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Pressure to Attend Therapy, Dyadic Adjustment, and Adverse Childhood Experiences: Direct and Indirect Effects on the Therapeutic Alliance in Couples Therapy
Author(s) -
Anderson Shayne R.,
Banford Witting Alyssa,
Tambling Rachel R.,
Ketring Scott A.,
Johnson Lee N.
Publication year - 2020
Publication title -
journal of marital and family therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.868
H-Index - 68
eISSN - 1752-0606
pISSN - 0194-472X
DOI - 10.1111/jmft.12394
Subject(s) - alliance , feeling , psychology , clinical psychology , psychotherapist , family therapy , social psychology , political science , law
In this study we examine the role that pressure to attend therapy, dyadic adjustment, and adverse childhood experiences (ACEs) play in developing the therapeutic alliance. A total of 351 couples received treatment as usual at three family therapy training clinics. Participants rated predictor variables at intake and alliance at the fourth session. Results of a path analysis indicate that each partner's dyadic adjustment is directly associated with the quality of her or his own alliance. In addition, when male partners report more ACEs and pressure to attend treatment, their own alliance scores decrease. Additionally, when one partner reports feeling pressure to attend therapy, the other partner's alliance decreases. Finally, for males, there is an indirect effect of dyadic adjustment on alliance through pressure to attend therapy. These results suggest that clinicians should routinely assess relationship adjustment, how pressured each partner is feeling to attend treatment, and ACEs; as these may impact alliance quality.