Abstract

Objective: Prior research has established that common therapeutic relationship factors are potent predictors of change in psychotherapy, but such factors are typically studied one at a time and their underlying structure when studied simultaneously is not clear. We assembled empirically validated relationship factors (e.g., therapist empathy; patient expectations; agreement about goals) into a single instrument and subjected it to factor analysis. Method: The instrument was applied to patients (N = 332) undergoing intensive psychotherapy of different types for depressive disorders, anxiety disorders, eating disorders, and childhood trauma in an inpatient specialized mental health setting. In order to examine the psychometric properties of the scale, we used half the sample (N=164) to conduct exploratory factor analysis (EFA) and parallel analysis before we tested the solution using exploratory structural equation modeling (ESEM) on the second half of the sample (N=168). Measurement invariance analysis was conducted to examine the stability of the factor structure. Results: The analysis yielded two factors, which were termed 1. “Confidence in the therapist” and 2. “Confidence in the treatment.” Discussion: When assessed simultaneously, patients differentiate between their evaluation of the therapist and of the treatment. The results indicate that there is substantial overlap among previously established relationship factors.

Trial registration: ClinicalTrials.gov identifier: NCT03503981.

摘要

目的：先前的研究已经确定，常见的治疗关系因素是心理治疗变化的有效预测因素，但这些因素通常一次研究一个，同时研究时它们的潜在结构尚不清楚。我们将经过经验验证的关系因素（例如，治疗师的同理心；患者的期望；对目标的同意）整合到一个单一的工具中，并对其进行因素分析。方法：仪器应用于患者（N = 332）在住院专业心理健康环境中接受不同类型的针对抑郁症、焦虑症、饮食失调和儿童创伤的强化心理治疗。为了检验量表的心理测量特性，我们使用一半样本（N = 164）进行探索性因素分析（EFA）和平行分析，然后我们使用探索性结构方程模型（ESEM）测试解决方案的后半部分样本（N = 168）。采用测量不变性分析检验因子结构的稳定性。结果：分析得出两个因素，分别称为 1.“对治疗师的信心”和 2.“对治疗的信心”。讨论：当同时评估时，患者会区分他们对治疗师和治疗的评估。结果表明，先前建立的关系因素之间存在大量重叠。

试用注册： ClinicalTrials.gov 标识符：NCT03503981。