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The Reliability and Validity of the Korean version of Working Alliance Inventory-Short Revised (WAI-SR-K)

한글판 치료 동맹 척도 단축개정판(WAI-SR-K)의 표준화연구 : 신뢰도와 타당도

  • Yeum, Ji-Yeun (Department of Psychiatry, College of Medicine, Catholic University of Korea) ;
  • Hong, Seung-Chul (Department of Psychiatry, College of Medicine, Catholic University of Korea) ;
  • Jeong, Jong-Hyun (Department of Psychiatry, College of Medicine, Catholic University of Korea) ;
  • Kim, Tae-Won (Department of Psychiatry, College of Medicine, Catholic University of Korea) ;
  • Um, Yoo-Hyun (Department of Psychiatry, College of Medicine, Catholic University of Korea) ;
  • Kim, Sung-Min (Department of Psychiatry, College of Medicine, Catholic University of Korea) ;
  • Seo, Ho-Jun (Department of Psychiatry, College of Medicine, Catholic University of Korea)
  • 염지연 (가톨릭대학교 의과대학 정신건강의학교실) ;
  • 홍승철 (가톨릭대학교 의과대학 정신건강의학교실) ;
  • 정종현 (가톨릭대학교 의과대학 정신건강의학교실) ;
  • 김태원 (가톨릭대학교 의과대학 정신건강의학교실) ;
  • 엄유현 (가톨릭대학교 의과대학 정신건강의학교실) ;
  • 김성민 (가톨릭대학교 의과대학 정신건강의학교실) ;
  • 서호준 (가톨릭대학교 의과대학 정신건강의학교실)
  • Received : 2017.08.30
  • Accepted : 2017.10.19
  • Published : 2017.10.31

Abstract

Objective : The Working Alliance Inventory-Short Revised (WAI-SR) has been reported as a reliable, valid and widely used tool for measuring therapeutic alliance. The aim of this study was to assess the reliability and validity of the Korean version of WAI-SR (WAI-SR-K). Methods : A sample of 196 outpatients completed the WAI-SR-K and the data were analyzed for internal consistency and factor structure. Additionally 51 outpatients re-filled WAI-SR-K after two weeks for the test-retest reliability. To test for the validity, questionnaires of treatment satisfaction, and scales including the Korean version of Drug attitude inventory-10 (K-DAI-10) and Hospital anxiety and depression scale (KHADS) were administered. Results : Internal consistency of WAI-SR-K was good (Cronbach's alpha=0.928) and an exploratory factor analysis revealed a two-factor structure. The WAI-SR-K showed a reasonable test-retest reliability (r= 0.810, p<0.01). The total score of WAI-SR-K was positively correlated with K-DAI-10 (r=0.276, p<0.01), and negatively correlated with scores of K-HADS-D (r=-0.217, p<0.01) and K-HADS-A (r=-0.159, p<0.05). Conclusion : The Korean version of Working Alliance Inventory-Short Revised proved to be a reliable and valid instrument for measuring therapeutic alliance in Korean patients with depressive symptoms.

Keywords

References

  1. Martin DJ, Garske JP, Davis MK. Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review. Journal of Consulting and Clinical Psychology 2000;68:438-450. https://doi.org/10.1037/0022-006X.68.3.438
  2. Gelso CJ, Carter JA. Components of the psychotherapy relationship: their interaction and unfolding during treatment. Journal of Counseling Psychology 1994;41:296-306. https://doi.org/10.1037/0022-0167.41.3.296
  3. Sterba RF. The fate of the ego in analytic therapy. International Journal of Psychoanalysis 1934;115:117-126.
  4. Zetzel E. Current concepts of transference. International Journal of Psychoanalysis 1956;37:369-375.
  5. Greenson RR. The technique and practice of psychoanalysis. Madison, CT:International Universities Press;1967.
  6. Luborsky L. Helping alliances in psychotherapy: The groundwork for a study of their relationship to its outcome. Successful Psychotherapy 1976:92-116.
  7. Lee JH, Yon MH. Developmental patterns of therapeutic alliance and counseling outcomes. The Korean Journal of Counseling and Psychotherapy 2009;21:1-24.
  8. Del Re AC, Fluckiger C, Horvath AO, Symonds D, Wampold BE. Therapist effects in the therapeutic alliance-outcome relationship: a restricted-maximum likelihood meta-analysis. Clinical Psychology Review 2012;32:642-649. https://doi.org/10.1016/j.cpr.2012.07.002
  9. Del Re AC, Fluckiger C, Horvath AO, Symonds D, Wampold BE, How central is the alliance in psychotherapy?: a multilevel longitudinal meta-analysis. Journal of Counseling Psychology 2012;59:10-17. https://doi.org/10.1037/a0025749
  10. Safran JD, Muran JC. Negotiating the therapeutic alliance: a relational treatment guide. New York Guilford Press 2000;260.
  11. Marmar CR, Weiss DS, Gaston L. Towards validation of the California therapeutic alliance rating system. Journal of Consulting and Clinical Psychology 1989;1:46-52. https://doi.org/10.1037/1040-3590.1.1.46
  12. Luborsky L, Crits-Christoph P, Alexander L, Margolis M, Cohen M. Two helping alliance methods of predicting outcomes of psychotherapy. Journal of Nervous and Mental Disease 1983;171:480-491. https://doi.org/10.1097/00005053-198308000-00005
  13. Marziali E. Prediction of outcome of brief psychotherapy from therapist interpretive interventions. Archives of General Psychiatry 1984;41:301-305. https://doi.org/10.1001/archpsyc.1984.01790140091011
  14. Saunders SM, Howard KI, Orlinsky DE. The therapeutic bond scales: psychometric characteristics and relationship to treatment effectiveness. Psychological Assessment 1989;1:323-330. https://doi.org/10.1037/1040-3590.1.4.323
  15. Hartley D, Strupp H. The therapeutic alliance: its relationship to outcome in brief psychotherapy. Empirical Studies of Psychoanalytic theories 1983;1:1-27.
  16. Horvath AO, Greenberg LS. Development and validation of the Working Alliance Inventory. Journal of Counseling Psychology 1989; 36:223-233. https://doi.org/10.1037/0022-0167.36.2.223
  17. Tracey TJ, Kokotovic AM. Factor structure of the Working Alliance Inventory. Psychological Assessment: A Journal of Consulting and Clinical Psychology 1989;1:207-210. https://doi.org/10.1037/1040-3590.1.3.207
  18. Bordin ES. The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice 1979; 16:252-260. https://doi.org/10.1037/h0085885
  19. Horvath AO, Del Re AC, Fluckiger C, Symonds D. Alliance in individual psychotherapy. Psychotherapy (Chicago, Ill.) 2011;48:9-16. https://doi.org/10.1037/a0022186
  20. Hanson WE, Curry KT, Deborah LB. Reliability generalization of working alliance inventory scale scores. Educational and Psychological Measuremen 2002;62:659-673. https://doi.org/10.1177/0013164402062004008
  21. Tichenor V, Hill CE. A comparison of six measures of working alliance. Psychotherapy: Theory, Research, Practice, Training 1989;26: 195-199. https://doi.org/10.1037/h0085419
  22. Busseri MA, Tyler JD. Interchangeability of the Working Alliance Inventory and Working Alliance Inventory, Short Form. Psychol Assess 2003;15:193-197. https://doi.org/10.1037/1040-3590.15.2.193
  23. Falkenstrom F, Hatcher RL, Holmqvist R. Confirmatory factor analysis of the patient version of the Working Alliance Inventory-Short Form Revised. Psychol Assess 2015;22:581-593.
  24. Hatcher RL, Gillaspy JA. Development and validation of a revised short version of the Working Alliance Inventory. Psychotherapy Research 2006;16:12-25. https://doi.org/10.1080/10503300500352500
  25. Munder T, Wilmers F, Leonhart R, Linster H, Barth J. Working Alliance Inventory-Short Revised (WAI-SR): psychometric properties in outpatients and inpatients. Clinical Psychology & Psychotherapy 2010;17:231-239.
  26. Bang KY. Relation between the working alliance and counselor response in the early phase of counseling. Seoul national university Dissertation of Master's Degree 1992.
  27. Yoo SH, Ha HK, Lee HJ. Korean cultural adaptation of Working Alliance Inventory and its reliability. The Journal of Korean Society of Physical Therapy 2014;26:90-96.
  28. Kanter JW, Mulick PS, Busch AM, Berlin KS, Martell CR. The Behavioral Activation for Depression Scale (BADS): psychometric properties and factor structure. Journal of Psychopathology and Behavioral Assessment 2006;29:191.
  29. Oh JH, Hwang NR, Cha YJ, Lee EB, Choir KH, Seo HJ. The reliability and validity of the Korean version of Behavioral Activation for Depression Scale. Journal of Korean Neuropsychiatric Association 2017;56:89-97. https://doi.org/10.4306/jknpa.2017.56.2.89
  30. Hogan TP, Awad AG, Eastwood R. A self-report scale predictive of drug compliance in schizophrenics: reliability and discriminative validity. Psychological Medicine 1983;13:177-183. https://doi.org/10.1017/S0033291700050182
  31. Awad AG. Subjective response to neuroleptics in schizophrenia. Schizophrenia Bulletin 1993;19:609-618. https://doi.org/10.1093/schbul/19.3.609
  32. Yoon BH, Bahk WM, Lee KU, Hong CH, Ahn JK, Kim MK. Psychometric properties of Korean version of Drug Attitude Inventory. Korean College of Neuro Psycho Pharmacology 2005;16:480-487.
  33. Brown K, Ryan R. The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology 2003;822-848.
  34. Jeon JH, Lee WK, Lee SJ, Lee WH. A pilot study of reliability and validity of the Korean version of Mindful Attention Awareness Scale. The Korean Journal of Clinical Psychology 2007;26:201-212. https://doi.org/10.15842/kjcp.2007.26.1.012
  35. Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica 1983;67:361-370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
  36. Dunbar M, Ford G, Hunt K, Der G. A confirmatory factor analysis of the Hospital Anxiety and Depression scale: comparing empirically and theoretically derived structures. British Journal of Clinical Psychology 2000;39:79-94. https://doi.org/10.1348/014466500163121
  37. Oh SM, Min KJ, Park DB. A comparison of normal, depressed and anxious Groups=A Study on the standardization of the Hospital Anxiety and Depressed Scale for Koreans. Journal of The Korean Neuropsychiatric Association 1999;38:289-296.
  38. Barak Y, Szor H, Kimhi R, Kam E, Mester R, Elizur A. Survey of patient satisfaction in adult psychiatric outpatient clinics. Eur Psychiatry 2001;16:131-133. https://doi.org/10.1016/S0924-9338(01)00551-X
  39. Davy B, Keizer I, Croquette P, Bertschy G, Ferrero F, Gex-Fabry, et al. Patient satisfaction with psychiatric outpatient care in Geneva: a survey in different treatment settings. Schweizer Archive for Neurology and Psychiatry 2009;160:240-245. https://doi.org/10.4414/sanp.2009.02087
  40. Jabbar F, Casey P, Schelten SL, Kelly BD. What do you think of us? Evaluating patient knowledge of and satisfaction with a psychiatric outpatient service. Irish Journal of Medical Science 2011;180:195-201. https://doi.org/10.1007/s11845-010-0504-4
  41. Parker G, Wright M, Robertson S, Gladstone G. The development of a patient satisfaction measure for psychiatric outpatients. The Australian and New Zealand Journal of Psychiatry 1996;30:343-349. https://doi.org/10.3109/00048679609064997
  42. Sheikh AJ, Meakin C. Consumer satisfaction with a psychiatric outpatient clinic. Psychiatric Bulletin 1990;14:271-274. https://doi.org/10.1192/pb.14.5.271
  43. Kim W. Methodology of Psychological Test;1994.
  44. Jin J, Sklar GE, Oh VMS, Li SC. Factors affecting therapeutic compliance: a review from the patient's perspective. Therapeutics and Clinical Risk Management 2008;4:269-286. https://doi.org/10.2147/TCRM.S1458
  45. Roter D. The enduring and evolving nature of the patient-physician relationship. Patient education and Counseling 2000;39:5-15. https://doi.org/10.1016/S0738-3991(99)00086-5
  46. Alegria M, Polo A, Gao S, Santana L, Rothstein D, Jimenez A, et al. Evaluation of a patient activation and empowerment intervention in mental health care. Medical Care 2008;3:247-256.
  47. Andrusyna TP, Tang TZ, DeRubeis RJ, Luborsky L. The factor structure of the Working Alliance Inventory in cognitive-behavioral therapy. Journal of Psychotherapy Practice & Research 2001;10:173-178.
  48. Hatcher RL, Barends AW. Patients' view of the alliance in psychotherapy: exploratory factor analysis of three alliance measures. Journal of Consulting and Clinical Psychology 1996;64:1326-1336. https://doi.org/10.1037/0022-006X.64.6.1326
  49. Park JH. A contribution to the philosophy of medicine-The basic models of the doctor-patient relationship. Seoul National University;2006.
  50. Kirmayer LJ. Cultural variations in the clinical presentation of depression and anxiety: implications for diagnosis and treatment. The Journal of Clinical Psychiatry 2001;62:Supple13:22-28.
  51. Fenton LR, Cecero JJ, Nich C, Frankforter TL, Carroll KM. Perspective is everything: the predictive validity of six working alliance instruments. Journal of Psychotherapy Practice and Research 2001: 10;262-268.