父母依恋一致性与子女依恋的关系

目的 探讨父母依恋一致性与子女依恋的关系.方法 采用整群抽样的方法,共抽取449名年龄12～18岁青少年作为研究对象,对青少年及其父母采用一般情况调查表、亲密关系体验问卷、青少年依恋问卷进行测量.运用Pearson相关分析,分析父母依恋一致性与子女依恋的关系.结果 父母依恋安全一致时,子女家庭依恋4维度均与父母依恋相关没有显著意义(P＞0.05);父母依恋不安全一致时,子女家庭依恋消极维度与父亲焦虑相关有显著意义(P=-0.195,P＜0.05);父母依恋不一致时,母亲回避、母亲焦虑与子女依恋家庭消极维度显著相关(P=-0.238,0.292,P＜0.05),母亲焦虑与子女家庭依恋依赖维度有显著相关(P=0.238,P＜0.05).结论 父母依恋与子女依恋关系受父母依恋一致性影响;母亲依恋与子女依恋的关系比父亲依恋与子女依恋关系更紧密;从各维度探讨父母与子女依恋关系,与用类型方法探讨父母与子女依恋关系结果不同.     

工作同盟的概念

工作同盟是心理治疗理论及研究中的重要概念.本文介绍了工作同盟受到关注的原因,对工作同盟概念的发展过程进行了系统回顾,对工作同盟与移情、真实关系的概念进行了辨析.在此基础上,对工作同盟给出了一个适用于研究的工作定义,并指出今后的研究方向.     

工作同盟问卷的编制

目的:对Bordin的工作同盟理论进行修正,编制工作同盟问卷.方法:在Bordin的理论及前期研究的基础上,假定工作同盟的结构由咨访双方的情感联结、目标任务一致和投人三个维度组成.经过3轮试测,将来自5所大学的心理咨询中心的469位当事人分为2个样本,使用样本1发展测量工具,使用样本2对测量工具进行验证.结果:探索性因素分析显示3个因素能够解释总变异的60%;验证性因素分析及测量等同性检验为问卷结构的稳定性提供了证据;各维度间存在中度相关(r=0.58至0.63),内部一致性均在0.70以上;与已有的工作同盟测量工具WAI-SR有高相关(r=0.86);对咨询效果有显著预测.结论:编制的<工作同盟问卷>(WAQ)的各项测量学指标良好.     

高校辅导员依恋类型与工作压力、职业倦怠的关系

目的:考察高校辅导员依恋类型与工作压力及职业倦怠的关系。方法:采用关系问卷、工作压力问卷和职业倦怠问卷对322名高校辅导员施测。结果:322名辅导员中,62.1%为安全型依恋,17.7%为忽视型依恋,14.0%为沉迷型依恋,6.2%为恐惧型依恋。安全型依恋的辅导员在工作压力和职业倦怠得分上均显著低于不安全依恋的辅导员,而三种不安全依恋(忽视型、沉迷型和恐惧型)辅导员间的工作压力和职业倦怠没有显著差异。结论:高校辅导员的成人依恋类型对其工作压力和职业倦怠具有显著影响。     

婚恋依恋、亲子依恋与儿童焦虑的关系

目的:考察母亲对配偶的婚恋依恋、亲子依恋与儿童焦虑的关系。方法:以亲密关系经历量表、依恋安全性量表和儿童焦虑量表为研究工具,对352名小学四年级儿童及其母亲进行测查。结果:①母亲的依恋回避与母子依恋、父子依恋呈显著负相关,与儿童焦虑总分呈显著正相关;母亲的依恋焦虑与母子依恋、父子依恋相关不显著,与儿童焦虑总分呈显著正相关。②母子依恋、父子依恋与儿童焦虑总分呈显著负相关。③母子依恋、父子依恋在母亲对配偶的依恋回避与儿童焦虑间起部分中介作用。④母子依恋在母亲对配偶的依恋回避和儿童焦虑间起调节作用,安全型母子依恋可有效缓解母亲依恋回避对儿童焦虑的消极影响效应。结论:母亲对配偶的婚恋依恋、亲子依恋显著影响儿童焦虑,亲子依恋在母亲婚恋依恋和儿童焦虑间起中介和调节作用。     

高校学生成人依恋与家庭环境的关系研究

目的 研究高校学生的成人依恋和家庭环境的关系.方法 采用亲密关系经历量表(ECR)和家庭环境评定量表(FES)对343名学生进行调查.结果 ①不同的依恋类型在亲密度、娱乐性和控制性上有显著性差异.②依恋回避与娱乐性有显著的负相关;依恋焦虑与成功性有显著的负相关.结论 家庭环境对成人依恋的形成有显著影响.     

儿童对宠物的依恋与社会性发展的关系

目的:研究儿童对宠物的依恋与社会性发展的关系。方法:选取北京市11所普通小学3～5年级的147名养宠物儿童为对象。采用宠物依恋量表、自我描述问卷、儿童社会生活适应量表的亲社会性和居家能力两个分量表,以及儿童孤独量表进行测量。结果:儿童对宠物的依恋与自我概念、亲社会性和日常生活能力正相关(r=0.47、0.42、0.34,Ps0.001),与孤独感负相关(r=-0.28,P0.01)。在控制了儿童的学业状况,人际关系,以及家庭社会经济地位等无关因素的影响后,高宠物依恋组儿童的自我概念、亲社会性及日常生活能力水平仍高于低依恋组[(163.81±17.81)vs.(138.36±27.71),(46.19±4.25)vs.(40.64±6.93),(39.05±4.17)vs.(33.77±6.51);Ps0.001],孤独感水平仍低于低依恋组[(28.53±11.08)vs.(34.79±10.96);P0.01]。结论:儿童与宠物的亲疏程度和情感联结的紧密性与儿童社会性发展的诸方面存在明显联系,但其中的影响机制和因果关系还有待进一步研究。     

依恋的发展病理和精神病理

1 依恋类型和不良依恋的防御性情报处理依恋 (attachment)是指个体对某一特定对象长久持续的情感连接。依恋研究者相信依恋的不同性质决定着内在工作模式的形成 ,影响着个体的发展 ,是测量亲子关系性质的重要维度。他们采用类型学的研究方法 ,关注不良依恋的发展病理和精神病理。在婴幼儿期 ,一般运用陌生情景技术 ,把依恋分为逃避行为显著的A型(avoidant)、情绪稳定的B型 (secure)、反抗行为显著的C型 (ambivalent)、处于一种未组织化的状态且经常出现互相矛盾行为的D型 (disorganized)。青年期以后依恋类型的评定一般采用成人访谈技术 (…     

亲子依恋与儿童焦虑的关系

目的:考察母子依恋、父子依恋与儿童焦虑的关系。方法:以Kerns依恋安全性量表、Spence儿童焦虑量表为研究工具,对584名8-15岁儿童进行测查。结果:①儿童焦虑存在显著的年龄、性别差异;②等级回归分析表明,控制了年龄、性别对儿童焦虑的影响后,母子依恋、父子依恋均能够显著负向预测儿童焦虑;③与父、母形成双重安全依恋的儿童焦虑得分最低,双重非安全依恋的儿童焦虑得分最高,只与一方父母形成安全依恋的儿童焦虑得分居中。结论:母子依恋、父子依恋显著影响儿童焦虑,父子依恋对儿童分离焦虑、躯体伤害恐惧的影响超过母子依恋。     

大学生成人依恋与人格特点的关系

目的:探讨大学生成人依恋和人格特点之间的关系。方法:采用成人依恋量表(AAS)和人格形容词检测表(PACL)对392名大学生进行调查。采用典型相关分析、聚类分析、方差分析等对数据进行分析。结果:对成人依恋维度和PACL的二阶人格因子进行典型相关分析,共得到3个典型变式。对不同成人依恋类型的大学生人格特点进行方差分析发现,不同依恋类型的个体在内向的、抑制的、合作的、社会化的、敏感的以及实验量表这几个人格分量表上都存在显著差异。结论:大学生的成人依恋与人格特点之间存在着显著的对应关系。     

Early working alliance in outpatient substance abuse treatment: Predicting substance use frequency and client satisfaction

Background: The study examined the effect of the early working alliance on outcome in outpatient substance abuse treatment. Methods: A total of 327 clients and 33 therapists participated in the study. Data were collected in southern and western Finland in outpatient treatment units (N = 7). The dependent variables were percentage of days abstinent and client satisfaction at six‐month follow‐up. The independent variables were both client and therapist alliance ratings of the first and third sessions. The client's percentage of days abstinent for the month preceding treatment was used as a covariate. Intra‐class correlation was used to measure between‐therapist variation. Results: The main finding was that there was considerable between‐therapist variation in both the frequency of clients’ substance use and client satisfaction at follow‐up. The client's earlier substance use frequency was a significant predictor of the substance use frequency at follow‐up. Client satisfaction was significantly predicted by the client's rating of the early alliance. Conclusions: More research on therapists is needed because between‐therapist differences seem to be associated with patient outcomes over differences within therapists. While the study confirmed that good early working alliance improves outcome during treatment without being linked to post‐treatment recovery, more research is needed also in that area.     

Relationship between the working alliance and social support on counseling outcome

The purpose of this study was to test the impact of two predictor variables, one representing extratherapeutic factors and one representing relationship factors, on outcome at a university counseling training clinic. A naturalistic design was used to collect session-by-session outcomes on 135 clients seen by 88 counselors. Hierarchical linear modeling was used to test hypotheses about the effects of clients' pretreatment social support (extratherapeutic factor) and working alliance (relationship factor) at session 3 on change over time. Results showed that higher rated alliances predicted greater change over the first 8 sessions. When clients reported poorer social supports, the therapeutic alliance was even more important in predicting a positive outcome. Limitations of the design and implications for further outcome studies are discussed.     

The physician-patient working alliance: Theory,research, and future possibilities

ObjectiveThis article discusses the physician-patient working alliance and reviews the empirical research that has been generated on the working alliance to date.MethodsThe paper presents a brief history of the study of the physician-patient relationship, and discusses constructs that have examined aspects of the relationship, such as empathy, trust, and shared decision-making. Lastly, a meta-analysis was conducted based on the seven empirical studies (a total N of 1023 patients) that have examined the physician-patient working alliance.ResultsResults of the meta-analysis found medium to large effect sizes between the working alliance and various behavioral care indices. The working alliance is positively associated with patient adherence, satisfaction, and improved patient outcomes.ConclusionOverall, the physician-patient working alliance provides researchers and medical-care providers with a unified construct that combines cognitive and affective dimensions inherent in the relationship in medical care. Furthermore, the PPWAI provides an efficient and inexpensive way to assess the physician-patient relationship in medical treatment.Practice implicationsThe present findings warrant the development of an intervention focused on working alliance training that could be offered to healthcare providers.     

Longitudinal changes in therapeutic alliance with people with psychosis: Relationship between client and therapist assessments

Although the clinical significance of therapeutic alliance with people with psychosis is well established, the agreement between client and therapist assessments of therapeutic alliance and the longitudinal changes of both assessments have been rarely addressed. The current study examined client and therapist assessments of therapeutic alliance longitudinally and sought to determine whether insight and severity of symptoms moderated the degree to which therapist and client assessments were in agreement with one another. Forty-five participants diagnosed with a schizophrenia spectrum disorder and their therapists were administered a therapeutic alliance questionnaire (Working Alliance Inventory-Short Form) monthly for 6 months. Baseline symptoms were assessed using the PANSS. Results did not produce evidence that insight into illness moderated the relationship between agreement on the therapeutic alliance. However, symptoms of emotional discomfort at baseline predicted differences in agreement between clients and therapists on the relationship aspect of therapeutic alliance over the course of therapy. These results suggest that the ability to express symptoms of emotional discomfort may affect whether clients and therapists form similar appraisals of the strength of the therapeutic alliance.     

The role of patient attachment and working alliance on patient adherence, satisfaction, and health-related quality of life in lupus treatment

Objective

Researchers tested the hypothesis that patients’ working alliance with their physicians, and patients’ attachment styles would predict patients’ adherence, satisfaction, and health-related quality of life.

Methods

One hundred ninety-three patients diagnosed with lupus participated in an online survey. They completed measures of the Physician–Patient Alliance Inventory, Experiences in Close Relationships Scale, SF-36, General Adherence Inventory, and the Medical Patient Satisfaction Questionnaire.

Results

Working alliance was significantly and positively associated with all three outcome variables of adherence, satisfaction, and quality of life. Attachment avoidance was significantly and negatively related to adherence, and attachment anxiety was significantly and negatively related to health-related quality of life.

Conclusions

A working alliance between physician and patient, characterized by agreement communication on goals and tasks of treatment, along with trust and patient liking of his/her doctor, predicts patient adherence, satisfaction, and quality of life. Psychological dimensions of attachment also predict patient adherence and quality of life.

Practice implications

Doctors and other health service providers ought to actively set goals and tasks of treatment, and foster patient trust and liking. A strong relationship with patients can increase treatment efficacy and effectiveness and improve outcomes for individuals with debilitating chronic illnesses such as lupus.     

Attachment and therapeutic alliance in psychological therapy for people with recent onset psychosis who use cannabis

We examine associations between client attachment style and therapeutic alliance in a 3‐arm randomized controlled trial of brief motivational interviewing and cognitive–behavioural therapy compared with longer term motivational interviewing and cognitive–behavioural therapy or standard care alone. Client self‐report measures of attachment style were completed at baseline, and both clients and therapists in the treatment arms of the trial completed alliance measures 1 month into therapy. We found that insecure–anxious attachment was positively associated with therapist‐rated alliance, whereas clients with insecure–avoidant attachment were more likely to report poorer bond with therapist. There was no evidence that client attachment significantly predicted clinical or substance misuse outcomes either directly or indirectly via alliance. Nor evidence that the length of therapy offered interacted with attachment to predict alliance.     

Client self rated adult attachment patterns and the therapeutic alliance: A systematic review

Attachment theory has been proposed as a suitable framework within which to understand and explore the therapeutic alliance. This review systematically explores research that has examined the relationship between clients' self reported attachment patterns and the therapeutic alliance. Methodological characteristics and study findings are reviewed and discussed with the aim of concluding whether assessing clients' attachment patterns would be beneficial to therapy. In spite of inconsistencies with regards to the measurement and conceptualisation of attachment and the alliance, the evidence suggests that clients who rate themselves as having a more secure attachment pattern are likely to rate the alliance as stronger. The implications of this for therapeutic practice are discussed.