School of Psychology, University of Ottawa.
Department of Psychiatry, University of Toronto.
Psychotherapy (Chic). 2023 Mar;60(1):98-109. doi: 10.1037/pst0000466. Epub 2022 Nov 10.
The goal of this study was to test the efficacy of training community-based psychotherapists who were part of a practice research network to be more attuned to their patients' experiences of the therapeutic relationship. We were particularly interested in the effect of therapist training on the congruence of alliance ratings with their patients. Forty psychotherapists who treated 117 patients were randomly assigned to receive either no training or training, whose learning objectives were to help therapists to develop and maintain a therapeutic alliance. The training included workshops and ongoing consultations to help the clinician to strengthen the therapeutic relationship with the use of mentalizing, attachment theory, countertransference management, and metacommunication. Therapeutic alliance and well-being outcomes were measured at each of six consecutive early psychotherapy sessions. We used the truth and bias model and response surface analysis within a multilevel modeling context to test hypotheses. There was a significantly faster rate of alliance growth in the training versus the no training condition when the alliance was rated by therapists, but not when rated by patients. Trained therapists experienced greater temporal congruence in alliance ratings with their patients compared to untrained therapists. Patient well-being outcomes improved in a session when trained therapists and their patients agreed in their positive alliance ratings in a previous session. This association not significant among untrained therapists. Training therapists in key interpersonally focused skills may lead them to be better attuned to their patients' experiences of the therapeutic relationship. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
本研究的目的是检验培训社区心理治疗师的效果，这些治疗师是实践研究网络的一部分，旨在使其更能理解患者在治疗关系中的体验。我们特别关注治疗师培训对治疗联盟评估与患者体验一致性的影响。40 名治疗师治疗了 117 名患者，他们被随机分配接受或不接受培训，培训的学习目标是帮助治疗师发展和维持治疗联盟。培训包括工作坊和持续咨询，以帮助临床医生使用心理化、依恋理论、反移情管理和元沟通来加强治疗关系。在连续六次早期心理治疗过程中，分别测量治疗联盟和幸福感结果。我们在多层次建模环境中使用真理和偏差模型以及响应面分析来检验假设。当治疗师对治疗联盟进行评估时，与不接受培训相比，接受培训的治疗师的治疗联盟增长速度更快，但当患者对治疗联盟进行评估时则不然。与未经培训的治疗师相比，接受培训的治疗师在其与患者的治疗联盟评估中表现出更大的时间一致性。当接受培训的治疗师及其患者在前一次治疗中对积极的治疗联盟评估达成一致时，患者的幸福感会在一次治疗中得到改善。在未经培训的治疗师中，这种关联并不显著。培训治疗师掌握关键的人际焦点技能可能会使他们更好地理解患者在治疗关系中的体验。（美国心理协会，所有权利保留）。
