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 Working Alliance Inventory for Online Interventions-Short Form (WAI-TECH-SF): The Role of the Therapeutic Alliance between Patient and Online Program in Therapeutic Outcomes

2020 ◽  
Vol 17 (17) ◽  
pp. 6169 ◽  
Author(s):  
Rocío Herrero ◽  
Mª Dolores Vara ◽  
Marta Miragall ◽  
Cristina Botella ◽  
Azucena García-Palacios ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Therapeutic Alliance ◽  
Working Alliance ◽  
Short Form ◽  
Behavioural Therapy ◽  
Dimensional Structure ◽  
Online Program ◽  
Online Interventions ◽  
Working Alliance Inventory ◽  
Therapeutic Outcomes

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.

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.

Therapeutic alliance and obesity management in primary care - a cross-sectional pilot using the Working Alliance Inventory

2016 ◽  
Vol 6 (6) ◽  
pp. 376-379 ◽  
Author(s):  
E. A. Sturgiss ◽  
G. M. Sargent ◽  
E. Haesler ◽  
E. Rieger ◽  
K. Douglas
Keyword(s):  
Primary Care ◽  
Therapeutic Alliance ◽  
Working Alliance ◽  
Obesity Management ◽  
Cross Sectional ◽  
Working Alliance Inventory

scholarly journals The relation between the therapeutic alliance and communicative intentions in therapeutic interaction during the initial phase of adolescent therapy

2019 ◽  
Vol 22 (2) ◽  
Author(s):  
Olga Fernández González ◽  
J. Carola Pérez ◽  
Mariane Krause
Keyword(s):  
Therapeutic Alliance ◽  
Initial Phase ◽  
Mutual Understanding ◽  
Coding System ◽  
Adolescent Psychotherapy ◽  
Therapeutic Interaction ◽  
Working Alliance Inventory ◽  
System A ◽  
New Meanings ◽  
Adolescent Therapy

This study aims to examine the connection between the therapeutic alliance (TA) – from both the patient’s and the therapist’s perspectives – and communicative intentions during the initial phase of adolescent psychotherapy. The sample comprised the first three sessions of 19 adolescents’ individual psychotherapeutic processes. Fifty therapeutic conversation segments were analyzed, representing 2043 adolescent and 3208 therapist speaking turns. The variables studied were Therapeutic Alliance, measured with the Working Alliance Inventory and Communicative Intentions (Exploring, Attuning and Resignifying), assessed by the Therapeutic Activity Coding System. A multilevel analysis was performed (HLM software). The Tasks dimension of the TA perceived by the adolescents increases the likelihood that their discourse will focus on providing and requesting information (Exploring), while also reducing the probability that they will seek to work together with the therapist to achieve mutual understanding (Attuning). The therapists’ discourse shows that a strong TA in the Bonds dimension makes it more probable for their utterances to focus on the construction of new meanings (Resignifying). Also, a stronger TA in the Goals dimension makes it more likely for their discourse to be directed toward seeking Attunement with the adolescent.

scholarly journals The early impact of therapeutic alliance in brief psychodynamic psychotherapy

2003 ◽  
Vol 25 (2) ◽  
pp. 78-86 ◽  
Author(s):  
José Alvaro Marques Marcolino ◽  
Eduardo Iacoponi
Keyword(s):  
Therapeutic Alliance ◽  
Working Alliance ◽  
Psychodynamic Psychotherapy ◽  
Self Report ◽  
Psychotherapy Outcomes ◽  
Brief Psychotherapy ◽  
The Third ◽  
Hamilton Anxiety Scale ◽  
The Impact ◽  
Psychotherapy Program

INTRODCTION: Therapeutic alliance is a key component of the psychotherapeutic process. This study estimated the impact of the therapeutic alliance as measured by CALPAS-P in an individual brief psychodynamic psychotherapy program. METHODS: To study the impact of the therapeutic alliance patients in psychotherapy answered to the CALPAS-P at the first and third session and to the Self-report Questionnaire (SRQ-20), to the Beck Depression Inventory (BDI) and to the Hamilton Anxiety Scale at the beginning and at the end of psychotherapy. RESULTS: The study of the impact of the therapeutic alliance in brief psychodynamic psychotherapy showed that higher TUI scores in the first session were significantly associated to the improvement on the BDI. Patients with best scores in the working alliance, measured at the third PWC session had also significant symptomatic changes. DISCUSSION: The study of the impact of the therapeutic alliance in brief psychotherapy indicated that patients who perceived that their therapists had the best capability to understand and to be involved in their issues had best results in reducing depressive symptoms and patients with higher capability to form the working alliance reached the best psychotherapy outcomes.

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
Keyword(s):  
Therapeutic Alliance ◽  
Behavioral Health ◽  
Working Alliance ◽  
Tobacco Cessation ◽  
Smoking Status ◽  
Treatment Plan ◽  
Community Support ◽  
Tobacco Dependence ◽  
Community Services ◽  
Working Alliance Inventory

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.

Factor Structure of the Short Version of the Working Alliance Inventory and Its Longitudinal Measurement Invariance Across Individual Career Counseling Sessions

2020 ◽  
Vol 28 (4) ◽  
pp. 693-705
Author(s):  
Francis Milot-Lapointe ◽  
Yann Le Corff ◽  
Réginald Savard
Keyword(s):  
Working Alliance ◽  
Factor Structure ◽  
Career Counseling ◽  
Hierarchical Models ◽  
Short Version ◽  
Confirmatory Factor Analyses ◽  
The Third ◽  
Longitudinal Measurement ◽  
Working Alliance Inventory ◽  
Three Factor

The aim of the present study was 2-fold: (a) to examine the factor structure of the short version of the Working Alliance Inventory (WAI-S) in clients who were engaged in individual career counseling sessions and (b) to investigate whether the factor structure of the WAI-S is invariant across the first and the third career counseling sessions. A total of 283 clients seeking individual career counseling completed the WAI-S at the end of the first session (T1). Of the 283 clients, 217 also completed the WAI-S at the end of the third session (T2). Confirmatory factor analyses were performed to assess the fit of one-factor, two-factor, three-factor, and bilevel hierarchical models. The results showed that the three-factor and the bilevel hierarchical models had the best fit to the data at both T1 and T2. The factor structure of the WAI-S was invariant across the first and the third career counseling sessions. Results suggest that researchers and clinicians can use the WAI-S knowing that it adequately measures Bordin’s theoretical model of working alliance in the specific context of individual career counseling.

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.

scholarly journals The Importance of the Working Alliance in the Treatment of Cluttering

2019 ◽  
Vol 4 (6) ◽  
pp. 1568-1572
Author(s):  
Hilda Sønsterud
Keyword(s):  
Working Alliance ◽  
Critical Element ◽  
Shared Understanding ◽  
Speech Language Pathology ◽  
Therapy Goals ◽  
Working Alliance Inventory ◽  
Personal Motivation ◽  
Language Pathology ◽  
The Impact

It is expected that the quality of the working alliance between speech-language pathologists (SLPs) and persons who clutter matters. The term working alliance is an important concept in cluttering and stuttering treatment and can be described as the degree to which the therapy dyad is engaged in collaborative, purposive work. The concept includes, among other factors, a shared understanding of therapy goals and the relevance of the therapy approach to achieving those goals. There has been an increasing interest regarding research that supports the therapeutic relationship as an evidence-based component of interventions in speech-language pathology, and recent research ( Sønsterud et al., 2019 ) supports that a critical element for successful stuttering therapy lies, among other factors, in the concept of the working alliance. Purpose Although there is consensus that SLPs should openly and honestly discuss the individual's goals and expectations for therapy, personal motivation and the impact of the working alliance for people who clutter have not been investigated. This clinical focus article highlights the importance of open and honest discussion around not only the individual's goals for treatment but also the tasks or activities to be incorporated in that treatment. Relevant and specific quantitative and qualitative assessments for measuring the working alliance are required to investigate the concept of the working alliance in more detail. The Working Alliance Inventory–Short Revised version is regarded to be one useful tool to evaluate this client–clinician relationship. The Working Alliance Inventory–Short Revised version is quick and easy to use and explores the working alliance across the 3 processes of bond, goal, and task. Conclusion This clinical focus article contains no research results. Anyhow, some considerations on this concept, both from a person who clutters and SLP perspectives, are included in this clinical focus article. Research is required to investigate whether shared understanding of treatment goals, agreement on tasks, and a respectful and trustful bond may become important predictors for successful therapy outcome also for people who clutter.

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