Absent Parent Also Flying Solo: Families with a Psychologically Absent Parent Case Example: The Wong Family Final Thoughts References Chapter 5: Child Maltreatment: Creating Therapeutic Alliances with Survivors of Relational Trauma Unique Challenges The Therapist Is Threatening to Love (aka Take Care of) Me The Vicious Cycle of Emotion Management Difficulties and Negative Identity The Challenge of Betrayal and Abandonment Family Role Confusion Role Confusion with Other Professionals The Obstructive Non-Offending Parent or Caregiver Denial and Dissociation Recommendations from the Literature Family Reattachment Focus on Family Resilience The Concept of “Both-And” Sharing Control Contain and Switch Alliance-Empowering Strategies Four Threats to Safety Emotional Connection Cannot Be Prescribed Tread Lightly Adapt to the Client’s Attachment Style Avoid Amplifying Denial Create Separate Spaces Case Example: The Colangelo Family Final Thoughts References Chapter 6: Disadvantaged, Multi-Stressed Families Adrift in a Sea of Professional Helpers Unique Challenges Multiproblem or Multi-Treated Families? Therapy or Social Control? Chronic Stress Disorganization in the Professional Network Accommodation to Chaos Intrafamilial Conflict Due to Acculturative Stress Recommendations from the Literature Family Subtypes Collaborative Therapy Home-Based Therapy Focus on Resilience Building Alliances with Mandated or Otherwise Involuntary Clients Alliance-Empowering Strategies Create an “Affected Community” Clarify Who Is the “Real Client” Visit the Family’s Home Convey Optimism Serve as a Bridge for Specialized Treatment Case Example: The Difús Family Final Thoughts References Chapter 7: Empowering Through the Alliance: A Practical Formulation Step One: Safety to Connect A Schema to Address the Initial Challenge Understanding and Working with Denial Guidelines for Creating Safety in a Context of Denial Guidelines for Creating Safety When Clients Are Drowning in Problems Guidelines for Creating Safety When Clients Have a Traumatic Response to Therapy Step Two: Connect to Engage Feeling Emotionally Understood Enhancing Engagement Step Three: Nurturing the Expanded Alliance Guidelines for Expanding the Alliance A Schematic Understanding of Couple and Family Alliances Concluding Thoughts References Appendix A: Operational Definitions of the SOFTA Indicators (Clients and Therapist) Client Item Descriptors ENGAGEMENT IN THE THERAPEUTIC PROCESS EMOTIONAL CONNECTION TO THE THERAPIST SAFETY WITHIN THE THERAPEUTIC CONTEXT SHARED SENSE OF PURPOSE WITHIN THE FAMILY Therapist Item Descriptions THERAPIST CONTRIBUTIONS TO ENGAGEMENT IN THE THERAPEUTIC PROCESS THERAPIST CONTRIBUTIONS TO EMOTIONAL CONNECTIONS THERAPIST CONTRIBUTIONS TO SAFETY WITHIN THE THERAPEUTIC SYSTEM THERAPIST CONTRIBUTIONS TO SHARED SENSE OF PURPOSE WITHIN THE FAMILY Appendix B: SOFTA-s Self-Report Questionnaires SOFTA-s (client) SOFTA-s (therapist) Scoring Guide for the SOFTA-s SOFTA-s (Shortened Versions) Appendix C: Rating Guidelines and Rating Sheets for the SOFTA-o (Client and Therapist) Rating Sheets SOFTA-o Rating Guidelines Index This practical breakthrough introduces a robust framework for family and couples therapy specifically designed for working with difficult, entrenched, and court-mandated situations. Using an original model (the System for Observing Family Therapy Alliances, or SOFTA) suitable to therapists across theoretical lines, the authors detail special challenges, empirically-supported strategies, and alliance-building interventions organized around common types of ongoing couple and family conflicts. Copious case examples illustrate how therapists can empower family members to discover their agency, find resources to address tough challenges, and especially repair their damaged relationships. These guidelines also show how to work effectively within multiple relationships in a family without compromising therapist focus, client individuality, or client safety. Included in the coverage: Using the therapeutic alliance to empower couples and families Couples' cross-complaints Engaging reluctant adolescents...and their parents Parenting in isolation, with or without a partner Child maltreatment: creating therapeutic alliances with survivors of relational trauma Disadvantaged, multi-stressed families: adrift in a sea of professional helpers Empowering through the alliance: a practical formulation Therapeutic Alliances with Families offers powerful new tools for social workers, mental health professionals, and practitioners working in couple and family therapy cases with reluctant clients and seeking specific, practical case examples and resources for alliance-related interventions.