Hersoug Anne Grete, Høglend Per, Havik Odd E, von der Lippe Anna, Monsen Jon Trygve
Department of Psychiatry, University of Oslo, Norway.
Psychother Res. 2009 Mar;19(2):172-80. doi: 10.1080/10503300802657374.
This study explored pretreatment patient characteristics associated with the level and growth of working alliance in therapies lasting up to 120 therapy sessions. The quality of working alliance was rated by both patients (N=201) and therapists (N=61) at Sessions 3, 12, and 20 and then at every 20th successive session. Patients reported that experience with good maternal care up to adolescence and better current interpersonal relationships were associated with positive ratings of working alliance throughout therapy. Higher global functioning was associated with growth of alliance over time. Higher levels of interpersonal problems of the cold/detached kind were associated with poorer early working alliance. On the other hand, this type of interpersonal problems was also associated with improvement of working alliance over time. Therapists' ratings of alliance were associated with patients' intrapsychic functioning. Implications for treatment and research are discussed.
本研究探讨了在长达120次治疗疗程的治疗中，与工作联盟水平及发展相关的治疗前患者特征。在第3、12和20次治疗时，以及之后每连续第20次治疗时，由患者（N = 201）和治疗师（N = 61）对工作联盟的质量进行评分。患者报告称，青春期前良好的母亲照料经历以及更好的当前人际关系与整个治疗过程中工作联盟的积极评分相关。更高的整体功能与联盟随时间的发展相关。较高水平的冷漠/疏离型人际问题与早期较差的工作联盟相关。另一方面，这种人际问题也与工作联盟随时间的改善相关。治疗师对联盟的评分与患者的心理内部功能相关。文中讨论了对治疗和研究的启示。
