The authors examined the influence of early phase dissociation, interpersonal problems, and retraumatization on the therapeutic alliance at early, middle, and later treatment phases. Participants were 84 female survivors of child abuse (ages 18 to 60 years, 53.6% Caucasian) who were receiving counseling at a university training clinic. Master’s‐ and doctoral‐level students provided counseling using integrated relationship and trauma‐based cognitive behavior therapy. Treatment followed a 3‐phase model. The authors used structural equation models to test the hypothesis. In the early and later phases, fewer interpersonal problems significantly predicted a stronger alliance. In the middle phase, fewer interpersonal problems, less dissociation, and more revictimization significantly predicted a stronger alliance. Tasks, goals, and bond contributed significantly to the alliance in each of the 3 phases. Interpersonal problems were consistently the strongest predictor across the 3 phases, whereas tasks consistently made the greatest contribution to the therapeutic alliance across all 3 phases.

中文翻译：

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创伤症状对整个治疗过程中治疗联盟的影响

作者研究了早期解体，人际关系问题和再创伤对早期，中期和后期治疗阶段治疗联盟的影响。参加调查的有84名虐待儿童的女性幸存者（年龄在18至60岁之间，白种人为53.6％），他们正在大学培训诊所接受辅导。硕士和博士学位的学生使用综合关系和基于创伤的认知行为疗法提供咨询。治疗遵循三阶段模型。作者使用结构方程模型来检验假设。在早期和后期，人际关系问题的减少显着预示了联盟的加强。在中间阶段，更少的人际交往问题，更少的分离和更多的重新折衷预示着更强大的联盟。任务，目标，债券和债券在这三个阶段的每个阶段都为联盟做出了重大贡献。在三个阶段中，人际问题始终是最强有力的预测因素，而在所有三个阶段中，任务始终对治疗联盟做出最大贡献。