Department of Educational Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
Faculty of Psychology, Beijing Normal University, Beijing, People's Republic of China.
Psychother Res. 2024 Apr;34(4):503-517. doi: 10.1080/10503307.2023.2193671. Epub 2023 Apr 4.
The aims of this study were to investigate the congruence and discrepancy between Chinese therapist trainees' estimated client working alliance (WA) and their clients' actual WA rating, and how the congruence and discrepancy predicted client symptom outcome.
Participants were 211 beginning therapist trainees and 1216 clients. Data from their 6888 sessions were analyzed using Truth and Bias Model and Response Surface Model.
(i) Chinese trainees' estimation of client WA was on average significantly lower than actual client WA. (ii) At the between-person level, whether the trainee generally over- or underestimated client WA was not related to the client's initial symptom level or symptom improvement rate. (iii) At the within-person between-session level, a session where a trainee accurately perceived high client WA, compared to a session where the trainee accurately perceived low client WA, was followed by greater client symptom relief before the next session. In the case of estimation bias, a session where the trainee underestimated client WA was followed by greater client symptom reduction in the next session, rather than the other way around when the trainee overestimated client WA. Implications on therapist training were discussed.
本研究旨在探讨中国治疗师受训者对客户工作联盟（WA）的估计与客户实际 WA 评分之间的一致性和差异，以及这种一致性和差异如何预测客户的症状结果。
参与者为 211 名开始的治疗师受训者和 1216 名客户。使用真实和偏差模型以及响应曲面模型对他们 6888 次治疗中的数据进行了分析。
（i）中国受训者对客户 WA 的估计平均明显低于实际客户 WA。（ii）在个体间水平上，受训者是否普遍高估或低估客户 WA 与客户的初始症状水平或症状改善率无关。（iii）在个体内治疗会话之间的水平上，与受训者准确感知低客户 WA 的治疗相比，在治疗中准确感知高客户 WA 的治疗后，在下一次治疗前客户的症状缓解更大。在估计偏差的情况下，与受训者高估客户 WA 的情况相反，当受训者低估客户 WA 时，下一次治疗会导致客户的症状减轻更多。讨论了对治疗师培训的影响。
