Yaffe-Herbst Lirit, Krapf Forteza-Rey Abigail, Peysachov Galit, Zilcha-Mano Sigal
The Department of Psychology, University of Haifa, Haifa, Israel.
Psychother Res. 2024 Feb;34(2):150-158. doi: 10.1080/10503307.2023.2189028. Epub 2023 Mar 16.
The available literature points to the potential therapeutic benefits of alliance strengthening during treatment. Both supportive and expressive techniques have been suggested to be associated with strengthening of the alliance. The present study investigates whether patients may show different effects of supportive vs. expressive techniques in improving alliance as a function of their pretreatment insight levels.
Fifty-five patients were randomly assigned to either supportive treatment (ST) or supportive-expressive treatment (SET), as part of a larger randomized controlled trial. Clinical interviews were administered at pretreatment to evaluate the patients' level of insight. The working alliance was measured after each of the 16 sessions. A multilevel model, including a 3-way interaction of pretreatment insight by treatment condition (ST vs. SET) by time, was used to predict alliance strengthening.
The findings suggest that, for individuals receiving ST, those with higher levels of insight show greater alliance strengthening. For individuals receiving SET, those with lower levels of insight show greater alliance strengthening.
The current study suggests that one size may not fit all and, whereas some individuals may benefit more from ST to achieve alliance strengthening, others may benefit more from SET.
现有文献指出在治疗过程中加强治疗联盟可能具有治疗益处。支持性技术和表达性技术都被认为与加强治疗联盟有关。本研究调查了患者在改善治疗联盟方面，支持性技术与表达性技术是否会因其治疗前领悟水平的不同而产生不同效果。
作为一项更大规模随机对照试验的一部分，55名患者被随机分配到支持性治疗（ST）组或支持性-表达性治疗（SET）组。在治疗前进行临床访谈以评估患者的领悟水平。在16次治疗的每次治疗后测量工作联盟。使用一个多层次模型，包括治疗前领悟水平、治疗条件（ST组与SET组）和时间的三向交互作用，来预测治疗联盟的加强情况。
研究结果表明，对于接受ST治疗的个体，领悟水平较高者治疗联盟加强程度更大。对于接受SET治疗的个体，领悟水平较低者治疗联盟加强程度更大。
当前研究表明，并非一种方法适用于所有人，虽然有些人可能从ST治疗中更受益于实现治疗联盟的加强，但另一些人可能从SET治疗中获益更多。
