Measuring working alliance and technical alliance from the perspective of healthcare professionals working with people with mild intellectual disabilities: adaptation, factor structure and reliability

Abstract

Background The establishment of a valuable and meaningful working alliance between people with mild intellectual disabilities (IDs) and healthcare professionals is critically important for improving both the quality of life and impact of therapy for people with mild IDs. Measuring the working alliance as a treatment or support component is therefore of utmost relevance. In light of the increased use of eHealth tools, it is also essential to measure the alliance using these tools, which is referred to as technical alliance. There was a lack of validation of these two measurements for healthcare professionals working with people with mild IDs, which this study sought to address. Method Both the validated Working Alliance Inventory -Short Form -MID (WAI-SF-MID) and Technical Alliance Inventory -Short Form -MID (TAI-SF-MID) for general patient populations were adapted for healthcare professionals working with people with mild IDs. A two-step approach was conducted to systematically adapt both measurements with an expert group of healthcare professionals. Confirmatory factor analysis was conducted to test a three-factor structure for both the WAI-SF-MID (N = 199) and the TAI-SF-MID (N = 139), and internal consistency was determined for both scales. Results An acceptable-to-good model fit was found for both the WAI-SF-MID and the TAI-SF-MID; confirmatory factor analysis confirmed a three-factor model for both measurements. Cronbach's alpha and McDonald's omega were excellent for both total scales (≥0.90) and acceptable to good for sub-scales of both versions. Conclusion Both the WAI-SF-MID and the TAI-SF-MID are promising measurements for determining healthcare professionals' perspective on the (digital) working alliance with people with mild IDs.

Validation of the Working Alliance Inventory- Short Form for Patient (WAI-S-P) in Peruvian Adults

“…This factorial model was also used in adults in Belgium 46 and the Netherlands. 47 In the Japanese context, favorable results supporting the two-dimensional structure of the instrument were observed in patients with musculoskeletal conditions. 45 Similarly, in China, significant correlations were found between the dimensions of the instrument, supporting a bidimensional model.…”

“… 46 This model has also been evaluated in other studies involving mental health professionals. 47 It is important to note that, so far, none of the studies have investigated the invariance of the WAI-SP in relation to sex and age, despite evidence suggesting that both variables may influence the therapeutic alliance. 26 , 27 , 32 , 48 Measurement invariance refers to the equivalence in the measurement of the therapeutic alliance between different groups, which is relevant to understanding whether the instrument measures consistently in different populations.…”