Department of Psychology, University of Oslo, Oslo, Norway.
Psychother Res. 2010 Nov;20(6):627-46. doi: 10.1080/10503307.2010.497633.
The present study investigated whether and how various therapists' (N = 68) self-reported characteristics relating to their therapeutic work predicted patients' (N = 335) early ratings of the working alliance in a naturalistic psychotherapy study. Results from multilevel modeling demonstrated that certain self-reports accounted well for the therapist effect in the early alliance. The effect of therapists' experiences of difficulties in practice was particularly strong: a negative influence of difficulties termed negative personal reaction (NPR) and a surprising positive influence of another factor, professional self-doubt (PSD), were found. The latter was interpreted as reflecting an attitude of therapist humbleness and sensitivity, which seems to facilitate alliance development. A negative impact of self-reported skills in using one's own and the patients' emotional reactions in the therapeutic relationship (advanced relational skills) was found when controlling for a warm interpersonal style. The negative effect of advanced relational skills depended on the level of NPR difficulties. The findings suggest that therapists should be cautious in using this kind of relational skill unless they experience relating to patients in a warm manner and report low levels of NPR in their practice.
本研究旨在探讨不同治疗师（N=68）的自我报告特征与其治疗工作之间的关系，以及这些特征是否能预测患者（N=335）在自然主义心理治疗研究中对工作联盟的早期评价。多层次模型的结果表明，某些自我报告能够很好地解释早期联盟中的治疗师效应。治疗师在实践中遇到困难的经验影响尤其强烈：一种被称为负面个人反应（NPR）的困难的负面影响，以及另一个因素，即职业自我怀疑（PSD）的令人惊讶的积极影响，都被发现了。后者被解释为反映了治疗师的谦逊和敏感态度，这似乎有助于联盟的发展。当控制人际温暖风格时，发现自我报告在治疗关系中使用自己和患者情绪反应的技能（高级关系技能）与消极的影响有关。高级关系技能的负面影响取决于 NPR 困难的程度。研究结果表明，治疗师应该谨慎使用这种关系技能，除非他们在实践中以温暖的方式与患者建立联系，并报告 NPR 水平较低。
