scholarly journals Interpretation and Working through Contemptuous Facial Micro-Expressions Benefits the Patient-Therapist Relationship

2019 ◽  
Vol 16 (24) ◽  
pp. 4901 ◽  
Author(s):  
Datz ◽  
Wong ◽  
Löffler-Stastka
Keyword(s):  
Working Alliance ◽  
Major Elements ◽  
Coding System ◽  
Psychotherapeutic Treatment ◽  
Verbal Interactions ◽  
Working Through ◽  
Working Alliance Inventory ◽  
Video Recordings ◽  
Vienna General Hospital ◽  
Acute Psychiatric Care

Introduction: The significance of psychotherapeutic micro-processes, such as nonverbal facial expressions and relationship quality, is widely known, yet hitherto has not been investigated satisfactorily. In this exploratory study, we aim to examine the occurrence of micro-processes during psychotherapeutic treatment sessions, specifically facial micro-expressions, in order to shed light on their impact on psychotherapeutic interactions and patient-clinician relationships. Methods: In analyzing 22 video recordings of psychiatric interviews in a routine/acute psychiatric care unit of Vienna General Hospital, we were able to investigate clinicians’ and patients’ facial micro-expressions in conjunction with verbal interactions and types. To this end, we employed the Emotion Facial Action Coding System (EmFACS)—assessing the action units and microexpressions—and the Psychodynamic Intervention List (PIL). Also, the Working Alliance Inventory (WAI), assessed after each session by both patients and clinicians, provided information on the subjective quality of the clinician–patient relationship. Results: We found that interpretative/confrontative interventions are associated with displays of contempt from both therapists and patients. Interestingly, displays of contempt also correlated with higher WAI scores. We propose that these seemingly contradictory results may be a consequence of the complexity of affects and the interplay of primary and secondary emotions with intervention type. Conclusion: Interpretation, confrontation, and working through contemptuous microexpressions are major elements to the adequate control major pathoplastic elements. Affect-cognitive interplay is an important mediator in the working alliance.

scholarly journals Semantic and cultural equivalence of the working alliance inventory short-revised scale for therapeutic alliance in family medicine: Lessons learned in Slovenia

2019 ◽  
Vol 58 (1) ◽  
pp. 21-30
Author(s):  
Davorina Petek ◽  
Ambrož Pušnik ◽  
Polona Selič ◽  
Eva Cedilnik-Gorup ◽  
Žan Trontelj ◽  
...  
Keyword(s):  
Family Medicine ◽  
Therapeutic Alliance ◽  
Working Alliance ◽  
Scale Validation ◽  
Lessons Learned ◽  
Delphi Consensus ◽  
Psychotherapeutic Treatment ◽  
Working Alliance Inventory ◽  
Back Translation ◽  
Conceptual Equivalence

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.

Working Alliance Inventory for Children and Adolescents

2019 ◽  
Author(s):  
Bárbara Figueiredo ◽  
Pedro Dias ◽  
Vânia Sousa Lima ◽  
Diogo Lamela
Keyword(s):  
Children And Adolescents ◽  
Working Alliance ◽  
Working Alliance Inventory

Evaluating the alliance in videolink teletherapy

1997 ◽  
Vol 3 (1_suppl) ◽  
pp. 33-35 ◽  
Author(s):  
G J Ghosh ◽  
P M Mclaren ◽  
J P Watson
Keyword(s):  
Working Alliance ◽  
Psychological Treatment ◽  
Single Case ◽  
Personality Factors ◽  
Control Group ◽  
Face To Face ◽  
Working Alliance Inventory ◽  
The Face

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.

scholarly journals Therapeutic alliance in the initial phase of psychotherapy with adolescents: different perspectives and their association with therapeutic outcomes

2016 ◽  
Vol 19 (1) ◽  
Author(s):  
Olga María Fernandez ◽  
Mariane Krause ◽  
Janet Carola Pérez
Keyword(s):  
Therapeutic Alliance ◽  
Working Alliance ◽  
Initial Phase ◽  
Psychotherapy Research ◽  
Positive Association ◽  
Outcome Questionnaire ◽  
The Third ◽  
Working Alliance Inventory ◽  
Therapeutic Outcomes

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.

scholarly journals Adaption and validation of the Working Alliance Inventory for General Practice: qualitative review and cross-sectional surveys

2018 ◽  
Vol 36 (4) ◽  
pp. 516-522 ◽  
Author(s):  
Elizabeth A Sturgiss ◽  
Elizabeth Rieger ◽  
Emily Haesler ◽  
Matthew J Ridd ◽  
Kirsty Douglas ◽  
...  
Keyword(s):  
Decision Making ◽  
Working Alliance ◽  
Shared Decision Making ◽  
Social Desirability ◽  
Concurrent Validity ◽  
Online Survey ◽  
Discriminant Validity ◽  
Short Form ◽  
Shared Decision ◽  
Working Alliance Inventory

Abstract Background Relational aspects of primary care are important, but we have no standard measure for assessment. The ‘working alliance’ incorporates elements of the therapeutic relationship, shared decision-making, goal setting and communication skills. The Working Alliance Inventory (short form) (WAI-SF) has been used in adult psychology, and a high score on the survey is associated with improved outcomes for clients. Objective To adapt the WAI-SF for use between GPs and patients and to test its concurrent validity with measures of shared decision-making and the doctor–patient relationship and discriminant validity with measures of social desirability. Methods Two rounds of online survey feedback from 55 GPs and 47 patients were used to adapt the WAI-SF—the WAI-GP. The tool was then completed by 142 patients in waiting rooms after seeing their GP and by 16 GPs at the end of their session. Concurrent validity with measures of shared decision-making and patient–doctor depth of relationship was determined using Spearman Rho correlations. Patients also completed two social desirability surveys, and discriminant validity with WAI-GP was assessed. Results Following feedback, the survey was re-worded to remove phrases that were perceived as judgmental or irrelevant. The patient measure of the WAI-GP was strongly correlated with Dyadic OPTION (rho = 0.705, P = 0.0001) and Patient–Doctor Depth of Relationship scale (rho = 0.591, P = 0.0001) and not with measures of social desirability. Conclusion The psychometric properties of the WAI-GP support its use for measuring GP-patient alliance. Possibilities for use include assessing the influence of therapeutic alliance on the effectiveness of interventions.

Working Alliance Inventory--Client Form

1989 ◽  
Author(s):  
Adam O. Horvath ◽  
Leslie S. Greenberg
Keyword(s):  
Working Alliance ◽  
Working Alliance Inventory

Validation of a Brief Form of the Supervisory Working Alliance Inventory

2019 ◽  
Vol 63 (2) ◽  
pp. 115-124 ◽  
Author(s):  
Scott A. Sabella ◽  
Jared C. Schultz ◽  
Trenton J. Landon
Keyword(s):  
Working Alliance ◽  
Convergent Validity ◽  
Secondary Data ◽  
National Sample ◽  
Full Scale ◽  
Rehabilitation Counselors ◽  
Supervisory Working Alliance ◽  
Cross Sectional ◽  
Electronic Survey ◽  
Working Alliance Inventory

The Supervisory Working Alliance Inventory–Trainee Form (SWAI-T) is among the most frequently used instruments for measuring the quality of supervisor–supervisee relationships within counselor supervision. Although the full-scale SWAI-T instrument has proven utility, there are instances when a shorter form may be useful for research and field applications. The current study used secondary data from a pair of cross-sectional studies to test the utility of a brief form of the SWAI-T in a two-step process: (a) reduction of the SWAI-T based on item analyses from an electronic survey of 87 rehabilitation counselors working in a Western state vocational rehabilitation agency and (b) an initial validation study of the instrument using electronic survey responses from a national sample of 228 rehabilitation counselors working in private rehabilitation. The resultant 5-item scale showed evidence of high internal consistency, convergent validity, and minimal differences in psychometric properties relative to the full-scale instrument. An abbreviated supervisory working alliance scale offers practical advantages for select research purposes and for continuous evaluation of supervisory relationships in field environments.

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