Barreto João F, Matos Paula Mena
Center for Psychology at University of Porto.
Faculty of Psychology and Education Science, University of Porto.
Res Psychother. 2017 Oct 27;20(3):279. doi: 10.4081/ripppo.2017.279.
The working alliance has been recognized as a predictor of psychotherapy outcome across therapeutic orientations. Despite mixed findings regarding the effect of problem severity on the alliance formation, there is evidence suggesting that therapist factors may interfere in this association. This study examined how clients' baseline clinical features affected the early alliance and the possible role of therapists' countertransference management as a mediator. Thirteen therapeutic dyads were assessed at 2 different time points. Clients' clinical dimensions were assessed prior to the 2nd session, and therapists' countertransference management and clients' ratings of the alliance were measured after the 2nd session. Positive associations were found between clients' subjective wellbeing, social functioning, risk, and global psychological distress and countertransference management dimensions and total score. Empathy-based countertransference management suppressed the negative impact of clinical risk on alliance. Our findings suggest that clinical problems activate countertransference management, which in turn may buffer their negative effect on alliance.
工作联盟已被公认为是跨治疗取向的心理治疗结果的一个预测指标。尽管关于问题严重程度对联盟形成的影响存在不一致的研究结果，但有证据表明治疗师因素可能会干扰这种关联。本研究考察了来访者的基线临床特征如何影响早期联盟，以及治疗师的反移情管理作为中介的可能作用。在两个不同时间点对13个治疗二元组进行了评估。在第二次治疗前评估来访者的临床维度，在第二次治疗后测量治疗师的反移情管理和来访者对联盟的评分。发现来访者的主观幸福感、社会功能、风险和总体心理困扰与反移情管理维度及总分之间存在正相关。基于共情的反移情管理抑制了临床风险对联盟的负面影响。我们的研究结果表明，临床问题会激活反移情管理，而这反过来可能会缓冲它们对联盟的负面影响。
