The Mediating Role of Psychological Wellbeing in the Relationship Between Defense Mechanisms and Therapeutic Alliance Among Therapists and Psychiatric Nurses

Abstract

Background: As the effectiveness of psychotherapy relies on the therapeutic alliance, it is essential to identify the variables related to this concept. The present study aimed to investigate the relationship between defense mechanisms and therapeutic alliance with the mediating role of psychological well-being in therapists and psychiatric nurses. Methods: It was a descriptive-correlational study which adopted structural equation modeling (SEM). The statistical population comprised all the therapists, psychiatric nurses, and counselors licensed by the Psychology and Counseling Organization of Iran in 2019. A sample of 255 was selected via convenience sampling. The research instruments included the Defense Style Questionnaire, Ryff’s Psychological Well-being Scale (short form), and the Working Alliance Inventory (short form). The data were analyzed by Pearson correlation coefficient and path analysis in AMOS software version 24.0. Results: Immature (β= -0.35, P<0.001) and neurotic defense mechanisms (β= -0.22, P<0.001) demonstrated a significant negative correlation with the therapeutic alliance, while mature defense mechanisms (β= 0.38, P<0.001) and psychological well-being (β= 0.24, P<0.001) showed a significant positive correlation with therapeutic alliance. The path analysis revealed the mediating role of psychological well-being in the relationship between immature (β= -0.11, P<0.01), mature (β= 0.14, P<0.01), and neurotic (β= -0.09, P<0.01) defense mechanisms and therapeutic alliance. Conclusion: The results of the present study confirmed the model’s goodness of fit. Therapists’ defense mechanisms and psychological well-being should be taken into account when designing measures to improve the psychotherapy and counseling outcome.

The Relationship of Mental Health and Resilience with Posttraumatic Growth through the Mediating of Defensive Styles in the COVID-19 Survivors

“…It is scored on the basis of the Likert scale, ranging from 1 to 9 [16]. Jafari et al [30] reported the reliability of this questionnaire equal to 0.79 based on Cronbach's alpha coefficient. In this study, Cronbach's alpha coefficient was 0.83for the questionnaire.…”