Department of Psychology, University of Oslo, Oslo, Norway.
Statped, Department of Speech and Language Disorders, Oslo, Norway.
Int J Lang Commun Disord. 2019 Jul;54(4):606-619. doi: 10.1111/1460-6984.12465. Epub 2019 Mar 13.
Multiple factors can influence the working alliance and treatment outcome in speech and language therapy. The 'working alliance' is an important concept in treatment and can be described as the degree to which a treatment dyad is engaged in collaborative, purposive work. To date, relatively little attention has been paid to this concept within speech and language treatment in general, and within stuttering treatment research in particular.
To investigate the role of the working alliance within stuttering treatment, and to evaluate whether the quality of the working alliance correlated with clients' concept of motivation and treatment outcomes 6 months post-therapy.
METHODS & PROCEDURES: Eighteen adults (21-61 years) participated in this multiple single-case treatment study, with treatment facilitated by an experienced speech and language therapist. The working alliance was investigated using the Working Alliance Inventory-Short Version Revised (WAI-SR), an Extended version of the Client Preferences for Stuttering Treatment (CPST-E), the Overall Assessment of Speakers' Experience of Stuttering-Adult version (OASES-A), the Wright & Ayre Stuttering Self-Rating Profile (WASSP) and the Hospital Anxiety and Depression Scale (HADS).
OUTCOMES & RESULTS: Analyses demonstrated significant associations between the working alliance and client motivation (r = 0.781) and treatment outcomes (r = 0.644) 6 months post-treatment. The association between client-led goals and therapy tasks appeared particularly important.
CONCLUSIONS & IMPLICATIONS: The working alliance between speech and language therapists and persons who stutter matters. Within the alliance, the level of client-clinician agreement on treatment goals and therapy tasks may be of greater importance than the bond between client and clinician. Further research with greater numbers of participants is warranted.
多种因素会影响言语治疗中的工作联盟和治疗效果。“工作联盟”是治疗中的一个重要概念，可以描述为治疗对立方参与合作、有目的工作的程度。迄今为止，人们对一般言语治疗中的这一概念，特别是在口吃治疗研究中，关注相对较少。
探讨工作联盟在口吃治疗中的作用，并评估工作联盟的质量是否与患者的动机概念和治疗后 6 个月的治疗效果相关。
本多项单病例治疗研究纳入了 18 名成年人（21-61 岁），由经验丰富的言语治疗师进行治疗。使用工作联盟量表-简短修订版（WAI-SR）、口吃治疗患者偏好扩展版（CPST-E）、成人口吃体验整体评估量表（OASES-A）、赖特和艾尔口吃自评量表（WASSP）和医院焦虑和抑郁量表（HADS）来调查工作联盟。
分析表明，治疗后 6 个月，工作联盟与患者动机（r=0.781）和治疗效果（r=0.644）之间存在显著关联。客户主导的目标和治疗任务之间的关联似乎尤为重要。
言语治疗师和口吃者之间的工作联盟很重要。在联盟中，患者和临床医生对治疗目标和治疗任务的一致性水平可能比患者和临床医生之间的联系更为重要。需要进一步进行更多参与者的研究。
