Is there an allegiance bias on the efficacy of systemic therapy? A three-level meta- regression analysis.

IF 3 1区心理学 Q2 PSYCHOLOGY, CLINICAL

Psychotherapy Research Pub Date : 2026-04-13 DOI:10.1080/10503307.2026.2654029

Niels Braus, Christoph Flückiger, Robin Gräfenkämper, Christian Frankman, Johanna Wichmann, Christina Hunger-Schoppe

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引用次数: 0

Abstract

Objective: Allegiance bias affects the reproducibility of psychotherapy outcomes, but its impact in systemic therapy (ST) remains largely unexplored.

Method: Two meta-analyses were conducted: Study 1 with 42 RCTs (364 effect sizes) for children and adolescents, as well as Study 2 with 30 RCTs (161 effect sizes) for adults. Allegiance was measured using a comprehensive rating scale across researcher, therapist, trainer, and supervisor levels. Furthermore, risk of bias (RoB) was assessed using the adapted tool for psychotherapy. Three-level meta-regressions were performed, controlling for dosage.

Results: No significant moderating effect of the overall allegiance score was found in either study, Study 1: F(2, 361) = .88, p = .42, k = 364, s = 42; Study 2: F(2, 158) = 2.35, p = .10, k = 161, s = 30 . Researcher allegiance predicted higher treatment efficacy in Study 1 (β = .14, p = .02) but not in Study 2 (β = .02, p = .82). A significant moderating effect of RoB emerged in Study 2 (F(8, 151) = 3.02, p = .004, k = 161, s = 30), indicating that higher RoB was associated with larger effects favoring ST. This pattern was absent in Study 1 (F(8,355) = 1.04, p = .41, k = 364, s = 42).

Conclusion: The findings underscore the role of researcher allegiance investigating ST for children and adolescents and RoB in ST for adults, highlighting the need for transparent methods and replication efforts.

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对全身治疗的疗效是否存在忠诚偏见？三水平元回归分析。

目的：忠诚偏倚影响心理治疗结果的可重复性，但其对全身治疗（ST）的影响在很大程度上仍未被探索。方法：进行了两项荟萃分析：研究1有42项随机对照试验（364个效应量）用于儿童和青少年，研究2有30项随机对照试验（161个效应量）用于成人。忠诚是通过研究者、治疗师、培训师和主管级别的综合评定量表来衡量的。此外，使用心理治疗的适应性工具评估偏倚风险（RoB）。进行三水平元回归，控制剂量。结果：两项研究均未发现整体忠诚得分的显著调节作用，研究1:F(2,361) = 0.88, p = 0.42, k = 364, s = 42；研究2:F(2,158) = 2.35, p = 0.10, k = 161, s = 30。研究1中研究者忠诚度预测更高的治疗疗效(β =。14、p =。02)，但在研究2中没有(β =。02, p = .82)。研究2中出现了显著的RoB调节效应（F(8,151) = 3.02, p = 0.004, k = 161, s = 30），表明较高的RoB与更大的st效应相关，而研究1中没有这种模式(F(8,355) = 1.04, p =。41, k = 364, s = 42)。结论：研究结果强调了研究人员忠诚的作用，研究儿童和青少年的ST和成人的ST中的RoB，强调了透明方法和复制努力的必要性。

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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.