Chiu Chui-De, Au Josephine Sheron, Pau Nerissa Hoi Yan, Chung Harris Chi Wai, Choi-Kain Lois W
Experimental Psychopathology and Psychotherapy Laboratory, Department of Psychology, Chinese University of Hong Kong.
Department of Applied Psychology, Northeastern University.
Psychol Trauma. 2025 Jan 9. doi: 10.1037/tra0001834.
Clients with relational trauma often face challenges in forming a therapeutic alliance, a primary predictor of psychotherapy outcomes. Unresolved traumatic stress can lead to a passive stance in therapy, manifested as a tendency to seek advice and approval from therapists in order to establish more predictable relational dynamics. This comes at the cost of adequately addressing their own therapeutic needs, which often leads to stagnation, treatment dropout, and frustration with the therapist. We postulated that neither relational nor nonrelational traumas could fully account for passive and maladaptive therapy role expectations, such as advice- and approval-seeking. Instead, we hypothesized that lingering effects of trauma, evident in trauma-related pathologies like dissociation, somatization, and borderline personality disorder, contribute more significantly to the tendency to adopt a passive interpersonal stance that can impede therapeutic progress.
Using a sample of 259 community mental health service users, we examined the link between histories of relational trauma (both in childhood and adulthood), trauma-related pathologies, and role expectations in the psychotherapeutic interaction.
Bivariate correlations revealed that history of relational trauma correlated with relationship-seeking expectation-an active way of approaching therapy. However, trauma-related pathologies were invariably related to maladaptive and passive role expectations. In subsequent hierarchical regressions, when multiple factors were entered into the model, dissociation emerged as the key factor that explains maladaptive role expectations.
These findings suggest the importance of establishing clear role expectations and ensuring alignment with clients at the outset of therapy, particularly when indications of trauma-related pathologies are present. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
患有关系性创伤的来访者在形成治疗联盟方面常常面临挑战，而治疗联盟是心理治疗效果的主要预测指标。未解决的创伤应激可能导致在治疗中采取被动姿态，表现为倾向于寻求治疗师的建议和认可，以便建立更可预测的关系动态。这是以充分满足自身治疗需求为代价的，而这往往会导致治疗停滞、脱落，并使来访者对治疗师感到沮丧。我们推测，无论是关系性创伤还是非关系性创伤，都无法完全解释被动和适应不良的治疗角色期望，比如寻求建议和认可。相反，我们假设创伤的持续影响，在诸如解离、躯体化和边缘型人格障碍等与创伤相关的病理状态中很明显，对采取可能阻碍治疗进展的被动人际姿态的倾向有更显著的影响。
我们以259名社区心理健康服务使用者为样本，研究了关系性创伤史（包括童年和成年期）、与创伤相关的病理状态以及心理治疗互动中的角色期望之间的联系。
双变量相关性分析显示，关系性创伤史与寻求关系期望相关——这是一种积极的治疗方式。然而，与创伤相关的病理状态总是与适应不良和被动的角色期望相关。在随后的分层回归分析中，当将多个因素纳入模型时，解离成为解释适应不良角色期望的关键因素。
这些发现表明，在治疗开始时就明确角色期望并确保与来访者保持一致非常重要，尤其是当存在与创伤相关的病理状态迹象时。（《心理学文摘数据库记录》（c）2025美国心理学会，保留所有权利）
