Counselling & Psychotherapy Research最新文献_第8页

Exploring young people with eating difficulties and their caregivers' experiences of person-centred counselling 探讨进食困难青少年及其照顾者在以人为本的辅导中的体验

IF 1.2 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2024-04-22 DOI: 10.1002/capr.12757

Samantha Ward, Nicola Daughtrey, Chloe Constable, Judith Bell

Background

There has been a significant increase in the number of young people with eating difficulties (EDs), and current waiting times are not meeting the standard recommended by the National Health Service. Therefore, TIC+, a mental health charity in Gloucestershire, launched an ED counselling service, TEDS. The service aimed to promptly provide young people with person-centred counselling as an alternative option for support.

Aims

Very few studies have investigated the experience of individuals with EDs who are engaging with person-centred counselling, and exploration of this can help us to ascertain whether the approach should be more widely deployed while also informing service development for TEDS.

Materials and Methods

This study qualitatively explored young people and their caregivers' experiences of the service using semi-structured interviews; four young people and four caregivers took part. Data were analysed using thematic analysis.

Results

The findings revealed that the person-centred counselling provided was valuable for young people, with improvements to their EDs evident.

Discussion

However, there were several barriers to counselling that must be addressed. Furthermore, caregivers experienced a sense of loss of control and helplessness, which may have ramifications for young people too, demonstrating a need to consider how best to support caregivers.

Conclusion

There is preliminary support for the use of person-centred counselling for young people with eating difficulites.

患有进食困难（ED）的青少年人数大幅增加，而目前的等待时间并未达到国家卫生服务机构建议的标准。因此，格洛斯特郡的心理健康慈善机构 TIC+ 推出了一项名为 TEDS 的进食障碍咨询服务。该服务旨在及时为年轻人提供以人为本的心理咨询，作为另一种支持选择。很少有研究调查过患有 ED 的个人在参与以人为本的心理咨询时的体验，对这一问题的探讨可以帮助我们确定是否应该更广泛地采用这种方法，同时为 TEDS 的服务发展提供信息。本研究采用半结构化访谈的方式，定性地探讨了年轻人及其照护者对该服务的体验；共有四名年轻人和四名照护者参与其中。研究结果表明，以人为本的辅导对青少年很有价值，他们的 ED 明显得到了改善，但辅导过程中也存在一些障碍，必须加以解决。此外，照顾者体验到一种失控感和无助感，这可能也会对青少年产生影响，因此有必要考虑如何为照顾者提供最好的支持。

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引用次数: 0

Artificial intelligence and psychotherapy: A counterpoint 人工智能与心理治疗：对立面

IF 1.2 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2024-04-19 DOI: 10.1002/capr.12758

Derek Richards

Psychotherapy practice is a human endeavour. Research on the specific and non-specific factors of treatment has helped crystallise its relevance and clinical impact. The challenges currently faced by the field revolve around ensuring access to evidence-based treatments and enhancing their effectiveness. Digitally delivered formats of empirically supported treatments increase access while supporting the relevance of the treatment-specific ingredients and the necessity for human guidance. Excitement surrounds the potential integration of novel artificial intelligence (AI) machine learning methods to advance psychotherapy effectiveness. The abundance of data in digitally delivered formats positions them well to harness the capabilities of AI. Recent work provides proof of concept in areas including detection and diagnosis, predicting outcomes, treatment adherence, remission and relapse. A potential risk emerges when applying machine learning methods, in which an overreliance on AI inferences may overshadow the human aspect of psychotherapy. The contrast is simple: we may over-invest in the rationality and relevance of our AI inferences, blindly obeying the algorithmic counsel that may lead to unintended consequences, such as oversimplifying human complexity. This would amount to changing psychotherapy from a human-centric to a techno-centric endeavour, something we should steadily avoid. This perspective highlights the importance of balancing enthusiasm for AI advancements with a cautious approach. The discussion outlines the risks associated with overdependence on AI and provides reasons to avoid a scenario in which psychotherapy loses its human essence. In conclusion, the perspective suggests avenues for future research to prevent such a transformation and maintain the human-centric nature of psychotherapy.

心理治疗是人类的一项事业。对治疗的具体和非具体因素的研究有助于明确其相关性和临床影响。该领域目前面临的挑战围绕着确保获得以证据为基础的治疗并提高其有效性。以数字形式提供的循证疗法既能增加治疗机会，又能支持特定治疗成分的相关性和人工指导的必要性。新型人工智能（AI）机器学习方法的潜在整合将促进心理治疗的有效性，这一点令人兴奋。以数字形式提供的大量数据使他们能够很好地利用人工智能的能力。最近的工作证明了在检测和诊断、结果预测、治疗依从性、缓解和复发等领域的概念。在应用机器学习方法时，会出现一种潜在风险，即过度依赖人工智能推断可能会掩盖心理治疗的人文关怀。对比很简单：我们可能会过度依赖人工智能推断的合理性和相关性，盲目听从算法建议，从而导致意想不到的后果，例如过度简化人类的复杂性。这相当于将心理治疗从以人为本转变为以技术为本，而这正是我们应该坚决避免的。这一观点强调了平衡对人工智能进步的热情与谨慎态度的重要性。讨论概述了过度依赖人工智能所带来的风险，并提出了避免心理疗法丧失人类本质的理由。最后，该视角提出了未来研究的途径，以防止这种转变并保持心理疗法以人为本的本质。

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引用次数: 0

‘What happens then?’: A 6-month follow-up on students accessing a university counselling service 然后呢？对接受大学咨询服务的学生进行为期 6 个月的跟踪调查

IF 1.2 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2024-04-17 DOI: 10.1002/capr.12756

Marco Bani, Federico Zorzi, Selena Russo, Stefano Ardenghi, Giulia Rampoldi, Maria Grazia Strepparava

Introduction

University psychological counselling services represent a frontline defence to detect, treat or refer students with a wide range of (clinical and non-clinical) difficulties. Nevertheless, only few studies describe their impact on academic self-efficacy and report follow-up data. Evidence on students' actual access to further psychological support in times of hardship is also scant and most needed. This study aimed to fill these gaps, exploring the stability of improvement in clinical conditions in a wide sample of university students and reporting post-intervention referrals to mental health services.

Methods

In a longitudinal study, 218 students who accessed a psychological counselling service at the University of Milano-Bicocca between 2015 and 2019 completed an assessment at the beginning (T0), conclusion (T1) and 6 months after (T2) a brief cognitive behavioural intervention. The assessment included psychological symptoms, general distress, emotion dysregulation and academic self-efficacy. Information about students' choices to continue a psychological intervention in other services was also collected and contrasted with the counsellor's indication.

Results

At follow-up, the improvement in academic self-efficacy remained stable, with more than 60% of the students maintaining a reliable clinical change, and nearly half of them reporting having accessed (or being willing to contact) a mental health service outside the university services.

Conclusion

These findings highlight the key role of counselling services in addressing students' distress and academic performances in the long term and in building bridges with mental health services outside the university system for students who need longer and specialised treatment.

大学心理咨询服务是发现、治疗或转介有各种（临床和非临床）困难的学生的第一道防线。然而，只有少数研究描述了这些服务对学业自我效能感的影响并报告了后续数据。关于学生在困难时期实际获得进一步心理支持的证据也很少，而且非常需要。在一项纵向研究中，218 名在 2015 年至 2019 年期间接受过米兰比可卡大学心理咨询服务的学生分别在简短认知行为干预开始（T0）、结束（T1）和 6 个月后（T2）完成了评估。评估内容包括心理症状、一般痛苦、情绪失调和学业自我效能感。这些研究结果凸显了咨询服务在长期解决学生的困扰和学业成绩方面，以及在为需要长期和专业治疗的学生与大学系统外的心理健康服务机构建立联系方面所发挥的关键作用。

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引用次数: 0

Gendered capital in psychotherapy: A thematic analysis of patients' experiences of the therapists' gender 心理治疗中的性别资本：病人对治疗师性别体验的主题分析

IF 1.2 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2024-03-31 DOI: 10.1002/capr.12755

Erwin Schweitzer, Yvonne Schaffler, Andrea Jesser, Thomas Probst, Elke Humer, Brigitte Schigl

Background

The impact of therapists' and patients' gender on therapy processes and outcomes remains a subject of intense debate in psychotherapy research.

Aims

This article explores the role of gender in psychotherapy from the patients' perspective.

Method

By conducting semi-structured interviews with 20 patients undergoing individual psychotherapy in private practices in Austria, the influence of the therapist's gender was investigated. The data collected were subjected to qualitative thematic analysis.

Findings

The authors adopted a Bourdieusian feminist perspective to interpret the results, revealing that patients perceived female psychotherapists as possessing unique resources not found in male therapists. These resources encompassed knowledge, skills, traits perceived as ‘female’, and shared body and life experiences. Referred to as ‘female gender capital’, these resources influenced the preferences of most female and one male patient, leading them to favour female psychotherapists.

Conclusion

Given the strong perceptions and preferences around gender observed in this study, gender identity and gendered practices should be critically reflected on by individual therapists as well as in psychotherapy training programmes.

背景治疗师和患者的性别对治疗过程和结果的影响仍然是心理治疗研究中争论的焦点。目的本文从患者的角度探讨性别在心理治疗中的作用。方法通过对奥地利私人诊所中接受个体心理治疗的 20 名患者进行半结构化访谈，研究治疗师性别的影响。对收集到的数据进行了定性主题分析。研究结果作者采用布尔迪厄斯女性主义观点来解释研究结果，结果显示，患者认为女性心理治疗师拥有男性治疗师所没有的独特资源。这些资源包括知识、技能、被视为 "女性 "的特质以及共同的身体和生活经历。这些资源被称为 "女性性别资本"，它们影响了大多数女性患者和一名男性患者对心理治疗师的偏好，使他们更青睐女性心理治疗师。结论鉴于本研究中观察到的对性别的强烈认知和偏好，治疗师个人以及心理治疗培训课程都应对性别认同和性别实践进行批判性反思。

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引用次数: 0

The linear pattern of therapeutic alliance development: Exploring the relationship between alliance trajectories over time and the outcomes of systemic psychotherapy treatment for adaptation disorders 治疗联盟发展的线性模式：探索适应障碍系统性心理疗法治疗的长期联盟轨迹与治疗结果之间的关系

IF 1.2 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2024-03-29 DOI: 10.1002/capr.12753

Tomasz Prusiński

Objective

This study aimed to determine the trajectories of therapeutic alliance development in individual systemic psychotherapy for adults with adaptation disorders and the differences in alliance development between groups with different treatment outcomes.

Method

The longitudinal quasi-experiment included 20 patients undergoing individual outpatient psychotherapy treatment in private practice for over a year. Therapeutic alliance was evaluated three times, by the psychotherapist and the patient simultaneously. Treatment outcomes were estimated twice based on patient ratings. Their clinical significance was assessed using the Reliable Change Index, analysis of variance for independent groups and trend analysis. The analyses concerned global therapeutic alliance and its three dimensions: goals, tasks and bonds.

Results

The study supported the hypothesised linear trend. It also confirmed a greater increase in alliance quality over the course of treatment in patients whose therapy was more successful.

Conclusion

The results indicate that, in patients with adaptation disorders, alliance development in systemic therapy follows a stable linear trend. The linear change observed for global therapeutic alliance is paralleled by similar trends in goals, tasks and bonds. Strong alliance correlates with better treatment outcomes.

本研究旨在确定在对患有适应障碍的成年人进行个体系统心理治疗时，治疗联盟的发展轨迹，以及不同治疗结果的群体在联盟发展方面的差异。这项纵向准实验包括20名在私人诊所接受个体门诊心理治疗的患者，时间超过一年。心理治疗师和患者同时对治疗联盟进行了三次评估。根据患者的评分对治疗结果进行了两次评估。采用可靠变化指数、独立组方差分析和趋势分析对其临床意义进行了评估。分析涉及全球治疗联盟及其三个维度：目标、任务和纽带。研究结果表明，对于适应障碍患者，系统疗法中的联盟发展遵循稳定的线性趋势。全球治疗联盟的线性变化与目标、任务和纽带的类似趋势相吻合。牢固的联盟关系与更好的治疗效果相关。

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引用次数: 0

Replication of relations among working alliance, distress and attendance variables 工作联盟、痛苦和出勤率变量之间关系的再现

IF 1.2 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2024-03-28 DOI: 10.1002/capr.12754

Scott T. Meier

Introduction

Recent reports from the World Health Organization and the American Psychological Association have highlighted the gap between the growing need for mental health services and available resources. Even with additional funding, however, the high proportion of clients who drop out after only a few sessions presents a significant obstacle to providing effective help.

Methods

Using archival data from the Research Consortium of Counseling and Psychological Services in Higher Education, this study examined relations between client attendance and two constructs of the early therapeutic environment model, working alliance and client distress.

Results

Session count evidenced a floor effect, with the mean of the distribution (4.45) <1 standard deviation (SD; 4.11) from the lowest possible score. In contrast, clients' alliance scores (measured with the Working Alliance Inventory) displayed a ceiling effect, with the mean 1.48 SD units from the highest possible score. Analyses indicated that alliance and distress (measured via the Outcome Questionnaire—45) scores exhibit different nonlinear relations with session count. Working alliance scores exhibited a power function indicating that rapid increases in alliance scores during initial sessions were associated with larger session counts. In contrast, distress scores formed a funnel shape with session count such that moderate initial distress was associated with greater attendance. Clients whose alliance scores evidenced a ceiling effect accounted for most of the observed change on the distress measure.

Conclusion

To enhance attendance, study findings suggest that, as early as possible, therapists should maximise the client–therapist alliance and moderate the level of client distress.

世界卫生组织和美国心理学会最近的报告强调了日益增长的心理健康服务需求与可用资源之间的差距。本研究利用高等教育咨询与心理服务研究联合会（Research Consortium of Counseling and Psychological Services in Higher Education）的档案数据，考察了客户出勤率与早期治疗环境模型的两个构建要素--工作联盟和客户困扰--之间的关系。与此相反，客户的联盟得分（用工作联盟量表测量）显示出天花板效应，平均值与可能的最高分相差 1.48 个标准差单位。分析表明，联盟和困扰（通过结果问卷-45）得分与疗程次数呈现出不同的非线性关系。工作联盟得分呈现出一种幂函数，表明在最初的疗程中，联盟得分的快速增长与疗程次数的增加有关。与此相反，痛苦得分与疗程次数呈漏斗状，最初的适度痛苦与更多的参加次数相关。为了提高出勤率，研究结果表明，治疗师应尽早最大限度地建立求助者与治疗师之间的联盟，并缓和求助者的痛苦程度。

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引用次数: 0

The effect of a spiritual intelligence-based counselling programme on suicidal ideation and self-concept among retirement 基于精神智能的辅导计划对退休人员自杀倾向和自我概念的影响

IF 1.2 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2024-03-28 DOI: 10.1002/capr.12752

Basma Eid Alshareef, Othman A. Alfuqaha

Background

Spiritual counselling techniques can offer individuals a sense of new meaning and a way to cope with difficulties. However, no prior study has specifically examined the effectiveness of a spiritual intelligence counselling programme on suicidal ideation and self-concept among retired individuals.

Aims

This study aimed to evaluate how a new counselling programme focusing on spiritual intelligence helps retired individuals deal with suicidal ideation and self-concept.

Materials and Methods

A total of 40 retired individuals were split into two groups: one that received the counselling programme (experimental group = 20) and one that did not (control group = 20) based on their initial scores of suicidal ideation and self-concept scales. The experimental group went through a 10-session counselling programme, meeting for 90 min each week from April to June 2023.

Results

Based on means, standard deviations and analysis of variance, results found significant differences in scores between those who underwent the counselling programme and those who did not. The experimental group revealed a decrease in suicidal ideation and an improvement in self-concept after completing the counselling programme. Males seemed to benefit more from the spiritual intelligence-based counselling programme than females in reducing suicidal ideation. There was no difference between males and females regarding self-concept.

Discussion

The spiritual counselling programme improves self-concept and reduces suicidal ideation among retired individuals.

Conclusion

The results suggest that the spiritual intelligence-based counselling programme shows promise in addressing mental health issues among retired individuals.

精神咨询技术可以为个人提供一种新的意义感和应对困难的方法。本研究旨在评估一项以灵性智慧为重点的新辅导计划如何帮助退休人员应对自杀意念和自我概念。研究人员根据 40 名退休人员自杀意念和自我概念量表的初始评分，将他们分成两组：一组接受辅导计划（实验组=20 人），另一组不接受辅导计划（对照组=20 人）。根据平均值、标准差和方差分析，结果发现接受辅导计划的学生与未接受辅导计划的学生在得分上存在显著差异。实验组显示，在完成辅导计划后，自杀念头有所减少，自我概念有所改善。在减少自杀念头方面，男性似乎比女性更能从基于灵性智能的辅导计划中受益。结果表明，基于灵性智能的辅导计划有望解决退休人员的心理健康问题。

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引用次数: 0

Group Radical Openness: Participants' attributions of change 团体激进开放性：参与者对变化的归因

IF 1.2 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2024-03-21 DOI: 10.1002/capr.12750

Violet Johnstone, Cian McDonough, Rachel Egan, Katie Browne, Amy Corbett

Background

Group Radical Openness (GRO) has been shown to be a feasible and acceptable intervention for individuals who struggle with costly overcontrol. This paper explores participants' reports of attributions of change following the engagement in GRO.

Method

Fourteen participants took part in qualitative interviews. An adapted version of ‘The Revised Client Change Interview Schedule: Version 5’ was used to capture the experiences of change following the intervention (Elliott & Rodgers, 2008). Research participants were outpatients of a psychiatric hospital who attended GRO. The sample consisted of 14 participants (6 females: 8 males); mean age 44.4 years; and age range 18–58. All participants attended 26, 3-h group sessions. Reflexive thematic analysis was used to identify the specific aspects of the group therapy to which clients attributed change.

Results

The analysis identified three superordinate themes, each with two subthemes. These included Safety and Connection (Safety and Tribe; Open and Genuine Facilitation); Understanding Overcontrol (Awareness of Overcontrol; The GRO Approach); and Carrying GRO Forward (Increased Awareness and Capacity to Reflect; Internalising GRO).

Conclusion

Group Radical Openness was shown to be an acceptable group therapy treatment for people with an overcontrolled coping style. This paper further clarifies the participants' experiences of GRO and what aspects led to change from their perspective.

小组激进开放疗法（GRO）已被证明是一种可行且可接受的干预方法，适用于因过度控制而付出代价的人。本文探讨了参与者对参与 GRO 后的变化归因的报告。14 名参与者参加了定性访谈。14 名参与者参加了定性访谈：14 名参与者参加了定性访谈，访谈使用了改编版的 "修订版客户变化访谈表：第 5 版"，以记录干预后的变化经历（Elliott & Rodgers，2008 年）。研究参与者是一家精神病医院的门诊病人，他们都参加了 GRO。样本包括 14 名参与者（6 名女性：8 名男性）；平均年龄为 44.4 岁；年龄范围为 18-58 岁。所有参与者均参加了 26 次、每次 3 小时的小组活动。我们采用了反思性主题分析法，以确定客户将变化归因于小组疗法的哪些具体方面。这些主题包括安全与联系（安全与部落；开放与真诚的促进）；理解过度控制（对过度控制的认识；GRO 方法）；以及将 GRO 发扬光大（增强反思的意识和能力；内化 GRO）。事实证明，激进开放团体疗法是一种可以接受的团体治疗方法，适用于具有过度控制应对方式的人。本文进一步阐明了参与者对 GRO 的体验，以及从他们的角度来看哪些方面导致了改变。

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引用次数: 0

Helping college students with autism spectrum disorder: Exploring factors affecting use of counselling 帮助患有自闭症谱系障碍的大学生：探索影响咨询使用的因素

IF 1.2 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2024-03-12 DOI: 10.1002/capr.12751

Nicole Noble, Nicholas Bueno, Audrey Zatopek, Jeremias Hernandez

Introduction

Individuals with autism spectrum disorder (ASD) experience mental health concerns at a higher prevalence rate than the general population, yet mental health professionals have limited education, training and experience in counselling individuals with ASD.

Methods

To better understand the unique mental health concerns this population encounters, this qualitative study explored the experiences of 102 college students with ASD as they considered, attended and stopped counselling.

Results

Specifically, this study investigated the motives the participants reported for attending counselling, the reasons professionals indicated that the participants should attend counselling, the barriers the participants were confronted with in seeking counselling and the causes for terminating counselling.

Conclusion

Based on these findings, implications for counselling this population and future research are provided.

自闭症谱系障碍（ASD）患者的心理健康问题发生率高于普通人群，但心理健康专业人员在辅导自闭症谱系障碍患者方面的教育、培训和经验却十分有限。为了更好地了解这一人群所遇到的独特心理健康问题，本定性研究探讨了 102 名患有自闭症谱系障碍的大学生在考虑、参加和停止咨询时的经历。具体而言，本研究调查了参与者报告的参加心理咨询的动机、专业人士表示参与者应该参加心理咨询的原因、参与者在寻求心理咨询时遇到的障碍以及终止心理咨询的原因。

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引用次数: 0

Inter-modality comparison of working alliance and client satisfaction in online counselling during the COVID-19 pandemic: An exploratory study COVID-19 大流行期间在线咨询中工作联盟和客户满意度的跨模式比较：探索性研究

IF 1.2 Q3 PSYCHOLOGY, CLINICAL

Counselling & Psychotherapy Research

Pub Date : 2024-03-11 DOI: 10.1002/capr.12748

Carla Moccia, Harriet L. Bowyer

Purpose

Mental health suffered during the COVID-19 pandemic lockdown in Scotland. While there was limited availability for face-to-face counselling, online counselling was available via telephone, videoconference, email, one-to-one chat and group basis. Existing research has failed to examine inter-modality comparisons of client experiences of online counselling during the COVID-19 pandemic.

Methods

Scottish participants (n = 94) who received online counselling during the COVID-19 pandemic completed an online survey using quantitative methodology, which explored their experiences of one of five online counselling modalities measured by two reliable scales: the Working Alliance Inventory-Short Revised and factor one of the Satisfaction with Therapy and Therapist Scale. Additional exploratory analysis investigated whether age, gender, choice of online counselling modality and pre-COVID-19 pandemic familiarity with online counselling affected these outcomes.

Results

Working alliance and satisfaction outcomes were positively correlated. No significant differences between working alliance and satisfaction scores were found between the five modalities. Female participants, and those who received their preferred choice of counselling modality, had significantly greater working alliance than those who did not.

Conclusion

These findings provide insights to clients and practitioners about the variety of synchronous and asynchronous online platforms that can facilitate good therapeutic outcomes. The importance of participant choice of counselling modality was reiterated. The broader implications of the findings and the future direction of a hybrid online and face-to-face counselling model were discussed.

在苏格兰 COVID-19 大流行封锁期间，心理健康受到了影响。虽然面对面咨询的机会有限，但在线咨询可通过电话、视频会议、电子邮件、一对一聊天和小组等方式进行。在 COVID-19 大流行期间接受过在线咨询的苏格兰参与者（n = 94）完成了一项采用定量方法进行的在线调查，该调查探讨了他们在五种在线咨询模式中的一种模式下的体验，这些模式由两个可靠的量表进行测量：工作联盟量表--简易修订版和治疗与治疗师满意度量表的因子一。额外的探索性分析调查了年龄、性别、在线咨询模式的选择以及在 COVID-19 大流行前对在线咨询的熟悉程度是否会影响这些结果。工作联盟和满意度结果呈正相关，五种模式之间的工作联盟和满意度得分无明显差异。这些研究结果为客户和从业人员提供了有关各种同步和异步在线平台的见解，这些平台可以促进良好的治疗效果。我们重申了参与者选择咨询模式的重要性。会议还讨论了研究结果的广泛影响以及在线和面对面混合咨询模式的未来发展方向。

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引用次数: 0