The therapeutic alliance in different mental disorders: A comparison of patients with depression, somatoform, and eating disorders
The therapeutic alliance in different mental disorders: A comparison of patients with depression, somatoform, and eating disorders
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不同精神障碍的治疗联盟：抑郁症、躯体形式障碍和饮食障碍患者的比较
DOI：
10.1111/papt.12131
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Sammet
中科院分区：
文献类型：
--
作者：
Mander;Neubauer;Schlarb;Teufel;Hautzinger;Zipfel;Wittorf;Sammet
目的治疗联盟在心理治疗研究中得到深入研究。然而，关于患者的具体诊断在治疗联盟形成中的作用的研究很少。因此，本研究的目的是通过比较不同精神障碍的联盟来弥补这一研究空白。 设计我们的样本包括 348 名患者（平均年龄 = 40 岁；68% 为女性；133 名抑郁症患者，122 名躯体形式障碍患者和 93 名饮食失调患者）。方法患者完成了工作联盟清单以及住院心理治疗早期、中期和晚期阶段的治疗结果测量。我们应用多元多级模型来解决嵌套数据结构。结果所有三个疾病组都经历了在治疗过程中增加的积极联盟，并显示出类似的联盟-结果关系，与当前的荟萃分析具有相当的强度。然而，我们发现三个障碍组中患者和治疗师对联盟评级的观点不一致。结论我们的结果总体表明，无论具体的精神障碍如何，工作联盟都很重要。工作联盟经验的视角不一致反馈有助于加强患者和治疗师之间的协调，从而改善治疗过程。讨论了这些发现的进一步含义。从业者观点我们发现抑郁症、躯体形式和饮食失调患者的联盟评级强度和联盟-结果关联没有差异。这表明，无论疾病组如何，工作联盟都具有一般临床重要性，并且应该成为所有治疗的中心目标。我们发现所有三个疾病组中患者和治疗师之间的联盟评级存在视角不一致。工作联盟经验的视角不一致反馈可能有助于加强双方之间的协调患者和治疗师，从而改善治疗过程。
ObjectiveThe therapeutic alliance is intensively investigated in psychotherapy research. However, there is scarce research on the role of the specific diagnosis of the patient in the formation of the therapeutic alliance. Hence, the aim of this study was to address this research gap by comparing the alliance in different mental disorders.DesignOur sample comprised 348 patients (mean age = 40 years; 68% female; 133 patients with depression, 122 patients with somatoform disorders, and 93 patients with eating disorders).MethodsPatients completed the Working Alliance Inventory and measures of therapeutic outcome in early, middle, and late stages of inpatient psychotherapy. We applied multivariate multilevel models to address the nested data structure.ResultsAll three disorder groups experienced positive alliances that increased across the course of therapy and showed similar alliance–outcome relations that were of comparable strengths as in current meta‐analyses. However, we found perspective incongruence of alliance ratings from patient and therapist in the three disorder groups.ConclusionsOur results generally indicate that the working alliance is of importance irrespective of the specific mental disorder. Perspective incongruence feedback of working alliance experiences could help to strengthen coordination between patient and therapist and thereby improve the therapeutic process. Further implications of these findings are discussed.Practitioner pointsWe found no differences in the strengths of alliance ratings and alliance–outcome associations in depressive, somatoform, and eating disorder patients.This indicates that the working alliance is of general clinical importance irrespective of the disorder group and should be a central target in all therapies.We found perspective incongruence in alliance ratings between patient and therapist in all three disorder groups.Perspective incongruence feedback of working alliance experiences could help to strengthen coordination between patient and therapist and thereby improve the therapeutic process.
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影响因子：
3.9
作者：
Marmarosh, Cheri L.;Kivlighan, Dennis M., Jr.
通讯作者：
Kivlighan, Dennis M., Jr.
影响因子：
3.9
作者：
Hartmann, Armin;Joos, Andreas;Zeeck, Almut
通讯作者：
Zeeck, Almut
[一般成年人群中精神障碍的终生患病率。
DOI：
--
发表时间：
2000
期刊：
Der Nervenarzt
影响因子：
--
作者：
C. Meyer;Hj Rumpf;U. Hapke;H. Dilling;U. John
通讯作者：
U. John
认知行为治疗中的治疗失败：治疗联盟是坚持和有效实施技术的先决条件
DOI：
10.1111/bjc.12063
发表时间：
2015
期刊：
The British journal of clinical psychology
影响因子：
--
作者：
Grikscheit;Höfling;Stangier
通讯作者：
Stangier
影响因子：
2.5
作者：
Mander, Johannes;Wittorf, Andreas;Sammet, Isa
通讯作者：
Sammet, Isa