4785Anna Freud National Centre for Children and Families, London, UK.
4919University College London, UK.
Clin Child Psychol Psychiatry. 2022 Jul;27(3):549-568. doi: 10.1177/13591045221081193. Epub 2022 Mar 25.
Internet-based treatments have been developed for youth mental health difficulties, with promising results. However, little is known about the features of therapeutic alliance, and how it is established and maintained, in text-based interactions between adolescents and therapists in internet-based treatments. This study uses data collected during a pilot evaluation of a psychodynamic internet-based therapy for depressed adolescents. The adolescents had instant-messaging chats with their therapists once a week, over 10 weeks. The adolescents also rated the therapeutic alliance each week, using the Session Alliance Inventory. The present study uses qualitative methods to analyse transcripts of text-based communication between the young people and their therapists. The aim is to identify and describe the key features of therapeutic alliance, and reflect upon the implications for theory and clinical practice. Analysis identified three 'values' that may underpin a strong therapeutic alliance: togetherness, agency and hope. A number of therapist techniques were also found, which seemed to create a sense of these values during text-chat sessions. These findings are discussed, alongside implications for future research.
互联网为青少年心理健康问题提供了治疗方式，效果显著。然而，在互联网治疗中，青少年与治疗师之间的基于文本的互动中，关于治疗联盟的特点，以及如何建立和维持治疗联盟，我们知之甚少。本研究使用在针对抑郁青少年的心理动力学互联网治疗的试点评估期间收集的数据。青少年每星期与他们的治疗师进行一次即时消息聊天，共持续 10 周。青少年还使用治疗联盟量表（Session Alliance Inventory）每周对治疗联盟进行评分。本研究使用定性方法分析青少年及其治疗师之间基于文本的交流的转录本。目的是确定和描述治疗联盟的关键特征，并反思其对理论和临床实践的影响。分析确定了可能构成强大治疗联盟的三个“价值观”：团结、能动性和希望。还发现了一些治疗师的技术，这些技术似乎在文本聊天会话中创造了这些价值观的感觉。讨论了这些发现，并探讨了对未来研究的影响。
