Development and validation of the Working Alliance Inventory.

Present stages of development and preliminary validation of a self-report instrument for measuring the quality of alliance, the Working Alliance Inventory (WAI). The measure is based on Bordin's (1980) pantheoretical, tripartite (bonds, goals, and tasks) conceptualizaton of the alliance. Results from 3 studies were used to investigate the instrument's reliability and validity and the relations among the WAI scales. Data suggest that the WAI has adequate reliability. The instrument is reliably correlated with a variety of counselor and client self-reported outcome measures. Nontrivial relations were also observed between the WAI and other relationship indicators. Results are interpreted as preliminary support for the validity of the instrument. Although the results obtained in the reviewed studies are encouraging, the high correlations between the 3 subscales of the inventory bring into question the distinctness of the alliance components. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rating group therapist interventions: The validation of the Group Psychotherapy Intervention Rating Scale.

The present study seeks to establish the validity of the Group Psychotherapy Intervention Rating Scale (GPIRS), an observer-rated measure of the quality of group leader interventions. Concurrent validity was tested by comparing GPIRS results to 2 group gold standard process measures, the Hill Interaction Matrix and the Group Climate Questionnaire. Significant correlations between leader intervention scores and group member perceptions of group climate, as well as verbal interaction scores, were found. In addition, results indicated correlations between interventions aimed to gain balance between confrontation and warmth and member-rated levels of cohesion. Results lend support for the concurrent validity of the GPIRS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development and validation of revisions in the Counselor Rating Form.

A Counselor Rating Form–Short Version (CRF-S) was developed and tested with 133 undergraduates in a replication of A. Bank and M. B. LaCrosse's (1975) procedure and with 155 clients receiving outpatient treatment. Results indicate that the reliabilities of scales in the CRF-S were comparable to those for the longer CRF. Factor analytic comparison of 5 theoretical models showed that the structure of ratings was best explained by 3 correlated factors corresponding to the Attractiveness, Expertness and Trustworthiness scales. Mediating effects for client individual and treatment differences were also revealed. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapeutic Alliance in Face-to-Face Versus Videoconferenced Psychotherapy.

Despite the great potential videoconferencing holds for providing psychotherapy services to a wide range of individuals, it is presently underused by psychologists. Do psychologists hold negative attitudes that interfere with their willingness to use the technology? What do psychologists think about the impact of the technology on the therapeutic alliance? Thirty clinical psychologists were randomly assigned to watch an identical therapy session, either face-to-face or videoconferencing format. Our prediction that psychologists in the videoconferencing condition would rate the therapeutic alliance significantly lower than would psychologists in the face-to-face condition was supported. We discuss the need to develop appropriate therapist training and improve the general dissemination of information regarding videoconferencing as an important means by which to reduce negative attitudes toward the technology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development and validation of a computer-administered version of the Hamilton Rating Scale.

Developed a computer-administered form of the Hamilton Anxiety Scale (HAS), designed to provide a high degree of correspondence with the clinician interview version of the HAS. Both computer and clinician forms of the HAS were administered to 214 psychiatric outpatients and 78 community-based adults (all Ss aged 18–77 yrs). The computer-administered HAS demonstrated high internal consistency and test–retest reliability. A correlation of r(290)?=?.92, p?≤?.001, was found between the computer and the clinician versions. The mean score difference between versions was small but significant. In Ss with anxiety disorders the mean score difference between computer and clinician versions was not significant. Results support the reliability and validity of the computer-administered HAS as an alternative to the clinician-administered version of this measure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development and validation of a computer-administered version of the Hamilton Depression Rating Scale.

A computer-administered form of the Hamilton Rating Scale for Depression was designed to provide scores with a high degree of correspondence with the clinician-administered 17-item version of the scale. Both forms of the Hamilton scale were administered in a counterbalanced design to 97 subjects, including 52 outpatients with a Research Diagnostic Criteria diagnosis of Major Depression, 20 outpatients with Minor Depression, and 25 nonpsychiatric control subjects. Both the computer- and clinician-administered interviews demonstrated high internal consistency reliability of .91 and .90, respectively. A correlation of .96 was found between the two versions, and the mean score difference between the two forms was nonsignificant for the total sample. Both forms also demonstrated clinical sensitivity and specificity in differentiating between Major and Minor Depression and Control group subjects. Overall results support the clinical and research use of the computer administered version of the Hamilton scale. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Critical Incidents in the Formation of the Therapeutic Alliance from the Client's Perspective.

The purpose of this study was to identify and categorize the variables that clients consider important for forming and strengthening a positive therapeutic alliance. Forty participants were interviewed using the critical incident technique and asked to describe observable behaviors and verbalizations that they thought had significantly helped establish the alliance. A total of 376 critical incidents for alliance formation were documented, 180 of which were judged to be repetitious. This set of 376 statements was consensually sorted into 25 categories, and ad hoc analyses supported the trustworthiness of the proposed categorical system. The results indicate a discrepancy between the client's perspective on the alliance and the understanding of the alliance from the psychotherapist's or investigator's perspective that is predominant in the literature. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

CBT With Older People: Alterations and the Value of the Therapeutic Alliance.

Cognitive-behavioral therapy (CBT) is empirically supported for use with older people. Reasons for its efficacy are not fully understood--i.e., whether theory-driven techniques or nonspecific "common factors" (such as the therapeutic alliance) are responsible. In this article, the authors discuss age-related psychotherapy components. They address the difficulties of using CBT with older populations and the importance of the TA in therapy with the elderly. Finally, they identify 4 areas where the application of the TA may enhance CBT among older adults: philosophy or socialization, cognitive restructuring, resource building in the context of aging, and affect tolerance. The authors argue that a strong TA can facilitate each of these processes in the application of CBT to current cohorts of older people. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Counselor Rating Form—Short version: Further validation and comparison to the long form.

Initial validation data on the Counselor Rating Form—Short Version (CRF—S; J. D. Corrigan and L. D. Schmidt; see record 1983-09385-001), a revised version of the Counselor Rating Form (CRF; A. Barak and M. B. LaCrosse; see record 1976-07806-001), were positive. The present study, with 215 college students, largely replicated the methodology, and simultaneous collection of data on the CRF and the CRF—S allowed for direct comparisons between the 2 instruments. Results generally add to the validation of the CRF—S, but it was not successful in facilitating greater use of the lower end of the 7-point rating scale. Differences in counselor ratings suggest that the 2 instruments might be measuring slightly different constructs. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Traduction et validation canadienne-fran?aise du Nisonger Child Behavior Rating Form.

The authors have translated the Nisonger Child Behavior Rating Form (Nisonger CBRF) into French. The resulting Grillee d'évaluation comportementale pour enfants Nisonger (GéCEN) was completed by 383 parents and 328 teachers. The congruence coefficients between the factor structure obtained from the Québec data and that obtained from the American data are also presented. Except for the congruence coefficient for the irritability scale from the GéCEN-teacher, the congruence coefficients for the parent and teacher profiles exhibit a good level of factor stability between the Nisonger CBRF, and the GéCEN. The internal consistency indicators are good to excellent for the GéCEN-parent and the GéCEN-teacher. The clinical applications of this dual diagnosis assessment tool (mental retardation and psychopathology) among children and teenagers are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapeutic change and the experience of joy: Toward a theory of curative processes.

This article builds an argument for a line of psychotherapy research aimed at uncovering the universal curative processes of change that can occur in many different circumstances, not only in psychotherapy. On the basis of theories and findings from psychological research on happiness, the experience of joy is regarded as a core indicator of therapeutic change leading to an increase in intrapsychic resources and life satisfaction. By studying experiences that trigger joy, a number of curative processes can be identified with a high potential for explaining why and how psychotherapy works. Hypothetical links between these curative processes and therapeutic interventions and conditions are explored. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrating clinical assessment with cognitive neuroscience: Construct validation of the California Verbal Learning Test.

A long-standing criticism of intellectual and neuropsychological assessment instruments is that they measure global achievement only and, thus, fail to quantify the different strategies, processes, and errors an examinee may display that reflect how a given task is solved. In this study, we psychometrically explored the validity of a new clinical test of verbal memory that incorporates constructs from normal and pathological memory research in order to quantify the multifactorial ways examinees learn, or fail to learn, verbal material. The results of factor analyses involving 286 normal subjects and 113 neurological patients indicated that verbal memory consists of a number of theoretically meaningful component factors, not just a single learning factor as was previously reported in clinical studies. These factors reflect learning strategy, acquisition rate, serial position effect, discriminability, and learning interference. Within the framework of traditional psychometric analysis, the study demonstrates empirically that the scope of clinical assessment can be expanded considerably when tests are designed to evaluate constructs developed in cognitive neuroscience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapeutic Alliance in Depression Treatment: Controlling for Prior Change and Patient Characteristics.

Although many studies report that the therapeutic alliance predicts psychotherapy outcome, few exclude the possibility that this association is accounted for by 3rd variables, such as prior improvement and prognostically relevant patient characteristics. The authors treated 367 chronically depressed patients with the cognitive-behavioral analysis system of psychotherapy (CBASP), alone or with medication. Using mixed effects growth-curve analyses, they found the early alliance significantly predicted subsequent improvement in depressive symptoms after controlling for prior improvement and 8 prognostically relevant patient characteristics. In contrast, neither early level nor change in symptoms predicted the subsequent level or course of the alliance. Patients receiving combination treatment reported stronger alliances with their psychotherapists than patients receiving CBASP alone. However, the impact of the alliance on outcome was similar for both treatment conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validating the Marschak Interaction Method Rating System with adolescent mother-child dyads.

The authors investigated the reliability and construct validity of the Marschak Interaction Method Rating System (MIMRS), a new observational scoring system for the play-based Marschak Interaction Method (MIM), particularly its ability to capture high-risk parenting in adolescent mother-child dyads. The MIMRS demonstrated high interrater reliability and high internal consistency. Convergent validity was supported by moderately negative correlations between the MIMRS and the Parenting Stress Index/Short Form. The MIMRS demonstrated good contrasted groups validity, differentiating between 15 adolescent-child dyads and 16 adult- child comparison dyads, even after adjustment for differences in children's age. These results suggest that the MIMRS has the potential be a valuable rating system for research and practice with the MIM, as well as understanding and assessing parent-child relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Association Between Patient Characteristics and the Therapeutic Alliance in Cognitive-Behavioral and Interpersonal Therapy for Bulimia Nervosa.

The therapeutic alliance is an established predictor of psychotherapy outcome. However, alliance research in the treatment of eating disorders has been scant, with even less attention paid to correlates of alliance development. The goal of this study was to examine the relation between specific patient characteristics and the development of the alliance in 2 different treatments for bulimia nervosa (BN). Data derive from a large, randomized clinical trial comparing cognitive- behavioral therapy (CBT) and interpersonal therapy (IPT) for BN. Across both treatments, patient expectation of improvement was positively associated with early- and middle-treatment alliance quality. In CBT, baseline symptom severity was negatively related to middle alliance. In IPT, more baseline interpersonal problems were associated with poorer alliance quality at midtreatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rating the clinical effectiveness of employed physicians.

The common procedure for evaluating individual physicians in hospitals and large clinics is a review and evaluation of their patients' records. Such records cannot give an overall assessment of clinical effectiveness whereas performance ratings can. Good rater acceptability and criterion validity (r = .75, p     

Therapeutic Alliance, Negative Mood Regulation, and Treatment Outcome in Child Abuse-Related Posttraumatic Stress Disorder.

This study examined the related contributions of the therapeutic alliance and negative mood regulation to the outcome of a 2-phase treatment for childhood abuse-related posttraumatic stress disorder (PTSD). Phase 1 focused on stabilization and preparatory skills building, whereas Phase 2 was comprised primarily of imaginal exposure to traumatic memories. Hierarchical regression analyses indicated the strength of the therapeutic alliance established early in treatment reliably predicted improvement in PTSD symptoms at posttreatment. Furthermore, this relationship was mediated by participants' improved capacity to regulate negative mood states in the context of Phase 2 exposure therapy. In the treatment of childhood abuse-related PTSD, the therapeutic alliance and the mediating influence of emotion regulation capacity appear to have significant roles in successful outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Therapeutic Alliance in Cognitive-Behavioral Treatment of Children Referred for Oppositional, Aggressive, and Antisocial Behavior.

The authors examined the therapeutic alliance in evidence-based treatment for children (N = 185, 47 girls, 138 boys; ages 3-14 years) referred clinically for oppositional, aggressive, and antisocial behavior. Different alliances (child-therapist, parent-therapist) were assessed from each participant's perspective at 2 points over the course of treatment. As predicted, both child-therapist and parent-therapist alliances related to therapeutic change, family experience of barriers to participation in treatment, and treatment acceptability. Greater alliance was associated with greater therapeutic change, fewer perceived barriers, and greater treatment acceptability. The findings could not be attributed to the influence of socioeconomic disadvantage, parent psychopathology and stress, and child dysfunction or to rater effects (common rater variance in the predictors and criteria). (PsycINFO Database Record (c) 2010 APA, all rights reserved)