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

Butler, Mark H.; Brimhall, Andrew S.; Harper, James M.

doi:10.1080/01926187.2010.493112

Cited by 8 publications

(5 citation statements)

References 16 publications

(13 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Mastering interpersonal engagement is the starting point of any therapy (Butler et al 2011). Forchuk et al (1998 agree with this study's findings stating that this rapport is dependent on the attitude of staff with friendliness, interest, caring, understanding, having a passion for work and treating the SU as a human being as central requirements.…”

Section: Discussionmentioning

confidence: 99%

Understand me; believe in me; accept me as I am: perceptions of psychiatry of later life service

Grady

Gilrane-McGarry²,

Sweeney

et al. 2014

Ir. j. psychol. Med.

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Understand me; believe in me; accept me as I am: perceptions of psychiatry of later life service

Grady

Gilrane-McGarry²,

Sweeney

et al. 2014

Ir. j. psychol. Med.

View full text Add to dashboard Cite

show abstract

“…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, ). Even though both a strong therapeutic alliance and neutrality of one form or another are considered core components of successful therapies, in practice they co‐exist in a dialectic tension (Butler et al., ).…”

Section: Findings and Discussionmentioning

confidence: 99%

“…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, ). Even though both a strong therapeutic alliance and neutrality of one form or another are considered core components of successful therapies, in practice they co‐exist in a dialectic tension (Butler et al., ). While these tensions are not easily resolved, regular clinical supervision is paramount in supporting staff identify and overcoming these challenges.…”

Section: Findings and Discussionmentioning

confidence: 99%

“…In addition to strengthening clinicians' professional identity, a shift towards multiple clinicians being allocated to one family enhances clinicians' capacity to support each other to maintain a balance between the alliance and neutrality as discussed before (Butler et al., ). By working together, a number of clinicians are present to observe and challenge the family system, increasing capacity for second order change.…”

Section: Findings and Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Coates

Howe

2015

Aust N Z J Fam Ther

View full text Add to dashboard Cite

Child abuse and neglect often occur within the context of multiple risk factors, in particular parental mental health (MH) and/or drug and alcohol (D&A) problems. Interventions aimed at improving parental MH and D&A issues can have a positive impact on children now, as well as in the future. However, implementing sustainable service models that facilitate positive change for families with multiple risk factors is challenging. The purpose of the present study was to gain feedback from key stakeholders on a service model targeted at families where there are parental D&A, MH and child protection concerns to identify possible strengths and limitations of the model. This identified possible strategies for service improvement from the perspective of discharged clients and clinical staff. Gaining feedback from key stakeholders on service models is increasingly recognised as central to service evaluation and development. Ten interviews were conducted with clinical staff and twenty interviews with discharged clients of a pilot service that works with families where the child or children are at risk of significant harm in the context of parental MH and/or D&A issues. The interviews with clinicians highlighted difficulties working with this complex client group and its impact on staff burnout. Clinicians suggested how the model could be changed to better support clinical staff from burnout. Interviews with discharged clients highlighted the importance of the relationship with the worker in establishing client engagement and facilitating change. The way in which these recommendations informed the design of the service model is discussed.Keywords: service design and improvement, qualitative enquiry, staff burnout, parental mental illness, parental drug and alcohol problems, child protection Key Points1 Families that come into contact with child protection services commonly experience multiple risk factors, in particular parental mental health and/or drug and alcohol problems. 2 Families with these risk factors benefit from interventions that include the whole family in treatment. 3 While much of the evidence-base focuses on first order change, for many of these families more enduring change may come from a change in the family system. 4 Interviews with clinicians highlight the difficulties of working with complex and crisis prone families and its impact on staff burnout. 5 Given the strong relationship between client outcomes and staff wellbeing, how to protect staff against burnout should be a key consideration in the design of service models.

show abstract

“…A first, salient point of intervention is to dampen such couples' diffuse physiological arousal (DPA; Levenson & Gottman, 1985), mutual volatility, and verbal, emotional, and psychological aggression. Through the careful practice of multipartiality or dynamic neutrality (Butler, Brimhall, & Harper, 2011; called multi-directed partiality within contextual family therapy, Boszormenyi-Nagy & Krasner, 1986), the therapist honors and validates each person's experience and thereby also promotes systemic perspective and www.FamilyProcess.org 1344 / FAMILY PROCESS shared responsibility. A cumulative impact of therapist multipartiality is to assist Manuel and Carla in being able to perceive, explore, acknowledge, and accept shared responsibility for their antagonistic and deadlocked patterns of engagement.…”

Section: Couple Configuration Interventionmentioning

confidence: 99%

Reshaping Couple Configurations that Get in the Way of Relationship Repair and Healing

Butler

Spencer²,

Seedall

2019

Family Process

View full text Add to dashboard Cite

In the context of relationship trauma, partners' reactive patterns of engagement can disrupt and derail attempts at relationship correction and healing. A circumplex typology of couple patterns of engagement in relational trauma context is defined in terms of partners' underlying views of self in relation to other (VSIRO). VSIRO is conceptualized along a continuum anchored at opposite poles by inflated (self‐aggrandizing) versus collapsed (self‐abnegating) VSIRO, with a balanced (egalitarian) VSIRO, characterized by accountability and forbearance, as the target position. The circumplex model delineates four problematic couple configurations—a dejected couple, a taker–enabler couple, an ultimate fighting couple, and a debtor–collector couple. Where problematic engagement occurs, therapists need to reshape couple engagement toward the balanced, egalitarian position prior to relational trauma work. Clinical vignettes depict these couples and springboard an analysis of unique needs and interventions associated with each couple configuration. Reshaping couple patterns of engagement using a circumplex model of couple configurations is an essential prerequisite to effective and ethical relational trauma work.

show abstract

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

Cited by 8 publications

References 16 publications

Understand me; believe in me; accept me as I am: perceptions of psychiatry of later life service

Understand me; believe in me; accept me as I am: perceptions of psychiatry of later life service

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

Reshaping Couple Configurations that Get in the Way of Relationship Repair and Healing

Contact Info

Product

Resources

About