心理咨询中当事人工作同盟的发展及与依恋的关系

Development pattern of working alliance and impact of client attachment in psychological counseling

目的:研究心理咨询中当事人工作同盟的发展模式,并探讨当事人依恋与工作同盟的关系。方法:从两所大学的心理咨询中心征集当事人71例,每次会谈后采用简版工作同盟量表-修订版(WAI-SR)测量工作同盟情况,并采用亲密关系体验问卷(ECR)测查当事人依恋。当事人的整个咨询过程分为前中后三期,第一次为前期,最后一次为后期,其余为咨询中期。采用多层线性回归,以每次会谈结束后的工作同盟追踪数据为第一层数据,以当事人的依恋为第二层数据,来探讨当事人工作同盟的发展模式。结果:多层线性模型分析结果表明,随会谈次数增加,WAI-SR得分上升(γ10=0.72,P<0.01)。ECR的依恋回避维度对工作同盟发展速率的影响接近有统计学意义(γ11=0.49,P=0.067)。方差分析的结果表明,在咨询前期,不同依恋类型当事人WAI-SR得分由高到低依次为恐惧型(29.3±5.8)、先占型(29.0±7.3)、安全型(23.0±7.8)和回避型(22.8±9.2)。安全型当事人中期和后期WAI-SR得分高于前期[(28.0±7.0),(30.0±6.1)vs.(23.0±7.8);P<0.05];而先占型、恐惧型、回避型当事人WAI-SR得分在前、中、后期差异均无统计学意义(均P>0.05)。结论:工作同盟随会谈次数的增加表现出线性增长模式,且当事人工作同盟的发展模式因其依恋的不同而有所差异,提示在咨询过程中应关注当事人依恋并有针对性地促进其工作同盟。

Objective： To explore the development pattern of working alliance and the relationship between client attachment and working alliance in psychological counseling. Methods： Altogether 71 clients were recruited at two university counseling centers, and working alliance was assessed with the Working Alliance Inventory -Short Revised（WAI-SR） after each counseling session, and client attachment style with the Experiences in Close Relationships Inventory（ECR）. Results： Based on hierarchical model regression analysis with working alliance tracking data after every counseling as the first level, client attachment data as the second level, the results showed that WAI-SR scores raised significantly through the process of counseling （γ10 = 0. 72, P 〈 0. 001）, and the ECR avoidance attachment scores had a marginal effect on the development of working alliance （γ11 = 0. 49, P =0. 067）. The results of repeated measure variance analysis showed that, at the beginning of the counseling, the WAI-SR scores of different attachment style of clients were in order of feared （29. 3 ± 5.8）, preoccupied （29.0 ± 7. 3）, secured （23.0 ± 7. 8） and preoccupied （22. 8 ±9. 2）. The secured clients had higher WAI-SR scores at the middle and end of the counseling than at the beginning[ （28.0 ± 7. 0）, （30. 0±6. 1） vs. （23.0± 7. 8） ; P 〈 0.05 ]. However, there was no significant difference in the scores of other clients during the counseling process. Conclusion： It suggests that the working alliance could increase with a linearity pattern in the process of counseling. Besides, the development pattern of working alliance varies from each other due to their different attachment style, which suggests that more attention should be paid to client attachment style to promote working alliance and make effective counseling future more.