Research Institute, Modum Bad Psychiatric Center, Vikersund, Norway.
Psychotherapy (Chic). 2012 Sep;49(3):291-302. doi: 10.1037/a0027895.
Therapeutic bond, as a component of the alliance, is considered a common factor in psychotherapy; however, it may operate differently in various treatments. This article investigates therapist actions, particularly affect focus, in the formation of the bond and on reduction of symptoms in short-term dynamic psychotherapy (STDP) and cognitive therapy (CT) for cluster C patients. Forty-six cases (23 STDP and 23 CT) were assessed using the Psychotherapy Process Q-Sort, the Helping Alliance Questionnaire, and the Symptom Checklist 90. These scores were used to determine (a) therapist actions that predict formation of the bond, (b) the relation of the bond to symptom reduction, and (c) how therapist actions and bond interacted to reduce symptoms. Multiple regressions were applied to the total sample and to the STDP and CT cases. Psychotherapy Process Q-Sort items describing avoidance of affects were positively related to the bond in the total sample, STDP and CT. However, the relation between therapist actions, bond, and symptom reduction differed for the two treatments. For STDP, avoidance of affect suppressed the relation of bond to symptom reduction and also negatively influenced symptom reduction. On the other hand, in CT, avoidance of affect was positively related to both the formation of the bond and to symptom reduction. Although the bond is a common factor and important component of the alliance, it appears to operate differently in STDP and CT. A focus on affect is important to the benefits of STDP but interferes with the benefits of CT.
治疗关系作为联盟的一个组成部分，被认为是心理治疗中的一个共同因素；然而，它在不同的治疗中可能有不同的作用。本文研究了治疗师的行为，特别是情感焦点，在短期动力心理治疗（STDP）和认知治疗（CT）中形成治疗关系和减少 C 群患者症状中的作用。使用心理治疗过程 Q 分类、帮助联盟问卷和症状清单 90 对 46 例（23 例 STDP 和 23 例 CT）进行评估。这些分数用于确定：（a）预测治疗关系形成的治疗师行为；（b）治疗关系与症状减轻的关系；（c）治疗师行为和治疗关系如何相互作用以减轻症状。多元回归应用于总样本和 STDP 和 CT 病例。描述回避情感的心理治疗过程 Q 分类项目与总样本、STDP 和 CT 中的关系呈正相关。然而，两种治疗方法的治疗师行为、关系和症状减轻之间的关系不同。对于 STDP，情感回避抑制了关系与症状减轻的关系，也对症状减轻产生负面影响。另一方面，在 CT 中，情感回避与治疗关系的形成和症状减轻都呈正相关。尽管治疗关系是一个共同因素和联盟的重要组成部分，但它在 STDP 和 CT 中的作用似乎不同。关注情感对 STDP 的益处很重要，但会干扰 CT 的益处。
