Training workshop on the SOFTA

A basic training on the SOFTA consists of a one-day workshop with the following components (clicking on them you can see a description of each training module):

1. Review of the therapeutic alliance construct and the major t instruments.

Summary of empirical and theoretical studies on the therapeutic alliance in individual psychotherapy, explaining the major research findings. Analysis of the unique characteristics of the therapeutic alliance when working with couples and families; review of constructs in the field of family therapy related to the therapeutic alliance; description of recent studies that have shown associations between the therapeutic alliance and treatment retention and/or outcomes in family therapy; description of the major questionnaires that can be used to assess the therapeutic alliance in couple and family therapy (the Couple Therapy Alliance Scale (CTAS) and Family Therapy Alliance Scale (FTAS) (Pinsof & Catherall, 1986) Working Alliance Inventory–Couples (WAI-Co) Symonds & Horvath, 2004).

2. The SOFTA model: dimensions and clinical applications.

Introducing the System for Observing Family Therapy Alliances as a multidimensional conceptual model and a set of tools (observational, SOFTA-o, as well as self-report, SOFTA-s) to evaluate the strength of the therapeutic alliance in the context of conjoint couple and family therapy. Description of the principal characteristics of the of the SOFTA model: trans-theoretical, based on observable behavioural indicators, focused on interpersonal/relational behaviours, and multidimensional; brief description of how the SOFTA was developed and studies of its reliability and validity.

Operational definitions and examples of the four SOFTA dimensions: Engagement in the therapeutic process, Emotional Connection with the Therapist, Safety within the Therapeutic System, and Shared Sense of Purpose within the Family. Group discussion of the dimensions’ operational definitions will be facilitated.

Description of an heuristic model for understanding the contribution of the 4 SOFTA dimensions to four fundamental tasks of the therapy process: (1) Establish appropriate conditions for a therapeutic relationship, including defining the context and conditions for treatment, as well as other aspects that affect the initial relationship between therapist and clients; (2) elaborate therapeutic goals that are acceptable to the couple or family, including the needs and expectations of each client (or subsystem) in relation to the presenting problem(s); (3) use techniques congruent with a theoretical model to achieve the goals negotiated with the family; and (4) ensure sufficient change so that the client system can become “emancipated,” i.e., to function well without therapeutic help.

3. How to use the SOFTA-o: behavioural indicators and rating scale guidelines.

Explaining the Training Manual guidelines for making inferences about the strength of the four underlying dimensions (Engagement in the Therapeutic Process, Emotional Connection with the Therapist, Safety within the Therapeutic System, and Shared Sense of Purpose within the Family) from observations of the clients’ and therapist’s behaviours. A validated list of behavioural indicators of alliance is offered for each of the four SOFTA dimensions. Based on the kind, frequency, intensity, and clinical meaningfulness of the observed indicators in a given session, each dimension is then scored on an ordinal 7-point scale, ranging from -3 (extremely problematic) to +3 (extremely strong). To aid this process, trainees will be shown how to use the software version of the observational measure (e-SOFTA). This computer program allows the evaluator to complete the rating scales for each SOFTA dimension based on observed alliance-related behaviour and also to record qualitative comments while making those observations. Trainees will also be shown how to use the software program’s time stamps to locate specific segments of the video and re-play them for analysis.

4. Practicing with training video-clips.

The objective of this module of the training workshop is to familiarize trainees with the behavioural indicators so that, when observing a session, they can easily remember where to locate a given indicator within the instrument and its corresponding dimension. The SOFTA training package includes 16 training video-clips (brief excerpts of no more than 3 minutes) illustrating several alliance behavioural indicators, both positive and negative, focusing on a single dimension at a time. Trainees will practice with about 8 of these video-clips during the workshop and then be asked to work with the rest of them at home. They should rate each video-clip and then compare their ratings with the “Solution” file (also available within e-SOFTA software program, which will be provided to trainees), paying close attention to the qualitative comments that explain the marking of individual behavioural indicators and the exact time of those markings.

5. Homework: rating of 6 video-recorded therapy sessions (for researchers) and live (self)supervision of 3 sessions using the SOFTA-o

This final section of the training workshop is used to prepare homework. Tow different kinds of tasks are explained and planed in the workshop depending on the objective of the training. When the training is for researchers, the homework is focused in the best procedures for achieve inter-raters reliability. When the training is for clinical purposes, the homework is oriented to use the SOFTA-o for supervision or self-supervision.

a. Live supervision of 3 sessions with the SOFTA-o procedures (for therapist and/or supervisors)

This homework task will be explained and planned at the workshop with supervisors or therapists. Three sessions with different cases will be supervised (when the workshop is for supervisors) or self-supervised (when the workshop is for therapists), focusing on the therapeutic alliance and using the SOFTA-o. Supervisors or therapists will observe each session, marking the behavioural indicators corresponding to each of the four SOFTA dimensions and then rating the scales (from -3 to +3) for each dimension. When the SOFTA is used for supervisors all of these observations and rating scales will be discussed with the supervised therapists after the session and, when possible, a video-recording of the session will be reviewed to give more specific feed-back to the therapist about behaviours indicating a strong or problematic alliance. If possible this homework should be completed during the weeks that follow the workshop. A report about the realization implementation of this supervision or self-supervision task will be sent to the trainers.

b. Rating of 6 video-recorded therapy sessions (for researchers).

Good reliabilities can typically be achieved in 10-15 hours of training. To achieve good inter-rater reliability, we recommend selecting 6-8 practice videotapes that are representative of the investigator’s final data set. Ideally, these training tapes should have few clients and good sound and video quality, as well as examples of negative as well as positive Engagement, Emotional Connection, Safety, and Shared Purpose. The difficulty level should be increased gradually as raters become fluent with the task. To assess inter-rater reliability, raters must observe the same sessions independently. During the rating of actual data, members of the rating team should rate the same sessions during the week and come together to compare their results and negotiate to consensus when necessary. Raters should closely compare their behavioural tallies as well as their global dimension ratings. Practice should continue until the raters, as a group, tend to make dimensional ratings that differ by no more than a single scale point at least 90% of the time.

Access to a web-site (www.softa-soatif.net) will be provided with readings, the training manual, and all the software and audiovisual materials required for the training exercises. The website also has a blog for trainees to consult about difficulties or make suggestions about the training. For additional information about training contact M. Friedlander or V.Escudero