The Therapeutic Relationship in CBT for Psychosis: Client, Therapist and Therapy Factors
The Therapeutic Relationship in CBT for Psychosis: Client, Therapist and Therapy Factors
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DOI：
10.1017/s1352465809990269
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发表时间：
2009-10-01
影响因子：
1.8
通讯作者：
Barker, Chris
中科院分区：
文献类型：
--
作者：
Evans-Jones, Catherine;Peters, Emmanuelle;Barker, Chris
背景资料：本研究探讨了哪些因素与精神病认知行为治疗（CBTp）的治疗关系。方法：在24个治疗师-客户配对中，在第二次到第九次治疗之间进行测量。来访者和治疗师完成工作联盟量表和来访者量表（性别、年龄、种族、精神病的阳性和阴性症状、病程、入院、社会接触、就业、认知洞察力、对假设矛盾的反应）、治疗师（同理心、专业性、吸引力、可信赖性、合格的年数和以前见过的CBTp客户数、对CBTp的信心），和治疗（进行的会话和CBTp干预的数量，制剂的介绍）因素。结果：平均而言，客户和治疗师评价的治疗关系为良好，客户给予更高的评级。没有一个客户变量与关系的质量显著相关。然而，一些治疗师和治疗因素与更好的治疗关系有关，即客户对治疗师同理心，专业性，吸引力和可信度的评级，以及在趋势水平上，更多的会话和CBTP干预措施，以及配方的介绍。结论：这些结果表明，治疗师能够与精神病患者建立良好的治疗关系，无论精神病的严重程度以及治疗师的信心和经验如何，尽管由于缺乏全方位的治疗联盟，不显著的发现需要谨慎解释。研究结果还表明，CBTP的基本原则，如同理心和合作目标，可能是治疗关系发展的重要因素。
Background: This study investigated which factors are associated with the therapeutic relationship in Cognitive-Behavioural Therapy for psychosis (CBTp). Method: Measures were taken between sessions two to nine in 24 therapist-client dyads. Clients and therapists completed the Working Alliance Inventory and measures of client (gender, age, ethnicity, positive and negative symptoms of psychosis, length of illness, admissions, social contacts, employment, cognitive insight, reaction to hypothetical contradiction), therapist (empathy, expertness, attractiveness, trustworthiness, number of years qualified and previous CBTp clients seen, confidence in CBTp), and therapy (number of sessions and CBTp interventions carried out, presentation of a formulation) factors. Results: On average, clients and therapists rated the therapeutic relationship as good, with clients giving higher ratings. None of the client variables was related significantly to the quality of the relationship. However, a number of therapist and therapy factors were linked to a better therapeutic relationship, namely clients' ratings of therapist empathy, expertness, attractiveness, and trustworthiness and, at trend level, a greater number of sessions and of CBTp interventions, and the presentation of a formulation. Conclusions: These results suggest that therapists are able to develop a good therapeutic relationship with clients with psychosis, regardless of the severity of the psychosis and the confidence and experience of the therapist, although non-significant findings need interpreting with caution due to the lack of a full range of therapeutic alliances. The findings also suggest that the basic tenets of CBTp, such as empathy and collaborative goals, may be important factors for the development of the therapeutic relationship.