Lauren M Lipner, Di Liu, Sophie Cassell, Elaine Hunter, Catherine F Eubanks, J Christopher Muran
{"title":"联盟中的 V 型发作:应用多种方法识别破裂修复的单一案例。","authors":"Lauren M Lipner, Di Liu, Sophie Cassell, Elaine Hunter, Catherine F Eubanks, J Christopher Muran","doi":"10.1037/pst0000469","DOIUrl":null,"url":null,"abstract":"<p><p>The therapeutic alliance has been consistently found to be a robust predictor of therapeutic outcome across various modalities of psychotherapy. Alliance ruptures are thought to occur commonly within each therapeutic dyad and, if left unresolved, are associated with premature termination and worsened psychotherapy outcome. Research efforts have identified V-shaped shifts in the alliance, characterized by a high-low-high pattern of postsession alliance scores, as a meaningful method of operationalizing rupture-repair episodes, but these efforts rarely evaluate the within-session process of the identified sessions. As a result, it is often unclear whether these sessions identified by methods based on postsession alliance measures are reflective of clinically meaningful within-session rupture process. This article aims to further explore the V-episode operationalization of rupture-repair episodes by assessing for convergence between rupture process identified by between-session measures and the within-session observer-based Rupture Resolution Rating Scale (3RS) in a single patient-therapist dyad in a 30-session brief relational therapy. V-episodes were operationalized using various previously utilized methods to identify ruptures based on postsession measures of alliance. Results of this case study demonstrate that postsession patient-rated V-episodes in the therapeutic alliance can be indicative of within-session rupture process, demonstrating convergence between within- and between-session measures of alliance process. Implications of these results for methodological approaches for identifying alliance ruptures are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).</p>","PeriodicalId":20910,"journal":{"name":"Psychotherapy","volume":"60 1","pages":"119-129"},"PeriodicalIF":2.6000,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10038834/pdf/","citationCount":"0","resultStr":"{\"title\":\"V-episodes in the alliance: A single-case application of multiple methods to identify rupture repair.\",\"authors\":\"Lauren M Lipner, Di Liu, Sophie Cassell, Elaine Hunter, Catherine F Eubanks, J Christopher Muran\",\"doi\":\"10.1037/pst0000469\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The therapeutic alliance has been consistently found to be a robust predictor of therapeutic outcome across various modalities of psychotherapy. Alliance ruptures are thought to occur commonly within each therapeutic dyad and, if left unresolved, are associated with premature termination and worsened psychotherapy outcome. Research efforts have identified V-shaped shifts in the alliance, characterized by a high-low-high pattern of postsession alliance scores, as a meaningful method of operationalizing rupture-repair episodes, but these efforts rarely evaluate the within-session process of the identified sessions. As a result, it is often unclear whether these sessions identified by methods based on postsession alliance measures are reflective of clinically meaningful within-session rupture process. This article aims to further explore the V-episode operationalization of rupture-repair episodes by assessing for convergence between rupture process identified by between-session measures and the within-session observer-based Rupture Resolution Rating Scale (3RS) in a single patient-therapist dyad in a 30-session brief relational therapy. V-episodes were operationalized using various previously utilized methods to identify ruptures based on postsession measures of alliance. Results of this case study demonstrate that postsession patient-rated V-episodes in the therapeutic alliance can be indicative of within-session rupture process, demonstrating convergence between within- and between-session measures of alliance process. Implications of these results for methodological approaches for identifying alliance ruptures are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).</p>\",\"PeriodicalId\":20910,\"journal\":{\"name\":\"Psychotherapy\",\"volume\":\"60 1\",\"pages\":\"119-129\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2023-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10038834/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Psychotherapy\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://doi.org/10.1037/pst0000469\",\"RegionNum\":2,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/1/9 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHOLOGY, CLINICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Psychotherapy","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1037/pst0000469","RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/1/9 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
引用次数: 0
摘要
在各种心理治疗模式中,治疗联盟一直被认为是治疗效果的有力预测因素。人们认为,联盟破裂通常发生在每个治疗二人组中,如果不加以解决,就会导致治疗过早终止和心理治疗效果恶化。研究发现,以治疗后联盟得分的高-低-高模式为特征的联盟中的 V 型转变,是操作破裂-修复事件的一种有意义的方法,但这些研究很少对已确定疗程的疗程内过程进行评估。因此,基于会后联盟测量的方法所识别出的会话是否反映了具有临床意义的会话内破裂过程往往并不清楚。本文旨在进一步探讨破裂修复事件的 V-episode 操作化,方法是在 30 个疗程的简短关系疗法中,在一个患者-治疗师二人组中评估由疗程间测量和基于观察者的疗程内破裂解决评分量表(3RS)所确定的破裂过程之间的趋同性。V-episodes 的操作使用了之前使用过的各种方法,根据会后的联盟测量来识别破裂。本案例研究的结果表明,治疗联盟中由患者在治疗后评定的 V-episodes 可以表明治疗过程中的破裂过程,证明了联盟过程的治疗内和治疗间测量之间的趋同性。本文讨论了这些结果对识别联盟破裂的方法论的影响。(PsycInfo Database Record (c) 2023 APA, 版权所有)。
V-episodes in the alliance: A single-case application of multiple methods to identify rupture repair.
The therapeutic alliance has been consistently found to be a robust predictor of therapeutic outcome across various modalities of psychotherapy. Alliance ruptures are thought to occur commonly within each therapeutic dyad and, if left unresolved, are associated with premature termination and worsened psychotherapy outcome. Research efforts have identified V-shaped shifts in the alliance, characterized by a high-low-high pattern of postsession alliance scores, as a meaningful method of operationalizing rupture-repair episodes, but these efforts rarely evaluate the within-session process of the identified sessions. As a result, it is often unclear whether these sessions identified by methods based on postsession alliance measures are reflective of clinically meaningful within-session rupture process. This article aims to further explore the V-episode operationalization of rupture-repair episodes by assessing for convergence between rupture process identified by between-session measures and the within-session observer-based Rupture Resolution Rating Scale (3RS) in a single patient-therapist dyad in a 30-session brief relational therapy. V-episodes were operationalized using various previously utilized methods to identify ruptures based on postsession measures of alliance. Results of this case study demonstrate that postsession patient-rated V-episodes in the therapeutic alliance can be indicative of within-session rupture process, demonstrating convergence between within- and between-session measures of alliance process. Implications of these results for methodological approaches for identifying alliance ruptures are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
期刊介绍:
Psychotherapy Theory, Research, Practice, Training publishes a wide variety of articles relevant to the field of psychotherapy. The journal strives to foster interactions among individuals involved with training, practice theory, and research since all areas are essential to psychotherapy. This journal is an invaluable resource for practicing clinical and counseling psychologists, social workers, and mental health professionals.