The therapeutic alliance in tension: an approach from the clinical practice of social work

Abstract

Evidence has demonstrated that the therapeutic alliance and the repair of alliance ruptures are related to positive psychotherapeutic results. However, this has been less frequently studied in other helping relationships, in family interventions, and in mandatory interventions. This article aims to analyze the tensions within the therapeutic alliance between caregivers** and social workers from the Chilean child protection system. Ours is a longitudinal study that followed six social worker-caregiver dyads for 11 months. Techniques such as observation, in-depth interviews, and session-by-session interviews were carried out, followed by content analysis. The main results are: the therapeutic alliance is subject to tensions when there is a questioning of the parental abilities; asymmetry of power and the threat that the children may be taken from the house. These tensions affect the caregiver's trust in the social worker; thus managing and understanding the tensions make it possible to strengthen the relationship. Some strategies are reinforcing the clinical space as a safe space and developing a collaborative dynamic. This article discusses how tensions are associated with the family, social worker, methodology, and child protection system. Future lines of research to observe, analyze, and strengthen the therapeutic alliance are proposed. © Universidad Autonoma de Chile. All Rights Reserved.