Holmqvist Rolf, Philips Björn, Mellor-Clark John
a Department of Behavioral Sciences and Learning , Linköping University , Sweden.
b CORE Information Management Systems , Rugby , Warwickshire , UK.
Psychother Res. 2016 Jul;26(4):399-409. doi: 10.1080/10503307.2015.1013160. Epub 2015 Mar 9.
A shared understanding of the patient's symptoms and problems is seen by most theories as a crucial aspect of the collaboration in therapy, presumably influencing alliance and outcome. The empirical ground for this argument is not solid, however. Several studies have found weak associations between a common view of the patient's problems and outcome. The purpose of the present study was to analyze whether agreement in the understanding of the patient's depression and anxiety problems was important for alliance and outcome.
The study used data from a practice-based study using the CORE system with 846 patients who received psychological treatment in primary care.
The analyses indicated that although patients who were assessed by their therapists as having depression and anxiety problems scored higher on these subscales than other patients, about half of the patients reported such problems when the therapists did not, and vice versa. Agreement was not associated with better alliance or outcome.
Productive collaboration in psychotherapy may be based on other factors than agreement about symptoms.
大多数理论认为，对患者症状和问题达成共识是治疗中合作的关键方面，大概会影响治疗联盟和治疗结果。然而，这一观点的实证依据并不确凿。多项研究发现，对患者问题的共同看法与治疗结果之间的关联较弱。本研究的目的是分析在理解患者的抑郁和焦虑问题上达成一致意见对治疗联盟和治疗结果是否重要。
该研究使用了基于实践的研究数据，采用CORE系统，对846名在初级保健机构接受心理治疗的患者进行了研究。
分析表明，尽管治疗师评估有抑郁和焦虑问题的患者在这些分量表上的得分高于其他患者，但当治疗师未评估出此类问题时，约有一半的患者报告了这些问题，反之亦然。达成一致意见与更好的治疗联盟或治疗结果并无关联。
心理治疗中的有效合作可能基于症状共识之外的其他因素。
