Nelson R A, Borkovec T D
Pennsylvania State University.
J Behav Ther Exp Psychiatry. 1989 Jun;20(2):155-62. doi: 10.1016/0005-7916(89)90048-7.
Dimensions of client participation in psychotherapy were assessed to investigate whether participation is unidimensional or multidimensional, stable over therapy, and/or related to measures of psychotherapy outcome. Participation dimensions included compliance with scheduling (lateness, rescheduling, no-show) and with homework assignments (completion of a daily diary and relaxation home-practice), reported acceptance of the credibility of therapy rationale, satisfaction with global and specific aspects of therapy, expectation of personal improvement in anxiety symptomatology, self-rated engagement in therapy activities, and reported judgments about therapist characteristics and relationship qualities. Outcome measures included assessor ratings, daily client self-report of anxiety severity, and questionnaire measures. Subjects were 30 clients participating in a 12-session generalized anxiety disorder comparative treatment study in which they receive progressive relaxation training plus either cognitive therapy or nondirective therapy. Across clients in both treatment groups, behavioral compliance measures were poorly intercorrelated and unrelated to the other participation measures. Canonical correlation of participation variables with change on pre-post outcome measures showed a significant relationship between some participation variables representing satisfaction with specific aspects of therapy and the therapeutic relationship and improvement in daily level of subjective anxiety.
对来访者在心理治疗中的参与维度进行了评估，以调查参与是单维度还是多维度的，在治疗过程中是否稳定，和/或与心理治疗结果的测量指标相关。参与维度包括对预约安排的依从性（迟到、重新安排、未出现）和对家庭作业的完成情况（完成每日日记和放松练习），报告的对治疗理论依据可信度的接受程度，对治疗整体及特定方面的满意度，对焦虑症状个人改善的期望，自我评定的参与治疗活动程度，以及报告的对治疗师特征和关系质量的判断。结果测量指标包括评估者评分、来访者每日焦虑严重程度的自我报告以及问卷调查测量结果。研究对象为30名参与一项为期12节的广泛性焦虑症对比治疗研究的来访者，在该研究中他们接受渐进性放松训练，外加认知疗法或非指导性疗法。在两个治疗组的所有来访者中，行为依从性测量指标之间的相互关联度很低，且与其他参与测量指标无关。参与变量与前后结果测量指标变化之间的典型相关分析表明，一些代表对治疗特定方面满意度和治疗关系的参与变量与每日主观焦虑水平的改善之间存在显著关系。
