Alliance Formations in Couple Therapy: A Multimodal and Multimethod Study

Abstract

The authors sought to study underlying processes of alliance formation, a multimethod and multimodal research procedure was developed and applied to a 6-minute episode from one couple therapy case. The participants were a couple and two male cotherapists. The interaction was analyzed at the levels of the conversational exchange, bodily postures, and movements, and autonomic nervous system responses. Data were also obtained from stimulated recall interviews and an alliance measure. When there were clear markers of alliance in a dyad’s conversation, markers of nonverbal synchrony (such as posture or movement mirroring, or sympathetic nervous system synchrony) were also observed in one or several modalities. Moreover, markers of nonverbal synchrony were often observed, not only between those who participated actively on the conversational level but also between listeners. These markers of nonverbal alliance served important balancing functions by providing support and maintaining the connection to a client. Even more than previously assumed, implicit nonverbal attunement between clients and therapists may be relevant in the formation of the therapeutic alliance.

Keywords:

• Alliance
• affiliation
• attunement
• bodily synchrony
• couple therapy

Acknowledgments

We thank Petri Kinnunen and Lauri Viljanto for assisting in technical issues related to the study design.

Compliance with Ethical Standards

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee of University of Jyvaskyla and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare that they have no conflict of interests.

Author contributions

VLK: designed and executed the study, analyzed the data (SRI, measures, integration of the modalities), and wrote the paper. AT: designed and executed the study, analyzed the data (psychophysiological measures), and collaborated in writing of the paper. PNS: analyzed the data (bodily mirroring) and collaborated in writing of the paper. KK: analyzed the data (conversational exchange), and collaborated in writing of the paper. JW: analyzed the data (conversational exchange), and collaborated in writing of the paper. JK: designed the study and collaborated in writing of the final manuscript. MP: designed the study and collaborated in writing of the final manuscript. JS: designed the study and collaborated in the writing of the final manuscript.

Notes

1 Finnish language uses the impersonal form (here translated as ’one’) more informally than ’one’ in English.

Additional information

Funding

This study was funded by the Academy of Finland (Grant number 265492).