Client characteristics and early working alliance development: A person-centered research approach.

IF 2.6 1区心理学 Q2 PSYCHOLOGY, CLINICAL Psychotherapy Research Pub Date : 2024-10-29 DOI:10.1080/10503307.2024.2418868

Wilson T Trusty, Louis G Castonguay, Caitlin L Chun-Kennedy, Sultan A N Magruder, Rebecca A Janis, Katherine A Davis, Dominic C Augustin, Brett E Scofield

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Abstract

Objective: Certain client characteristics are associated with early working alliance difficulties in psychotherapy. However, there is limited quantitative evidence on whether combinations of these characteristics (e.g., intersectional identities, prior treatment experiences) are related to alliance development. The present study leveraged a person-centered research approach to examine profiles of early alliance development and differences in the latent class structure of client characteristics among alliance development profiles.

Method: Individual psychotherapy clients (N = 2,579) rated the working alliance for their first four sessions and self-reported demographics, treatment history, and psychological distress. Therapists provided their assessment of clients' primary presenting concerns at baseline.

Results: Latent profile analysis revealed three profiles of working alliance development: high and stable, moderate and increasing, and low and stable. Follow-up person-centered analyses (multigroup confirmatory latent class analysis) indicated that clients in the alliance profiles differed in their combinations of clinical and demographic characteristics. For example, women of color with high baseline distress and a history of prior psychotherapy were over-represented in the low and stable alliance profile.

Conclusion: These results are consistent with recommendations to holistically consider how clients' characteristics and experiences shape psychotherapy processes. Results also highlight the utility of person-centered quantitative methods in psychotherapy research.

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客户特征与早期工作联盟的发展：以人为本的研究方法。

目的：某些客户特征与心理治疗中的早期工作联盟困难有关。然而，关于这些特征的组合（如交叉身份、先前的治疗经历）是否与联盟发展有关，目前的定量证据还很有限。本研究采用以人为本的研究方法，对早期联盟发展的特征以及联盟发展特征中客户特征的潜类结构差异进行了研究：方法：个人心理治疗客户（N = 2,579）对其前四次治疗的工作联盟进行评分，并自我报告人口统计学、治疗史和心理困扰。治疗师提供了他们对客户在基线期主要关注问题的评估：潜在特征分析显示了工作联盟发展的三个特征：高度稳定、中度增加和低度稳定。后续的以人为中心的分析（多组确认潜类分析）表明，联盟特征中的客户在临床和人口特征组合方面存在差异。例如，基线痛苦程度高且曾接受过心理治疗的有色人种女性在低度和稳定联盟特征中的比例较高：这些结果与全面考虑客户的特征和经历如何影响心理治疗过程的建议是一致的。这些结果也凸显了以人为中心的定量方法在心理治疗研究中的实用性。

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来源期刊

Psychotherapy Research PSYCHOLOGY, CLINICAL-

CiteScore

7.80

自引率

10.30%

发文量

期刊介绍： Psychotherapy Research seeks to enhance the development, scientific quality, and social relevance of psychotherapy research and to foster the use of research findings in practice, education, and policy formulation. The Journal publishes reports of original research on all aspects of psychotherapy, including its outcomes, its processes, education of practitioners, and delivery of services. It also publishes methodological, theoretical, and review articles of direct relevance to psychotherapy research. The Journal is addressed to an international, interdisciplinary audience and welcomes submissions dealing with diverse theoretical orientations, treatment modalities.