Mutual agreement between the patient and the psychotherapist in psychotherapy. Psychometrics value and factor structure of the Working Alliance Inventory
Tomasz Prusiński
Pracownia Testów Psychologicznych, Instytut Psychologii, Akademia Pedagogiki Specjalnej w Warszawiehttps://orcid.org/0000-0002-8782-1498
Abstract
The aim of the present research was to investigate the structure of working alliance assessed by means of the Working Alliance Inventory (WAI, two versions: WAI-PA for patients and WAI-PT for psychotherapists) and to present the Polish version of the 36-item WAI and its psychometric properties.
The adopted validation strategy brought the expected results, revealing the three-factor structure of the Polish versions of the WAI identical to the structure of the original measures. The results of the analyses provided strong evidence pointing to the acceptable goodness of working alliance quality measurement using the Polish versions of the examined instruments. WAI is a psychometrically valuable measure.
Keywords:
przymierze w działaniu, rzetelność i trafność WAIReferences
Andrade-González, N., Fernández-Liria, A. (2015). Spanish Adaptation of the Working Alliance Inventory (WAI). Psychometric properties of the patient and therapist forms (WAI-P and WAI-T). Annals of Psychology, 31(2), 524‒533. DOI: 10.6018/analesps.31.2.177961.
Crossref
Google Scholar
Andrusyna, T. P., Tang, T. Z., DeRubeis, R. J., Luborsky, L. (2001). The factor structure of the Working Alliance Inventory in cognitive-behavioral therapy. The Journal of Psychotherapy Practice and Research, 10(3), 173‒178. Google Scholar
Atzil-Slonim, D., Bar-Kalifa, E., Rafaeli, E., Lutz, W., Rubel, J., Schiefele, A. K., Peri, T. (2015). Therapeutic bond judgments: Congruence and incongruence. Journal of Consulting and Clinical Psychology, 83(4), 773–784.
Crossref
Google Scholar
Bat Or, M., Zilcha-Mano, S. (2019). The art therapy working alliance inventory: The development of a measure. International Journal of Art Therapy, 24(2), 76‒87. DOI: 0.1080/17454832.2018.1518989.
Crossref
Google Scholar
Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16(3), 252–260.
Crossref
Google Scholar
Bordin, E. S. (1994). Theory and research on the therapeutic working alliance: New directions. W: A. O. Horvath, L. S. Greenberg (red.), The working alliance: Theory, research, and practice (s. 13–37). New York: Wiley. Google Scholar
Busseri, M. A., Tyler, J. D. (2003). Interchangeability of the working alliance inventory and working alliance inventory, short form. Psychological Assessment, 15(2), 193‒197.
Crossref
Google Scholar
Cierpiałkowska, L. (2018). Sojusz terapeutyczny a efektywność terapii osób z zaburzeniami zachowania związanymi z hazardem. Uzależnienia, 3(83), 6‒11. Google Scholar
Cierpiałkowska, L., Kubiak, J. (2010). Niespecyficzne czynniki leczące a efektywność terapii alkoholików. Nauka, 2, 89‒111. Google Scholar
Cirasola, A., Midgley, N., Fonagy, P., Impact Consortium, Martin, P. (2020). The factor structure of the Working Alliance Inventory Short Form in youth psychotherapy: An empirical investigation. Psychotherapy Research, 31(4), 535‒547. DOI:10.1080/10503307.2020.1765041.
Crossref
Google Scholar
Crits-Christoph, P., Gallop, R., Gaines, A., Rieger, A., Connolly Gibbons, M. B. (2020). Instrumental variable analyses for causal inference: Application to multilevel analyses of the alliance-outcome relation. PsychotherapyResearch,30, 53–67. DOI: 10.1080/10503307.2018.1544724.
Crossref
Google Scholar
Cronbach, L. J., Meehl, P. E. (2005). Trafność teoretyczna testów psychologicznych. W: J. Brzeziński (red.), Trafność i rzetelność testów psychologicznych. Wybór tekstów (s. 177‒212). Gdańsk: GWP. Google Scholar
Czabała, Cz. (2013). Czynniki leczące w psychoterapii. Warszawa: PWN Google Scholar
Del Re, A. C., Flückiger, C., Horvath, A. O., Wampold, B. E. (2021). Examining therapist effects in the alliance-outcome relationship: A multilevel meta-analysis. Journal of Consulting and Clinical Psychology, 89(5), 371–378. DOI:10.1037/ccp0000637.
Crossref
Google Scholar
Gaston, L. (1990). The concept of the alliance and its role in psychotherapy: Theoretical and empirical considerations. Psychotherapy: Theory, Research, Practice, Training, 27(2), 143–153. DOI:10.1037/0033-3204.27.2.143.
Crossref
Google Scholar
Gelso, C. (2014). A tripartite model of the therapeutic relationship: Theory, research, and practice. Psychotherapy Research, 24(2), 117‒131. DOI: 10.1080/10503307.2013.845920.
Crossref
Google Scholar
Gómez Penedo, J. M., Berger, T., Grosse Holtforth, M., Krieger, T., Schröder, J., Hohagen, F., Klein, J. P. (2020). The Working Alliance Inventory for guided Internet interventions (WAI‐I). Journal of Clinical Psychology, 76(6), 973‒986. DOI: 10.1002/jclp.22823.
Crossref
Google Scholar
Guédeney, N., Fermanian, J., Curt, F., Bifulco, A. (2005). Testing the Working Alliance Inventory (WAI) in a French primary care setting. Social Psychiatry and Psychiatric Epidemiology, 40(10), 844‒852. DOI: 10.1007/s00127-005-0972-4.
Crossref
Google Scholar
Gülüm, İ. V., Sait, U. L. U. Ç., Soygüt, G. (2018). Psychometric properties of the Turkish working alliance inventory-short form. Turk PsikiyatriDergisi, 29(1), 1‒6. DOI: 10.5080/u18260.
Crossref
Google Scholar
Halfon, S., Özsoy, D., Çavdar, A. (2019). Therapeutic alliance trajectories and associations with outcome in psychodynamic child psychotherapy. Journal of Consulting and Clinical Psychology, 87(7), 603. DOI:10.1037/ccp0000415.
Crossref
Google Scholar
Hall, A. M., Ferreira, P. H., Maher, C. G., Latimer, J., Ferreira, M. L. (2010). The influence of the therapist-patient relationship on treatment outcome in physical rehabilitation: a systematic review. Physical Therapy, 90(8), 1099‒1110.
Crossref
Google Scholar
Hartmann, A., Joos, A., Orlinsky, D. E., Zeeck, A. (2015). Accuracy of therapist perceptions of patients’ alliance: Exploring the divergence. Psychotherapy Research, 25(4), 408‒419. DOI: 10.1080/10503307.2014.927601.
Crossref
Google Scholar
Hatcher, R. L., Barends, A., Hansell, J., Gutfreund, M. J. (1995). Patients’ and therapists’ shared and unique views of the therapeutic alliance: An investigation using confirmatory factor analysis in a nested design. Journal of Consulting and Clinical Psychology, 63(4), 636–643.
Crossref
Google Scholar
Hatcher, R. L., Gillaspy, J. A. (2006). Development and validation of a revised version of the working alliance inventory. Psychotherapy Research, 16(1), 12‒25.
Crossref
Google Scholar
Holopainen, R., Simpson, P., Piirainen, A., Karppinen, J., Schütze, R., Smith, A., O’Sullivan, P., Kenti, P.(2020). Physiotherapists’ perceptions of learning and implementing a biopsychosocial intervention to treat musculoskeletal pain conditions: Pain, 161, 1150–1168. DOI:10.1097/j.pain.0000000000001809.
Crossref
Google Scholar
Horvath, A. O. (1981). An exploratory study of the concept of therapeutic alliance and its measurement. Unpublished doctoral dissertation, University of British Columbia, Vancouver, Canada. Google Scholar
Horvath, A. O. (1994). Empirical validation of Bordin’s pantheoretical model of alliance: the Working Alliance Inventory perspective. W: A. O. Horvath, L. S. Greenberg (red.), The working alliance. Theory, research, and practice (s. 109‒128). New Jersey: Wiley & Sons. Google Scholar
Horvath, A.O. (2018). Research on the alliance: Knowledge in search of a theory. Psychotherapy Research, 28(4), 499–516.DOI: 10.1080/10503307.2017.1373204.
Crossref
Google Scholar
Horvath, A. O., Greenberg, L. S. (1989). Development and validation of the Working Alliance Inventory. Journal of Counseling Psychology, 2(36), 223‒233.
Crossref
Google Scholar
Hsu, S., Yu, C. K. C. (2017). A Hong Kong study of working alliance inventory short form–therapist. Asia Pacific Journal of Counseling and Psychotherapy, 8(2), 87‒100. DOI: 10.1080/21507686.2017.1313285.
Crossref
Google Scholar
Hsu, S., Zhou, R. H., Yu, C. K. C. (2016). A Hong Kong validation of working alliance inventory – short form – client. Asia Pacific Journal of Counselling and Psychotherapy, 7(1–2), 69–81. DOI:10.1080/21507686.2016.1193036.
Crossref
Google Scholar
Hukkelberg, S. S., Ogden, T. (2016). The short Working Alliance Inventory in parent training: Factor structure and longitudinal invariance. Psychotherapy Research, 26(6), 719‒726. DOI: 10.1080/10503307.2015.1119328.
Crossref
Google Scholar
Hunik, L., Galvin, S., Hartman, T., Rieger, E., Lucassen, P., Douglas, K., Sturgiss, E. (2021). Exploring the psychometric properties of the Working Alliance Inventory in general practice: a cross-sectional study. BJGP Open, 5(1), 1‒9. DOI: 10.3399/bjgpopen20X101131.
Crossref
Google Scholar
Killian, M., Forrester, D., Westlake, D., Antonopoulou, P. (2017). Validity of the working alliance inventory within child protection services. Research on Social Work Practice, 27(6), 704‒715. DOI: 10.1177/1049731515596816.
Crossref
Google Scholar
Klajs, K. (2017). Poznawanie pacjenta. Poznań: Zysk i S-ka. Google Scholar
Knowles, C., Murray, C., Gau, J., Toste, J. R. (2020). Teacher–Student Working Alliance Among Students with Emotional and Behavioral Disorders. Journal of Psychoeducational Assessment, 38(6), 753–761. DOI: 10.1177/0734282919874268.
Crossref
Google Scholar
LaCrosse, M. B. (1980). Perceived counselor social influence and counseling outcomes: Validity of the Counselor Rating Form. Journal of Counseling Psychology, 27, 320‒327.
Crossref
Google Scholar
Larsson, M. H., Falkenström, F., Andersson, G., Holmqvist, R. (2018). Alliance ruptures and repairs in psychotherapy in primary care. Psychotherapy Research, 28(1), 123‒136. DOI: 10.1080/10503307.2016.1174345.
Crossref
Google Scholar
Laws, H. B., Constantino, M. J., Sayer, A. G., Klein, D. N., Kocsis, J. H., Manber, R., Arnow, B. A. (2017). Convergence in patient–therapist therapeutic alliance ratings and its relation to outcome in chronic depression treatment. Psychotherapy Research, 27(4), 410‒424. DOI: 10.1080/10503307.2015.1114687.
Crossref
Google Scholar
Marmarosh, C. L., Kivlighan, D. M., Jr. (2012). Relationships among client and counselor agreement about the working alliance, session evaluations, and change in client symptoms using response surface analysis. Journal of Counseling Psychology, 59(3), 352–367. DOI: 10.1037/a0028907.
Crossref
Google Scholar
McWilliams, N. (2018). Diagnoza psychoanalityczna. Gdańsk: GWP. Google Scholar
Mentovich, A., Rhee, E., Tyler, T. R. (2014). My life for a voice: The influence of voice on health-care decisions. Social Justice Research, 27(1), 99‒117.
Crossref
Google Scholar
Miloff, A., Carlbring, P., Hamilton, W., Andersson, G., Reuterskiöld, L., Lindner, P. (2020). Measuring alliance toward embodied virtual therapists in the era of automated treatments with the Virtual Therapist Alliance Scale (VTAS): Development and psychometric evaluation. Journal of Medical Internet Research, 3(22), e16660. DOI: 10.2196/16660.
Crossref
Google Scholar
Milot-Lapointe, F., Le Corff, Y., Savard, R. (2020). Factor structure of the short version of the Working Alliance Inventory and its longitudinal measurement invariance across individual career counseling sessions. Journal of Career Assessment, 28(4), 693‒705. DOI:10.1177/1069072720925048.
Crossref
Google Scholar
Mokkink, L. B., Prinsen, C. A., Bouter, L. M., de Vet, H. C., Terwee, C. B. (2016). The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) and how to select an outcome measurement instrument. Brazilian Journal of Physical Therapy, 20, 105‒113. DOI:10.1590/bjpt-rbf.2014.0143.
Crossref
Google Scholar
Moseley, D. C. (1983). The therapeutic relationship and its association with outcome. Unpublished master’s thesis, University of British Columbia, Vancouver, Canada. Google Scholar
Munder, T., Wilmers, F., Leonhart, R., Linster, H. W., Barth, J. (2009). Working Alliance Inventory-Short Revised (WAI-SR): psychometric properties in outpatients and inpatients. Clinical Psychology & Psychotherapy, 17, 231–239. DOI: 10.1002/cpp.658.
Crossref
Google Scholar
Muran, J. C., Eubanks, C. F., Samstag, L. W. (2019). The processes of Jeremy Safran. Psychotherapy Research, 29(3), 277–278. DOI: 10.1080/10503307.2018.1562250.
Crossref
Google Scholar
Nissen-Lie, H. A., Solbakken, O. A., Falkenström, F., Wampold, B. E., Holmqvist, R., Ekeblad, A., Monsen, J. T. (2021). Does it make a difference to be more “on the same page”? Investigating the role of alliance convergence for outcomes in two different samples. Psychotherapy Research, 31(5), 573‒588. DOI: 10.1080/10503307.2020.1823030.
Crossref
Google Scholar
Paap, D., Karel, Y. H., Verhagen, A. P., Dijkstra, P. U., Geertzen, J. H., Pool, G. (2022). The Working Alliance Inventory's Measurement Properties: A Systematic Review. Frontiers in Psychology, 13, 1‒19. DOI: 10.3389/fpsyg.2022.945294.
Crossref
Google Scholar
Paap, D., Schepers, M., Dijkstra, P. U. (2020). Reducing ceiling effects in the Working Alliance Inventory-Rehabilitation Dutch Version. Disability and Rehabilitation, 42(20), 2944–2950. DOI:10.1080/09638288.2018.1563833.
Crossref
Google Scholar
Pérez-Arechaederra D. (2019). The psychology of perceived justice in shared health care decision making. W: J. Jackson, K. Pósch (red.), Social psychology and justice (s. 284‒294). London: Routledge.
Crossref
Google Scholar
Perdrix, S., de Roten, Y., Kolly, S., Rossier, J. (2010). The psychometric properties of the WAI in a career counseling setting: Comparison with a personal counseling sample. Journal of Career Assessment, 18(4), 409‒419. DOI:10.1177/1069072710374583.
Crossref
Google Scholar
Petek, D., Pušnik, A., Selič, P., Cedilnik-Gorup, E., Trontelj, Ž., Riou, M., Le Reste, J. Y. (2019). Semantic and cultural equivalence of the working alliance inventory short-revised scale for therapeutic alliance in family medicine: Lessons learned in Slovenia. Slovenian Journal of Public Health, 58(1), 21‒30. DOI: 10.2478/sjph-2019-0003.
Crossref
Google Scholar
Prusiński, T. (2020). Szacowanie przymierza terapeuty i pacjenta w procesie indywidualnej psychoterapii. Adaptacja i właściwości psychometryczne Skali Przymierza w Działaniu (WAI). Badania wstępne. Polskie Forum Psychologiczne, 25(3), 352–375. DOI: 10.14656/PFP20200306. Google Scholar
Prusiński, T. (2021b). Trafność pomiaru kwestionariuszem Przymierza w Działaniu WAI-PC (wersja dla pacjenta) w psychoterapii systemowej osób dorosłych. Dowody z eksperymentu przeprowadzonego metodą zmian nieprzypadkowych. Przegląd Psychologiczny, 64(3), 103‒111. DOI: 10.31648/pp.7333.
Crossref
Google Scholar
Prusiński, T. (2021a). Patients’ and psychotherapists’ combined and separate evaluations of the psychotherapeutic relationship: the structure of working alliance and polish versions of the WAI. Journal of Contemporary Psychotherapy, 51(4), 323‒329. DOI: 10.1007/s10879-021-09500-z.
Crossref
Google Scholar
Prusiński, T. (2022). The Role of Doctor’s Authority in Patients’ Treatment Decisions. American Journal of Health Behavior, 46(5), 503‒514. DOI: 10.5993/AJHB.46.5.2.
Crossref
Google Scholar
Rogers, C. R. (1951). Client-centered therapy. Cambridge, MA: Riverside Press. Google Scholar
Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 22, 95‒1103.
Crossref
Google Scholar
Santirso, F. A., Martín-Fernández, M., Lila, M., Gracia, E., Terreros, E. (2018). Validation of the Working Alliance Inventory–Observer Short Version with male intimate partner violence offenders. International Journal of Clinical and Health Psychology, 18(2), 152–161. DOI:10.1016/j.ijchp.2018.02.003.
Crossref
Google Scholar
Toste, J. R., Heath, N. L., McDonald Connor, C., Peng, P. (2015). Reconceptualizing teacher-student relationships: Applicability of the working alliance within classroom contexts. The Elementary School Journal, 116(1), 30‒48. DOI: 10.1086/683110.
Crossref
Google Scholar
Tyler, T. R. (2021). Why people obey the law. Princeton University Press.
Crossref
Google Scholar
Tryon, G. S., Blackwell, S. C., Hammel, E. F. (2007). A metaanalytic examination of client–therapist perspectives of the working alliance. Psychotherapy Research, 17, 629–642. DOI: 10.1080/10503300701320611.
Crossref
Google Scholar
Warlick, C., Richter, K. P., Catley, D., Gajewski, B. J., Martin, L. E., Mussulman, L. M. (2019). Two brief valid measures of therapeutic alliance in counseling for tobacco dependence. Journal of Substance Abuse Treatment, 86, 60‒64. DOI: 10.1016/j.jsat.2017.12.010.
Crossref
Google Scholar
Pracownia Testów Psychologicznych, Instytut Psychologii, Akademia Pedagogiki Specjalnej w Warszawie
https://orcid.org/0000-0002-8782-1498
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