Better understanding of the connection between therapeutic processes and outcomes in minority groups can help design and use culturally adapted treatments. To explore the active ingredient in the therapeutic process, the present case study compared two ethnic minority male clients, recruited as part of a randomized controlled trial, one with a good outcome, the other with a poor one. The 12-item Working Alliance Inventory-Observer (S-WAI-O) coding system was used to capture the process of change, alongside a qualitative analysis of content. The cases were identified based on their change in pre- to post-treatment scores on the Beck Depression Inventory and the Hamilton Rating Scale for Depression. The findings suggest a rupture-resolution process in the good outcome case, including a process of negotiation of the alliance and work on issues of trust. In contrast, the poor outcome case showed strong and steady alliance, but context analysis pointed to withdrawal ruptures. Although it is difficult to generalize from a two-case study analysis, the present work suggests that building and negotiating alliance with minority clients has a potential for treatment success.

中文翻译：

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少数族裔男性接受心理动力学心理治疗的变化过程：两个案例的详细比较

更好地了解少数群体的治疗过程和结果之间的联系可以帮助设计和使用适应文化的治疗方法。为了探索治疗过程中的活性成分，本案例研究比较了作为随机对照试验的一部分招募的两名少数族裔男性客户，一名结果良好，另一名结果不佳。12 项工作联盟库存观察员 (S-WAI-O) 编码系统用于捕捉变化过程，同时对内容进行定性分析。这些病例是根据贝克抑郁量表和汉密尔顿抑郁量表上治疗前后评分的变化来确定的。研究结果表明在良好结果案例中存在破裂解决过程，包括联盟的谈判过程和关于信任问题的工作。相比之下，结果不佳的案例显示出强大而稳定的联盟，但背景分析表明退出破裂。虽然很难从两个案例研究分析中概括出来，但目前的工作表明，与少数客户建立和谈判联盟具有治疗成功的潜力。