Constructing the therapeutic alliance in couple therapy: An illustrative case study with therapeutic management difficulties

The purpose of this study is to learn how the therapeutic alliance is constructed and modulated in a case of couple therapy that presented different indicators of difficulties in the therapeutic management. With the support of the System for Observing Family Therapy Alliances (SOFTA-o) the evolution of four dimensions of the therapeutic alliance was analyzed (Engagement in the Therapeutic Process, Emotional Connection with the Therapist, Safety within the Therapeutic System, and Shared Sense of Purpose within the Family) in the first, third and sixth sessions. The results showed how out of the four dimensions that the SOFTA-o measures, the Safety within the Therapeutic System, and Shared Sense of Purpose within the Family dimensions were the ones that better expressed the difficulties of building a satisfactory therapeutic alliance in the initial phases of treatment and resulted to be the two most discriminative dimensions to consider viability and prognosis of the treatment. In conclusion, this study has allowed analyzing in detail how the therapeutic alliance is built in a couple therapy case throughout the psychotherapeutic process.