The development of the therapeutic alliance and the emergence of alliance ruptures

• Autores: Joana Fernandes Pereira Coutinho, Eugénia Ribeiro, Catarina Fernandes, Inês Pereira de Sousa, Jeremy D. Safran
• Localización: Anales de psicología, ISSN-e 1695-2294, ISSN 0212-9728, Vol. 30, Nº. 3, 2014, págs. 985-994
• Idioma: inglés
• DOI: 10.6018/analesps.30.3.168911
• Enlaces
  • Texto completo
• Dialnet Métricas: 3 Citas
• Resumen
  • español

    Objetivos: Este estudio evaluó el desarrollo de la alianza tera-péutica y la aparición de rupturas de alianzas, en una muestra de pacientes con diferentes diagnósticos y resultados terapéuticos. Diseño: Se analizaron los datos longitudinales de 38 díadas terapéuticas que recibieran terapia cognitivo-conductual. La muestra incluyó a casos de abandonos, así como casos exitosos y no exitosos. La muestra incluyó a casos con trastornos del Eje I y Eje II. Método: Al final de cada sesión, los pacientes evaluaron la alianza mediante el Inventario de Alianza de Terapéutica (WAI). Seis jueces entrenados en la observación de los marcadores de ruptura de alianza con un sistema de observación de rupturas, codificaran 201 sesiones terapéuti-cas grabadas en vídeo. Se aplicaran modelos estadísticos longitudinales a los datos. Resultados: Se encontró que el patrón de desarrollo de la alianza de los casos de éxito era diferente de la de los casos sin éxito y abandonos. En media, los pacientes con trastornos de la personalidad iniciaran la terapia con una menor puntuación en el WAI que disminuyó con el tiempo, mien-tras que los pacientes con trastornos del Eje I iniciaran la terapia con una mayor puntuación en el WAI que aumentó con el tiempo

  • English

    Objectives: This study evaluated the development of the thera-peutic alliance and the emergence of alliance ruptures, in a sample of pa-tients with different diagnosis and different therapeutic outcome. Design: We examined the longitudinal data of 38 therapeutic dyads receiving cogni-tive-behavioural therapy, including dropouts as well as successful and un-successful cases. The sample included cases with Axis I and Axis II disor-ders. Method: At the end of each session, patients evaluated the alliance using the Working Alliance Inventory (WAI). Six judges trained in the ob-servation of alliance rupture markers with an observational system of rup-tures, rated 201 videotaped sessions. Longitudinal statistical models were applied to the data. Results: We found that the pattern of alliance devel-opment of successful cases was different from the unsuccessful and drop-outs cases. In addition on average, patients with personality disorders be-gan therapy with a lower WAI score that decreased over time, whereas pa-tients with Axis-I disorders began therapy with a higher WAI score that in-creased over time

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