Decades of research show that the working alliance, or the degree of agreement between a client and therapist on the goals and tasks of therapy and the quality of their affective bond (Bordin, 1979), is positively associated with clinical outcomes (Fluckiger et al., 2018). However, there are sometimes ruptures in the working alliance, or instances […]
Many therapists in training, and even experienced therapists, anticipate working with couples and families with trepidation. As family therapists and researchers, we understand that trepidation, and indeed, sometimes find ourselves experiencing these same feelings! However, we know that understanding systemic interactions really helps in learning to work with couples and families; thus, we offer some […]
The quality of the therapeutic alliance is a robust predictor of psychotherapy outcomes (Horvath, Del Re, Flückinger, & Symonds, 2011). Recent studies have shown that some therapists are consistently better at developing and maintaining alliances with their patients than others (Baldwin, Wampold, & Imel, 2007; Dinger, Strack, Leichsenring, Wilmers, & Schauenburg, 2008; Zuroff, Kelly, Leybman, […]
Sigmund Freud originally described psychological resistance as a phenomenon wherein patients unconsciously “cling to their disease” through “tenacious” and “critical objections” in order to repress distressing thoughts, emotions and experiences as they are raised by the therapist (Freud, 1904; 1920; 1940). This understanding—a somewhat patronizing view that pitted expert doctor against oblivious patient—persisted in the […]
Psychological resistance refers to patients’ conscious or unconscious opposition to aspects of the therapy process. When not skillfully addressed, resistance can lead to therapeutic alliance ruptures, “deteriorations in the relationship [indicated by] patient behaviors or communications that are interpersonal markers indicating critical points in therapy for exploration” (Safran & Muran, 1996, p. 447). While ruptures […]
A voluminous and ever-expanding research literature points to the general effectiveness of psychotherapy (Lambert & Ogles, 2004). Through the use of controlled clinical trials, psychotherapy researchers have identified many empirically-supported treatments for specific clinical phenomena (Roth & Fonagy, 2005). The extant research also suggests that, with just a few exceptions, different therapy modalities yield comparable […]