Mutual understanding and cooperation between patient and psychotherapist in psychotherapy. Evaluation of the goodness-of-fit of measurement by means of the Working Alliance Inventory (WAI) questionnaire
Tomasz Prusiński
Psychological Testing Unit, Institute of Psychology, The Maria Grzegorzewska University in Warsawhttps://orcid.org/0000-0002-8782-1498
Abstrakt
Objective
This article presents the results of the efforts on the Polish adaptation of the WAI questionnaire, gathered from several publications to date and from the current analysis. The tool, after several years of research with its application and estimation of psychometric properties, can be recommended to take measurement of the quality of the psychotherapeutic relationship.
Theses
The focus is on the key function of the psychotherapeutic relationship towards generating positive performance in the treatment of health problems. Globally there are many tools to assess the quality of a psychotherapeutic relationship. To date the Polish psychologists and psychotherapists have not had such tools at their disposal.
Conclusions
Analysis of the reliability of three of the four versions of the questionnaire (WAI-PC, WAI-PT, WAI-R, WAI-SUM) showed that the measurement made by the scale can be considered reliable. Evidence is presented verifying the alliance structure in action. Confirmatory factor analysis confirmed the three-dimensional structure of the psychotherapeutic alliance. The WAI questionnaire showed satisfactory theoretical validity. The WAI questionnaire in its 36-item version is a consistent tool that can be successfully used in research.
Słowa kluczowe:
Bordin pantheoretical model of psychotherapeutic relationship, Working Alliance Inventory, Working Alliance Inventory (WAI) questionnaire, WAI reliability, WAI validityBibliografia
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-behavioural 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. In A. O. Horvath, L. S. Greenberg (Eds.), 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 [Therapeutic alliance and the effectiveness of treatment for people with gambling-related behavioural disorders]. Uzależnienia [Addictions], 3 (83), 6‒11. Google Scholar
Cierpiałkowska, L., & Kubiak, J. (2010). Niespecyficzne czynniki leczące a efektywność terapii alkoholików [Nonspecific treatment factors versus treatment effectiveness for alcoholics]. Nauka [Science], 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. Psychotherapy Research, 30, 53–67. DOI: 10.1080/10503307.2018.1544724.
Crossref
Google Scholar
Cronbach, L. J., & Meehl, P. E. (2005). Trafność teoretyczna testów psychologicznych. [Theoretical validity of psychological tests]. In J. Brzeziński (Ed.), Trafność i rzetelność testów psychologicznych. Wybór tekstów [Validity and reliability of psychological tests. Text selection] (pp. 177‒212). Gdańsk: GWP. Google Scholar
Czabała, Cz. (2013). Czynniki leczące w psychoterapii [Therapeutic factors in psychotherapy]. 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 Psikiyatri Dergisi, 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). Validity 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. In A. O. Horvath, L. S. Greenberg (Eds.), The working alliance. Theory, research, and practice (pp. 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 Counselling 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 Counselling 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 [Getting to know your patient]. 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 Behavioural Disorders. Journal of Psychoeducational Assessment, 38(6), 753–761. DOI: 10.1177/0734282919874268.
Crossref
Google Scholar
LaCrosse, M. B. (1980). Perceived counsellor social influence and counselling outcomes: Validity of the Counsellor Rating Form. Journal of Counselling 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 counsellor agreement about the working alliance, session evaluations, and change in client symptoms using response surface analysis. Journal of Counselling Psychology, 59(3), 352–367. DOI: 10.1037/a0028907.
Crossref
Google Scholar
McWilliams, N. (2018). Diagnoza psychoanalityczna [Psychoanalytical diagnosis]. 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 counselling 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. In J. Jackson, K. Pósch (Eds.), Social psychology and justice (pp. 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 counselling setting: Comparison with a personal counselling 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 [Estimating the alliance of therapist and patient in the process of individual psychotherapy. Adaptation and psychometric properties of the Working Alliance Inventory Scale (WAI). Preliminary survey], Polskie Forum Psychologiczne [Polish Psychological Forum], 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 [Evidence from an experiment conducted using the non-random change method. Measurement validity of the Working Alliance Inventory Questionnaire (WAI-PC – patient version) in adult systemic psychotherapy]. Przegląd Psychologiczny [The Review of Psychology], 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-centred 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). Reconceptualising 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 counselling for tobacco dependence. Journal of Substance Abuse Treatment, 86, 60‒64. DOI: 10.1016/j.jsat.2017.12.010.
Crossref
Google Scholar
Psychological Testing Unit, Institute of Psychology, The Maria Grzegorzewska University in Warsaw
https://orcid.org/0000-0002-8782-1498
Licencja
Utwór dostępny jest na licencji Creative Commons Uznanie autorstwa – Użycie niekomercyjne – Bez utworów zależnych 4.0 Międzynarodowe.