The Working Alliance Inventory's Measurement Properties: A Systematic Review

Paap, Davy; Karel, Yasmaine; Verhagen, Arianne P.; Dijkstra, Pieter U.; Geertzen, Jan H. B.; Pool, Grieteke

doi:10.3389/fpsyg.2022.945294

Cited by 15 publications

(7 citation statements)

References 107 publications

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“…Although the WAI-SP is widely used, research that has evaluated the psychometric properties of the instrument has revealed inconsistencies in its internal structure; which were mostly examined by means of exploratory and confirmatory factor analysis, yielding divergent results of 1, 2, and 3 factors, including proposals for bifactor models. 6 , 20 , 37 For example, the original WAI-SP study found that the bifactor model, which includes one general factor and three specific factors, had a better fit in both the patient and therapist versions, 36 This measurement model has also been replicated in a study conducted in Norway. 38 In addition, the three-factor correlated structure of the WAI-SP has been validated in different countries.…”

Section: Introductionmentioning

confidence: 89%

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

Ramos-Vera,

Sánchez-Villena,

Calle

et al. 2023

PPA

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Background Although the importance of the therapeutic alliance in the treatment process and health outcomes is recognized, so far, there has been no evaluation in the Peruvian context that considers possible individual differences that could influence this assessment. Purpose This study assessed the psychometric properties of the WAI-S-P in a sample of individuals from Peru who are receiving psychological therapy. Furthermore, a network analysis was conducted to investigate the direct relationships between the therapeutic alliance and several relevant sociodemographic variables. Methods The short version of the Working Alliance Inventory was used in a sample of 241 participants ( M age =32.58, SD =12.67) that had attended less than 6 sessions. Three models were considered, including a three-factor and a two-factor correlated model, as well as a bifactor model. In addition, a network of partial associations was created including the overall therapeutic alliance, sex, age, and number of psychotherapeutic sessions. Results The bifactor model, with an overall therapeutic alliance factor and two specific factors (“contact” and “contract”), better fit the data. Invariance of the structure by sex and age showed equitable measurement. On the other hand, network analysis revealed a positive correlation between total session attendance and therapeutic alliance. Men reported higher therapeutic alliance, while women had higher total session attendance. Conclusion The results of this study suggest that the therapeutic alliance is better represented by a bifactor model and demonstrates invariance across sex and age in Peruvian adults. Additionally, findings indicate that differences in life experiences and the sex of patients may need to be verified in future studies to better understand nuanced needs in forming therapeutic alliances at least in the early stages of session attendance.

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Section: Introductionmentioning

confidence: 89%

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

Ramos-Vera,

Sánchez-Villena,

Calle

et al. 2023

PPA

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“…The WAI‐SF has been utilized for several years as a tool to assess the perceived strength of WA in psychotherapy and in various healthcare contexts. Its psychometric properties have been established in several studies (Busseri & Tyler, 2003; Del Re et al., 2012; Fenton et al., 2001; Flückiger et al., 2018; Horvath & Greenberg, 1989, Horvath & Symonds, 1991; Munder et al., 2010), although a recent systematic review (Paap et al., 2022), encompassing 66 studies published between 1989 and 2021, has shown inconsistent findings of reliability and validity of the WAI‐SF using rigorous criteria adopted by the consensus‐based Standards for the Selection of Health Measurement Instruments (COSMIN). However, these authors have recognized that COSMIN criteria may not be adequate for evaluating the measurement properties of instruments within the context of psychological research, and have advocated the development of new strategies to assess the psychometric properties of tools aimed at assessing conceptually complex domains, such as WA.…”

Section: Methodsmentioning

confidence: 99%

Working alliance in treating staff and patients with Schizophrenia Spectrum Disorder living in Residential Facilities

Fusar‐Poli,

Panariello,

Berry

et al. 2023

British J Clinic Psychol

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ObjectivesWorking Alliance (WA) is important in the care of patients with Schizophrenia Spectrum Disorders (SSD). This study aims to determine which sociodemographic and clinical factors are associated with WA, as assessed by patients and staff members in Residential Facilities (RFs), and may predict WA dyads' discrepancies.MethodsThree hundred and three SSD patients and 165 healthcare workers were recruited from 98 RFs and characterized for sociodemographic features. WA was rated by the Working Alliance Inventory (WAI) for patients (WAI‐P) and staff members (WAI‐T). SSD patients were assessed for the severity of psychopathology and psychosocial functioning.ResultsPearson's correlation revealed a positive correlation (ρ = .314; p < .001) between WAI‐P and WAI‐T ratings. Linear regression showed that patients with higher education reported lower WAI‐P ratings (β = −.50, p = .044), while not being engaged in work or study was associated with lower WAI‐T scores (β = −4.17, p = .015). A shorter lifetime hospitalization was associated with higher WAI‐P ratings (β = 5.90, p = .008), while higher psychopathology severity negatively predicted WAI‐T (β = −.10, p = .002) and WAI‐P ratings (β = −.19, p < .001). Better functioning level positively foresaw WAI‐T (β = .14, p < .001) and WAI‐P ratings (β = .12, p < .001). Regarding discrepancies, staff members' age was associated with higher dyads discrepancy in Total scale and Agreement subscale scores, which were also associated with more severe negative symptoms, while patients' age was negatively correlated to Relationship subscale discrepancy.ConclusionsThis study provides insight into the factors that influence WA in SSD patients and health workers in RFs. The findings address interventions to improve WA and ultimately patient outcomes.

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“…In addition, since the WAI was originally developed to assess the working alliance between therapists and psychotherapy patients, research recommended that the measurement properties of the WAI should continue to be evaluated when applying to a diferent setting or diferent target population [25]. Hence, the psychometric properties of the WAI were re-evaluated for the target population of this study.…”

Section: Methodsmentioning

confidence: 99%

The Impact of Relationship on Goal Attainment in a Home-Based Family Support Program

Siedlik,

Chiang,

Gardner

et al. 2023

Health & Social Care in the Community

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Home-based family support programs provide early intervention to support families with young children. Home visiting models typically serve pregnant and parenting women with risk factors known to influence the caregiver-child relationship including history of trauma, low academic achievement, low income, limited support networks, maternal depression, and maternal substance use. Few, if any, home visiting models, however, were developed specifically to support families affected by maternal substance use. The Team for Infants Exposed to Substance use (TIES) Program is a home-based family support program exclusively serving families affected by maternal substance use. The model design and intensive services allow TIES participants to achieve significant positive outcomes in the program’s six goal areas: maternal substance use, parenting skills, child mental and physical health, maternal mental and physical health, family income, and family housing. Goal scores are assessed jointly by participants and staff throughout the program using a validated scale. Program staff hypothesize that goal attainment in these areas may be influenced by the therapeutic relationship developed between home visitors and participants. This relationship is assessed using the Working Alliance Inventory (WAI), a validated assessment of therapeutic alliance administered to both participants and staff. An analysis of 127 program participants shows that when controlling for home visitor WAI scores in multilevel models (MLMs), goal attainment scores improved from intake to discharge across all goal areas except for housing stability. These results stress the importance of the therapeutic relationship in maximizing TIES participants’ growth and success.

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The Working Alliance Inventory's Measurement Properties: A Systematic Review

Cited by 15 publications

References 107 publications

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

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

Working alliance in treating staff and patients with Schizophrenia Spectrum Disorder living in Residential Facilities

The Impact of Relationship on Goal Attainment in a Home-Based Family Support Program

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