Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Healthcare System, Durham, North Carolina, USA.
Psychol Psychother. 2024 Jun;97(2):354-371. doi: 10.1111/papt.12522. Epub 2024 Feb 14.
We investigated the effect of the therapeutic alliance on both change in social recovery outcomes and usage of a moderated online social therapy platform for first-episode psychosis (FEP), Horyzons.
Secondary analysis of a single group pilot trial.
Clients completed an alliance measure adapted for guided digital interventions at mid-treatment. A series of multi-level models evaluated change in outcomes by mid- and post-treatment assessments (relative to baseline) as a function of the overall alliance. Quasi-Poisson models evaluated the effect of the overall alliance on aggregated counts of platform usage. Exploratory analyses repeated these models in terms of the bond (human-human) or the task/goal (human-program) alliance.
Stronger overall alliance at mid-treatment predicted lower loneliness at mid-treatment and lower social anxiety at mid- and post-treatment. It was also associated with higher completion of therapy activities and authoring of comments and reactions. A strong bond with an online therapist was associated with lower loneliness and higher perceived social support at mid-treatment, lower social anxiety at post-treatment as well as a higher number of reactions made on the social network. Stronger alliance with the platform's tasks and goals facilitated lower social anxiety at both follow-up assessments and was further associated with higher completion of therapy activities and reactions in the social network.
The alliance may impact aspects of social recovery and usage in digital interventions for FEP. Specific aspects of the alliance (human-human and human-program relationships) should be considered in future research.
我们研究了治疗联盟对社会康复结果的变化以及对首次发作精神病（FEP）的 Horyzons 在线社交治疗平台的使用的影响。
一项单组试点试验的二次分析。
在治疗中期，患者完成了一项适用于指导数字干预的联盟测量。一系列多层次模型评估了中期和治疗后评估（相对于基线）的结果变化，作为整体联盟的函数。拟泊松模型评估了整体联盟对平台使用情况的汇总计数的影响。探索性分析根据债券（人与人）或任务/目标（人与程序）联盟重复了这些模型。
治疗中期更强的整体联盟预测了中期更低的孤独感和中期及后期更低的社交焦虑。它还与更高的治疗活动完成率以及评论和反应的撰写相关。与在线治疗师建立紧密联系与中期的孤独感降低和更高的感知社会支持有关，以及后期的社交焦虑降低以及在社交网络上做出的更多反应。与平台的任务和目标建立更强的联盟，有助于在两次随访评估中降低社交焦虑，并且还与治疗活动和社交网络中的反应完成率更高相关。
联盟可能会影响 FEP 数字干预中社会康复和使用的各个方面。未来的研究应考虑联盟的具体方面（人与人以及人与程序的关系）。
