scholarly journals Measuring Therapeutic Alliance for Tobacco Cessation Counseling for Behavioral Health Clinicians

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Bruce Christiansen ◽  
Stevens S. Smith ◽  
Michael C. Fiore

Introduction. Those coping with significant mental illness smoke at a high prevalence rate. Increasingly, behavioral health clinicians (BHCs) are being asked to provide tobacco-dependence interventions. In this context, it is important to measure their success at doing so. While the Working Alliance Inventory (WAI) is a well-established measurement of the effectiveness of therapeutic alliance, it is not specific to tobacco-dependence interventions. The Working Alliance Inventory for Tobacco (WAIT-3) has been found valid for tobacco cessation counselors (health providers who address tobacco), but its validity has not been established when BHCs address tobacco cessation as part of addressing all other needs of their patients. The purpose of this study was to examine the validity of the WAIT-3 in the context of behavioral health clinicians. Methods. Wisconsin Community Support Programs and Comprehensive Community Services programs distributed an anonymous, brief (14 items) survey to 1,930 of their clients. Measured variables included smoking status, behavioral intentions regarding quitting, and perception of help received from their clinic. Respondents could enter a chance to win a gift card as a thank you. Results. WAIT-3 scores were correlated with quitting-related variables. Compared to those with lower WAIT-3 scores, those with higher scores reported more attempts to quit, were more motivated to quit, were more likely to have a smoking cessation/reduction goal in their general treatment plan, had more conversations about quitting with their BHC, and wanted more help from their BHC to quit. Conclusions. The WAIT-3 may be a valid way to measure the effectiveness of BHCs to address the tobacco use of their patients. Next steps include establishing its predictive validity.

Author(s):  
Olga María Fernandez ◽  
Mariane Krause ◽  
Janet Carola Pérez

Psychotherapy research focusing on adults as well as on children and adolescents has revealed a positive association between the quality of the therapeutic alliance (TA) in the first sessions and therapeutic outcomes. Nevertheless, there is controversy regarding which perspective (of the adolescents, therapists, or parents) and what moment of evaluation (first, second, or third session) is most strongly associated with outcome. This study aims to describe the TA during the initial phase of psychotherapy with adolescents, from several perspectives, and relate it to the intermediate and final outcomes of the therapy. The study is descriptive-correlational and was conducted in naturalistic settings. The sample comprised 20 individual psychotherapeutic processes (15 females, 5 males; average age: 15.8 years; standard deviation=1.04). The variables studied were: TA, measured with the Working Alliance Inventory, applied to adolescents, therapists, and parents, and therapeutic outcomes, measured using Lambert’s Outcome Questionnaire (OQ- 45.2). The results show that the TA improved from session one to session three, both in the adolescents and the therapists. The TA, as perceived by the adolescents in the third session, is positively correlated with final outcomes (r=-.732*, P=.025). The TA evaluated from the therapists’ perspective in the third session, specifically the bond component of the TA, predicts the final success of psychotherapy with adolescent patients [β=0.426, Exp. (B)=1.531, degree of freedom=1, P=0.034]. The importance of the initial construction of the working alliance by both participants is discussed.


2016 ◽  
Vol 6 (6) ◽  
pp. 376-379 ◽  
Author(s):  
E. A. Sturgiss ◽  
G. M. Sargent ◽  
E. Haesler ◽  
E. Rieger ◽  
K. Douglas

Author(s):  
Rocío Herrero ◽  
Mª Dolores Vara ◽  
Marta Miragall ◽  
Cristina Botella ◽  
Azucena García-Palacios ◽  
...  

Background: Therapeutic alliance (TA) between the patient and therapist has been related to positive therapeutic outcomes. Because Internet-based interventions are increasingly being implemented, a tool is needed to measure the TA with Internet-based self-guided programs. The Working Alliance Inventory for online interventions (WAI-TECH-SF) was adapted based on the WAI Short Form (Hatcher & Gillaspy, 2006). The objectives of this study were: (1) to analyse the psychometric properties of the WAI-TECH-SF; (2) to explore the differences in the WAI-TECH-SF scores according to different categories of the sample; and (3) to analyse whether the WAI-TECH-SF can predict therapeutic outcomes and satisfaction with the treatment. Methods: 193 patients diagnosed with depression were included and received blended Cognitive-Behavioural Therapy. Measures of preferences, satisfaction, and credibility about the treatment, TA with the online program, depressive symptoms, and satisfaction with the treatment were administered. Results: An exploratory factor analysis revealed a one-dimensional structure with adequate internal consistency. Linear regression analyses showed that the WAI-TECH-SF predicted changes in depressive symptoms and satisfaction with the treatment. Conclusions: WAI-TECH-SF is a reliable questionnaire to assess the TA between the patient and the online program, which is associated with positive therapeutic outcomes and satisfaction with the treatment.


2019 ◽  
Vol 58 (1) ◽  
pp. 21-30
Author(s):  
Davorina Petek ◽  
Ambrož Pušnik ◽  
Polona Selič ◽  
Eva Cedilnik-Gorup ◽  
Žan Trontelj ◽  
...  

Abstract Introduction Therapeutic alliance is a term most commonly associated with psychotherapeutic treatment, but recently its use has become increasingly significant in the other fields of medicine. An increasing amount of evidence implies that the quality of the therapeutic alliance between the doctor and patient substantially affects treatment outcomes. A European consensus chose the Working Alliance Inventory – Short Revised (WAI-SR) scale as the most efficient for European primary care. This paper presents the process of establishing the semantic and cultural equivalence of the two WAI-SR scales in Slovene. Method As a part of a larger international project, a group of four experts translated the two WAI SR scales (physician and patient versions) from English into Slovene. Twenty-six Slovenian family medicine doctors participated in the process of obtaining semantic, idiomatic, experiential and conceptual equivalence in translation using a Delphi consensus procedure. Afterward, a cultural equivalence was made to adapt the translations within the national context. Results Agreement on translation was achieved after two Delphi rounds. The back-translation and cultural equivalence were accomplished without major problems, with some minor additional linguistic corrections. Conclusion A Slovene version of the WAI-SR scale was successfully adapted and is available for further scale validation and research on therapeutic alliance.


BJGP Open ◽  
2020 ◽  
pp. bjgpopen20X101131
Author(s):  
Liesbeth Hunik ◽  
Shelley Galvin ◽  
Tim olde Hartman ◽  
Elizabeth Rieger ◽  
Peter Lucassen ◽  
...  

BackgroundThe therapeutic alliance is a framework from psychology that describes three components: goals, tasks, and bond. The Working Alliance Inventory adapted for general practice (WAI-GP) measures the strength of the therapeutic alliance between the patient and the clinician, and it could be useful in both research and clinical settings.AimTo determine if the patient score on WAI-GP can delineate the three components (goals, tasks, and bond), and to test concurrent validity with the Consultation and Relational Empathy (CARE) measure and the Patient Perception of Patient-Centredness (PPPC) measure.Design & settingA cross-sectional study took place in 12 general practice waiting rooms in Australia.MethodThe research instruments included the 12-item WAI-GP (the patient version), the CARE and PPPC measures, plus a survey of demographics and reason for consultation. To perform a principal components factor analysis of the WAI-GP, this dataset was combined with an existing dataset. The Spearman rank correlation was used to determine concurrent validity between the WAI-GP and the CARE and PPPC measures.ResultsParticipants (97–99%) reported a strong positive alliance after the consultation (average WAI-GP mean 4.27 ± 0.67 out of 5, n = 146). Factor analysis could not separate the three components (one factor, eigenvalue >1; Cronbach’s α = 0.957; n = 281). Concurrent validity was supported by moderate correlations with the other measures (PPPC ρ = –0.51, P<0.005, CARE ρ = 0.56, P<0.005).ConclusionThree components could not be identified, but the WAI-GP has a high internal consistency and concurrent validity with moderate correlations with the CARE and PPPC. A more diverse sample may better distinguish the three components leading to more specific feedback to clinicians on their consultation practices.


2021 ◽  
pp. 1357633X2110212
Author(s):  
Ehud Mekori-Domachevsky ◽  
Noam Matalon ◽  
Yael Mayer ◽  
Noga Shiffman ◽  
Ido Lurie ◽  
...  

Introduction Online mental health services were previously found to be effective in many studies. However, this method was not generally used in Israel. By the end of 2019, the coronavirus disease 2019 pandemic erupted, forcing mental health services to transition to online meetings to maintain the standard of care. In this cross-sectional study, we investigated the attitudes of adolescent patients toward this involuntary new mode of care. Methods Forty-four adolescents (mean age 14.62 ± 2.12 years, 54.5% females) and 40 of their primary caregivers completed a battery of questionnaires that included the telemedicine satisfaction questionnaire, session evaluation questionnaire, working alliance inventory, and pediatric symptom checklist. Results Both adolescents and their caregivers reported a reasonable experience with the online medium and a feeling that the meetings were overall powerful, helpful, and comfortable as demonstrated by medium to high scores on the telemedicine satisfaction questionnaire and session evaluation questionnaire questionnaires. A therapeutic alliance was generally maintained according to working alliance inventory scores. However, working alliance inventory scores were negatively correlated with higher levels of internalizing symptoms and parental stress. Discussion Our findings point to the possibility that anxious/depressed adolescents will have greater difficulties re-establishing therapeutic alliance when transitioned from in-person to online meetings. This may be due to the introduction of an “invisible” third party to the therapeutic setting—the computer. Psychologists and psychiatrists should be aware of these difficulties and respond adequately to maintain the standard of care.


2021 ◽  
Vol 30 (1) ◽  
pp. 11-21
Author(s):  
Lori H. Erby ◽  
Tyler Wisniewski ◽  
Katie L. Lewis ◽  
Christian Hernandez ◽  
Leslie G. Biesecker ◽  
...  

2019 ◽  
Author(s):  
Bárbara Figueiredo ◽  
Pedro Dias ◽  
Vânia Sousa Lima ◽  
Diogo Lamela

1997 ◽  
Vol 3 (1_suppl) ◽  
pp. 33-35 ◽  
Author(s):  
G J Ghosh ◽  
P M Mclaren ◽  
J P Watson

The use of videoconferencing in psychotherapy remains largely unexplored. Videoconferencing compromises the range and quality of interactional information and thus might be expected to affect the working alliance (WA) between client and therapist, and consequently the process and outcome of therapy. A single case study exploring the effect of videoconferencing on the development of the WA in the psychological treatment of a female–male transsexual is described. The self-rated Working Alliance Inventory (WAI) was used to measure client and therapist perceptions of the WA after each session over 10 sessions of eclectic therapy conducted over a videolink. The serial WAI measurements charting the development of the WA in 4 cases of 10-session, face-to-face therapy by Horvath and Marx1 were used as a quasi-control. Therapist and client impressions of teletherapy are described. WAI scores were essentially similar to the face-to-face control group except for lower client-rated bond subscale scores. It is suggested that client personality factors accounted for this difference and that videoconferencing did not impair the development of an adequate working alliance or successful therapeutic outcome.


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