Laurie Heatherington

Publications (44) View all

• Article: Building and Maintaining Healthy Alliances.

  Myrna L. Friedlander, Valentín Escudero, Laurie Heatherington
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  ABSTRACT: This chapter discusses the ways in which therapists can build and maintain healthy alliances in couples and family therapy. The authors use the System for Observing Family Therapy Alliances model to answer the question, "How would we know a good alliance when we see it?" (PsycINFO Database Record (c) 2012 APA, all rights reserved)
  10/2012;
• Article: Therapeutic alliances in couple and family therapy: An empirically informed guide to practice.

  Myrna L. Friedlander, Valentín Escudero, Laurie Heatherington
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  ABSTRACT: "Therapeutic Alliances in Couple and Family Therapy" demonstrates the crucial importance of healthy working relationships with clients in couple and family therapy. The authors' conceptual model (System for Observing Family Therapy Alliances, or SOFTA) integrates theory, research, and practice related to the alliance in couple and family therapy. The authors demonstrate how to gather evidence about working alliances by tracking specific positive and negative behaviors in therapy sessions, including clients' as well as therapists' behavioral contributions to the alliance. Therapists, therapists-in-training, and clinical supervisors can use the SOFTA to assess the strength of the alliance on four dimensions (Engagement in the Therapeutic Process, Emotional Connection With the Therapist, Safety Within the Therapeutic System, and Shared Sense of Purpose Within the Family) and figure out a strategy to move the therapy forward. The book is rich in clinical case examples illustrating each SOFTA dimension with culturally diverse couples and families. Throughout, the authors discuss various challenging clinical situations, including "split" alliances, therapist countertransference, problematic professional alliances, and working with involuntary and mandated clients. The observational and self-report instruments, available in both English and Spanish, are included as part of the book. They are also available free, along with a software version, on the Internet at http://www.softa-soatif.net. Users can download their own videos into the software to rate the alliance for clinical or research purposes. Couple and family therapists, their supervisors, academics and graduate students, and researchers will all benefit from this book. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
  10/2012;
• Article: How do therapists ally with adolescents in family therapy? An examination of relational control communication in early sessions.

  Cristina Muñiz de la Peña, Myrna L Friedlander, Valentín Escudero, Laurie Heatherington
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  ABSTRACT: Sequential analyses examined associations between the working alliance and therapist-adolescent communication patterns in 10 Spanish cases of brief conjoint family therapy. Early sessions with strong versus problematic alliances, rated by observers, were selected for coding of relational control communication patterns. No differences were found in the frequency of exchanges, but competitive responding by the therapists (reflecting an interpersonal struggle for control) was significantly more likely in problematic alliance sessions than in strong alliance sessions. Cases in which the adolescent's alliance with the therapist remained positive from Session 1 as compared with Session 3 showed a decrease in the likelihood of competitive symmetry. Notably, when the quality of the alliance deteriorated over time, the therapists were increasingly more likely to respond to the adolescents' domineering messages in a competitive manner. Results underscore the need to avoid competitive responding in order to ally with adolescents in conjoint family treatment.
  Journal of Counseling Psychology 05/2012; 59(3):339-51. · 3.23 Impact Factor
• Article: Using the e-SOFTA for video training and research on alliance-related behavior.

  Valentín Escudero, Myrna L Friedlander, Laurie Heatherington
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  ABSTRACT: In this article, we describe a specific technology for training/supervision and research on the working alliance in either individual or couple/family therapy. The technology is based on the System for Observing Family Therapy Alliances (SOFTA; Friedlander, Escudero, & Heatherington, 2006), which contains four conceptual dimensions (Engagement in the Therapeutic Process, Emotional Connection with the Therapist, Safety within the Therapeutic System, and Shared Sense of Purpose within the Family), observational rating tools (SOFTA-o), and self-report measures (SOFTA-s) shown to be important indicators of therapeutic progress. The technology, e-SOFTA, is a computer program (available for PC downloading free of charge) that can be used to rate client(s) and therapist on the specific SOFTA-o behaviors that contribute to or detract from a strong working alliance in each dimension. In addition to providing time-stamped frequencies of alliance-related behaviors, e-SOFTA allows users to link the observed behaviors to qualitative comments and to compare one person's rating of a session to that of another person. Suggestions are provided for using e-SOFTA in research, in didactic training, and in supervision, including a specific training module for introducing graduate students to the working alliance and assessing their observational and executive skills.
  Psychotherapy Theory Research Practice Training 06/2011; 48(2):138-47. · 0.84 Impact Factor
• Article: Alliance in couple and family therapy.

  Myrna L Friedlander, Valentín Escudero, Laurie Heatherington, Gary M Diamond
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  ABSTRACT: Couple and family therapy (CFT) is challenging because multiple interacting working alliances develop simultaneously and are heavily influenced by preexisting family dynamics. An original meta-analysis of 24 published CFT alliance-retention/outcome studies (k = 17 family and 7 couple studies; N = 1,416 clients) showed a weighted aggregate r = .26, z = 8.13 (p < .005); 95% CI = .33, .20. This small-to-medium effect size is almost identical to that reported for individual adult psychotherapy (Horvath, Del Re, Flückiger, & Symonds, this issue, pp. 9-16). Analysis of the 17 family studies (n = 1,081 clients) showed a similar average weighted effect size (r = .24; z = 6.55, p < .005; 95% CI = .30, .16), whereas the analysis of the 7 couple therapy studies (n = 335 clients) indicated r = .37; z = 6.16, p < .005; 95% CI = .48, .25. Tests of the null hypothesis of homogeneity suggested unexplained variability in the alliance-outcome association in both treatment formats. In this article we also summarize the most widely used alliance measures used in CFT research, provide an extended clinical example, and describe patient contributions to the developing alliance. Although few moderator or mediator studies have been conducted, the literature points to three important alliance-related phenomena in CFT: the frequency of "split" or "unbalanced" alliances, the importance of ensuring safety, and the need to foster a strong within-family sense of purpose about the purpose, goals, and value of conjoint treatment. We conclude with a series of therapeutic practices predicated on the research evidence.
  Psychotherapy Theory Research Practice Training 03/2011; 48(1):25-33. · 0.84 Impact Factor