Evidence for Bidirectional, Cross-Lagged Associations Between Alliance and Psychological Distress in an Unguided Mobile-Health Intervention.

IF 4.8 2区医学 Q1 PSYCHIATRY Clinical Psychological Science Pub Date : 2024-05-01 Epub Date: 2023-07-20 DOI:10.1177/21677026231184890

Simon B Goldberg, Zishan Jiwani, Daniel M Bolt, Kevin M Riordan, Richard J Davidson, Matthew J Hirshberg

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Abstract

Bidirectional associations between changes in symptoms and alliance are established for in-person psychotherapy. Alliance may play an important role in promoting engagement and effectiveness within unguided mobile health (mHealth) interventions. Using models disaggregating alliance and psychological distress into within- and between-person components (random intercept cross-lagged panel model), we report bidirectional associations between alliance and distress over the course of a 4-week smartphone-based meditation intervention (n=302, 80.0% elevated depression/anxiety). Associations were stable across time with effect sizes similar to those observed for psychotherapy (βs=-.13 to -.14 and -.09 to -.10, for distress to alliance and alliance to distress, respectively). Alliance may be worth measuring to improve the acceptability and effectiveness of mHealth tools. Further empirical and theoretical work characterizing the role and meaning of alliance in unguided mHealth is warranted.

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在无指导的移动医疗干预中，联盟与心理压力之间存在双向、跨滞后关联的证据。

在面对面心理治疗中，症状变化与联盟之间存在双向关联。在无指导的移动医疗（mHealth）干预中，联盟可能在促进参与度和有效性方面发挥重要作用。利用将联盟和心理困扰分解为人内和人际组成部分的模型（随机截距交叉滞后面板模型），我们报告了在为期 4 周的基于智能手机的冥想干预过程中，联盟和困扰之间的双向关联（人数=302，80.0% 抑郁/焦虑升高）。这种关联在不同时间段内保持稳定，其效应大小与心理治疗中观察到的效应大小相似（βs=-.13 至 -.14 和 -.09 至 -.10，分别为痛苦对联盟和联盟对痛苦）。为了提高移动医疗工具的可接受性和有效性，可能值得对联盟进行测量。有必要进一步开展实证研究和理论研究，以确定联盟在无指导的移动医疗中的作用和意义。

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来源期刊

Clinical Psychological Science Psychology-Clinical Psychology

CiteScore

9.70

自引率

2.10%

发文量

期刊介绍： The Association for Psychological Science’s journal, Clinical Psychological Science, emerges from this confluence to provide readers with the best, most innovative research in clinical psychological science, giving researchers of all stripes a home for their work and a place in which to communicate with a broad audience of both clinical and other scientists.