Therapist effects in the therapeutic alliance-outcome relationship: A restricted-maximum likelihood meta-analysis
Therapist effects in the therapeutic alliance-outcome relationship: A restricted-maximum likelihood meta-analysis
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DOI：
10.1016/j.cpr.2012.07.002
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发表时间：
2012-11-01
影响因子：
12.8
通讯作者：
Wampold, Bruce E.
中科院分区：
文献类型：
--
作者：
Del Re, A. C.;Flueckiger, Christoph;Wampold, Bruce E.
目的：虽然治疗联盟和结果之间的关系一直在几项研究和荟萃分析中得到支持，但关于患者和治疗师如何促进这种关系却知之甚少。本荟萃分析的目的是（1）测试治疗师的影响，在联盟的结果相关性和（2）通过检查几个潜在的混淆/协变量，这种关系扩展以前的研究结果。方法：随机效应分析研究了几个主持人的联盟结果相关性。这些包括（a）患者治疗师比（患者N除以治疗师N），（B）联盟和结果评价者（患者，治疗师和观察员），（c）联盟措施，（d）研究设计和（e）DSM IV轴II diagnosis.Results：患者治疗师比（PTR）是一个显着的联盟结果相关的调节剂。在多预测元回归控制几个潜在的混淆，包括评估联盟，研究设计，患者轴II诊断的百分比，评估结果和联盟measure，PTR仍然是一个显着的主持人的联盟，结果correlation.Conclusion：证实以前的研究，治疗师在联盟中的变异性似乎是更重要的比患者的变异性，改善患者的预后。即使同时控制这种关系的几个潜在协变量，这种关系仍然显着。爱思唯尔有限公司出版
Objective: Although the relationship between the therapeutic alliance and outcome has been supported consistently across several studies and meta-analyses, there is less known about how the patient and therapist contribute to this relationship. The purpose of this present meta-analysis was to (1) test for therapist effects in the alliance-outcome correlation and (2) extend the findings of previous research by examining several potential confounds/covariates of this relationship.Method: A random effects analysis examined several moderators of the alliance-outcome correlation. These included (a) patient-therapist ratio (patient N divided by therapist N), (b) alliance and outcome rater (patient, therapist, and observer), (c) alliance measure, (d) research design and (e) DSM IV Axis II diagnosis.Results: The patient-therapist ratio (PTR) was a significant moderator of the alliance-outcome correlation. Controlling for several potential confounds in a multi-predictor meta-regression, including rater of alliance, research design, percentage of patient Axis II diagnoses, rater of outcome and alliance measure, PTR remained a significant moderator of the alliance-outcome correlation.Conclusion: Corroborating previous research, therapist variability in the alliance appears to be more important than patient variability for improved patient outcomes. This relationship remains significant even when simultaneously controlling for several potential covariates of this relationship. Published by Elsevier Ltd.