PDF(Pubmed)
Abstract：
BACKGROUND: Working alliance is a prominent non-specific factor for treatment outcomes in face-to-face and internet-based interventions. The association between working alliance and therapy outcome appears to be time- and disorder-specific, but less is known about the change of working alliance during the intervention and the impact of working alliance in grief-specific interventions. The present study examines the association between the change of working alliance and treatment outcomes in an internet-based intervention for parents who experienced pregnancy loss.
METHODS: 228 participants received a grief intervention based on cognitive behavioral therapy with asynchronous text-based therapist feedback. Prolonged grief and related symptoms of traumatic stress, depression, anxiety, and general psychopathology were assessed with validated instruments before and after the intervention. The change of working alliance was assessed using the short version of the Working Alliance Inventory at mid-treatment (session 4) and the end of the treatment (session 10).
RESULTS: Data for N = 146 persons was analyzed. Working alliance in total and all subscales increased significantly from sessions 4 to 10. This change in working alliance correlated significantly with a reduction in prolonged grief. Changes in subscales of working alliance also correlated with symptoms of depression and general psychopathology. Regression analysis showed that a change in working alliance predicted a reduction in prolonged grief but did not predict improvements in other grief-related symptoms.
CONCLUSIONS: The results examine the change of working alliance during an internet-based intervention and the association with treatment outcome. A small impact of change in working alliance on treatment outcome of prolonged grief was confirmed, but not on related symptoms. Further research is needed to assess moderators of the alliance-outcome association to improve internet-based interventions.
BACKGROUND: Not applicable.
METHODS: 228 participants received a grief intervention based on cognitive behavioral therapy with asynchronous text-based therapist feedback. Prolonged grief and related symptoms of traumatic stress, depression, anxiety, and general psychopathology were assessed with validated instruments before and after the intervention. The change of working alliance was assessed using the short version of the Working Alliance Inventory at mid-treatment (session 4) and the end of the treatment (session 10).
RESULTS: Data for N = 146 persons was analyzed. Working alliance in total and all subscales increased significantly from sessions 4 to 10. This change in working alliance correlated significantly with a reduction in prolonged grief. Changes in subscales of working alliance also correlated with symptoms of depression and general psychopathology. Regression analysis showed that a change in working alliance predicted a reduction in prolonged grief but did not predict improvements in other grief-related symptoms.
CONCLUSIONS: The results examine the change of working alliance during an internet-based intervention and the association with treatment outcome. A small impact of change in working alliance on treatment outcome of prolonged grief was confirmed, but not on related symptoms. Further research is needed to assess moderators of the alliance-outcome association to improve internet-based interventions.
BACKGROUND: Not applicable.
摘要：
背景：工作联盟是面对面和基于互联网的干预措施中治疗结果的突出非特异性因素。工作联盟和治疗结果之间的关联似乎是特定于时间和疾病的，但是对干预期间工作联盟的变化以及工作联盟在针对悲伤的干预中的影响知之甚少。本研究调查了在基于互联网的干预措施中，针对经历过怀孕失败的父母，工作联盟的变化与治疗结果之间的关系。
方法：228名参与者接受了基于认知行为疗法和异步基于文本的治疗师反馈的悲伤干预。长期的悲伤和相关的创伤压力症状，抑郁症,焦虑,和一般精神病理学在干预前后使用经过验证的仪器进行评估.在治疗中期（第4次会议）和治疗结束时（第10次会议），使用工作联盟清单的简短版本评估了工作联盟的变化。
结果：分析了N=146人的数据。从第4届会议到第10届会议，工作联盟的总数和所有分量表都大大增加。工作联盟的这种变化与长期悲伤的减少显着相关。工作联盟分量表的变化也与抑郁症状和一般精神病理学有关。回归分析显示，工作联盟的变化预测了长时间悲伤的减少，但没有预测其他悲伤相关症状的改善。
结论：结果检查了基于互联网的干预期间工作联盟的变化以及与治疗结果的关联。确认了工作联盟的变化对长期悲伤的治疗结果的影响很小，但没有相关症状。需要进一步的研究来评估联盟-结果协会的主持人，以改善基于互联网的干预措施。
背景：不适用。
方法：228名参与者接受了基于认知行为疗法和异步基于文本的治疗师反馈的悲伤干预。长期的悲伤和相关的创伤压力症状，抑郁症,焦虑,和一般精神病理学在干预前后使用经过验证的仪器进行评估.在治疗中期（第4次会议）和治疗结束时（第10次会议），使用工作联盟清单的简短版本评估了工作联盟的变化。
结果：分析了N=146人的数据。从第4届会议到第10届会议，工作联盟的总数和所有分量表都大大增加。工作联盟的这种变化与长期悲伤的减少显着相关。工作联盟分量表的变化也与抑郁症状和一般精神病理学有关。回归分析显示，工作联盟的变化预测了长时间悲伤的减少，但没有预测其他悲伤相关症状的改善。
结论：结果检查了基于互联网的干预期间工作联盟的变化以及与治疗结果的关联。确认了工作联盟的变化对长期悲伤的治疗结果的影响很小，但没有相关症状。需要进一步的研究来评估联盟-结果协会的主持人，以改善基于互联网的干预措施。
背景：不适用。
