Controversy remains on the psychometric properties of the Working Alliance Inventory-Short Form (WAI-S). In the present study we first examined the factor structure and reliability of WAI-S scores in a sample of 557 Flemish mental health consumers. Subsequently, we investigated the relationship between early alliance quality and client's psychological dysfunctioning (symptomatic distress, interpersonal functioning and personality pathology). Participants completed the Outcome Questionnaire and the Dimensional Assessment of Personality Pathology-Short Form at start of treatment. The WAI-S was completed after the third treatment session. The structure of the WAI-S was examined using confirmatory factor analysis. Four different factor models were compared. Internal consistencies of the scales were ascertained using the Cronbach's alpha coefficient. Pearson correlations were calculated to determine the relationships between alliance ratings and the independent variables. CFA resulted in a two-factor model, with a Bond component (Contact) and a Task-Goal (Contract) component. Reliability of the WAI-S subscale scores proved to be very good. Symptomatic distress, interpersonal dysfunctioning and personality traits were associated to the Contract component of the alliance, but not to the Contact component. Clinical implications, limitations and suggestions for further research are formulated.

Valid and reliable instruments to measure monitoring attitudes of clinicians are scarce. The influence of sociodemographics and professional characteristics on monitoring attitudes is largely unknown. First, we investigated the factor structure and reliability of the Outcome Measurement Questionnaire among a sample of Flemish mental health professionals (n = 170). Next, we examined the relationship between clinicians' sociodemographic and professional characteristics and monitoring attitudes. Construct validity was determined using a confirmatory factor analysis. Internal consistency was ascertained using Cronbach's alpha. Mean level differences in monitoring attitudes related to clinicians' gender, work setting, level of education and psychotherapeutic training, were investigated using ANOVAs. The relationships between clinicians' age, clinical experience and attitudes were calculated using the Pearson correlation coefficient. A model with one general factor and a method factor referring to reverse-worded items best fitted our data. Internal consistency was good. Clinicians with psychotherapeutic training reported more favorable monitoring attitudes than those without such training. Compared to clinicians working in subsidized outpatient services, private practitioners and clinicians from inpatient mental health clinics had more positive attitudes. Results highlight the need for sustained and targeted training, with particular focus on transforming measurement data into meaningful clinical support tools.

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Sinds de jaren tachtig is in de clie¨ntgericht-experie¨ntie¨le psychotherapie de klemtoon verschoven van een universele aanpak naar een meer procesdiagnostische en -directieve benadering. Een voorbeeld hiervan is het werken met de innerlijke criticus. Hier gaan we na of Carl Rogers in zijn geschriften impliciet een procesvisie heeft ontwikkeld met betrekking tot de problematiek van de innerlijke criticus. Vertrekkende vanuit zijn conceptualisering van de gewetensfunctie en de destructieve uitloper ervan hebben we een aantal proceskenmerken van de innerlijke criticus kunnen afleiden. We kregen inzicht in de wijze waarop de criticus op een constructieve manier kan evolueren en welke veranderingscomponenten hierin betrokken zijn. Ten slotte konden uit het werk van Rogers een aantal impliciete procesgedachten worden gedistilleerd over zijn therapeutische aanpak van de innerlijke criticus. InleidingDe term 'innerlijke criticus' werd door Gendlin (1981, 1996) geı¨ntroduceerd in het clie¨ntgericht-experie¨ntiele gedachtegoed en staat voor de strenge innerlijke normerende stem waarmee mensen zichzelf blokkeren. De term is sedertdien opgenomen in het clie¨ntgerichte vocabularium; iedere clie¨ntgerichte psychotherapeut weet wat ermee bedoeld wordt of waar hij voor staat. In de beginjaren van de clie¨ntgerichte therapie was in de theorievorming van een dergelijke innerlijke criticus echter nog geen sprake. Wel werd in de persoonlijkheidstheorie van Rogers aan het normerende een centrale rol toegekend, maar de specifieke problemen of processen hiervan werden toen nog niet afzonderlijk beschreven en geanalyseerd. De nadruk lag in deze periode immers op de beschrijving van het algemene therapieverloop en de formulering van de universeel werkzame ingredie¨nten. Rogers verzette zich namelijk met klem tegen de in die tijd heersende gedachte in het klinische werk dat men met neurotici zus en met psychotici zo zou moeten werken en dat bepaalde condities moesten worden aangeboden aan dwangneurotici en andere aan homoseksuelen (Rogers,

The term ‘inner critic’ describes the strong inner normative voice with which some people block themselves. In client‐centred/experiential psychotherapy this voice is considered as a process disturbance that interferes with the organismic experiencing of the client. Although various attempts have been made to characterise the way the inner critic appears in therapy, these are mostly based on clinical impressions rather than systematic research. This paper introduces a new model of the phenomenon of the ‘inner critic’ in psychotherapy, structured around five main process clusters: 1.A past history of rejection, restriction and neglect 2.Negative self-schemes 3.Information processing deficits 4.Self-protective behaviours 5.Interpersonal problems. The operation of these factors is illustrated through analysis of a single case which draws on a combination of qualitative and quantitative research methods to explore aspects of the inner critic within a good outcome case of client‐centred/experiential psychotherapy. The aim of this analysis is to chart the various manifestations of the inner critic and to examine how they gradually evolve during the course of therapy. In a first stage we give a narrative account of each session, including some excerpts from the transcript, along with an analysis of the key themes within each session. The second stage of the analysis offers a summary of the quantitative data that we collected, analysed in terms of longitudinal trends across the case as a whole. Finally, we discuss the limitations of our study, explore the implications for practice and make some suggestions for future research.