Hersoug Anne Grete, Monsen Jon T, Havik Odd E, Høglend Per
Department of Psychiatry, University of Oslo, Norway.
Psychother Psychosom. 2002 Jan-Feb;71(1):18-27. doi: 10.1159/000049340.
The aim of the study was the prediction of the quality of early working alliance, using possible predictors among patient pretreatment variables: diagnoses, current and past relationships and intrapsychic ones. Data are from the ongoing, naturalistic Norwegian Multisite Project on Process and Outcome of Psychotherapy (NMSPOP).
The sample, n = 270, is recruited from 15 outpatient clinics; 61.1% of the patients have personality disorders. Alliance was assessed with the Working Alliance Inventory (WAI), and predictors include independent clinicians' evaluations of diagnostic/interpersonal/intrapsychic characteristics and the patients' self-reports on similar and additional variables.
Four of 6 hypotheses were supported: Quality of working alliance is difficult to predict, early alliance is better predicted than later, diagnostic variables do not predict quality of working alliance, but quality of both current and past relationships is associated with working alliance. In a hierarchical multiple-regression analysis, 7% variance of working alliance in the 3rd session was explained from current relationship variables, whereas alliance in the 12th session was not predicted by the same model. Intrapsychic variables predicted the therapists' ratings of alliance, but not the patients' ratings.
The results are in line with previous research, and also with the theoretical model for working alliance.
本研究旨在利用患者治疗前变量中的可能预测因素，即诊断、当前和过去的人际关系以及心理内部因素，来预测早期工作联盟的质量。数据来自正在进行的挪威心理治疗过程与结果多中心自然主义项目（NMSPOP）。
样本量为n = 270，从15个门诊诊所招募；61.1%的患者患有个性障碍。使用工作联盟量表（WAI）评估联盟情况，预测因素包括独立临床医生对诊断/人际/心理内部特征的评估以及患者对类似和其他变量的自我报告。
6个假设中有4个得到支持：工作联盟的质量难以预测，早期联盟比后期联盟更易于预测，诊断变量无法预测工作联盟的质量，但当前和过去人际关系的质量与工作联盟相关。在分层多元回归分析中，第三次治疗中工作联盟7%的方差可由当前关系变量解释，而同一模型无法预测第十二次治疗中的联盟情况。心理内部变量可预测治疗师对联盟的评分，但无法预测患者的评分。
研究结果与先前研究一致，也与工作联盟的理论模型相符。
