School of Social Work, Rutgers, The State University of New Jersey.
Department of Counseling and Counseling Psychology, College of Integrative Sciences and Arts, Arizona State University.
Psychotherapy (Chic). 2019 Jun;56(2):229-240. doi: 10.1037/pst0000210. Epub 2019 Feb 4.
In this study, we tested a conceptual model through which lesbian, gay, bisexual, and queer (LGBQ) clients' perceptions of their therapists' affirmative practices and the therapeutic relationship (i.e., working alliance and the real relationship) would correlate with psychological well-being. We hypothesized that the therapeutic relationship would mediate the relation between clients' perceptions of their therapists' affirmative practices and psychological well-being while controlling for precounseling distress, client age, client race/ethnicity, number of psychotherapy sessions, and therapist gender. A nationwide sample of 184 LGBQ individuals was recruited through the Internet. Participants ranged in age from 18 to 64 years old (Mage = 27.57; SD = 8.50), and the majority identified as female (65.8%) and White (77.2%). Structural equation modeling showed that participants' perceptions of their therapists' affirmative practices were associated with psychological well-being (β = .21, p < .01). Findings also indicated that the therapeutic relationship mediated the association between clients' perceptions of therapists' affirmative practices and psychological well-being (β = .34, p < .001, 95% confidence interval [.15, .52]). More specifically, practicing affirmatively was correlated with a stronger therapeutic relationship, which was associated with higher levels of psychological well-being for LGBQ clients. Hence, these findings inform and encourage advancements in LGBQ affirmative psychotherapy research, practice, and training. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
在这项研究中，我们通过一个概念模型检验了这样一种假设，即同性恋、双性恋、跨性别和酷儿（LGBQ）来访者对治疗师肯定性实践的看法以及治疗关系（即工作联盟和真实关系）与心理健康之间存在相关性。我们假设治疗关系将在控制咨询前困扰、来访者年龄、来访者种族/民族、心理治疗次数和治疗师性别等因素的情况下，调节来访者对治疗师肯定性实践的看法与心理健康之间的关系。通过互联网，我们招募了来自全国各地的 184 名 LGBQ 个体作为研究对象。参与者的年龄从 18 岁到 64 岁不等（Mage = 27.57；SD = 8.50），大多数人是女性（65.8%）和白人（77.2%）。结构方程模型显示，参与者对治疗师肯定性实践的看法与心理健康呈正相关（β =.21，p <.01）。研究结果还表明，治疗关系在来访者对治疗师肯定性实践的看法与心理健康之间起中介作用（β =.34，p <.001，95%置信区间[.15，.52]）。更具体地说，积极的治疗实践与更强大的治疗关系相关，这与 LGBQ 来访者的心理健康水平呈正相关。因此，这些发现为 LGBQ 肯定性心理治疗研究、实践和培训提供了信息，并鼓励其进一步发展。（PsycINFO 数据库记录（c）2019 APA，保留所有权利）。
