The Advisory Working Alliance Inventory--Advisor Version: Scale Development and Validation.

The development of the Advisory Working Alliance Inventory--Advisor Version (AWAI-A) is presented. In the first study, data from 236 faculty members from APA-accredited counseling psychology programs were subjected to a principal components analysis, yielding 3 subscales: Rapport (15 items), Apprenticeship (8 items), and Task Focus (8 items). The data also revealed evidence of the AWAI-A's internal consistency and concurrent validity, the latter being demonstrated by correlations with measures of satisfaction with the advising relationship, costs and benefits of advising, advisee interest in science and practice, and advisee research self-efficacy. In the 2nd study, data from 44 additional advisors yielded evidence of the AWAI-A's test-retest reliability and discriminant validity. Implications of the advising working alliance for doctoral training are discussed, and suggestions are provided for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ratings of Therapist Dynamic Activities and Alliance Early and Late in Psychotherapy.

The present study examines the concurrent and predictive relationships between therapist psychodynamic-interpersonal activity and therapist-rated alliance. Ratings from 45 patient and therapist dyads engaged in short term psychodynamic psychotherapy from a point early (3rd or 4th session) and late (the session at which 90% of the treatment was completed) in treatment were used. The results suggest that therapists who have positive views of the alliance early in treatment also have positive views of the alliance later in treatment. Therapists who used psychodynamic-interpersonal activities early in treatment also made use of psychodynamic-interpersonal activities later in treatment. Moreover, the use of psychodynamic-interpersonal activities early in treatment was positively related to both global and specific aspects of therapist-rated alliance late in treatment. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The Therapy Process Observational Coding System-Alliance Scale: Measure Characteristics and Prediction of Outcome in Usual Clinical Practice.

The authors describe psychometric characteristics of the new Therapy Process Observational Coding System-Alliance scale (TPOCS-A; B. D. McLeod, 2001) and illustrate its use in the study of treatment as usual. The TPOCS-A uses session observation to assess child-therapist and parent-therapist alliance. Both child and parent forms showed acceptable interrater reliability and internal consistency; when applied to cases treated for internalizing disorders, both forms were associated with youth outcomes. Child-therapist alliance during treatment predicted reduced anxiety symptoms at the end of treatment. Parent-therapist alliance during treatment predicted reduced internalizing, anxiety, and depression symptoms at the end of treatment. The findings held up well after confounding variables were controlled, which suggests that both child-therapist and parent-therapist alliance play key (and potentially different) roles in the outcome of treatment as usual. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development and validation of the Refugee Trauma Experience Inventory.

This article reports the development and validation of a new self-report measure, the Refugee Trauma Experience Inventory (RTEI). This scale was designed to assess refugees’ traumatic experiences. The RTEI was administered to 226 Tibetan refugees (113 men and 113 women) residing in India. Principal-components analysis generated 3 factors—Survival Trauma, Ethnic Concern, and Deprivation–Uncertainty. Three subscales and the Total scale showed high internal consistency. The factors derived from this scale correlated moderately to strongly with theoretically related constructs such as intrusion, avoidance, rumination, and posttraumatic schema changes, namely negative cognitions about the self and world and self-blame, thus endorsing the RTEI’s convergent validity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Working alliance as a mediator of client attachment dimensions and psychotherapy outcome.

Studies that employ multidimensional attachment measures to explore the impact of attachment style on psychotherapy process and outcome are virtually absent in the literature. Further, the role of the working (therapeutic) alliance as a mediator of the influence of attachment on treatment outcome has not been formally investigated. In order to address these gaps in the research, archival data from 66 psychotherapy clients treated at a university graduate program training clinic were used to examine the influence of three adult attachment dimensions (Comfort with Closeness, Comfort Depending on Others, and Rejection Anxiety) on the therapeutic alliance and outcome, as well as to assess whether the alliance mediates the relationship between attachment and therapy outcome. Both Comfort with Closeness and Comfort Depending on Others were significantly related to alliance and outcome, whereas Rejection Anxiety was not significantly related to either variable. Alliance was a significant partial mediator of the effect of Comfort with Closeness on outcome. The results suggest that multidimensional measures of attachment capture important influences on alliance and psychotherapy and that Comfort with Closeness promotes successful outcome by virtue of its influence on alliance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining the construct validity of the Eating Disorder Inventory.

The construct validity of the Eating Disorder Inventory (EDI) was examined in 3 samples. An archival clinic sample (n=318) of women completed the EDI, a structured interview, and the Millon Clinical Multiaxial Inventory--II (MCMI-II). Confirmatory factor analyses (CFAs) indicated that neither null nor 1-factor models of the EDI fit item-level or item-parcel data. The proposed 8-factor model did not fit at the item level but did fit item-parcel data. Reliability estimates of the 8 scales ranged from .82 to .93, and low-to-moderate interscale correlations among the eating and weight-related scales provided partial support for convergent validity. EDI personality scales showed moderate interscale correlations and were associated with MCMI-II scales. A final CFA of the EDI scales supported a 2-factor model (Eating and Weight, Personality) of the 8 EDI scales. Strong associations between depression and several EDI scale scores were found in a treatment study sample (n=50). The archival clinic sample scored significantly higher on the 8 EDI scales than the nonpatient college comparison sample (n=487). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Real Relationship Inventory: Development and psychometric investigation of the client form.

The development and validation of a client version of the Real Relationship Inventory (RRI-C) is reported. Using a sample of clients (n = 94) who were currently in psychotherapy, a 24-item measure was developed consisting of two subscales (Realism and Genuineness) and a total score. This 24-item version and other measures used for validation were completed by 93 additional clients. Results of the present study offer initial support for the validity and reliability of the RRI-C. The RRI-C correlated significantly in theoretically expected ways with measures of the client-rated working alliance and therapists' congruence, clients' observing ego, and client ratings of client and therapist real relationship on an earlier measure of the real relationship (Eugster & Wampold, 1996). A nonsignificant relation was found between the RRI-C and a measure of social desirability, providing support for discriminant validity. A confirmatory factor analysis supported the two theorized factors of the RRI-C. The authors discuss the importance of measuring clients' perceptions of the real relationship. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Convergent and discriminant validity for areas and methods of rating job satisfaction.

A study to determine the convergent and discriminant validity of 4 rating methods and 5 areas of job satisfaction. Measures were administered to 133 randomly selected employees from 2 companies. A rating method employing a series of 6 faces ranging from a scowl to a smile and a direct graphic rating method were best according to the criteria of convergent and discriminant validity. All areas adequately satisfied both criteria, but the pay, promotions, and supervision areas showed somewhat greater discriminant validity than the work and people areas. The greater appropriateness of the convergent and discriminant criteria, as compared to other possible criteria, for demonstrating the validity of areas and measures of job satisfaction is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Convergent and divergent validity of the Devereux Student Strengths Assessment.

This study assessed the convergent and divergent validity of the Devereux Student Strengths Assessment (DESSA; LeBuffe, Shapiro, & Naglieri, 2008). A total of 227 (n = 94 teachers, n = 133 parents) raters completed the DESSA, in addition to the Behavioral and Emotional Rating Scales–2 (BERS–2; Epstein, 2004) and/or the Behavior Assessment System for Children–2 (BASC–2; Reynolds & Kamphaus, 2004). All DESSA and BERS–2 subscales and total scales completed by parents and teachers correlated significantly. DESSA subscales and BASC–2 Adaptive Skills subscales correlated significantly for both parent and teacher raters. The divergent validity of the DESSA was explored by correlating the Total Protective Factor scale and subscales with the BASC–2 Behavioral Symptoms Index and clinical subscales. The majority of correlations for the parent ratings were significantly, negatively correlated, with the exception of the Anxiety, Somatization, and Withdrawal subscales. Support for the convergent validity of the DESSA was consistent across raters (e.g., parents; teachers) and measures (e.g., BASC–2; BERS–2). Thus, these findings support the divergent validity of the DESSA. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in clients' attachment styles over the course of time-limited dynamic psychotherapy.

This study utilized a theory-specific measure to examine client relational change over the course of time-limited dynamic psychotherapy in 84 Ss (aged 26–64 yrs). Specifically, this study examined change and stability in clients' attachment style. Categorical and dimensional ratings attachment styles were obtained. Pretreatment and posttreatment measures of attachment styles were then examined in association with Global Assessment Scale (GAS) scores and symptoms. Results show that at posttreatment, a significant number of clients were evaluated as having changed from an insecure to a secure attachment style. Additionally, the sample as a whole demonstrated significant changes toward increased secure attachment. Significant relationships were also found among changes in attachment style, GAS scores, and symptom levels. Implications for psychodynamic/interpersonal psychotherapy research and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empathic relational bonds and personal agency in psychotherapy: Implications for psychotherapy supervision, practice, and research.

Although psychotherapy researchers have become increasingly interested in identifying common factors that contribute to effective therapeutic practices, across psycho-diagnostic categories and treatment approaches, relatively little attention to date has been focused on the impact of these research findings for psychotherapy supervision and training programs. To address this gap, in this article we describe key components of an integrative psychotherapy supervision and training program that focuses on the development of a strong therapeutic alliance as an empirically supported, common principle of change in psychotherapy. We review empirical research evidence that addresses the contributions of therapist empathic engagement for the development of secure, relational bonds, heightened client agency, and the development of strong therapeutic alliances, and we discuss the implications of these findings for therapy practice and supervision training. We conclude with specific recommendations for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validity and reliability of the Lesbian, Gay, Bisexual Working Alliance Self-Efficacy Scales.

In this paper, the authors report on the development and initial psychometric evaluation of the Lesbian, Gay, and Bisexual Working Alliance Self-Efficacy Scales (LGB-WASES) with data collected from two studies and 534 counseling trainees. Exploratory factor analysis results yielded a 32-item scale with a three-factor model (a) Emotional Bond, (b) Establishing Tasks, and (c) Setting Goals. LGB-WASES scores were internally consistent and remained stable over a 3-week period. Construct validity evidence suggests the LGB-WASES scores were (a) positively related to general perceptions of counseling self-efficacy and multicultural counseling competency, (b) negatively related to attitudes toward lesbians and gay men, and (d) unrelated to social desirability. Recommendations for future research are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diagnostic validity of the Eppendorf Schizophrenia Inventory (ESI): A self-report screen for ultrahigh risk and acute psychosis.

[Correction Notice: An erratum for this article was reported in Vol 23(1) of Psychological Assessment (see record 2011-04411-006). Presents changes that are very small and do not in any way affect the findings of the research. These changes are explained in the correction.] Providers of mental health services need tools to screen for acute psychosis and ultrahigh risk (UHR) for transition to psychosis in help-seeking individuals. In this study, the Eppendorf Schizophrenia Inventory (ESI) was examined as a screening tool and for its ability to correctly predict diagnostic group membership (e.g., help seeking, mild psychiatric complaints, highly symptomatic mood or anxiety disorder, UHR, acute psychosis). Diagnostic evaluation with established instruments was used for diagnosis in 3 research samples. UHR status was assessed with the Structured Interview for Prodromal Symptoms/Scale of Prodromal Symptoms (Miller et al., 1999) and the Bonn Scale for the Assessment of Basic Symptoms Prediction list (Gross, Huber, Klosterk?tter, & Linz, 1987; Klosterk?tter, Hellmich, Steinmeyer, & Schulze-Lutter, 2001). This study showed that members of different diagnostic groups rate themselves significantly differently on the ESI and its subscales. A new subscale was constructed, the UHR–Psychosis scale, that showed good utility in detecting individuals with interview-diagnosed UHR status and acute psychosis. The scale is also sensitive to the threshold between UHR and acute psychosis. Practical applications of the ESI include use as a diagnostic tool within various settings. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

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)     

Assessing Consequences of Substance Use: Psychometric Properties of the Inventory of Drug Use Consequences.

Negative consequences are an important component of the substance use change process, yet no standardized measure exists to assess consequences of use. This study evaluated the psychometric properties of the Inventory of Drug Use Consequences, a self-report measure assessing drinking and drug use consequences. Participants (N=252) were assessed at entry into outpatient substance abuse treatment. Items loaded strongly on 1 factor, and internal consistency of the total scale was high. Fifteen items with the highest correlations with the total scale were chosen to represent the construct. The shortened measure exhibited good internal consistency, convergent and discriminant validity, and detected change over time and may be the measure of substance use consequences that is lacking in the field. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An Examination of Therapist and Client Behavior in High- and Low-Alliance Sessions In Cognitive-Behavioral Therapy and Process Experiential Therapy.

This study examined therapist and client behaviors in cognitive-behavioral therapy (CBT) and process experiential therapy (PET) in 24 high- and 24 low-alliance sessions. Sequential analyses revealed that client resistance was not a function of therapist directiveness in either therapy. Repeated measures analysis of variance revealed that overall, CBT therapists taught more and asked more directive questions, whereas PET therapists offered more support. However, both CBT and PET therapists provided more support during low-alliance than high-alliance sessions. Clients in PET challenged more and showed greater resistance in low-alliance sessions than clients in CBT. (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)     

Diagnostic validity of the Eppendorf Schizophrenia Inventory (ESI): A self-report screen for ultrahigh risk and acute psychosis: Correction to Niessen et al. (2010).

Reports an error in Diagnostic validity of the Eppendorf Schizophrenia Inventory (ESI): A self-report screen for ultrahigh risk and acute psychosis by Maurice A. J. Niessen, Peter M. A. J. Dingemans, Reinaud van de Fliert, Hiske E. Becker, Dorien H. Nieman and Don Linszen (Psychological Assessment, 2010[Dec], Vol 22[4], 935-944). In the first full paragraph, the references to the numbers in Table 5 are incorrect in the sentence that begins We then proceeded with calculating accuracy measures.... A corrected version of the sentence is presented in the erratum. Also presented in the erratum are corrections to variables mentioned elsewhere in the article. The aforementioned changes are very small and do not in any way affect the findings of the research. (The following abstract of the original article appeared in record 2010-24850-009.) Providers of mental health services need tools to screen for acute psychosis and ultrahigh risk (UHR) for transition to psychosis in help-seeking individuals. In this study, the Eppendorf Schizophrenia Inventory (ESI) was examined as a screening tool and for its ability to correctly predict diagnostic group membership (e.g., help seeking, mild psychiatric complaints, highly symptomatic mood or anxiety disorder, UHR, acute psychosis). Diagnostic evaluation with established instruments was used for diagnosis in 3 research samples. UHR status was assessed with the Structured Interview for Prodromal Symptoms/Scale of Prodromal Symptoms (Miller et al., 1999) and the Bonn Scale for the Assessment of Basic Symptoms Prediction list (Gross, Huber, Klosterk?tter, & Linz, 1987; Klosterk?tter, Hellmich, Steinmeyer, & Schulze-Lutter, 2001). This study showed that members of different diagnostic groups rate themselves significantly differently on the ESI and its subscales. A new subscale was constructed, the UHR–Psychosis scale, that showed good utility in detecting individuals with interview-diagnosed UHR status and acute psychosis. The scale is also sensitive to the threshold between UHR and acute psychosis. Practical applications of the ESI include use as a diagnostic tool within various settings. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The convergence and predictive validity of the Multidimensional Pain Inventory and the Personality Assessment Inventory among individuals with chronic pain.

Objective: To explore the convergence, redundancy, and validity of the Multidimensional Pain Inventory (MPI) and the Personality Assessment Inventory (PAI) in a chronic pain treatment setting. Participants: Data from intake (N=235) and follow-up (N=187) for individuals with an average of 9 years of chronic pain who participated in a 20-day integrative treatment program were analyzed. Outcome Measures: Oswestry Disability Index, Beck Depression and Anxiety inventories, Rand Short-Form Health Survey, and clinician-rated ability to stand and carry. Results: Conjoint factor analyses suggested that the MPI and PAI combine to tap five orthogonal factors: Negative Affect, Support, Externalizing, Physical Dysfunction, and Impulsivity. MPI and PAI scales significantly related to various aspects of client functioning, although these scales were more limited in predicting clinician-rated markers and change during treatment. Conclusion: Results support the combined use of the MPI and PAI to understand patient heterogeneity and predict treatment outcome in chronic pain samples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)