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The Alliance and Rupture Observation Scale (AROS): Development and validation of an alliance and rupture measure for repeated observations within psychotherapy sessions
Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Psychiatry.ORCID iD: 0000-0002-1890-3959
Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
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2019 (English)In: Journal of Clinical Psychology, ISSN 0021-9762, E-ISSN 1097-4679, Vol. 75, no 3, p. 404-417Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this study was to test a new observer-rated instrument, the Alliance and Rupture Observation Scale (AROS). It was designed for repeated measurements of the alliance within sessions and to detect alliance ruptures.

Method: Videotaped therapy sessions with depressed adults were analyzed. Reliability was mainly assessed as inter-rater reliability. Convergent, predictive, and discriminant validity of the AROS was assessed by comparing the instrument with both observer-rated and patient-rated measures.

Results: The AROS exhibited excellent inter-rater reliability. Alliance levels measured with the AROS predicted patients’ ratings of the alliance in the same session and were highly correlated with another observer-rated alliance measure. Alliance patterns (rupture; repair; and no-rupture) based on AROS scores were significantly correlated with patients’ ratings of the alliance.

Conclusions: Preliminary support for convergent and predictive validity was found. It is yet to be determined whether AROS scores are related to psychotherapy outcomes.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019. Vol. 75, no 3, p. 404-417
Keywords [en]
alliance ruptures and repairs, measurement, observer-based alliance measure, psychotherapy process, test development, therapeutic alliance, therapeutic relationship
National Category
Psychology
Identifiers
URN: urn:nbn:se:liu:diva-154932DOI: 10.1002/jclp.22704ISI: 000459626300006PubMedID: 30431649Scopus ID: 2-s2.0-85056660476OAI: oai:DiVA.org:liu-154932DiVA, id: diva2:1293993
Available from: 2019-03-06 Created: 2019-03-06 Last updated: 2019-06-27Bibliographically approved
In thesis
1. Rupture and Repair in the Working Alliance: Relation to Psychotherapy Outcome and Within-Session Interaction
Open this publication in new window or tab >>Rupture and Repair in the Working Alliance: Relation to Psychotherapy Outcome and Within-Session Interaction
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Alliansbrott och reparation : Relation till psykoterapiutfall och interaktion inom sessioner
Abstract [en]

Ruptures and repairs are processes related to shifts in the collaborative relationship Cthe working allianceJ between patient and therapist in psychotherapy. Ta study ruptures and repairs is one way ta disentangle mechanisms that might underlie the association between the working alliance and psychotherapy outcome. The overarching aim af this thesis was ta analyze the clinical relevance af the rupture and repair concepts at different process levels. The same three alliance patterns were investigated in the three empirical studies: the rupture pattern, the repair pattern, and the no-rupture/stable pattern. The analyses af the alliance patterns moved fromwhole treatments ta session segments. In Study I ruptures were found ta be associated with worse outcomes than treatments without ruptures. Repairs were, in longer therapies, shown ta be related ta better outcomes than norupture treatments. In Study Il it was found that the three alliance patterns could be discerned within sessions. Ruptures and repairs within sessions were found ta be associated with patient-ratings af the working alliance. In Study 111 the alliance patterns were found ta be related ta different  interaction patterns within sessions. In these analyses, importont patient contributions ta repairs af ruptures were found.

Abstract [sv]

Alliansbrott och reparationer är processer relaterade till förändringar i samarbetet och relationen mellan patient och terapeut i psykoterapi. Att studera alliansbrott och reparationer av dem kan utveckla kunskapen om sambandet mellan arbetsallians och psykoterapiutfall. Avhandlingens övergripande syfte var att pröva den kliniska relevansen av begreppen alliansbrott och reparationer på olika processnivåer. Samma tre alliansmönster undersöktes i de tre empiriska studierna: alliansbrottsmönstret, reparationsmönstret och icke-alliansbrott/stabila mönstret. Analyserna av alliansmönstren gick från hela behandlingar till sessionssegment. Studie I visade att alliansbrott hade samband med sämre utfall än behandlingar med mönstret icke-alliansbrott. Reparationer visade sig, för längre terapier, vara relaterade till bättre resultat än mönstret ickealliansbrott I Studie Il befanns de tre alliansmönstren vara urskiljbara inom sessioner. Alliansbrott och reparationer inom sessionerna visade sig vara associerade med patientskattad arbetsallians. I studie 111 befanns alliansmönstren vara relaterade till olika interaktionsmönster inom sessionerna. Det visade sig att patienterna bidrog på viktiga sätt till reparationer av alliansbrott.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2019. p. 89
Series
Linköping Studies in Arts and Sciences, ISSN 0282-9800 ; 765Linköping Studies in Behavioural Science, ISSN 1654-2029 ; 216
Keywords
Rupture and repair, working alliance, interpersonal interaction, psychotherapy outcome, Alliansbrott och reparation, arbetsallians, interpersonell interaktion, utfall av psykologisk behandling
National Category
Psychology
Identifiers
urn:nbn:se:liu:diva-154934 (URN)9789176851111 (ISBN)
Public defence
2019-03-22, 1:101, Hus I, Campus Valla, Linköping, 13:00 (Swedish)
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Available from: 2019-03-06 Created: 2019-03-06 Last updated: 2019-06-27Bibliographically approved

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Holmqvist Larsson, MattiasFalkenström, FredrikHolmqvist, Rolf

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Holmqvist Larsson, MattiasBjörkman, KarinNilsson, KarinFalkenström, FredrikHolmqvist, Rolf
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PsychologyFaculty of Arts and SciencesDepartment of PsychiatryDepartment of Behavioural Sciences and Learning
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