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首页> 外文期刊>Journal of medical Internet research >Does the Quality of the Working Alliance Predict Treatment Outcome in Online Psychotherapy for Traumatized Patients?
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Does the Quality of the Working Alliance Predict Treatment Outcome in Online Psychotherapy for Traumatized Patients?

机译：工作联盟的质量是否可以预测创伤患者在线心理治疗的治疗结果？

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Background: The provision of online counseling and online therapy is steadily increasing. The results of a number of controlled trials investigating the efficacy of online approaches indicate that some of these new treatment alternatives might indeed be effective. Yet, little is known about how the therapeutic relationship (or working alliance) evolves over the Internet and whether it influences treatment outcome as it does in traditional face-to-face therapy. The working alliance has been defined as the extent to which a patient and a therapist work collaboratively and purposefully and connect emotionally.Objective: The aim of the study was to investigate the quality and predictive relevance of the therapeutic alliance for patients receiving a short-term, Internet-based, cognitive-behavioral therapy program for posttraumatic stress reactions.Methods: After rigorous screening for exclusion criteria of high dissociative tendencies, risk of psychosis, and suicidal tendencies, 48patients, who had experienced a traumatic event in the past, were included in the online treatment study. The short form of the Working Alliance Inventory (WAI-S) was administered at the fourth treatment session. The relevance of the therapeutic relationship for treatment outcome was assessed in terms of residual gain from pretreatment assessment to the end of treatment. The revised Impact of Event Scale (IES-R) and the depression and anxiety subscales of the Brief Symptom Inventory (BSI) were used to assess treatment outcome.Results: A total of 48 participants were included in the analysis. Overall, high alliance scores were found. In contrast to previous studies of conventional face-to-face therapy, there was only a low to modest association (.13 to .33) between the quality of the therapeutic relationship and treatment outcome.Conclusion: High alliance scores indicate that it was possible to establish a stable and positive therapeutic relationship online. However, the therapeutic relationship was found to be a less relevant predictor of the therapy outcome than in face-to-face approaches. We discuss whether this finding can be attributed to methodological reasons such as the restricted range of alliance ratings obtained or the time of administration of the WAI-S, or whether the therapeutic relationship might be less relevant to the treatment outcome of online therapy approaches.
机译：背景：在线咨询和在线治疗的提供稳步增长。许多调查在线方法功效的对照试验的结果表明，这些新的治疗方法中的某些可能确实有效。然而，关于治疗关系（或工作联盟）如何在互联网上发展以及它是否像传统的面对面治疗一样影响治疗结果，鲜为人知。工作联盟被定义为患者和治疗师在多大程度上进行有目的的合作并在情感上建立联系的目的。目的：研究的目的是研究治疗联盟对于短期接受治疗的患者的质量和预测意义方法：经过严格筛选高分离倾向，精神病风险和自杀倾向的排除标准后，过去曾经历过创伤事件的48名患者被纳入研究范围。在在线治疗研究中。在第四次治疗中使用了工作联盟清单（WAI-S）的缩写形式。根据从治疗前评估到治疗结束的剩余收益，评估治疗关系与治疗结果的相关性。修订后的事件影响量表（IES-R）和简易症状量表（BSI）的抑郁和焦虑亚量表用于评估治疗结果。结果：该分析共包括48名参与者。总体而言，发现联盟得分很高。与以前的传统面对面治疗研究相反，治疗关系的质量和治疗结果之间的关联度较低（0.13至0.33）。结论：高联盟评分表明有可能在网上建立稳定和积极的治疗关系。但是，与面对面方法相比，发现治疗关系与治疗结果的相关性较小。我们讨论该发现是否可归因于方法学原因，例如获得的联盟评级范围受限或WAI-S的给药时间，或者治疗关系是否与在线治疗方法的治疗结果相关性较低。

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