a La Trobe Rural Health School , La Trobe University , Bendigo , Australia.
b Living with Disability Research Centre , School of Allied Health , La Trobe University , Melbourne , Australia.
Disabil Rehabil. 2019 Feb;41(4):489-497. doi: 10.1080/09638288.2017.1396366. Epub 2017 Oct 31.
The aim was to review the empirical literature to determine the nature and breadth of research into the working alliance in acquired brain injury (ABI) rehabilitation.
A scoping review was conducted, beginning with a systematic search of relevant databases using key search terms. Studies with a focus on the role of the working alliance in shaping rehabilitation outcomes, and factors influencing perceptions of the working alliance were included and key information extracted.
A total of 10 quantitative studies met inclusion criteria. In most studies, ratings of the working alliance were compared with other process variables or outcome measures. The working alliance was linked to positive activity and participation outcomes, including return to work, school, and driving. Client related factors such as age, level of education and approach to rehabilitation tasks were associated with client and therapist perceptions of the working alliance.
The working alliance emerged as a complex process that interacts with many factors and processes at play in the rehabilitation environment. Notwithstanding the limitations of the research base, findings indicate that enhancement of the working alliance may indeed influence rehabilitation outcomes. Allowing time for the development of the working alliance, and consideration of factors such as therapist skill, may support therapists to strengthen their alliances in ABI rehabilitation. Implications for Rehabilitation Allowing time for the development of the working alliance has the potential to enhance the alliance and thereby influence rehabilitation outcomes. Factors such as the client's age and level of education may influence the strength of the working alliance, and hence, awareness of these factors may assist clinicians in maintaining strong alliances with all clients. A strong working alliance is possible in the presence of client cognitive impairment, however, the skill of the therapist may be important in managing the potential impact of cognitive impairment on the working alliance.
本研究旨在回顾有关获得性脑损伤（ABI）康复中工作联盟的实证文献，以确定研究的性质和广度。
本研究采用范围综述方法，首先使用关键搜索词对相关数据库进行系统搜索。纳入了重点研究工作联盟在塑造康复结果中的作用以及影响工作联盟感知的因素的研究，并提取了关键信息。
共有 10 项定量研究符合纳入标准。在大多数研究中，工作联盟的评分与其他过程变量或结果测量进行了比较。工作联盟与积极的活动和参与结果相关，包括重返工作、学校和驾驶。与客户相关的因素，如年龄、教育水平和康复任务的方法，与客户和治疗师对工作联盟的看法有关。
工作联盟是一个复杂的过程，它与康复环境中发挥作用的许多因素和过程相互作用。尽管研究基础存在局限性，但研究结果表明，增强工作联盟确实可能影响康复结果。为工作联盟的发展留出时间，并考虑治疗师技能等因素，可能有助于治疗师加强他们在 ABI 康复中的联盟。
为工作联盟的发展留出时间有潜力增强联盟，从而影响康复结果。客户的年龄和教育水平等因素可能会影响工作联盟的强度，因此，了解这些因素可能有助于临床医生与所有客户保持强大的联盟。即使存在客户认知障碍，也可以建立强大的工作联盟，但治疗师的技能可能对管理认知障碍对工作联盟的潜在影响很重要。
