The Working Alliance in the Focus‐Based Integrated Model: An Interpretative Phenomenological Analysis

Background: The Working Alliance (WA) can be considered a core variable influencing the efficacy of the Focus-Based Integrated Model (FBIM), able to emphasise diagnosis, focus, integrated intervention and self-therapy. Recognising and resolving WA ruptures is critical, particularly in a model that demands adaptability and precision. However, limited research has explored the role of WA in FBIM, especially from the psychotherapist's perspective. Objectives: The main aim of this study was to explore psychotherapists' experiences of the WA with clients who have received psychotherapy based on the FBIM. Methods: Using Interpretative Phenomenological Analysis (IPA), semi-structured interviews were conducted with 16 psychotherapists treating 25 clients, audio-recorded, and transcribed verbatim. Results: The findings are organised into three key areas: the construction of the therapeutic alliance, the setting and the dyadic relationship. These areas are further delineated into superordinate themes, each of which is characterised by specific themes and sub-themes. The superordinate themes include: (1) the definition of the WA; (2) the perceived WA; (3) moments of rupture; (4) strategies employed to address ruptures; (5) the therapeutic setting; (6) the therapeutic focus; (7) the reins; (8) therapist characteristics; and (9) client characteristics. Discussion: This study highlights the role of WA within FBIM-based psychotherapy, emphasising the need for therapists to remain attuned to ruptures and relational dynamics. Findings underscore the importance of therapist adaptability, relational sensitivity, and responsivity in navigating the complexities of WA. These insights offer valuable implications for training and supervision within FBIM frameworks, supporting psychotherapists in optimising outcomes through enhanced alliance management.