Therapeutic alliance and obesity management in primary care - a cross-sectional pilot using the Working Alliance Inventory

2016 ◽  
Vol 6 (6) ◽  
pp. 376-379 ◽  
Author(s):  
E. A. Sturgiss ◽  
G. M. Sargent ◽  
E. Haesler ◽  
E. Rieger ◽  
K. Douglas
Keyword(s):  
Primary Care ◽  
Therapeutic Alliance ◽  
Working Alliance ◽  
Obesity Management ◽  
Cross Sectional ◽  
Working Alliance Inventory

scholarly journals Exploring the psychometric properties of the Working Alliance Inventory in general practice: a cross-sectional study

BJGP Open ◽  
2020 ◽  
pp. bjgpopen20X101131
Author(s):  
Liesbeth Hunik ◽  
Shelley Galvin ◽  
Tim olde Hartman ◽  
Elizabeth Rieger ◽  
Peter Lucassen ◽  
...  
Keyword(s):  
General Practice ◽  
Factor Analysis ◽  
Therapeutic Alliance ◽  
Working Alliance ◽  
Concurrent Validity ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Working Alliance Inventory ◽  
Three Components

BackgroundThe therapeutic alliance is a framework from psychology that describes three components: goals, tasks, and bond. The Working Alliance Inventory adapted for general practice (WAI-GP) measures the strength of the therapeutic alliance between the patient and the clinician, and it could be useful in both research and clinical settings.AimTo determine if the patient score on WAI-GP can delineate the three components (goals, tasks, and bond), and to test concurrent validity with the Consultation and Relational Empathy (CARE) measure and the Patient Perception of Patient-Centredness (PPPC) measure.Design & settingA cross-sectional study took place in 12 general practice waiting rooms in Australia.MethodThe research instruments included the 12-item WAI-GP (the patient version), the CARE and PPPC measures, plus a survey of demographics and reason for consultation. To perform a principal components factor analysis of the WAI-GP, this dataset was combined with an existing dataset. The Spearman rank correlation was used to determine concurrent validity between the WAI-GP and the CARE and PPPC measures.ResultsParticipants (97–99%) reported a strong positive alliance after the consultation (average WAI-GP mean 4.27 ± 0.67 out of 5, n = 146). Factor analysis could not separate the three components (one factor, eigenvalue >1; Cronbach’s α = 0.957; n = 281). Concurrent validity was supported by moderate correlations with the other measures (PPPC ρ = –0.51, P<0.005, CARE ρ = 0.56, P<0.005).ConclusionThree components could not be identified, but the WAI-GP has a high internal consistency and concurrent validity with moderate correlations with the CARE and PPPC. A more diverse sample may better distinguish the three components leading to more specific feedback to clinicians on their consultation practices.

scholarly journals Therapeutic alliance in the initial phase of psychotherapy with adolescents: different perspectives and their association with therapeutic outcomes

2016 ◽  
Vol 19 (1) ◽  
Author(s):  
Olga María Fernandez ◽  
Mariane Krause ◽  
Janet Carola Pérez
Keyword(s):  
Therapeutic Alliance ◽  
Working Alliance ◽  
Initial Phase ◽  
Psychotherapy Research ◽  
Positive Association ◽  
Outcome Questionnaire ◽  
The Third ◽  
Working Alliance Inventory ◽  
Therapeutic Outcomes

Psychotherapy research focusing on adults as well as on children and adolescents has revealed a positive association between the quality of the therapeutic alliance (TA) in the first sessions and therapeutic outcomes. Nevertheless, there is controversy regarding which perspective (of the adolescents, therapists, or parents) and what moment of evaluation (first, second, or third session) is most strongly associated with outcome. This study aims to describe the TA during the initial phase of psychotherapy with adolescents, from several perspectives, and relate it to the intermediate and final outcomes of the therapy. The study is descriptive-correlational and was conducted in naturalistic settings. The sample comprised 20 individual psychotherapeutic processes (15 females, 5 males; average age: 15.8 years; standard deviation=1.04). The variables studied were: TA, measured with the Working Alliance Inventory, applied to adolescents, therapists, and parents, and therapeutic outcomes, measured using Lambert’s Outcome Questionnaire (OQ- 45.2). The results show that the TA improved from session one to session three, both in the adolescents and the therapists. The TA, as perceived by the adolescents in the third session, is positively correlated with final outcomes (r=-.732*, P=.025). The TA evaluated from the therapists’ perspective in the third session, specifically the bond component of the TA, predicts the final success of psychotherapy with adolescent patients [β=0.426, Exp. (B)=1.531, degree of freedom=1, P=0.034]. The importance of the initial construction of the working alliance by both participants is discussed.

Validation of a Brief Form of the Supervisory Working Alliance Inventory

2019 ◽  
Vol 63 (2) ◽  
pp. 115-124 ◽  
Author(s):  
Scott A. Sabella ◽  
Jared C. Schultz ◽  
Trenton J. Landon
Keyword(s):  
Working Alliance ◽  
Convergent Validity ◽  
Secondary Data ◽  
National Sample ◽  
Full Scale ◽  
Rehabilitation Counselors ◽  
Supervisory Working Alliance ◽  
Cross Sectional ◽  
Electronic Survey ◽  
Working Alliance Inventory

The Supervisory Working Alliance Inventory–Trainee Form (SWAI-T) is among the most frequently used instruments for measuring the quality of supervisor–supervisee relationships within counselor supervision. Although the full-scale SWAI-T instrument has proven utility, there are instances when a shorter form may be useful for research and field applications. The current study used secondary data from a pair of cross-sectional studies to test the utility of a brief form of the SWAI-T in a two-step process: (a) reduction of the SWAI-T based on item analyses from an electronic survey of 87 rehabilitation counselors working in a Western state vocational rehabilitation agency and (b) an initial validation study of the instrument using electronic survey responses from a national sample of 228 rehabilitation counselors working in private rehabilitation. The resultant 5-item scale showed evidence of high internal consistency, convergent validity, and minimal differences in psychometric properties relative to the full-scale instrument. An abbreviated supervisory working alliance scale offers practical advantages for select research purposes and for continuous evaluation of supervisory relationships in field environments.

Testing the Working Alliance Inventory (WAI) in a French primary care setting

2005 ◽  
Vol 40 (10) ◽  
pp. 844-852 ◽  
Author(s):  
Nicole Guédeney ◽  
Jacques Fermanian ◽  
Florence Curt ◽  
Antonia Bifulco
Keyword(s):  
Primary Care ◽  
Working Alliance ◽  
Care Setting ◽  
Primary Care Setting ◽  
Working Alliance Inventory

Cooperation behaviour of primary care paediatricians: facilitators and barriers to multidisciplinary obesity management

2020 ◽  
Vol 30 (3) ◽  
pp. 407-414
Author(s):  
Franca Brüggen ◽  
Paul Gellert ◽  
Nadja-Raphaela Baer ◽  
Birgit Jödicke ◽  
Jana Brauchmann ◽  
...  
Keyword(s):  
Primary Care ◽  
Childhood Obesity ◽  
Health Care Professionals ◽  
Missing Values ◽  
Inpatient Rehabilitation ◽  
Female Gender ◽  
Structural Factors ◽  
Obesity Management ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Background Multidisciplinary management of obesity by primary care paediatricians, providing a promising approach to tackle childhood obesity includes cooperation with other health care professionals. However, facilitators for and barriers to multidisciplinary cooperation in ambulatory care are not yet well understood and are investigated in the present study. Methods A nationwide, cross-sectional survey of 83% of German primary care paediatricians was conducted, using a questionnaire based on qualitative expert interviews. Frequency of paediatricians’ cooperation with external partners (i.e. nutrition counsellors; sports groups; interdisciplinary obesity centres; inpatient rehabilitation centres; and endocrinologists) was assessed. Individual and structural factors were associated with cooperation patterns. Missing values were addressed using multiple imputation. Results Out of the 6081 primary care paediatricians approached, 2024 (33.3%) responded. Almost half of the respondents (40.8%) stated that they disengaged in the field of obesity prevention due to perceived inefficacy. Lack of financial reimbursement for consultation was agreed on by most of the respondents (90.4%). Identified barriers to cooperation included: higher proportion of patients with migration background, lack of time and available services. A more comprehensive conception of the professional role regarding overweight prevention, higher age, female gender, higher proportion of overweight/obese patients and practice location in urban or socially strained areas surfaced as facilitators for cooperation. Conclusion Low-perceived self-efficacy in obesity management and insufficient financial reimbursement for consultation are commonly stated among German paediatricians. For cooperation behaviour, however, other individual and structural factors seem to be relevant, which provide indications on how multidisciplinary childhood obesity management can be improved.

scholarly journals Working Alliance Inventory for Online Interventions-Short Form (WAI-TECH-SF): The Role of the Therapeutic Alliance between Patient and Online Program in Therapeutic Outcomes

2020 ◽  
Vol 17 (17) ◽  
pp. 6169 ◽  
Author(s):  
Rocío Herrero ◽  
Mª Dolores Vara ◽  
Marta Miragall ◽  
Cristina Botella ◽  
Azucena García-Palacios ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Therapeutic Alliance ◽  
Working Alliance ◽  
Short Form ◽  
Behavioural Therapy ◽  
Dimensional Structure ◽  
Online Program ◽  
Online Interventions ◽  
Working Alliance Inventory ◽  
Therapeutic Outcomes

Background: Therapeutic alliance (TA) between the patient and therapist has been related to positive therapeutic outcomes. Because Internet-based interventions are increasingly being implemented, a tool is needed to measure the TA with Internet-based self-guided programs. The Working Alliance Inventory for online interventions (WAI-TECH-SF) was adapted based on the WAI Short Form (Hatcher & Gillaspy, 2006). The objectives of this study were: (1) to analyse the psychometric properties of the WAI-TECH-SF; (2) to explore the differences in the WAI-TECH-SF scores according to different categories of the sample; and (3) to analyse whether the WAI-TECH-SF can predict therapeutic outcomes and satisfaction with the treatment. Methods: 193 patients diagnosed with depression were included and received blended Cognitive-Behavioural Therapy. Measures of preferences, satisfaction, and credibility about the treatment, TA with the online program, depressive symptoms, and satisfaction with the treatment were administered. Results: An exploratory factor analysis revealed a one-dimensional structure with adequate internal consistency. Linear regression analyses showed that the WAI-TECH-SF predicted changes in depressive symptoms and satisfaction with the treatment. Conclusions: WAI-TECH-SF is a reliable questionnaire to assess the TA between the patient and the online program, which is associated with positive therapeutic outcomes and satisfaction with the treatment.

Alliance With an Unguided Smartphone App: Validation of the Digital Working Alliance Inventory

Assessment ◽  
2021 ◽  
pp. 107319112110153
Author(s):  
Simon B. Goldberg ◽  
Scott A. Baldwin ◽  
Kevin M. Riordan ◽  
John Torous ◽  
Cortland J. Dahl ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Psychological Distress ◽  
Working Alliance ◽  
Convergent Validity ◽  
Discriminant Validity ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Working Alliance Inventory ◽  
Trial Testing ◽  
Test Retest Reliability

The working alliance may be relevant in unguided smartphone-based interventions, but no validated measure exists. We evaluated the psychometric properties of the six-item Digital Working Alliance Inventory (DWAI) using a cross-sectional survey of meditation app users ( n = 290) and the intervention arm of a randomized trial testing a smartphone-based meditation app ( n = 314). Exploratory factor analysis suggested a single-factor solution which was replicated using longitudinal confirmatory factor analysis. The DWAI showed adequate internal consistency and test–retest reliability. Discriminant validity was supported by a lack of association with social desirability, psychological distress, and preference for a waitlist condition. Convergent validity was supported by positive associations with perceived app effectiveness and preference for an app condition. Supporting predictive validity, DWAI scores positively predicted self-reported and objective app utilization. When assessed at Weeks 3 or 4 of the intervention, but not earlier, DWAI scores predicted pre–post reductions in psychological distress.

scholarly journals Measuring Therapeutic Alliance for Tobacco Cessation Counseling for Behavioral Health Clinicians

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Bruce Christiansen ◽  
Stevens S. Smith ◽  
Michael C. Fiore
Keyword(s):  
Therapeutic Alliance ◽  
Behavioral Health ◽  
Working Alliance ◽  
Tobacco Cessation ◽  
Smoking Status ◽  
Treatment Plan ◽  
Community Support ◽  
Tobacco Dependence ◽  
Community Services ◽  
Working Alliance Inventory

Introduction. Those coping with significant mental illness smoke at a high prevalence rate. Increasingly, behavioral health clinicians (BHCs) are being asked to provide tobacco-dependence interventions. In this context, it is important to measure their success at doing so. While the Working Alliance Inventory (WAI) is a well-established measurement of the effectiveness of therapeutic alliance, it is not specific to tobacco-dependence interventions. The Working Alliance Inventory for Tobacco (WAIT-3) has been found valid for tobacco cessation counselors (health providers who address tobacco), but its validity has not been established when BHCs address tobacco cessation as part of addressing all other needs of their patients. The purpose of this study was to examine the validity of the WAIT-3 in the context of behavioral health clinicians. Methods. Wisconsin Community Support Programs and Comprehensive Community Services programs distributed an anonymous, brief (14 items) survey to 1,930 of their clients. Measured variables included smoking status, behavioral intentions regarding quitting, and perception of help received from their clinic. Respondents could enter a chance to win a gift card as a thank you. Results. WAIT-3 scores were correlated with quitting-related variables. Compared to those with lower WAIT-3 scores, those with higher scores reported more attempts to quit, were more motivated to quit, were more likely to have a smoking cessation/reduction goal in their general treatment plan, had more conversations about quitting with their BHC, and wanted more help from their BHC to quit. Conclusions. The WAIT-3 may be a valid way to measure the effectiveness of BHCs to address the tobacco use of their patients. Next steps include establishing its predictive validity.

scholarly journals Semantic and cultural equivalence of the working alliance inventory short-revised scale for therapeutic alliance in family medicine: Lessons learned in Slovenia

2019 ◽  
Vol 58 (1) ◽  
pp. 21-30
Author(s):  
Davorina Petek ◽  
Ambrož Pušnik ◽  
Polona Selič ◽  
Eva Cedilnik-Gorup ◽  
Žan Trontelj ◽  
...  
Keyword(s):  
Family Medicine ◽  
Therapeutic Alliance ◽  
Working Alliance ◽  
Scale Validation ◽  
Lessons Learned ◽  
Delphi Consensus ◽  
Psychotherapeutic Treatment ◽  
Working Alliance Inventory ◽  
Back Translation ◽  
Conceptual Equivalence

Abstract Introduction Therapeutic alliance is a term most commonly associated with psychotherapeutic treatment, but recently its use has become increasingly significant in the other fields of medicine. An increasing amount of evidence implies that the quality of the therapeutic alliance between the doctor and patient substantially affects treatment outcomes. A European consensus chose the Working Alliance Inventory – Short Revised (WAI-SR) scale as the most efficient for European primary care. This paper presents the process of establishing the semantic and cultural equivalence of the two WAI-SR scales in Slovene. Method As a part of a larger international project, a group of four experts translated the two WAI SR scales (physician and patient versions) from English into Slovene. Twenty-six Slovenian family medicine doctors participated in the process of obtaining semantic, idiomatic, experiential and conceptual equivalence in translation using a Delphi consensus procedure. Afterward, a cultural equivalence was made to adapt the translations within the national context. Results Agreement on translation was achieved after two Delphi rounds. The back-translation and cultural equivalence were accomplished without major problems, with some minor additional linguistic corrections. Conclusion A Slovene version of the WAI-SR scale was successfully adapted and is available for further scale validation and research on therapeutic alliance.

scholarly journals Internalizing symptoms impede adolescents’ ability to transition from in-person to online mental health services during the 2019 coronavirus disease pandemic

2021 ◽  
pp. 1357633X2110212
Author(s):  
Ehud Mekori-Domachevsky ◽  
Noam Matalon ◽  
Yael Mayer ◽  
Noga Shiffman ◽  
Ido Lurie ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Therapeutic Alliance ◽  
Working Alliance ◽  
Internalizing Symptoms ◽  
Standard Of Care ◽  
Satisfaction Questionnaire ◽  
Working Alliance Inventory ◽  
Session Evaluation

Introduction Online mental health services were previously found to be effective in many studies. However, this method was not generally used in Israel. By the end of 2019, the coronavirus disease 2019 pandemic erupted, forcing mental health services to transition to online meetings to maintain the standard of care. In this cross-sectional study, we investigated the attitudes of adolescent patients toward this involuntary new mode of care. Methods Forty-four adolescents (mean age 14.62 ± 2.12 years, 54.5% females) and 40 of their primary caregivers completed a battery of questionnaires that included the telemedicine satisfaction questionnaire, session evaluation questionnaire, working alliance inventory, and pediatric symptom checklist. Results Both adolescents and their caregivers reported a reasonable experience with the online medium and a feeling that the meetings were overall powerful, helpful, and comfortable as demonstrated by medium to high scores on the telemedicine satisfaction questionnaire and session evaluation questionnaire questionnaires. A therapeutic alliance was generally maintained according to working alliance inventory scores. However, working alliance inventory scores were negatively correlated with higher levels of internalizing symptoms and parental stress. Discussion Our findings point to the possibility that anxious/depressed adolescents will have greater difficulties re-establishing therapeutic alliance when transitioned from in-person to online meetings. This may be due to the introduction of an “invisible” third party to the therapeutic setting—the computer. Psychologists and psychiatrists should be aware of these difficulties and respond adequately to maintain the standard of care.

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