Title

Pressure to Attend Therapy, Dyadic Adjustment, and Adverse Childhood Experiences: Direct and Indirect Effects on the Therapeutic Alliance in Couples Therapy

Keywords

adverse childhood experiences, therapeutic alliance, therapy, marriage and family therapy, MFT

Abstract

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.

Original Publication Citation

Anderson, S. R., Banford Witting, A., Tambling, R. R., Ketring, S. A., Johnson, L. N. (2020). Pressure to Attend Therapy, Dyadic Adjustment, and Adverse Childhood Experiences: Direct and Indirect Effects on the Therapeutic Alliance in Couples Therapy. Journal of Marital and Family Therapy, 46, 366– 380.

Document Type

Peer-Reviewed Article

Publication Date

2019-06-20

Publisher

Journal of Marital and Family Therapy

Language

English

College

Family, Home, and Social Sciences

Department

Family Life

University Standing at Time of Publication

Associate Professor

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