Hervé M-J, Picot M-C, Maury M, Kerbage H, Purper-Ouakil D
Department of Child and Adolescent Psychiatry, CHRU Montpellier, St Eloi University Hospital, 80, avenue Augustin Fliche, 34295 Montpellier cedex 5, France.
Clinical research and epidemiology unit (Department of Medical Information), CHRU Montpellier, University of Montpellier, Montpellier, France; Centre de Recherche en Épidémiologie et Santé des Populations (CESP), U1018, INSERM, Université Paris-Saclay, Villejuif, France.
Encephale. 2023 Dec;49(6):564-571. doi: 10.1016/j.encep.2022.06.010. Epub 2022 Oct 15.
The therapeutic alliance, an essential component of the therapeutic process, has been investigated in adult and child therapy, but studies in the context of parent-infant or parent-toddler therapeutic interventions are scarce. This monocentric study aims to produce a French cross-cultural adaptation of a therapeutic alliance scale for the context of early consultations in a child and psychiatry department.
Fifty-five young children aged 3 to 30 months consulting for regulation or behavioral disorders and their mothers were included in the study. The working alliance inventory (WAI) was translated into French by two bilingual translators and adapted to early-age consultations in parent and therapist versions. Assessments of the child's symptoms and the parents' anxiety and depression were carried out at the start and end of therapy. We studied the association of the alliance with the initial clinical characteristics and with the outcome of the child and the mother. An exploratory factor analysis was performed considering the items most associated with expected outcomes.
The alliance coded by the mother was lower in case of child behavioral problems and was associated with the mother and child outcome. Short versions of the infant-toddler WAI were developed based on factor analysis, highlighting four factors: positive goals and tasks, bond with the mother, alliance with the child, negative experience of care relationship.
Results were similar to those found in therapy with adults or older children. The alliance issue in mother-baby therapies was as essential as in other therapy contexts. The short Infant-Toddler WAI resulting from this work must be validated in future studies.
治疗联盟是治疗过程的重要组成部分，已在成人和儿童治疗中得到研究，但在亲子或亲幼治疗干预背景下的研究却很少。这项单中心研究旨在针对儿童与精神科早期咨询的背景，对治疗联盟量表进行法语跨文化改编。
55名年龄在3至30个月、因调节或行为障碍前来咨询的幼儿及其母亲被纳入研究。工作联盟量表（WAI）由两名双语翻译人员翻译成法语，并改编为适用于亲子和治疗师版本的早期咨询量表。在治疗开始和结束时对儿童症状以及父母的焦虑和抑郁进行评估。我们研究了联盟与初始临床特征以及儿童和母亲治疗结果之间的关联。考虑到与预期结果关联度最高的项目进行了探索性因素分析。
母亲编码的联盟在儿童存在行为问题的情况下较低，并且与母亲和儿童的治疗结果相关。基于因素分析开发了幼儿WAI的简短版本，突出了四个因素：积极目标与任务、与母亲的联结、与儿童的联盟、护理关系的负面体验。
结果与在成人或大龄儿童治疗中发现的结果相似。母婴治疗中的联盟问题与其他治疗背景下的一样重要。这项工作得出的简短幼儿WAI必须在未来研究中进行验证。
