Process and Outcome in Conjoint Family Therapy

Forty‐nine coded twenty‐minute transcript segments sampled at six‐week intervals from the conjoint treatment of eleven families were examined. Coding procedures tapped both participation and affective expression (Emergency, Welfare, and Neutral) of family members and the quantity, direction, and quality of therapists' interventions. The families were assigned to two outcome groups on the basis of change scores in four areas (Overall; Affective Involvement; Affective Communication and Affective Expression) derived from the independent ratings of pre and post‐therapy interviews by three judges (73 percent agreement). A two‐way analysis of variance applied to the Good and Poor Outcome group coding data indicated an increase in Welfare feelings, a sharp decrease in Neutral speech paralleled by an initial rise then leveling off of Emergency. For any given therapist‐family unit, therapist's output remained within a unique range, the level of which rose gradually only in the Good Outcome group. Therapists focused increasingly on only one family member, usually a parent, the parent initially most talkative. A Good Outcome resulted when the father was initially the more vocal parent, a Poor Outcome when mother outtalked father. The Drive‐Interpretation ratio decreased as therapy progressed. The initial level of this ratio was positively related to outcome and inversely to drop‐out rate.