Assessing the Alliance-Outcome Association Adjusted for Patient Characteristics and Treatment Processes: A Meta-Analytic Summary of Direct Comparisons

被引：72

作者：

Fluckiger, Christoph ^{[1
]}

Del Re, A. C. ^{[1
]}

Wlodasch, Daniel ^{[1
]}

Horvath, Adam O. ^{[2
]}

Solomonov, Nili ^{[3
]}

Wampold, Bruce E. ^{[4
,5
]}

机构：

[1] Univ Zurich, Dept Psychol, Binzmuhlestr 14-04, CH-8050 Zurich, Switzerland

[2] Simon Fraser Univ, Fac Educ, Burnaby, BC, Canada

[3] Weill Cornell Med Coll, Weill Cornell Inst Geriatr Psychiat, New York, NY USA

[4] Modum Bad Psychiat Ctr, Vikersund, Norway

[5] Univ Wisconsin Madison, Sch Educ, Madison, WI USA

来源：

JOURNAL OF COUNSELING PSYCHOLOGY | 2020年 / 67卷 / 06期

基金：

瑞士国家科学基金会;

关键词：

working alliance; adherence; process-based therapy; between-patients effects; meta-analysis; THERAPEUTIC ALLIANCE; THERAPIST COMPETENCE; NATIONAL-INSTITUTE; WORKING ALLIANCE; PSYCHOTHERAPY; DEPRESSION; DISORDERS; SYMPTOMS;

D O I：

10.1037/cou0000424

中图分类号：

G44 [教育心理学];

学科分类号：

0402 ; 040202 ;

摘要：

The alliance is widely recognized as a robust predictor of posttreatment outcomes. However, there is a debate regarding whether the alliance is an epiphenomenon of intake characteristics and/or treatment processes occurring over the course of treatment. This meta-analysis aimed to synthesize the evidence on this issue. We identified 125 effect sizes in 60 independent samples (6,061 participants) of studies that reported alliance-outcome correlations as well as parallel intake or process characteristics. We examined the impact of these potential confounds on the alliance-outcome correlations. We meta-analyzed the studies estimates by computing omnibus effects models as well as multivariate models. We identified 3 variable types that were used to adjust the alliance-outcome correlations: (a) intake characteristics (k = 35); (b) simultaneous processes, such as adherence or competence (k = 13); and (c) both intake and simultaneous processes (k = 24). We found moderate alliance-outcome correlations with or without adjustments for intake and simultaneous processes (range from r =.23 to r =.31). Our results provide robust empirical evidence for the assertion that the alliance-outcome association is an independent process-based factor. Findings suggest that alliance is positively related to outcome above and beyond the studied patient intake characteristics and treatment processes.

引用

页码：706 / 711

页数：6