The temporal dance: How therapist presence and alliance evolve across early sessions of psychotherapy?

IF 2.7 3区 医学 Q2 PSYCHIATRY
I Volkan Gülüm, İlknur Dilekler-Aldemir, Gözde İkizer, A Nuray Karanci
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引用次数: 0

Abstract

Objective: Although there is notable evidence supporting the importance of the therapeutic alliance and therapist presence in psychotherapy practice, the question of how these factors interact dynamically over time remains to be answered. This study investigated how therapists adjust their presence in response to client distress and how this responsive pattern is moderated by therapeutic alliance during the beginning phase of psychotherapy.

Method: Pre-session symptom measurements and post-session ratings of therapist presence and alliance were collected across the first five consecutive sessions from 46 clients and 22 novice therapists, allowing examination of temporal sequences in therapeutic processes.

Results: Therapists' presence increased in response to higher pre-session symptom levels, with this responsive pattern evolving over time. This relationship was moderated by therapeutic alliance, with stronger alliance providing a context that attenuated the presence-symptom association. Notably, therapist ratings showed stronger predictive relationships with outcomes than client ratings, possibly reflecting the unique observational capacity of therapists in their earliest professional encounters.

Conclusion: These findings demonstrated how therapist presence operates as a dynamic, responsive intervention rather than a static therapeutic factor, suggesting that alliance functions as a contextual moderator rather than merely a direct predictor of outcome.

时间之舞:治疗师的存在和联盟如何在心理治疗的早期阶段演变?
目的:虽然有显著的证据支持治疗联盟和治疗师在心理治疗实践中的重要性,但这些因素如何随时间动态相互作用的问题仍有待回答。本研究探讨了在心理治疗的开始阶段,治疗师如何调整他们对来访者痛苦的反应,以及这种反应模式如何被治疗联盟所缓和。方法:从46名来访者和22名新手治疗师中收集前5个连续疗程的会前症状测量和会后治疗师在场和联盟的评分,允许检查治疗过程中的时间序列。结果:治疗师对较高的会前症状水平的反应增加,这种反应模式随着时间的推移而演变。这种关系被治疗联盟所缓和,更强的联盟提供了一个减弱存在-症状关联的背景。值得注意的是,治疗师的评分与结果的预测关系比来访者的评分更强,这可能反映了治疗师在他们最初的专业接触中独特的观察能力。结论:这些发现表明,治疗师的存在是一种动态的、反应性的干预,而不是一种静态的治疗因素,这表明联盟的作用是情境调节,而不仅仅是结果的直接预测因子。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.10
自引率
5.90%
发文量
68
审稿时长
6 months
期刊介绍: Psychology and Psychotherapy: Theory Research and Practice (formerly The British Journal of Medical Psychology) is an international scientific journal with a focus on the psychological and social processes that underlie the development and improvement of psychological problems and mental wellbeing, including: theoretical and research development in the understanding of cognitive and emotional factors in psychological problems; behaviour and relationships; vulnerability to, adjustment to, assessment of, and recovery (assisted or otherwise) from psychological distresses; psychological therapies with a focus on understanding the processes which affect outcomes where mental health is concerned.
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