Untangling the alliance-outcome correlation: Exploring the relative importance of therapist and patient variability in the alliance
Untangling the alliance-outcome correlation: Exploring the relative importance of therapist and patient variability in the alliance
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DOI：
10.1037/0022-006x.75.6.842
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发表时间：
2007-12-01
影响因子：
5.9
通讯作者：
Imel, Zac E.
中科院分区：
文献类型：
--
作者：
Baldwin, Scott A.;Wampold, Bruce E.;Imel, Zac E.
尽管治疗联盟是心理治疗结果的一致预测因素，但研究尚未区分患者和治疗师在联盟中的角色差异。使用多级模型来探索联盟中患者和治疗师变异性的相对重要性，因为它们与 80 名治疗师所见的 331 名患者的结果相关（治疗师平均病例数为 4.1）。患者对联盟和结果进行评分，并根据基线心理功能调整所有模型。结果表明，治疗师在联盟中的变异性可以预测结果，而患者在联盟中的变异性与结果无关。讨论了治疗师可变性与患者可变性预测结果的原因。临床影响包括治疗师监控他们对联盟的贡献，诊所向治疗师提供有关其联盟的反馈，以及治疗师接受培训以发展和维持强大的联盟。
Although the therapeutic alliance is a consistent predictor of psychotherapy outcomes, research has not distinguished between the roles of patient and therapist variability in the alliance. Multilevel models were used to explore the relative importance of patient and therapist variability in the alliance as they relate to outcome among 331 patients seen by 80 therapists (therapist average caseload was 4.1). Patients rated both the alliance and outcome and all models adjusted for baseline psychological functioning. The results indicated that therapist variability in the alliance predicted outcome, whereas patient variability in the alliance was unrelated to outcome. Reasons why therapist variability as opposed to patient variability predicted outcome are discussed. Clinical implications include therapists monitoring their contribution to the alliance, clinics providing feedback to therapists about their alliances, and therapists receiving training to develop and maintain strong alliances.