Castonguay L G, Goldfried M R, Wiser S, Raue P J, Hayes A M
Department of Psychology, Stanford University, USA.
J Consult Clin Psychol. 1996 Jun;64(3):497-504.
The ability of several process variables to predict therapy outcome was tested with 30 depressed clients who received cognitive therapy with or without medication. Two types of process variables were studied: 1 variable that is unique to cognitive therapy and 2 variables that this approach is assumed to share with other forms of treatment. The client's improvement was found to be predicted by the 2 common factors measured: the therapeutic alliance and the client's emotional involvement (experiencing). The results also indicated, however, that a unique aspect of cognitive therapy (i.e., therapist's focus on the impact of distorted cognitions on depressive symptoms) correlated negatively with outcome at the end of treatment. Descriptive analyses that were conducted to understand this negative correlation suggest that therapists sometimes increased their adherence to cognitive rationales and techniques to correct problems in the therapeutic alliance. Such increased focus, however, seems to worsen alliance strains, thereby interfering with therapeutic change.
研究人员对30名接受认知疗法（无论是否同时服药）的抑郁症患者进行测试，以检验几个过程变量预测治疗结果的能力。研究了两种类型的过程变量：一种是认知疗法独有的变量，另一种是假定该疗法与其他治疗形式共有的变量。研究发现，所测量的两个共同因素可预测患者的改善情况：治疗联盟和患者的情感投入（体验）。然而，结果还表明，认知疗法的一个独特方面（即治疗师关注扭曲认知对抑郁症状的影响）与治疗结束时的结果呈负相关。为理解这种负相关而进行的描述性分析表明，治疗师有时会加强对认知原理和技术的坚持，以纠正治疗联盟中的问题。然而，这种增加的关注似乎会加剧联盟紧张关系，从而干扰治疗改变。
