The role of therapeutic alliance in therapy for adults with problematic aggression and associated disorders.
The role of therapeutic alliance in therapy for adults with problematic aggression and associated disorders.
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治疗联盟在治疗有攻击性问题和相关疾病的成年人中的作用。
DOI：
10.1002/cpp.2475
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发表时间：
2020
影响因子：
3.6
通讯作者：
McCloskey,MichaelS
中科院分区：
文献类型：
--
作者：
Fahlgren,MarthaK;Berman,MitchellE;McCloskey,MichaelS
心理治疗中治疗师和客户之间关系的性质和质量，称为治疗联盟，已被提出为成功治疗结果的最重要因素之一，这已在许多类型的治疗，人群，联盟评级者（即，客户端，治疗师，或观察员），和联盟措施。然而，大多数关于联盟和治疗结果的研究都是在有内化问题的儿童和成人中进行的（例如，情绪和焦虑障碍）或具有外化问题的儿童（例如，行为障碍），尽管事实上，联盟可能是特别重要的成年人与外部化的问题，如有问题的侵略，谁可能有高水平的阻力，指责，和人际关系的问题。非常有限的研究已经检查了联盟在由于高水平的攻击性行为而接受治疗的个体中的作用（例如，被判犯有暴力罪的人）。目前的系统性综述检查了现有的关于联盟与治疗高度攻击性个体的结果之间关系的研究，以及那些被诊断患有以攻击性为主要症状的疾病的人（即，创伤后应激障碍、反社会人格障碍和边缘型人格障碍）。总的来说，它表明，联盟有积极的影响，在那些从事或有风险的问题侵略的治疗结果。此外，联盟-结局关系可能受到治疗方式、联盟评定者观点和潜在联盟机制的影响。未来的研究，包括利用更多的主要侵略性样本的影响，进行了讨论。
The nature and quality of the relationship between therapist and client in psychotherapy, known as therapeutic alliance, have been proposed as one of the most important factors for successful treatment outcome, which has been has robustly supported across many types of treatment, populations, raters of alliance (i.e., client, therapist, or observer), and alliance measures. However, most research on alliance and treatment outcome has been conducted in children and adults with internalizing problems (e.g., mood and anxiety disorders) or children with externalizing problems (e.g., conduct disorder), despite the fact that alliance may be particularly important for adults with externalizing problems such as problematic aggression, who may have high levels of resistance, blaming, and interpersonal problems. Very limited research has examined the role of alliance in individuals who present to treatment due to high levels of aggressive behaviour specifically (e.g., those convicted of a violent offence). The current systematic review examined the extant research on the relationship between alliance and outcome in treatment of highly aggressive individuals, as well as those who are diagnosed with a disorder for which aggression is a primary symptom (i.e., post‐traumatic stress disorder, antisocial personality disorder, and borderline personality disorder). Overall, it was shown that alliance has a positive impact on treatment outcome among those engaging in or at risk for problematic aggression. Additionally, the alliance‐outcome relationship may be affected by therapy modality, alliance rater perspective, and potential mechanisms of alliance. Implications for future research, including utilizing more primarily aggressive samples, are discussed.
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