Dolev Tohar, Zilcha-Mano Sigal, Chui Harold, Barrett Marna S, McCarthy Kevin S, Barber Jacques P
The Department of Psychology, University of Haifa.
The Department of Psychology, Chinese University of Hong Kong.
Psychoanal Psychother. 2018;32(2):157-180. doi: 10.1080/02668734.2017.1417323. Epub 2018 Jan 8.
Better understanding of the connection between therapeutic processes and outcomes in minority groups can help design and use culturally-adapted treatments.
To explore the active ingredient in the therapeutic process, the present case study compared two ethnic minority male clients, recruited as part of a randomized controlled trial (RCT), one with a good outcome, the other with a poor one. The 12-item Working Alliance Inventory-Observer (S-WAI-O) coding system was used to capture the process of change, alongside a qualitative analysis of content. The cases were identified based on their change in pre- to post-treatment scores on the Beck Depression Inventory (BDI) and the Hamilton Rating Scale for Depression (HRSD).
The findings suggest a rupture-resolution process in the good outcome case, including a process of negotiation of the alliance and work on issues of trust. In contrast, the poor outcome case showed strong and steady alliance, but context analysis pointed to withdrawal ruptures.
Although it is difficult to generalize from a two-case study analysis, the present work suggests that building and negotiating alliance with minority clients has a potential for treatment success.
更好地理解少数群体的治疗过程与治疗结果之间的联系，有助于设计和使用文化适应性治疗方法。
为探究治疗过程中的有效成分，本案例研究比较了两名少数族裔男性客户，他们是作为一项随机对照试验（RCT）的一部分招募的，其中一名治疗效果良好，另一名效果不佳。使用12项工作联盟量表-观察者版（S-WAI-O）编码系统来记录变化过程，并对内容进行定性分析。根据他们在治疗前到治疗后贝克抑郁量表（BDI）和汉密尔顿抑郁评定量表（HRSD）得分的变化来确定案例。
研究结果表明，治疗效果良好的案例存在一个破裂-修复过程，包括联盟协商过程和信任问题处理。相比之下，治疗效果不佳的案例显示出牢固且稳定的联盟，但情境分析指出存在退缩性破裂。
尽管很难从双案例研究分析中得出一般性结论，但目前的研究表明，与少数族裔客户建立和协商联盟具有治疗成功的潜力。
