Dimensionen der therapeutischen Beziehung aus Patienten-Perspektive – Entwicklung der „Skala Therapeutische Allianz-Revised STA-R”

Abstract

Studies on the dimensionality of the therapeutic alliance had been conducted by Hatcher et al. factor-analyzing three widely used alliance measures (Helping Alliance Questionnaire, Working Alliance Inventory, California Psychotherapy Alliance Scales) and proposing two additional dimensions (on affects and interpersonal aspects). The present study intended to construct an economic German patient questionnaire on the basis of this preliminary work, which represents relevant dimensions of the therapeutic alliance in an economic way. 36 items, purposed by Hatcher et al. were translated into German. They have been examined by confirmative factor analysis (sample 1: N=301 psychotherapy patients). As a result of further factor analysis, the "Skala Therapeutische Allianz - Revised STA-R" was developed. The 17-items questionnaire has 4 scales: "Confident Collaboration", "Bond", "Patient Fear" and "Therapist Interference", which correspond to Hatcher et al. The latter scales have not yet been considered in German questionnaires. A confirmatory factor analysis with sample 2 (N=427 patients) showed a good model fit with these factors, too. Correlations of the therapeutic alliance at the end of the treatment with change in symptom load (SCL-90-R) proved to be significant (rSTA-R, GSI=0.43**).

Subjektiv erlebte Nebenwirkungen ambulanter Verhaltenstherapie: Zusammenhänge mit Patientenmerkmalen, Therapeutenmerkmalen und der Therapiebeziehung

“…Zur Erfassung der Qualität der therapeutischen Beziehung aus Sicht der Patienten wurde die "Skala therapeutische Allianz -Revised" (STA-R; [21]) genutzt, welche über 4 Skalen ("Angst, sich zu öffnen", "Positive emotionale Beziehung", "Zuversichtliche Zusam-menarbeit", "Interferenz mit der Therapeutenpersönlichkeit") oder den Gesamtwert ausgewertet werden kann. Die Gütekriterien dieses Instrumentes werden als hinreichend gut bewertet [21].…”

“…Als Merkmal der Therapie wurde die therapeutische Beziehung, erfasst mittels des Gesamtwerts der STA-R [21], welcher die Qualität der therapeutischen Beziehung beschreibt, auf Zusammenhänge zu negativen Therapiewirkungen hin untersucht. Dabei fand sich eine signifikant negative Korrelation zum Gesamtmittelwert berichteter negativer Therapiewirkungen (r = − 0,35; p = 0,004).…”

Inpatient and Day-Clinic Experience Scale (IDES) - a Psychometric Evaluation/ Tageskliniks- und Stationserfahrungsbogen – eine psychometrische Evaluation

“…In case the scale can predict premature termination, it might prove useful for practitioner contexts and psychotherapy hospitals. Because of the high clinical relevance of identifying potential drop outs, more studies are needed in order to answer this question (Brockmann et al 2011). Therefore, the scale "critical attitude" was kept despite the somewhat lower internal consistency with only two items.…”

Effects of interventions promoting mentalization and interventions disconfirming pathogenic beliefs: A comparative single case study of three patients

“…Questionnaires evaluating the therapeutic relationship capture only some aspects, with an emphasis on the working alliance. The therapeutic alliance was investigated after each session with a self-report questionnaire (STA-R, Brockmann et al, 2011) completed by the patient.…”