A Primer on the Evolution of Therapeutic Engagement in MFT: Understanding and Resolving the Dialectic Tension of Alliance and Neutrality. Part 1—Retrospective: The Evolution of Neutrality

Abstract

Alliance and neutrality are the two fundamental constructs defining therapeutic engagement. Although both are critical to positive clinical process and outcome, they become much more difficult to effectively balance in relational therapies. In many ways they coexist in an unrecognized dialectic tension. A history of the evolution of neutrality in relational therapies is provided. Evolutionary iterations of relational therapy have experimented with different formulations of the neutrality-alliance mix. We critique these hybrid conceptualizations of neutrality as they relate to the therapeutic alliance. In a second paper, we propose multipartiality and enactments as a dynamic, engaged neutrality that represents a fully realized relational advocacy. Together, the papers provide a primer on therapeutic engagement in MFT.[Therapy] is above all else a human endeavor. It will flourish and grow as long as its scientific aspects, including objective evaluation, are promoted. But its fundamental therapeutic efficacy will always remain much more intimately connected to the fact that human beings . . . can This paper is one of a two-part series and introductory portions of the two papers overlap and are reprinted with permission.

Working with Families Who Experience Parental Mental Health and/or Drug and Alcohol Problems in the Context of Child Protection Concerns: Recommendations for Service Improvement

“…In addition to the complexities in facilitating second order change, clinicians who work with multiple family members are faced with the challenge of forming a therapeutic alliance with multiple family members. When working with multiple members in a family, the position the clinician takes in relation to competing and contradictory lived experiences of various family members must be carefully considered if the working alliance is to be sustained (Brimhall & Butler, ). The clinician must develop an alliance with each family member while remaining ‘neutral.’ When working with multiple family members, the complexity and importance of neutrality is heightened because of the necessity of creating and sustaining multiple alliances (Butler, Harper & Brimhall, ).…”

A Primer on the Evolution of Therapeutic Engagement in MFT: Understanding and Resolving the Dialectic Tension of Alliance and Neutrality. Part 2—Recommendations: Dynamic Neutrality Through Multipartiality and Enactments

“…Address correspondence to Mark Butler, Marriage and Family Therapy Program, School of Family Life, 262 TLRB, Brigham Young University, Provo, UT 84602. E-mail: Mark.Butler@ BYU.edu 193 in the attempt to provide a working resolution that sustains multilateral alliances and clinical neutrality (Brimhall & Butler, 2011). Building on a historical retrospective and critique of neutrality in relational therapies (Brimhall & Butler, 2011), we identify distinct dimensions of neutrality and then propose a new approach to therapeutic neutrality.…”

“…E-mail: Mark.Butler@ BYU.edu 193 in the attempt to provide a working resolution that sustains multilateral alliances and clinical neutrality (Brimhall & Butler, 2011). Building on a historical retrospective and critique of neutrality in relational therapies (Brimhall & Butler, 2011), we identify distinct dimensions of neutrality and then propose a new approach to therapeutic neutrality. Operationalized through multipartial therapist interaction and multipartial enactments, a new, dynamic neutrality represents an evolutionary advance of neutrality responsive to the ecological pressures of relational therapy.…”