Mellado Augusto, Suárez Nicolás, Altimir Carolina, Martínez Claudio, Pérez Janet, Krause Mariane, Horvath Adam
a Facultad de Psicología , Universidad Alberto Hurtado , Santiago , Chile.
b Escuela de Psicología, Pontificia Universidad Católica de Chile , Santiago , Chile.
Psychother Res. 2017 Sep;27(5):595-607. doi: 10.1080/10503307.2016.1147657. Epub 2016 Apr 21.
The therapeutic alliance is considered the most robust process variable associated with positive therapeutic outcome in a variety of psychotherapeutic models [Alexander, L. B., & Luborsky, L. (1986). The Penn Helping Alliance Scales. In L. S. Greenberg & W. M. Pinsoff (Eds.), The psychotherapeutic process: A research handbook (pp. 325-356). New York: Guilford Press; Horvath, A. O., Gaston, L., & Luborsky, L. (1993). The alliance as predictor of benefits of counseling and therapy. In N. Miller, L. Luborsky, J. Barber, & J. P. Docherty (Eds.), Psychodynamic treatment research: A handbook for clinical practice (pp. 247-274). New York, NY: Basic Books; Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48, 9-16; Orlinky, D., Grawe, K., & Parks, B. (1994). Process and outcome in psychotherapy: Noch einmal. In A. Bergin & J. S. Garfield (Eds.), Handbook of psychotherapy and behaviour change (4th ed., pp. 270-378). New York, NY: Wiley and Sons]. The relationship between alliance and outcome has traditionally been studied based on measures that assess these therapy factors at a global level. However, the specific variations of the alliance process and their association with therapy segments that are relevant for change have not yet been fully examined. The present study examines the variations in the therapeutic alliance in 73 significant in-session events: 35 change and 38 stuck episodes identified through the observation of 14 short-term therapies of different theoretical orientations. Variations in the alliance were assessed using the VTAS-SF [Shelef, K., & Diamond, G. (2008). Short form of the revised Vanderbilt Therapeutic Alliance Scale: Development, reliability, and validity. Psychotherapy Research, 18, 433-443]. Nested analyses (HLM) indicate a statistically significant better quality of the alliance during change episodes.
治疗联盟被认为是在各种心理治疗模式中与积极治疗结果相关的最有力的过程变量[亚历山大，L.B.，& 卢伯斯基，L.（1986）。《宾夕法尼亚帮助联盟量表》。载于L.S. 格林伯格 & W.M. 平索夫（编），《心理治疗过程：研究手册》（第325 - 356页）。纽约：吉尔福德出版社；霍瓦斯，A.O.，加斯顿，L.，& 卢伯斯基，L.（1993）。联盟作为咨询和治疗益处的预测指标。载于N. 米勒、L. 卢伯斯基、J. 巴伯 & J.P. 多彻蒂（编），《心理动力治疗研究：临床实践手册》（第247 - 274页）。纽约，NY：基础图书公司；霍瓦斯，A.O.，德尔·雷，A.C.，弗吕基格，C.，& 西蒙兹，D.（2011）。个体心理治疗中的联盟。《心理治疗》，48，9 - 16；奥林斯基，D.，格拉韦，K.，& 帕克斯，B.（1994）。心理治疗中的过程与结果：再探讨。载于A. 伯金 & J.S. 加菲尔德（编），《心理治疗与行为改变手册》（第4版，第270 - 378页）。纽约，NY：威利父子公司]。传统上，联盟与结果之间的关系是基于在总体水平上评估这些治疗因素的测量方法来研究的。然而，联盟过程的具体变化及其与对改变至关重要的治疗阶段的关联尚未得到充分研究。本研究考察了7３个重要的治疗中事件中的治疗联盟变化：通过观察14种不同理论取向的短期治疗确定的35个改变阶段和38个停滞阶段。使用《修订版范德比尔特治疗联盟量表简表》（VTAS - SF）[谢列夫，K.，& 戴蒙德，G.（2008）。《修订版范德比尔特治疗联盟量表简表：编制、信度和效度》。《心理治疗研究》，18，433 - 443]评估联盟的变化。嵌套分析（HLM）表明，在改变阶段联盟质量在统计学上显著更好。
