Dr. Totura is with the Department of Psychology, Auburn University, Auburn, Alabama. Dr. Fields is with the Department of Psychology, Texas A&M University, College Station. Dr. Karver is with the Department of Psychology, University of South Florida, Tampa.
Psychiatr Serv. 2018 Jan 1;69(1):41-47. doi: 10.1176/appi.ps.201700114. Epub 2017 Sep 15.
Patient nonadherence to psychopharmacological treatment is a significant barrier to effective treatment. The therapeutic relationship is known to be a critical component of effective psychological treatment, but it has received limited study. A meta-analysis was conducted to examine the role of the therapeutic relationship in the delivery of effective psychopharmacological treatment.
PubMed, PsycINFO, CINAHL, Google Scholar, Ingenta, and the Web of Science-Science Citation Index were searched, including reference lists of found articles. Meta-analytic methods were used to examine the association between the physician-patient therapeutic relationship and outcomes in psychopharmacological treatment.
Eight independent studies of psychopharmacological treatment reported in nine articles met the inclusion criterion (1,065 participants) of being an empirically based study in which measures of the therapeutic relationship were administered and psychiatric treatment outcomes were assessed. The overall average weighted effect size for the association between the therapeutic relationship and treatment outcomes was z=.30 (95% confidence interval=.20-.39), demonstrating a statistically significant, moderate effect.
Findings indicate that a positive therapeutic relationship or alliance between the physician and the psychiatric patient is associated with patient improvement over the course of psychopharmacological treatment. Results suggest that more attention should be paid to psychiatrist communication skills that may enhance the therapeutic alliance in psychopharmacological treatment.
患者不遵守精神药理学治疗方案是有效治疗的重大障碍。治疗关系是有效心理治疗的关键组成部分，但目前对此研究有限。本研究进行了荟萃分析，以检验治疗关系在提供有效精神药理学治疗中的作用。
检索了 PubMed、PsycINFO、CINAHL、Google Scholar、Ingenta 和 Web of Science-Science Citation Index，并查阅了已找到文章的参考文献列表。采用荟萃分析方法检验了医患治疗关系与精神药理学治疗结果之间的关联。
9 篇文章中报告了 8 项独立的精神药理学治疗研究（1065 名参与者）符合纳入标准，即这是一项基于实证的研究，其中实施了治疗关系评估措施，并评估了精神科治疗结果。治疗关系与治疗结果之间的总体平均加权效应大小为 z=.30（95%置信区间：.20-.39），表明具有统计学意义的中等效应。
研究结果表明，医生与精神科患者之间积极的治疗关系或联盟与患者在精神药理学治疗过程中的改善有关。结果表明，应该更加关注精神科医生的沟通技巧，这些技巧可能会增强精神药理学治疗中的治疗联盟。
