Department of Psychology, Gordon F. Derner School of Psychology, Adelphi University.
Department of Clinical Psychology and Psychotherapy for Adults, University of Osnabruck.
J Consult Clin Psychol. 2024 Feb;92(2):129-133. doi: 10.1037/ccp0000861. Epub 2023 Nov 27.
During treatment, the therapeutic alliance is characterized by rupture and repair episodes, which in turn are associated with psychotherapy outcome. It would be important to have a parsimonious tool to identify ruptures in psychotherapy sessions to provide therapists with meaningful feedback about when they occur. The present study thus aims to establish whether measuring self-reported alliance dynamics can function as a measure of alliance ruptures.
The sample consisted of 58 depressed patients, who received 22 sessions of cognitive therapy for depression in an outpatient setting. The observer-rated Rupture Resolution Rating System (3RS) was applied to 58 sessions where the self-reported Working Alliance Inventory (WAI) completed by patients after each therapy session indicated that alliance ratings declined more than 2 SDs from that patient's individual mean. For comparison purposes, the 3RS was also applied to 58 randomly chosen sessions from the same treatment phase (early, middle, late).
Results showed significant differences between sessions where the WAI indicated a drop in the alliance and randomly chosen sessions of the same treatment phase with regard to the frequency and impact of ruptures.
This speaks for the construct validity of the 3RS. Session-by-session alliance ruptures may reliably be measured using a case-sensitive approach to identify meaningful drops in alliance self-report (WAI). (PsycInfo Database Record (c) 2024 APA, all rights reserved).
在治疗过程中，治疗联盟的特点是出现破裂和修复事件，而这些事件反过来又与心理治疗结果相关。拥有一种简洁的工具来识别心理治疗过程中的破裂，从而为治疗师提供关于何时发生破裂的有意义的反馈，这将非常重要。因此，本研究旨在确定自我报告的联盟动态是否可以作为联盟破裂的衡量标准。
该样本由 58 名抑郁症患者组成，他们在门诊环境中接受了 22 次认知治疗。采用观察者评定的破裂修复评分系统（3RS）对 58 次治疗过程进行评估，其中患者在每次治疗后完成的工作联盟评估量表（WAI）显示，联盟评分比患者个体平均值下降了超过 2 个标准差。为了比较目的，3RS 还应用于同一治疗阶段（早期、中期、晚期）的 58 次随机选择的治疗过程。
结果表明，在 WAI 显示联盟下降的治疗过程与同一治疗阶段的随机选择的治疗过程之间，在破裂的频率和影响方面存在显著差异。
这证明了 3RS 的结构有效性。使用对有意义的联盟自我报告（WAI）下降敏感的方法，可以可靠地衡量治疗过程中每次治疗的联盟破裂情况。
