Although supportive techniques play an important role in supportive-expressive psychodynamic psychotherapy, little is known about the mechanisms responsible for their effect on treatment success. In this study, we propose and investigate a model according to which the mechanism of change underlying the effect of supportive techniques on therapeutic improvement is the strengthening of the therapeutic alliance. According to the proposed mediation model, the implementation of supportive techniques brings about strengthening in the alliance, which in turn results in subsequent reduction in symptoms. The present study was designed to test the proposed mediation model. Analyses were conducted on a sample of 61 patients diagnosed with major depressive disorder and enrolled in an ongoing psychotherapy trial. For each patient, Session 4 of the supportive-expressive treatment was coded for therapist adherence to supportive techniques, using the Penn Adherence-Competence Scale. The therapeutic alliance was assessed using a self-report scale, and the Hamilton Rating Scale for Depression was used to assess the subsequent change in symptoms. The analyses suggest a significant mediation model, according to which the implementation of supportive techniques resulted in improvements in the alliance, which in turn resulted in reduction in symptoms at the subsequent session (bootstrapping for the indirect effect, 95% confidence interval [-1.96, -0.16]). The findings support the proposed mediation model, suggesting that the alliance may act as a mechanism of change underlying the effect of supportive techniques on treatment success. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

中文翻译：

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支持技术如何带来治疗上的改变：治疗联盟作为潜在媒介的作用。

尽管支持技术在支持性表达心理动力学心理治疗中起着重要作用，但对其影响治疗成功的机制知之甚少。在这项研究中，我们提出并研究了一种模型，根据该模型，支持技术对治疗改善的作用机理是加强治疗联盟。根据建议的调解模型，支持技术的实施可增强联盟的力量，进而减少随后的症状。本研究旨在测试建议的调解模型。对被诊断患有重度抑郁症并参加了一项正在进行的心理治疗试验的61名患者的样本进行了分析。对于每个病人 使用Penn坚持能力量表，对支持性表达治疗的第4节编码，以指示治疗师对支持技术的依从性。使用自我报告量表评估治疗联盟，并使用汉密尔顿抑郁量表来评估随后的症状变化。分析提出了一个重要的调解模型，根据该模型，支持技术的实施可改善联盟，进而减少后续工作阶段的症状（引导间接效果，95％置信区间[-1.96， -0.16]）。该发现支持拟议的调解模型，表明该联盟可以作为支持技术对治疗成功的基础的变化机制。（PsycINFO数据库记录（c）2019 APA，