Process and Outcome in Cojoint Family Therapy

The process & outcome in conjoint fam therapy was studied by examining transcripts of the conjoint treatment of 11 fam's. A coding system which tapped both participation & affective expression of fam members (Emergency, Welfare & Neutral) & the quantity, direction & quality of the therapist's interventions was applied to 49 20-minute transcript segments sampled at 6-week intervals. The fam's were assigned to 2 outcome groups on the basis of change scores in 4 areas (Overall; Affective Involvement; Affective COMM; & Affective Expression) derived from the independent ratings of pre & post therapy interviews by 3 judges (73% agreement). A 2-way analysis of variance applied to the Good & Poor Outcome group coding data revealed the following results. As therapy progressed there was an increase in Welfare feelings, a sharp decrease in Neutral speech paralleled by an initial rise, then levelling off of Emergency. For any given therapist fam unit, the therapist's output remained within a unique range. The therapist focused increasingly on only one fam member, usually a parent, the parent initially the more talkative. Within this pattern, a Good Outcome resulted when the father was initially the more vocal parent. However, when mother out talked father, a Poor Outcome resulted suggesting that special approaches may be necessary for fam's with talkative mothers. The Drive-Interpretation ratio of the therapist decreased as therapy progressed. The initial level of this ratio was positively related to outcome & inversely to drop-out rate. AA.