Vanderbilt University, Nashville, TN, USA,
Adm Policy Ment Health. 2012 Mar;39(1-2):78-89. doi: 10.1007/s10488-011-0398-0.
This paper presents the psychometric evaluation of brief measures of therapeutic alliance (TA) for youths, clinicians and caregivers and a longitudinal analysis of relationships between changes in TA and changes in youth symptom and functioning severity. Psychometric analyses using methods from Classical Test Theory, Item Response Theory, and Factor Analysis indicate that the measures of TA used in this study offer something new for both practice and research. The measures have variability, sensitivity to change over time, brevity and can be used with multiple parties through parallel forms. The longitudinal analyses, employing hierarchical linear modeling with time-varying covariates, found that TA ratings of the clinician correlated with symptom improvement as rated by the clinician, caregiver and youth. Additional analyses showed that decreases in clinician-rated youth TA was most important in predicting a lower rate of youth improvement. Implications for future research and clinical practice are discussed.
本文介绍了青少年、临床医生和护理人员治疗联盟（TA）简短测量的心理计量学评估，以及 TA 变化与青少年症状和功能严重程度变化之间的纵向分析。使用经典测试理论、项目反应理论和因素分析方法进行的心理计量学分析表明，本研究中使用的 TA 测量方法为实践和研究提供了一些新的东西。这些测量方法具有可变性、随时间变化的敏感性、简洁性，并且可以通过并行形式与多个群体一起使用。采用具有时变协变量的分层线性建模的纵向分析发现，临床医生对 TA 的评估与临床医生、护理人员和青少年的症状改善评估相关。进一步的分析表明，临床医生评定的青少年 TA 下降对预测青少年改善率较低最为重要。讨论了对未来研究和临床实践的影响。
