Professional Psychology Program, The George Washington University, Washington, DC 20037, USA.
J Couns Psychol. 2012 Jul;59(3):352-67. doi: 10.1037/a0028907.
Two studies explored how counselor and client agreement on the therapy alliance, at the beginning of treatment, influenced early session evaluations and symptom change. Unlike prior studies that operationalized alliance convergence as either a profile similarity correlation or a difference score, the present study used polynomial regression and response surface analysis to examine agreement. Study 1 explored the impact of working alliance congruence on session depth and smoothness at the 3rd session of treatment with 36 client-counselor dyads. Results revealed that session smoothness was greater when clients' and therapists' perceptions of the working alliance were in agreement and high compared with when they were in agreement and low. In addition, clients rated sessions less smooth when their ratings of the alliance were lower than their therapists' ratings of the alliance, and they rated sessions as more smooth when their ratings of the alliance were higher than their therapists' ratings of the alliance. The authors did not find a significant relationship with session depth. In Study 2, the authors explored the impact of working alliance congruence, at the 3rd session of therapy, on symptom change for 63 client-counselor dyads. Results revealed that as the therapist and client have more positive agreement on the perceived alliance at the beginning of the treatment, there is greater symptom change. The authors also found that the consequences of alliance disagreement are the same regardless of who rated the alliance higher than the other. Implications and recommendations for future research are discussed.
两项研究探讨了治疗开始时咨询师和客户对治疗联盟的共识如何影响早期会议评估和症状变化。与之前将联盟趋同操作化为特征相似性相关或差异分数的研究不同，本研究使用多项式回归和响应面分析来检查协议。研究 1 探讨了在 36 个客户-咨询师对中，第 3 次治疗会议中工作联盟一致性对会议深度和流畅度的影响。结果表明，当客户和治疗师对工作联盟的看法一致且较高时，会议流畅度较高，而当他们一致且较低时，会议流畅度较低。此外，当客户对联盟的评价低于治疗师对联盟的评价时，他们对会议的评价就不那么流畅，而当他们对联盟的评价高于治疗师对联盟的评价时，他们对会议的评价就更流畅。作者没有发现与会议深度有显著关系。在研究 2 中，作者探讨了治疗第 3 次会议时工作联盟一致性对 63 个客户-咨询师对的症状变化的影响。结果表明，治疗开始时，治疗师和客户对感知联盟的积极共识越多，症状变化就越大。作者还发现，无论谁对联盟的评价高于另一个，联盟不一致的后果都是相同的。讨论了对未来研究的影响和建议。
