CHU Toulouse, Hôpital Purpan, Toulouse, France.
Psychiatry Res. 2009 Dec 30;170(2-3):229-33. doi: 10.1016/j.psychres.2008.09.005. Epub 2009 Nov 10.
The therapeutic alliance is considered as one of the active relational factors to improve the outcome of patients engaged in a psychotherapeutic process. Our objective was to examine the role played by the therapeutic alliance in psychodynamic versus supportive psychotherapy. We examined data from a previously published randomized controlled study. Outpatients suffering from depression (n=74) received the same antidepressant (clomipramine) and were randomized into two groups, receiving either psychodynamic or supportive psychotherapy. Subjects were assessed at inclusion (Structured Clinical Interview for DSM-IV Disorders, SCID), during treatment and at discharge (Global Assessment Scale, Hamilton Depression Rating Scale, Helping Alliance questionnaire). Over time, the therapeutic alliance improved regardless of condition, and the relationship between alliance and outcome strengthened. This relationship was significant only among patients assigned to the supportive therapy condition. These data suggest that although the therapeutic alliance is an important factor in psychodynamic treatment, additional ingredients may be involved in its superiority compared to supportive therapy.
治疗联盟被认为是改善参与心理治疗过程的患者结局的积极关系因素之一。我们的目的是研究治疗联盟在精神动力学与支持性心理治疗中的作用。我们分析了先前发表的一项随机对照研究的数据。患有抑郁症的门诊患者（n=74）接受相同的抗抑郁药（氯米帕明）治疗，并随机分为两组，分别接受精神动力学或支持性心理治疗。在纳入时（DSM-IV 障碍的结构临床访谈，SCID）、治疗期间和出院时（总体评估量表、汉密尔顿抑郁评定量表、帮助联盟问卷）对受试者进行评估。无论条件如何，治疗联盟都随着时间的推移而改善，联盟与结果之间的关系也得到加强。这种关系仅在分配到支持性治疗条件的患者中具有显著性。这些数据表明，尽管治疗联盟是精神动力学治疗中的一个重要因素，但与支持性治疗相比，其优越性可能还涉及其他因素。
