【作者】 侯艳飞； 张小远；

【Author】 Hou Yanfei;Zhang Xiaoyuan;Department of Psychology,Southern Medical University;

【机构】 南方医科大学心理学系；

【摘要】 心理治疗适宜性是来访者拥有的促进其心理治疗参与的心理特征。既往研究停留在分取向的治疗适宜性研究阶段(如心理动力学取向治疗适宜性,认知行为取向治疗适宜性),研究结果初步表明分取向治疗适宜性可帮助判断来访者是否适合该取向的心理治疗,帮助治疗师选择合适的治疗技术。但现有研究无法满足当代心理治疗整合主义发展需要,目前急需跨理论的心理治疗适宜性研究。且该领域缺乏自评工具。本研究旨在界定跨理论心理治疗适宜性的指标,开发自评工具,并初步探究心理治疗适宜性对治疗效果的预测作用。本研究通过文献调研法和专家讨论法,界定了跨理论心理治疗适宜性的概念和5个维度:治疗动机、治疗认同、开放性、坚持性和洞察力。编制的心理治疗适宜性量表包括20个条目,量表条目经Delphi法筛选,各条目与维度总分相关系数大于0.4,内部一致性系数为0.896,探索性因素分析累计方差贡献率为70.44%,验证性因素分析各项指标符合要求,实证效度分析发现心理治疗适宜性高的来访者其首次治疗的会谈深度、会谈积极和会谈顺畅高于心理治疗适宜性低者,量表信效度较好。来访者心理治疗适宜性的均分为78.81±8.48。且纵向研究发现,心理治疗适宜性可直接影响会谈效果的深度、顺畅和积极,也可通过工作同盟的中介对其产生间接影响(中介效应为37.2%、63.9%和47.9%)。本研究为心理治疗适宜性评估提供了良好的自评工具,工具简短、适用性强。研究发现心理治疗适宜性对治疗效果有一定的预测作用,为判断来访者是否适合心理治疗及治疗师干预技术的选取提供科学指导。更多还原

【Abstract】 The suitability for psychotherapy(SP) is one of the characteristics of clients which can promote their involvement in psychotherapy. Past researches have mainly been designed to study psychotherapy suitability for a specific orientation of psychotherapy(e.g. suitability for psychodynamic therapy, suitability for cognitive behavior therapy), and it was preliminary demonstrated that the related study results could help the client to assess whether he/she is suitable for a specific orientation of therapy and help counselors to choose appropriate therapy techniques for a specific client. While in recent decades, integration has become an important and influential movement within psychotherapy practice. Thus there is an urgent need for integrative research on SP. But there is a lack of reliable self-report tool for assessing SP. Based on these, the purpose of this study is to develop a self-report measurement to investigate the SP in integrative perspective and explore the prediction role of the SP on the effect of psychotherapy.Through reviewing literature and brainstorming of experts, the concept of the suitability for psychotherapy in integrative perspective was defined and five dimensions were classified: motivation, belief, self-revelation, perseverance and insight.Then, the Suitability for Psychotherapy Scale were developed(20 items), with a satisfactory reliability and validity. Specifically, the items of the scale were evaluated by two rounds of Delphi evaluation. Then, the correlation coefficient of each item and the dimension score was greater than 0.4 and the Cronbach α coefficient was 0.896 for the total scale. And the five dimensions accounted for 70.44% of the total variance.The result of confirmatory factor analysis also indicated that the model was accepted. Meanwhile it was revealed that clients with better values in relation to suitability for psychotherapy had reported higher scores in the depth, smoothness, and positiveness at the first therapy session. And through the self-rating of the clients, it was found that the score of the SP among clients was(78.81±8.48.). Meanwhile, the result of the longitudinal study showed that the suitability for psychotherapy might have a directly effect on the depth, smoothness and positiveness of the first therapy session, and it might also have an indirect effect on those outcomes through the mediating effects of the working alliance(the mediating effects was 37.2%, 63.9% and 47.9%, respectively). Taken together, this study provides the first reliable and short self-rating measure of suitability for psychotherapy in an integrative perspective. It also may provide preliminary evidences for the selections between psychotherapy and other interventions(e.g. pharmacotherapy) for the clients and data basis for the treatment techniques selection for the psychotherapists.更多还原