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The therapeutic relationship in systemic family and couple psychotherapy: different perspectives in development

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Valeria Pomini


The relationship between therapist and client plays a central role in the quality and effectiveness of psychotherapy, independently from the therapeutic approach adopted by the therapist. The therapeutic relationship in the frame of Systemic Family and Couple Psychotherapy (SFCP), presents several peculiarities, especially when displayed in the "classical" therapeutic context of systemic psychotherapy, where complex and multifaceted relationships develop between therapists and family members, in front and through the one-way mirror, forming a network of "multiple bonds". Modern views on therapeutic relationship in SFCP have been influenced by the development of the "second order cybernetic", since the late 1980s, and the subsequent "linguistic shift", according to which the therapist, as a part of the therapeutic system, dialogues with family members, contributing to co-constructs  new realities, as a therapeutic change cannot result from a didactic / guiding relationship. In this context, the emotions and feelings of the members of the therapeutic system come to the fore, whilst the issue of clients’ resistance to the treatment process is completely redefined. The research regarding the therapeutic relationship in the systemic approach, using both quantitative and qualitative methods, focused on a variety of dimensions, e.g., the impact of the session context and the used techniques, the degree of empathy between therapists and clients, and the therapeutic alliance that develops between them. In more recent years, the provision of mental health services using digital practices raised new challenges and concerns regarding the development of the therapeutic relationship in the new conditions of cooperation between therapist(s) and client(s) in online settings.


therapeutic alliance; therapeutic relationship; systemic family and couple psychotherapy;


American Association for Marriage and Family Therapy (2012). Code of Ethics. Retrieved from http://www .aamft.org/imis15/Content/Legal_Ethics/Code_of_Ethics.aspx

Andersen, T. (1987). The reflecting team: dialogue and meta-dialogue in clinical work. Family Process, 26, 415–428. https://doi.org/10.1111/j.1545-5300.1987.00415.x

Anderson, H., & Goolishian, H. (1988). Human Systems as Linguistic Systems: Preliminary and Evolving Ideas about the Implications for Clinical Theory. Family Process, 27, 371-393. https://doi.org/10.1111/j.1545-5300.1988.00371.x

Anderson, H. & Goolishian, H. (1992). The client is the expert: a not-knowing approach to therapy. In S. McNamee and K. Gergen (Εds), Therapy as Social Construction (pp. 25–39). Sage.

Andersson, G. (2009). Using the internet to provide cognitive behaviour therapy. Behaviour Research and Therapy, 47, 175-180. https://doi.org/10.1016/j.brat.2009.01.010

Bateson, G. (1972). Steps to an Ecology of Mind. The University of Chicago Press.

Bertrando, P. (2000). Text and Context. narrative, post-modernism and cybernetics. Journal of Family Therapy, 22, 83-103. https://doi.org/10.1111/1467-6427.00139

Bertrando, P. (2014). Il terapeuta e le emozioni. Un modello sistemico-dialogico [The therapist and the emotions. A systemic-dialog model]. Cortina.

Bianciardi, Μ. & Bertrando, P. (2009). Ethical Therapy: A Proposal for the postmodern era. Human Systems: The Journal of Therapy, Consultation & Training, 20, 87-101.

Bianciardi, Μ. & Telfener, U. (2014). Ricorsivita in psicoterapia. Riflessioni sulla pratica clinica [Recursion in psychotherapy. Reflections on clinical practice]. Bollati Boringhieri.

Bianciardi, Μ. & Galvez Sanchez, F. (Eds), (2012). Psicoterapia come etica. Condizione postmoderna e responsabilita’ clinica [Psychotherapy as ethics. Postmodern condition and clinical responsibility]. Antigone Edizioni.

Borcsa, M., & Pomini, V. (2017). Virtual Relationships and Systemic Practices in the Digital Era. Contemporary Family Therapy, 39:239–248. https://doi.org/10.1007/s10591-017-9446-6

Borcsa, M., & Pomini, V. (2018). Couple and family therapy in the digital era. In: J. L. Lebow et al. (Eds), Encyclopedia of Couple and Family Therapy. Springer International. https://doi.org/10.1007/978-3-319-15877-8_1069-1

Borcsa, M. & Pomini, V., & Saint Mont, U. (2021). Digital systemic practices in Europe: A survey before the COV-SARS-2 pandemic. Journal of Family Therapy, 43(1), 4–26. https://doi.org/10.1111/1467-6427.12308

Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research, & Practice, 16, 252–260. https://doi.org/10.1037/h0085885

Boscolo, L. & Bertrando, P. (1996). Terapia sistemica individuale [Individual systemic therapy]. Bollati Boringhieri.

Byng-Hall, J. (2008). The crucial role of attachment in family therapy. Journal of Family Therapy, 30, 129-146. https://doi.org/10.1111/j.1467-6427.2008.00422.x

Caldwell, B. E., Bischoff, R. J., Derrig-Palumbo, K. A., & Liebert, J. D. (2017). Best practices in the online practice of couple and family therapy. Report of the online therapy workgroup. American Association for Marriage and Family Therapy (AAMFT). Retrieved from http://www.aamft.org/iMIS15/AAMFT/Content/Online Education/Online TherapyGuidelines2.aspx

Cecchin, G. (1988). Revisione dei concetti di Ipotizzazione, Circolarità, Neutralita’: un Invito alla Curiosità. Ecologia della Mente, 5, 29-41.

Cecchin, G. (1992). Vino vecchio in bottiglie nuove. Connessioni, 1, 7-12.

Cecchin, G., Lane, G., & Ray, W.A. (1993). From strategizing to non intervention: Toward irreverence in systemic practice. Journal of Marital & Family Therapy, 19(2), 125-136. https://doi.org/10.111/j.1752-0606.1993.tb00972.x

Cecchin, G., Lane, G., & Ray, W. A. (1994). The cybernetics of prejudices in the practice of psychotherapy. Karnac Books. https://doi.org/10.4324/9780429473487

Cooklin, A. (2001). Eliciting children’s thinking in families and family therapy. Family Process, 40, 293-312.

Davis, S. D., Gonzalez, V., & Sahibzada, S. (2018). Therapeutic Alliance in Couple and Family Therapy. In: J. L. Lebow et al. (Eds), Encyclopedia of Couple and Family Therapy. Springer International. https://doi.org/10.1007/978-3-319-15877-8_508-1

Denton, W. H., Nakonezny, P. A., & Burwell S. R. (2011). The effects of meeting a family therapy supervision team on client satisfaction in an initial session. Journal of Family Therapy, 33(1), 85-97. https://doi.org/10.1111/j.1467-6427.2010.00518.x

Dumont, R. H. (2008). Drawing a family map: an experiential tool for engaging children in family therapy. Journal of Family Therapy. 30, 247–259. https://doi.org/10.1111/j.1467-6427.2008.00429

Elkaim, M. (1986). A systemic approach to couple therapy. Family Process, 25, 35-42. https://doi.org/10.1111/j.1545-5300.1986.00035.x

Epstein, N. B., Curtis, D. S., Edwards, E., Young, J.L., & Zheng, L. (2014). Therapy with families in China: Cultural Factors Influencing the Therapeutic Alliance and Therapy Goals. Contemporary Family Therapy, 36, 201-212. https://doi.org/10.1007/s10591-014-9302-x

Escudero, V., Friedlander, M. L., Varela, N., & Abascal, A. (2008). Observing the therapeutic alliance in family therapy: Associations with participants’ perceptions and therapeutic outcomes. Journal of Family Therapy, 30, 194-214. https://doi.org/10.1111/j.1467-6427.2008.00425.x

Θεοδωράκη, Κ. (2014). Μια άλλη «ανάγνωση- κατασκευή» πάνω στον Φιλοκτήτη του Σοφοκλή. Συστημική Σκέψη και Ψυχοθεραπεία, 4. https://hestafta.org/systimiki-skepsi-psychotherapeia-periodiko/teuxos-4/mia-alli-anagnosi-kataskevi-pano-sto-filoktiti-tou-sofokli/

Flaskas, C. (1996) Understanding the therapeutic relationship: using psychoanalytic ideas in the systemic context. In: C. Flaskas and A. Perlesz (Eds), The Therapeutic Relationship in Systemic Therapy. Karnac Books. https://doi.org/10.4324/9780429483431-3

Flaskas, C. (1997). Engagement and the therapeutic relationship in systemic therapy. Journal of Family Therapy, 19 (3), 263-282. https://doi.org/10.1111/1467-6427.00052

Flaskas, C. (2007). Holding hope and hopelessness: therapeutic engagements with the balance of hope. Journal of Family Therapy, 29 (3), 186-202. https://doi.org/10.1111/j.1467-6427.2007.00381.x

Flaskas, C., & Perlesz A. (Eds), (1996). The therapeutic relationship in systemic therapy. Karnac Books. https://doi.org/10.4324/9780429483431

Fonagy, P. & Target, M. (2001). Attaccamento e funzione riflessiva [Attachment and reflexive function]. Cortina.

Friedlander, M. L., Escudero, V., Horvath, A.O., Heatherington, L., Cabero, A., & Martens, M. P. (2006). System for Observing Family Therapy Alliances: A tool for research and practice. Journal of Counseling Psychology, 53(2), 186-202. https://doi.org/10.1037/0022-0167.53.2.214

Friedlander, M. L., Escudero, V., Heatherington, L. & Diamond, G. M. (2011). Alliance in couple and family therapy. Psychotherapy, 48(1), 25–33. https://doi.org/10.1037/a002206

Gelso, C. (2014) A tripartite model of the therapeutic relationship: Theory, research, and practice. Psychotherapy Research, 24 (2), 117-131. https://doi.org/10.1080/10503307.2013.845920

Gorell Barnes, G. (2004). Family Therapy in Changing Times (2nd ed.). Palgrave MacMillian

Γουρνάς, Γ. (2015). Η θεραπευτική σχέση στη συστημική ομαδική θεραπεία. Στο: Καραμανωλάκη Χ., Χαραλαμπάκη Κ., Μιχόπουλος Γ. (Επιμ. Εκδ.). Η θεραπευτική σχέση. Ψυχοθεραπευτικές προσεγγίσεις από την ψυχαναλυτική, τη γνωσιακή και τη συστημική οπτική. Καστανιώτη.

Haley, J. (1973). Uncommon therapy. Norton. https://doi.org/10.1080/00029157.1976.10403813

Hecker, L. L. & Murphy, M. J. (2015). Contemporary and emerging ethical issues in family therapy. Australian and New Zealand Journal of Family Therapy, 36, 467–479. https://doi.org/10.1002/anzf.112

Holmes, J. (2012). Storr’s The Art of Psychotherapy. Hodder Arnold. https://doi.org/10.1201/b13356-13

Horvath, A.O. (2015). Therapeutic/Working Alliance. In: R.L. Cautin & S.O. Lilienfeld (eds). The Encyclopedia of Clinical Psychology. First Edition. Wiley & Sons, Inc. https://doi.org/10.1002/9781118625392.wbecp26

Horvath, A. O., & Greenberg, L. S. (1989). Development and validation of the Working Alliance Inventory. Journal of Counseling Psychology, 36(2), 223-233. https://doi.org/10.1037/0022-0167.36.2.223

Hunter, S. (2012). Walking in sacred spaces in the therapeutic bond: Therapists’ experiences of compassion satisfaction coupled with the potential for vicarious traumatisation. Family Process, 51 (2), 179-192. https://doi.org/10.1111/j.1545-5300.2012.01393.x

Καραμανωλάκη, Χ., Χαραλαμπάκη, Κ., Μιχόπουλος, Γ. (Επιμ. Εκδ.) (2015). Η θεραπευτική σχέση. Ψυχοθεραπευτικές προσεγγίσεις από την ψυχαναλυτική, τη γνωσιακή και τη συστημική οπτική. Καστανιώτη.

Knott, F. & Espie, C. (1997). Families’ perceptions of the one-way screen in the first meeting. Journal of Family Therapy,19 (4), 431-439. https://doi.org/10.1111/1467-6427.00060

Lal, S. & Adair C.E. (2014). E-mental health: A rapid review of the literature. Psychiatric Services, 65 (1), 24-32. https://doi.org/10.1176/appi.ps.201300009

Lambert, J.E., Skinner, A.H., & Friedlander M.L. (2012). Problematic within-family alliances in conjoint family therapy: A close look at five cases. Journal of Marital and Family Therapy, 38, 417–428. https://doi.org/10.1111/j.1752-0606.2010.00212.x

Manfrida, G., Albertini, V., & Eisenberg, E. (2017). Connected: Recommendations and techniques in order to employ internet tools for the enhancement of online therapeutic relationships. Experiences from Italy. Contemporary Family Therapy, 39 (4), 314-328. https://doi.org/10.1007/s10591-017-9439-5

Minuchin, S. (2000) Οικογένειες και οικογενειακή θεραπεία. (Φ. Αναγνωστόπουλος, Μεταφρ.). Ελληνικά Γράμματα. (1967).

Montano, A. (2014). La terapia cognitivο-comportamentale e il web. Un rapporto fruttuoso. [Web and cognitive behaviour therapy, A fertile relationship]. Psicobiettivo, 34 (3): 33-50. https://doi.org/10.3280/ PSOB2014-003003

Pakman, M. (2016). Beyond Biology and the Linguistic Turn: Event, Singularity, Sense and the Work of Imagination. In: I. McCarthy and G. Simon (Εds), Systemic Therapy as Transformative Practice (pp. 386-400). Farnhill.

Pinsof, W., Zinbarg, R. & Knobloch-Fedders, L.M. (2008). Factorial and Construct Validity of the Revised Short Form Integrative Psychotherapy Alliance Scales for Family, Couple, and Individual Therapy. Family Process, 47 (3), 281-301. https://doi.org/10.1111/j.1545-5300.2008.00254.x

Pocock, D. (1997) Feeling understood in family therapy. Journal of Family Therapy, 19, 279–298. https://doi.org/10.1111/1467-6427.00053

Πομίνι, Β. (1994). Ο Xρόνος και η «Ασέβεια». Πρόσφατες εξελίξεις στη Σχολή του Μιλάνου. Τετράδια Ψυχιατρικής, 45, 118–126.

Pomini, V. & Tomaras, V. (2014, March 6-8). Clients’ opinions about family therapy and its setting [Conference presentation]. 1st European Conference on Systemic Research in Therapy, Education and Organizational Development, Heidelberg, Germany.

Πομίνι Β., Τομαράς Β. (2015). Η θεραπευτική σχέση στη συστημική προσέγγιση: Πολλαπλοί δεσμοί. Στο: Καραμανωλάκη Χ., Χαραλαμπάκη Κ., Μιχόπουλος Γ. (Επιμ. Εκδ.). Η θεραπευτική σχέση. Ψυχοθεραπευτικές προσεγγίσεις από την ψυχαναλυτική, τη γνωσιακή και τη συστημική οπτική (σελ. 85-123). Καστανιώτη.

Reimers, S. & White, C. (1995). Learning from users. In S. Reimers and A. Treacher (Εds), Introducing User Friendly Family Therapy. Routledge.

Rober, P. (1999). The Therapist’s Inner Conversation in Family Therapy Practice: Some Ideas About the Self of the Therapist, Therapeutic Impasse, and the Process of Reflection. Family Process, 38(2), 209–228. https://doi.org/10.1111/j.1545-5300.1999.00209.x

Rober, P. (2011). The therapist’s experiencing in family therapy practice. Journal of Family Therapy, 33 (3), 235-255. https://doi.org/10.1111/j.1467-6427.2010.00502.x

Roy-Chowdhury, S. (2006). How is the therapeutic relationship talked into being? Journal of Family Therapy, 28,(2) 153-174. https://doi.org/10.1111/j.1467-6427.2006.00344.x

Schwartz, R. C., & Johnson, S. M. (2000). Does Couple and Family Therapy Have Emotional Intelligence? Family Process, 39(1), 29–33. https://doi.org/10.1111/j.1545-5300.2000.39105.x

Seikkula, J., Karvonen, A., Kykyri, V.-L., Kaartinen, J., & Penttonen, M. (2015). The Embodied Attunement of Therapists and a Couple within Dialogical Psychotherapy: An Introduction to the Relational Mind Research Project. Family Process, 54(4), 703–715. https://doi.org/10.1111/famp.12152

Selvini Palazzoli, M., Boscolo, L., Cecchin, G. & Prata G. (1978). Paradosso e Controparadosso [Paradox and Counter-paradox]. Feltrinelli

Selvini Palazzoli, M., Boscolo, L., Cecchin, G. & Prata G. (1980). Hypothesizing — Circularity — Neutrality: Three Guidelines for the Conductor of the Session. Family Process, 19 (1), 3-12. https://doi.org/10.1111/j.1545-5300.1980.00003.x

Sparks, J., Ariel, J., Pulleyblank Coffey, E. & Tabachnik S. (2011). A fugue in four voices: Sounding themes and variations on the reflecting team. Family Process, 50 (1), 115–128. https://doi.org/10.1111/j.1545-5300.2011.01349.x

Sprenkle, D. H., Davis, S. D., & Lebow, J. L. (2009). Common factors in couple and family therapy: The overlooked foundation for effective practice. Guilford Press.

Σταλίκας, Α. & Μερτίκα, Α. (2004). Η Θεραπευτική Συμμαχία. Ελληνικά Γράμματα.

Sutherland, O. & Strong, T. (2011). Therapeutic collaboration: a conversation analysis of constructionist therapy. Journal of Family Therapy, 33 (3), 256–278. https://doi.org/10.1111/j.1467-6427.2010.00500.x

Telfener, U. (2014). La relazione terapeutica come azione riflessiva [The therapeutic relationship as a reflexive action]. In M. Bianciardi and U. Telfener, (Eds). Ricorsivita’ in psicoterapia. Riflessioni sulla pratica clinica. Bollati Boringhieri.

Τομαράς, Β. (1996). Ο ρόλος της μεταβίβασης – αντιμεταβίβασης και της θεραπευτικής σχέσης στη συστημική θεραπεία οικογένειας. Στο: Μπουλουγούρης, Ι. (Επιμ.Εκδ.) Θέματα γνωσιακής και συμπεριφοριστικής θεραπείας (σελ. 106-115), Ελληνικά Γράμματα.

Τομαράς, Β., Χαραμανωλάκη, Χ. & Ζέρβας, Ι. (Επιμ. Εκδ.) (2008). Θεραπεία Ζεύγους. Αθήνα Εκδ. Καστανιώτη.

Τομαράς, Β. & Πομίνι, Β. (2008). Οικογενειακή ψυχοθεραπεία σε προβλήματα εφηβείας. Στο: Θέματα ψυχοδυναμικής και ψυχοκοινωνικής παιδοψυχιατρικής (σελ. 623-634). Καστανιώτη.

Τομαράς, Β., Πομίνι, Β. & Γουρνέλης, Ρ. (2013). Συστημική – Οικογενειακή Ψυχοθεραπεία. Στο: Παπαδημητρίου Γ.Ν., Λιάππας Ι., Λύκουρας Ε. (Επιμ. έκδ.). Σύγχρονη Ψυχιατρική. ΒΗΤΑ.

Tseliou, E. (2013). A critical methodological review of discourse and conversation analysis studies of family therapy. Family Process, 52 (4), 653-672. https://doi.org/10.1111/famp.12043

Wampold, B. E. (2015). How important are the common factors in psychotherapy? An update. World Psychiatry, 14 (3), 270–277. https://doi.org/10.1002/wps.20238

Watzlawick, P., Bavelas J.B. & Jackson D. (2005). Ανθρώπινη επικοινωνία και οι επιδράσεις της στην συμπεριφορά. (Κ. Χαραλαμπάκη, Μεταφρ.). Ελληνικά Γράμματα. (1967).

Weingarten, K. (1992). A consideration of intimate and non-intimate interactions in therapy. Family Process, 31 (1), 45–59. https://doi.org/10.1111/j.1545-5300.1992.00045.x

Wells, M., Mitchell, K.J., Finkelhor, D. & Becker-Blease, K.A. (2007). Online mental health treatment: Concerns and considerations. Cyberpsychology & Behavior, 10 (3), 453-459. https://doi.org/10.1089/cpb.2006.9933

Willott, S., Hatton, T. & Oyebode, J. (2012). Reflecting team processes in family therapy: a search for research. Journal of Family Therapy, 34 (2), 180–203. https://doi.org/10.1111/j.1467-6427.2010.00511.x

Wilcoxon, S. A. (2015), Technology and client care: therapy considerations in a digital society. Australian and New Zealand Journal of Family Therapy, 36 (4), 480–491. https://doi.org/10.1002/anzf.1128

Zimmerman, K. J. (2011). Commentary: is collaboration a viable target for family therapists? Journal of Family Therapy, 33 (2), 215-223. https://doi.org/10.1111/j.1467-6427.2011.00535.x

Χαραλαμπάκη, Κ. (2008). Το θεραπευτικό τρίγωνο. Στο: Ζέρβας, Ι., Καραμανωλάκη, Χ., Τομαράς, Β. (Επιμ. Εκδ.). Θεραπεία ζεύγους. Ψυχοθεραπευτικές προσεγγίσεις από την ψυχαναλυτική, τη συμπεριφορική και τη συστημική οπτική (σελ. 255-285). Καστανιώτη.


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