Stratford Trisha, Meara Alan, Psychotherapy M Gestalt, Lal Sara
*University of Technology (UTS), Department of Medical and Molecular Biosciences, Sydney, NSW, Australia; and †Academic Governing Board, Gestalt Therapy, Queensland, Australia.
J Nerv Ment Dis. 2014 Aug;202(8):613-9. doi: 10.1097/NMD.0000000000000163.
This exploratory study was designed to investigate the link between a client's heart rate variability (HRV) and the forming of a therapeutic alliance (TA) during psychotherapy. Change in HRV is associated with many psychological and physiological situations, including cardiac mortality. Cardiac effects were evaluated during therapy in 30 symptomatically anxious clients using HRV during six weekly 1-hour therapy sessions (S1-S6). Therapeutic index (TI), a measure of TA, was evaluated using skin conductance resonance between client and therapist. The Working Alliance Inventory provides a subjective measure of TA. State and trait anxiety and mood states were also assessed. Most HRV parameters were highest during S4. The sympathovagal balance was highest in S1 but stabilized after S2. In S4, TI was linked to high HRV parameters. Overall higher anxiety levels seem to be associated to lower HRV parameters. Conversely, in S4, high HRV parameters were linked to higher mood scores. This study found that a subjective measure of TA contradicted the physiological outcome. Results suggest that physiological data collected during therapy are a more accurate barometer of TA forming. These research findings suggest a need for further research identifying physiological markers in clients with a variety of mental health disorders over long-term therapy.
这项探索性研究旨在调查客户的心率变异性（HRV）与心理治疗期间治疗联盟（TA）形成之间的联系。HRV的变化与许多心理和生理状况相关，包括心脏死亡率。在六次每周1小时的治疗疗程（S1 - S6）中，使用HRV对30名有症状焦虑的客户在治疗期间的心脏效应进行了评估。使用客户与治疗师之间的皮肤电导共振评估治疗指数（TI），这是一种衡量TA的指标。工作联盟量表提供了TA的主观测量方法。还评估了状态焦虑、特质焦虑和情绪状态。大多数HRV参数在S4期间最高。交感神经 - 迷走神经平衡在S1时最高，但在S2之后稳定下来。在S4中，TI与高HRV参数相关。总体而言，较高的焦虑水平似乎与较低的HRV参数相关。相反，在S4中，高HRV参数与较高的情绪得分相关。本研究发现，TA的主观测量结果与生理结果相矛盾。结果表明，治疗期间收集的生理数据是TA形成的更准确指标。这些研究结果表明，需要进一步开展研究，以确定长期治疗中患有各种精神健康障碍客户的生理标志物。
