工作同盟和领悟对咨询效果的影响

为了解短程咨询中工作同盟和领悟对咨询效果的影响,以12个个案94次会谈为对象,考察工作同盟、领悟分别与会谈效果、治疗效果的关系,并考察二者共同作用于效果的方式。结果表明,咨访双方评定的工作同盟都可以正向预测会谈效果,但不能预测治疗效果;领悟与会谈有效性正相关,领悟正向预测治疗效果;咨询师评定的同盟的三个维度以领悟为中介影响其对会谈效果的评价。     

咨询会谈中的人际互补及其与工作同盟、咨询效果的关系

Leary的人际理论将人际互动行为划分为"情感"和"控制"两个维度,互动双方在情感维度的一致性和控制维度的互补性统称为人际互补。为探究心理咨询过程中人际互补的发展趋势及其与工作同盟、咨询效果的关系,采用电脑操纵杆方法,编制《咨询会谈人际互补行为评分手册》,对16个个案的48个心理咨询会谈录像进行评估。结果表明:有经验的咨询师在咨询前期的情感轴一致性高于中期和后期,在咨询后期的控制轴互补性高于前期和中期,新手咨询师的情感轴一致性和控制轴互补性均无阶段性差异;咨询中期的情感轴一致性负向预测工作同盟和会谈深度;情感轴一致性呈高-低-高发展趋势的个案咨询效果更好。结论:心理咨询的人际互补三阶段模型得到一定程度的支持,其作用机制有待进一步验证。     

心理咨询中工作同盟的发展模式与咨询效果

为了探索工作同盟在咨询过程中的发展模式, 采用Stiles等(2004)提出的4个变化特征参数(shape-of-change parameters)对30个个案的工作同盟在咨询过程中的发展变化进行描述。聚类分析的结果显示有3类工作同盟的发展模式, 分别是线性增长、线性下降和二次增长模式。不过, 3种发展模式、4个变化特征参数及同盟的破裂?修复片段对咨询效果均没有影响。比较咨询效果不同的当事人在工作同盟发展模式上的差异, 发现同一个发展模式对于不同的个案可能有着不同的含义, 咨询师在早期对同盟关系的处理与调控对咨询效果有着重要的影响。     

心理咨询中的突然获益：工作同盟及初始症状的影响

对82位当事人在咨询中的症状改变过程进行纵向研究,检验突然获益模式（Sudden Gain, SG）的发生及其与咨询效果的联系,并探索初始症状水平、工作同盟对SG的影响。结果表明,24.93%的当事人经历了SG,咨询效果显著好于其他当事人;SG组与对照组在初始症状水平和总体工作同盟水平上差异显著。结论：SG出现于本土心理咨询中,经历SG的当事人取得了更好的咨询效果,工作同盟与初始症状水平与SG的发生相关。     

当事人眼里的工作同盟：质的分析

为了解中国当事人如何看待咨询中的工作同盟, 对工作同盟做初步的本土概念化, 采用协商一致的质的研究方法对来自1所大学心理咨询中心的20名当事人的访谈结果进行了分析。结果发现, 与工作同盟相关的域有6个, 分别是情感联结、任务、投入、合作模式、发展变化、影响因素。前三个域可以看作是工作同盟的构成要素, 而后三个域则是对其外部特征的描述。对每个域的含义及其与现有理论和研究的关系进行了讨论。     

工作同盟的结构：基于两种测量工具的检验

以大学心理咨询中心的当事人为样本,对国外两种广泛使用的工作同盟测量工具WAI-S和WAI-SR的结构和测量学指标进行检验。结果发现,WAI-S和WAI-SR的任务一致与目标一致两个维度的相关较高,分别为0.71和0.74;WAI-S和WAI-SR的一因素、二因素和三因素结构均没有得到充分支持;WAI-SR与咨询效果的相关不显著。WAI-S和WAI-SR的结构不能很好反映其所依据的理论假设,提示在对测量工具进行改进的同时,还需要对工作同盟的理论结构进行思考。     

反馈类型和反馈时间对动作技能获得的影响

基于简单直线运动任务和复杂曲线追踪任务,在运动技能获得阶段考察不同反馈类型和反馈时间对操作绩效的影响。结果发现,在复杂曲线轨迹追踪任务中,接受运动轨迹反馈的被试组比接受偏差数值反馈组的成绩更好;即时反馈和延迟反馈组的操作绩效间没有显著差异。在简单直线运动任务中,提供落点偏差的图形反馈组成绩始终优于提供“近/远”信息的文本反馈组;在练习初期,即时反馈组成绩更好。说明,反馈信息的具体-抽象程度影响被试运动技能获得,提供具体直观的轨迹/图形反馈利于运动技能获得;反馈时间对运动技能的影响因任务难度而异。     

心理咨询的LIWC语言特征对咨询效果的预测

语言是心理咨询的重要内容。语言探索和词频统计（Language Inquiry and Word Count, LIWC）被广泛用于分析语言使用的心理意义。本研究收集了28名当事人共144次有效咨询录音及每次会谈后当事人的症状自评结果。将录音转录成文本后,抽取当事人的LIWC语言特征,进行主成分降维,结果获得8个因子,解释了总体方差的75.11%。一般线性回归中,躯体感受、功能词、情绪、认知和口语赘词对当事人的症状水平具有显著的预测作用,进一步多层线性模型中,躯体感受和情绪用词显著预测咨询效果。LIWC文本特征能够呈现与当事人症状相关的信息,为未来计算机自动化监控咨询过程和结果提供了新视角。     

有调节的多层中介效应分析

多层中介和多层调节效应分析在社科领域已常有应用,但如果将多层中介和调节整合在一起,可以产生2（多层中介类型）×2（调节变量的层次）×3（调节的中介路径）共12种有调节的多层中介模型。面对有调节的多层中介效应分析,研究者往往束手无策。详述了基于多层线性模型的12种有调节的多层中介的分析方法和基于多层结构方程模型的4类有调节的多层中介分析方法,包括正交分割法,随机系数预测法,潜调节结构方程法和贝叶斯合理值法。这四类方法的核心议题在于如何处理潜调节项。当样本量足够大时,建议选择潜调节结构方程法;当样本量不足时,建议选择贝叶斯合理值法。随后用一个实际例子演示如何进行有调节的多层中介效应分析并有相应的Mplus程序。最后展望了有调节的多层中介效应分析研究的拓展方向。     

基于多层结构方程模型的情境效应分析—— 兼与多层线性模型比较

多层(嵌套)数据的变量关系研究, 必须借助多层模型来实现。两层模型中, 层一自变量Xij按组均值中心化, 并将组均值 置于层2截距方程式中, 可将Xij对因变量Yij的效应分解为组间和组内部分, 二者之差被称为情境效应, 称为情境变量。多层结构方程模型(MSEM)将多层线性模型(MLM)和结构方程模型(SEM)相结合, 通过设置潜变量和多指标的方法校正了MLM在情境效应分析中出现的抽样误差和测量误差, 同时解决了数据的多层(嵌套)结构和潜变量的估计问题。除了分析原理的说明, 还以班级平均竞争氛围对学生竞争表现的情境效应为例进行分析方法的示范, 并比较MSEM和MLM的异同, 随后展望了MSEM情境效应模型、情境效应无偏估计方法和情境变量研究的拓展方向。     

Basic psychological needs satisfaction,working alliance,and early termination in psychotherapy

The goal of this study was to evaluate the relationship between basic psychological needs satisfaction and working alliance in psychotherapy and to determine whether client ratings of basic needs and working alliance during psychotherapy were associated with early termination of therapy. Former psychotherapy clients (n = 87) completed a semi-structured interview regarding basic needs satisfaction in therapy, working alliance and dropout status. Participant ratings on the Basic Needs Satisfaction in Psychotherapy scale (BNSP) and the Retrospective Working Alliance Inventory – Short (RWAI-S) were significantly correlated (r = .77) in our sample. A comparison of intercorrelations between working alliance subscales and basic needs subscales indicated higher factorial distinctiveness within the basic needs measure. T-tests comparing those who terminated psychotherapy early with those who had planned endings on scores on the BNSP and RWAI-S were significant (Cohen’s d = .65 and 1.82, respectively). Results suggest that the basic needs measure might tap into a wider breadth of the therapist and client interaction than the RWAI-S.     

One-to-one support for crisis intervention using online synchronous instant messaging: evaluating working alliance and client satisfaction

Young people are increasingly turning to online support, especially when traditional mental health services are not immediately available. Using a cross-sectional design, sociodemographic information and self-reported perceptions of the strength of the working alliance and client satisfaction were collected from a sample of participants (n = 78) who were users of a service providing free online support using synchronous instant messaging. The results reported a significant positive relationship between the strength of the working alliance and client satisfaction, suggesting that the strength of the working alliance remains a key component in counselling, even online. Participants, however, scored significantly lower on both the strength of the working alliance and client satisfaction, compared to participants in offline settings as reported in past studies.     

Relationship between therapist empathy and client-perceived working alliance in China: A multilevel modelling analysis

This naturalistic study examined the relationship between two types of therapist empathy, intellectual empathy and empathic emotion, and client-perceived working alliance (WA) in China. The study adopted the definitions and assessment methods of empathy recommended by Duan and Hill and used the theory of WA by Bordin and WA Inventory-Short by Tracey and Kokotovic. Eighty-six clients and 43 therapists from a university counselling centre at a comprehensive university in China participated in the study. Therapist intellectual empathy and empathic emotion and client-reported WA measured in six consecutive sessions from the second through the seventh session were assessed for each session. The results of multilevel modelling analyses showed that client-perceived WA increased significantly session after session, and therapist empathic emotion significantly predicted Tasks of WA. Moreover, there was significant therapist effect associated with Bond. In the context of empathy and WA research findings reported in the USA, some of the non-significant results of this study were intriguing. We discuss the study results with particular attention to the Chinese cultural context and present suggestions for future research.     

Clinician experiences of homework in couples and family therapy: A survey of perceived impact on the working alliance

The process of engaging clients in homework assignments has been studied extensively in research settings, but rarely have the challenges in the implementation of the science been considered in couples and family therapy. A survey was conducted of 226 clinicians regarding (1) their experience of homework adherence (quantity and quality) with couple and family clients, and (2) their experience of the impact of homework non-completion (IHN) on the working alliance. Clinicians working with families reported less overall homework quantity and quality. However, across both couples and family clients, more negative IHN was reported among clinicians experiencing less homework quantity, both in terms of IHN bond (couple ρ = 0.71, p < 0.001; family ρ = 0.78, p < 0.001) and IHN agreement (couples ρ = 0.25, p < 0.001; ρ = 0.19, p = 0.006), and among clinicians with fewer years of clinical experience (r = 0.19, n = 136, p < 0.05). The present findings suggest that, in the context of couples and family therapy, there is a risk of perceived negative IHN on the working alliance. There would be merit to future investigations examining the processes of facilitating homework engagement within the context of a strong working alliance.     

Videoconferencing versus face-to-face psychotherapy: Insights from patients and psychotherapists about comparability of therapeutic alliance,empathy and treatment characteristics

Objective

Videoconferencing psychotherapy (VCT) is an effective treatment option. Yet, it is unclear whether a similar therapeutic alliance as in conventional face-to-face psychotherapy (F2F) can be achieved, since previous studies yielded mixed results. Furthermore, surveys about the attitudes towards VCT amongst patients have been missing until now. The current study gathered opinions from patients and psychotherapists about the perceived comparability of VCT and F2F regarding contextual factors and treatment characteristics, focusing on therapeutic alliance and empathy.

Method

An online survey amongst patients (N = 189) and practitioners (N = 57) taking part in cognitive behavioural therapy was conducted after the first lockdown in Germany due to the COVID-19 pandemic and a resulting transition from F2F to VCT for most participants.

Results

While patients experienced therapeutic alliance and empathy as comparable, psychotherapists indicated advantages of F2F. Both groups indicated advantages of F2F for the therapy contents and expressed advantages of VCT for flexibility regarding location and time. More than half of the participants expressed a preference for a combination of analogue and digital therapy.

Conclusion

The perceived disadvantages of VCT can be addressed, for example, with training programmes for psychotherapists targeting communication in VCT and adapting established psychotherapy methods to a digital format to further improve VCT.     

Therapeutic alliance and progress in couple therapy: multiple perspectives

Therapeutic alliance research in couple therapy using multiple perspectives and longitudinal data has been sparse. This study used structural equation modelling to explore relationships between changes in alliance and in progress from clients' and therapists' perspective in a fairly large sample of couples (N=195) during the initial stage of therapy at an on‐campus training clinic. Self‐rated alliance was measured after sessions 2 through 4 with the Working Alliance Inventory. There was very little change in alliance over the early sessions of therapy, and changes in alliance did not always account for changes in relationship satisfaction. Husbands' perceptions of satisfaction and alliance seem to play an important role in the dynamics of the therapeutic process. Findings suggest a reciprocal relationship between perceptions of alliance and progress in therapy when combining perceptions of therapists and couple clients. Clinical implications and future research are discussed.     

The relationship of supervisor and trainee gender match and gender attitude match to supervisory style and the supervisory working alliance

Background: Gender‐related events have the potential to impact the supervisory relationship. Gender events might be related to the match between supervisors and supervisees on variables such as gender or gender attitudes. Method: In this study, we sought to determine whether gender match and gender attitude match were related to supervisory style and the supervisory working alliance in 94 supervisory dyads using four instruments: the Gender Attitude Inventory; Operationalisation of Gender Match; Supervisory Styles Inventory; and the Working Alliance Inventory/Supervision. Results: Progressive dyads (in which supervisors have more liberal attitudes about societal issues and culturally defined roles for women than their supervisees) were perceived by supervisors as more task‐oriented than parallel‐high dyads (in which supervisors and supervisees both had liberal attitudes). Implications for counselling supervision are discussed.     

Cultural ruptures in short‐term therapy: Working alliance as a mediator between clients' perceptions of microaggressions and therapy outcomes

Aim: To determine whether or not clients' perceptions of microaggressions varied based on their own and the therapist's race/ethnicity and whether or not they would be negatively related to the effectiveness of therapy and if the working alliance would mediate this effect. Method: The study utilised a cross‐sectional, retrospective, methodology. Clients were recruited from a large university counselling centre in the United States (N=232 clients and 29 therapists). Results: Neither clients' race/ethnicity, therapists’ race/ethnicity, nor client‐therapist ethnic matching predicted perceptions of microaggressions. Clients' ratings of microaggressions were negatively associated with their psychological wellbeing; however, this effect was mediated by clients' ratings of the working alliance. Implications: Therapists should take into account the cultural messages they may be conveying to both white and racial/ethnic minority clients. Therapists should develop strategies that are consistent with a general therapeutic approach that promotes discussions about culture with their clients and, most importantly, should attend to the therapeutic relationship.     

Relationship between orientation toward multicultural competence,multicultural competent behaviors,and working alliance: Examining a multigroup mediation model

In this study, the researchers examined the relationship among an orientation toward multicultural counseling competence, multicultural competent behaviors, and the working alliance from the perspective of 574 client participants across various therapeutic dyads. There was a positive relationship between clients’ perspectives on counselors’ multicultural orientation, counselors’ multicultural competent behavior, and working alliance. Multicultural competent behaviors mediated the relationship between an orientation toward multicultural competence and working alliance. However, the mediated effect was inconsistent across cross and similar racial/ethnic therapeutic dyads. Implications for counselors, limitations of the study, and future directions for research are provided.