Ramos-Vera Cristian, Sánchez-Villena Andy R, Calle Dennis, Calizaya-Milla Yaquelin E, Saintila Jacksaint
Área de Investigación, Universidad Cesar Vallejo (UCV), Lima, Perú.
Facultad de Ciencias de La Salud, Universidad Privada del Norte, Cajamarca, Perú.
Patient Prefer Adherence. 2023 Sep 25;17:2365-2376. doi: 10.2147/PPA.S422733. eCollection 2023.
Although the importance of the therapeutic alliance in the treatment process and health outcomes is recognized, so far, there has been no evaluation in the Peruvian context that considers possible individual differences that could influence this assessment.
This study assessed the psychometric properties of the WAI-S-P in a sample of individuals from Peru who are receiving psychological therapy. Furthermore, a network analysis was conducted to investigate the direct relationships between the therapeutic alliance and several relevant sociodemographic variables.
The short version of the Working Alliance Inventory was used in a sample of 241 participants (=32.58, =12.67) that had attended less than 6 sessions. Three models were considered, including a three-factor and a two-factor correlated model, as well as a bifactor model. In addition, a network of partial associations was created including the overall therapeutic alliance, sex, age, and number of psychotherapeutic sessions.
The bifactor model, with an overall therapeutic alliance factor and two specific factors ("contact" and "contract"), better fit the data. Invariance of the structure by sex and age showed equitable measurement. On the other hand, network analysis revealed a positive correlation between total session attendance and therapeutic alliance. Men reported higher therapeutic alliance, while women had higher total session attendance.
The results of this study suggest that the therapeutic alliance is better represented by a bifactor model and demonstrates invariance across sex and age in Peruvian adults. Additionally, findings indicate that differences in life experiences and the sex of patients may need to be verified in future studies to better understand nuanced needs in forming therapeutic alliances at least in the early stages of session attendance.
尽管治疗联盟在治疗过程和健康结果中的重要性已得到认可，但迄今为止，在秘鲁的背景下，尚未有评估考虑到可能影响这一评估的个体差异。
本研究评估了工作联盟量表秘鲁版（WAI-S-P）在接受心理治疗的秘鲁个体样本中的心理测量特性。此外，还进行了网络分析，以研究治疗联盟与几个相关社会人口学变量之间的直接关系。
对241名参与者（=32.58，=12.67）的样本使用了工作联盟量表简版，这些参与者参加的疗程少于6次。考虑了三个模型，包括一个三因素相关模型、一个两因素相关模型以及一个双因素模型。此外，创建了一个偏相关网络，包括总体治疗联盟、性别、年龄和心理治疗疗程数。
双因素模型，即一个总体治疗联盟因素和两个特定因素（“接触”和“契约”），与数据拟合得更好。按性别和年龄划分的结构不变性显示出测量的公平性。另一方面，网络分析显示总疗程出席次数与治疗联盟之间存在正相关。男性报告的治疗联盟得分较高，而女性的总疗程出席次数较高。
本研究结果表明，治疗联盟由双因素模型能更好地体现，并且在秘鲁成年人中跨性别和年龄具有不变性。此外，研究结果表明，生活经历和患者性别的差异可能需要在未来的研究中进行验证，以便更好地理解至少在疗程初期形成治疗联盟时的细微需求。
