Academic literature on the topic 'Working Alliance Inventory (WAI)'

Abstract. The purpose of this study was to validate a version of the Working Alliance Inventory (WAI) for children and adolescents (WAI-CA). The sample included 109 children/adolescents aged between 7 and 17 years, outpatients in a Clinical Psychology Unit (Portugal), who completed the WAI-CA between psychotherapy sessions 3 and 35. A subsample of 30 children/adolescents aged between 10 and 14 years filled out both the WAI-CA and the WAI within a one-to-two week’s interval. A subsample of 57 children/adolescents with ages between 7 and 17 years filled out the WAI-CA, and their accompanying parent the WAI. Results show high internal consistency (Cronbach’s alpha ranging from .71 to .89) and good external validity. Significant differences were found in the bond subscale according to age, gender, and diagnosis, with higher values in children compared to adolescents, in girls compared to boys, and in participants with internalizing and externalizing problems compared to participants with school problems. Moderate to strong significant correlations were found between children/adolescents’ WAI-CA and WAI scores and weak correlations between children/adolescents’ WAI-CA scores and parent’s WAI scores. Results suggest that the WAI-CA is a valid measure of working alliance to be used with children and adolescents.

The Working Alliance Inventory remains a widely studied measure of quality of therapeutic relationships between the practitioner and client. No prior study has examined the psychometrics and validity of the Working Alliance Inventory–Short (WAI-S) in a sample of families, social workers, and trained observers within child protection services. Surveys were completed by 130 families, social workers concerning 274 cases, and observers following 165 home visits during the first wave of data collected from a randomized controlled trial of child protection services. Confirmatory factor analyses were conducted on three versions of the WAI-S and demonstrated moderate to good model fit. Convergent construct validity was found with other standardized measures. Results support the use of the WAI-S during in child protection services practice and research. Future research into family engagement in child protection social work services should focus on the working relationship.

The present study examined the working alliance, as measured by the full-length Working Alliance Inventory (WAI), and its association with psychopathy, treatment completion, and recidivism in a sample of 111 incarcerated adult male sexual offenders. The men completed the WAI 3 months into their treatment program, while psychopathy was measured via file-based ratings of the Hare’s Psychopathy Checklist–Revised (PCL-R), and outcome data were collected via the Canadian Police Information Centre. The majority (85%) of high PCL-R scoring men (PCL-R 25+) successfully completed their treatment program, and by and large, the men demonstrated strong working alliances with their primary therapists. The WAI scale components showed differential associations with the structural features of psychopathy. Specifically, the Affective facet was significantly associated with weaker Bond scores, while the Lifestyle facet was associated with lower Task scores; these results were upheld after controlling for scores on the other PCL-R facets. Strength of alliance, however, was not significantly associated with any recidivism outcomes, irrespective of controls for psychopathy. Implications for the treatment of offenders with high levels of psychopathic traits are discussed in light of extant findings and unique features of the therapeutic alliance.

Abstract Background Relational aspects of primary care are important, but we have no standard measure for assessment. The ‘working alliance’ incorporates elements of the therapeutic relationship, shared decision-making, goal setting and communication skills. The Working Alliance Inventory (short form) (WAI-SF) has been used in adult psychology, and a high score on the survey is associated with improved outcomes for clients. Objective To adapt the WAI-SF for use between GPs and patients and to test its concurrent validity with measures of shared decision-making and the doctor–patient relationship and discriminant validity with measures of social desirability. Methods Two rounds of online survey feedback from 55 GPs and 47 patients were used to adapt the WAI-SF—the WAI-GP. The tool was then completed by 142 patients in waiting rooms after seeing their GP and by 16 GPs at the end of their session. Concurrent validity with measures of shared decision-making and patient–doctor depth of relationship was determined using Spearman Rho correlations. Patients also completed two social desirability surveys, and discriminant validity with WAI-GP was assessed. Results Following feedback, the survey was re-worded to remove phrases that were perceived as judgmental or irrelevant. The patient measure of the WAI-GP was strongly correlated with Dyadic OPTION (rho = 0.705, P = 0.0001) and Patient–Doctor Depth of Relationship scale (rho = 0.591, P = 0.0001) and not with measures of social desirability. Conclusion The psychometric properties of the WAI-GP support its use for measuring GP-patient alliance. Possibilities for use include assessing the influence of therapeutic alliance on the effectiveness of interventions.

The working alliance is one of the most widely studied constructs in psychotherapy process research. The purpose of our study was to adapt the patient and therapist forms of the Working Alliance Inventory (WAI-P and WAI-T) into Spanish. Both measurement instruments were translated into Spanish through a systematic translation process. The psychometric properties of the instruments were evaluated in both a pilot study and a clinical study involving Spanish outpatients with depressive disorders and their therapists. In the clinical study, patients completed the Spanish-language Beck Depression Inventory (BDI) prior to initiating therapy and after the third and tenth psychotherapy sessions. High average scores were obtained with the Spanish-language WAI-P and WAI-T. A large number of individual items correlated satisfactorily with the overall score for the corresponding subscale. Both measures demonstrated excellent reliability (internal consistency) and convergent validity. There were some limitations in the discriminant validity of the measures vs. measures of empathy. Regarding predictive validity, the overall WAI-P and the Task subscale of the WAI-T separately explained a moderate percentage of the variance in patient change in the BDI after the tenth psychotherapy session. These results were satisfactory and consistent with those obtained in studies using the English-language WAI.

The use of videoconferencing in psychotherapy remains largely unexplored. Videoconferencing compromises the range and quality of interactional information and thus might be expected to affect the working alliance (WA) between client and therapist, and consequently the process and outcome of therapy. A single case study exploring the effect of videoconferencing on the development of the WA in the psychological treatment of a female–male transsexual is described. The self-rated Working Alliance Inventory (WAI) was used to measure client and therapist perceptions of the WA after each session over 10 sessions of eclectic therapy conducted over a videolink. The serial WAI measurements charting the development of the WA in 4 cases of 10-session, face-to-face therapy by Horvath and Marx1 were used as a quasi-control. Therapist and client impressions of teletherapy are described. WAI scores were essentially similar to the face-to-face control group except for lower client-rated bond subscale scores. It is suggested that client personality factors accounted for this difference and that videoconferencing did not impair the development of an adequate working alliance or successful therapeutic outcome.

Abstract Introduction Therapeutic alliance is a term most commonly associated with psychotherapeutic treatment, but recently its use has become increasingly significant in the other fields of medicine. An increasing amount of evidence implies that the quality of the therapeutic alliance between the doctor and patient substantially affects treatment outcomes. A European consensus chose the Working Alliance Inventory – Short Revised (WAI-SR) scale as the most efficient for European primary care. This paper presents the process of establishing the semantic and cultural equivalence of the two WAI-SR scales in Slovene. Method As a part of a larger international project, a group of four experts translated the two WAI SR scales (physician and patient versions) from English into Slovene. Twenty-six Slovenian family medicine doctors participated in the process of obtaining semantic, idiomatic, experiential and conceptual equivalence in translation using a Delphi consensus procedure. Afterward, a cultural equivalence was made to adapt the translations within the national context. Results Agreement on translation was achieved after two Delphi rounds. The back-translation and cultural equivalence were accomplished without major problems, with some minor additional linguistic corrections. Conclusion A Slovene version of the WAI-SR scale was successfully adapted and is available for further scale validation and research on therapeutic alliance.

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Os estudos sobre intervenções para dependentes de álcool têm priorizado compreender os ingredientes ativos que influenciam o processo psicoterapêutico, sendo a aliança terapêutica (AT) um desses mecanismos. Tem sido recomendado o uso de medidas preenchidas por um observador clínico para a avaliação da AT. Todavia, observa-se a ausência de medidas observacionais de AT no Brasil, sendo o seu estudo ainda incipiente. Objetivo: Os objetivos deste trabalho envolveram dois estudos: 1) desenvolver uma revisão da literatura visando caracterizar os instrumentos de AT; 2) e realizar a adaptação transcultural do Working Alliance Inventory - Short Revised Observer (WAI-SR-O) e analisar suas evidências de validade para dependentes de álcool em tratamento cognitivo-comportamental breve. Método: Para a revisão, foram coletados os dados bibliométricos e realizada análise de conteúdo categorial temática. O segundo estudo envolveu a adaptação transcultural do WAI-SR-O, o qual foi submetido à análise de evidências de confiabilidade baseadas na estrutura interna, evidências de validade baseadas nas relações com variáveis externas, avaliação das diferenças das médias inter e intravaliadores, além do cálculo do Coeficiente de Correlação Intraclasse (CCI) do WAI nas versões terapeuta e cliente. Resultados: Os resultados da revisão indicam instrumentos de AT em variadas versões, avaliados sob diferentes perspectivas e fundamentados em diversos modelos teóricos. Eles apresentaram boas propriedades psicométricas, embora tenham sido identificadas importantes questões quanto à estrutura fatorial. O segundo estudo abarcou a tradução, retrotradução e avaliação do WAI-SR-O por peritos. Foi realizado um treinamento com os avaliadores que culminou em alguns ajustes no intrumento. As análises iniciais das suas propriedades psicométricas indicaram bom alfa de Cronbach (α = 0,86), evidências de validade convergente com o WAI-Terapeuta e alto CCI intravaliadores para escala geral e subescalas. Discussão: Os problemas na estrutura fatorial dos instrumentos de AT levantados no primeiro estudo podem ser uma explicação para as dificuldades dos observadores na diferenciação das dimensões do WAI-SR-O. De modo geral, os resultados psicométricos do WAI-SR-O em versão adaptada apontam que este instrumento pode ser promissor quanto aos estudos do processo psicoterapêutico no Brasil.
Studies regarding interventions for alcohol dependents have prioritized understanding psychotherapeutic process active ingredients, being therapeutic alliance (TA) one of these mechanisms. The measures which are evaluated by a clinical observer have been widely recommended to assess TA. However, it is observed the absence of observational measures of TA in Brazil, and its study is still incipient. Aim: The present work encompasses two studies: 1) developing a literature review to characterize the TA instruments; 2) to conduct the Working Alliance Inventory - Short Revised Observer (WAI-SR-O) cross-cultural adaptation and investigate its validity evidences for alcohol dependents on brief cognitive-behavioral treatment. Method: Bibliometric data were collected and thematic content analysis was performed on literature review study. On the second study, the WAI-SR-O were submitted to the analysis of reliability evidences based on the internal structure, evidence of validity based on relations with external variables, evaluation of inter and intra raters mean differences, and Intraclass Correlation Coefficient (ICC) of the WAI in the therapist and client versions. Results: Literature review indicates TA instruments in various versions, assessed from different perspectives and based in a whole range of theoretical models. They presented appropriated psychometric properties although important factorial structure issues were indentified. In the second study, the WAI-SR-O were translated, backtranslated and evaluated by experts. Observer raters training was carried out, resulting in some adjustments on instrument. The results pointing out good psychometric properties, with a high Cronbach’s alpha (α = 0.86), convergent validity evidences among WAI-SR-O and WAI-Therapist and high ICC intra raters for general scale and subscales. Discussion: Problems in the TA instruments factorial structure raised on the first study could be a explanation for the observer difficulties in differenciate the WAI-SR-O dimensions. On the whole, the adapted WAI-SR-O initial psychometric properties shows its may be a promising instrument for studying of psychotherapeutic process in the Brazil.

Ce mémoire porte sur l'alliance thérapeutique perçue par les jeunes, les parents et les intervenants en début d'intervention dans le cadre d'un programme d'intervention brève et intensive de crise. L'alliance thérapeutique est considérée comme un facteur favorisant la réussite des interventions offertes aux jeunes et aux familles en difficultés ou en situation de crise. Toutefois, il existe, à ce jour, peu de connaissances sur les caractéristiques des jeunes et des familles associées à l'alliance thérapeutique.Ce mémoire tente de pallier cette lacune en identifiant les caractéristiques des jeunes et des familles associées à l'alliance thérapeutique. L'échantillon à l'étude est composé de 123 familles ayant bénéficié du programme d'intervention CAFE en 2010-2011 dans un des sept Centres de la santé et des services sociaux (CSSS) de la Montérégie. Les résultats indiquent que le fait que le jeune et l'intervenant soient tous deux de sexe féminin, le ratio de flexibilité au sein de la famille et le manque de supervision parentale prédisent l'alliance thérapeutique évaluée par le jeune alors que le ratio de cohésion perçu à la fois par le jeune et le parent, le fait de vivre de nombreux évènements de vie stressants, la détresse cognitive chez le parent et la fréquence des conflits conjugaux perçue par le jeune prédiraient l'alliance perçue par le parent. Du coté de la perception de l'alliance par l'intervenant, l'engagement parental, perçu à la fois par le jeune et le parent, les évènements de vie stressants vécus par le parent et une relation parent-enfant détériorée sont associés à l'alliance thérapeutique, mais n'apparaissent pas comme étant des prédicteurs significatifs de l'alliance perçue par l'intervenant.

Kronisk smärta utgör ett folkhälsoproblem, där psykologiska faktorer är betydelsefulla. Psykologiska behandlingar har god effekt, och det finns ett växande intresse för den terapeutiska alliansen i smärtbehandling. Syftet med denna studie var att undersöka relationen mellan patientkaraktäristiska, allians och utfall, i två behandlingar för smärta; KBT och exponering. Ljudinspelningar av behandlingssessioner har skattats avseende allians med instrumentet Working Alliance Inventory. Ångest före behandling hade ett positivt samband med alliansen i båda behandlingarna. Det fanns inga statistiskt signifikanta samband mellan allians och utfall. Regressionsanalyser visade att ångest, behandlingens trovärdighet, depression och katatstroftankar predicerade utfall. Detta visar att specifika patientkaraktäristika har särskild betydelse för behandlingsutfall och att alliansen är mindre betydelsefull, möjligen på grund av att alla observerade allianser var "good enough".