), 王巍欣4, 沈国成4 1华中师范大学心理学院
2青少年网络心理与行为教育部重点实验室
3人的发展与心理健康湖北省重点实验室
4华中师范大学大学生心理健康教育中心, 武汉 430079
收稿日期:2020-07-01出版日期:2021-04-25发布日期:2021-04-07通讯作者:于丽霞E-mail:yulixia@mail.ccnu.edu.cn基金资助:*国家社会科学基金重大项目(16ZDA232);*人的发展与心理健康湖北省重点实验室开Progress feedback and its effects on working alliance and treatment outcomes
SUN Qiwu1,2, WU Caizhi1,3, YU Lixia1,2(), WANG Weixin4, SHEN Guocheng4 1School of Psychology, Central China Normal University
2Key Laboratory of Adolescent Cyberpsychology and Behavior (Central China Normal University)), Ministry of Education
3Key Laboratory of Human Development and Mental Health of Hubei Province
4Mental Health Service Center, Central China Normal University, Wuhan 430079, China
Received:2020-07-01Online:2021-04-25Published:2021-04-07Contact:YU Lixia E-mail:yulixia@mail.ccnu.edu.cn摘要/Abstract
摘要： 进度反馈指将对当事人的标准化测量结果和解释反馈给咨询师的干预, 其目的在于矫正咨询师对咨询效果主观评估的偏差, 提高咨询效果。考虑到咨询师和当事人“面对面”的标准反馈程序不符合我国社会文化习惯, 采用多层结构方程模型, 分析了自然情境下非“面对面”的进度反馈对工作同盟和咨询效果的影响。结果发现, 在组间水平, 反馈组的工作同盟质量更好; 在组内水平, 工作同盟与症状是相互预测的关系。在结案时, 反馈组在抑郁症状和咨询的有帮助性上效果更好。结论是进度反馈对工作同盟和咨询效果有积极影响。研究从工作同盟和中国人的关系角度拓展了对进度反馈作用机制的认识, 为进度反馈的应用提供了基于实践干预有效的证据。
图/表 4
图1研究参与者入组和分析数据流程图
图1研究参与者入组和分析数据流程图
图2阅读进度反馈信息对工作同盟和咨询效果影响的多层线性模型 注：s1和s2是WAI和CORE的自回归斜率, Sxy是WAIt-1预测COREt斜率, Syx是COREt预测WAIt斜率。
图2阅读进度反馈信息对工作同盟和咨询效果影响的多层线性模型 注：s1和s2是WAI和CORE的自回归斜率, Sxy是WAIt-1预测COREt斜率, Syx是COREt预测WAIt斜率。 表1阅读进度反馈信息组与对照组的描述性统计
| 会谈 次数 | 阅读进度反馈信息组 | 对照组 | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| CORE-OM | WAQ | CORE-OM | WAQ | |||||||
| N | M | SD | M | SD | N | M | SD | M | SD | |
| 1 | 263 | 16.33 | 6.28 | 46.16 | 7.56 | 87 | 17.06 | 5.81 | 45.09 | 8.18 |
| 2 | 218 | 15.06 | 6.45 | 47.59 | 7.07 | 76 | 16.01 | 6.11 | 45.68 | 8.69 |
| 3 | 176 | 14.53 | 6.61 | 49.18 | 6.99 | 56 | 16.29 | 5.59 | 45.54 | 9.53 |
| 4 | 138 | 14.49 | 6.64 | 49.80 | 6.23 | 44 | 17.18 | 5.98 | 46.61 | 8.61 |
| 5 | 113 | 14.85 | 7.12 | 51.15 | 6.13 | 40 | 16.14 | 5.94 | 47.88 | 8.00 |
| 6 | 75 | 14.71 | 6.81 | 51.04 | 6.06 | 29 | 14.78 | 6.46 | 50.24 | 7.70 |
| 7 | 30 | 17.93 | 6.49 | 50.9 | 6.75 | 13 | 17.00 | 6.99 | 48.62 | 10.07 |
| 8 | 23 | 16.27 | 8.36 | 51.69 | 6.28 | 12 | 15.00 | 6.39 | 50.00 | 8.80 |
| 9 | 19 | 15.74 | 8.68 | 52.88 | 6.03 | 9 | 16.33 | 4.69 | 48.00 | 7.31 |
| 10 | 14 | 14.71 | 8.55 | 51.33 | 6.65 | 8 | 16.13 | 3.09 | 48.75 | 8.01 |
| 11 | 7 | 13.14 | 9.74 | 51.43 | 5.19 | 8 | 14.38 | 4.75 | 50.86 | 6.09 |
| 12 | 6 | 13.20 | 13.01 | 52.33 | 5.65 | 7 | 16.00 | 4.58 | 51.71 | 6.47 |
| 13 | 3 | 29 | 49.33 | 4.16 | 6 | 15.83 | 5.34 | 51.50 | 5.96 | |
| 14 | 1 | 24 | 49 | 6 | 16.00 | 6.57 | 49.83 | 7.39 | ||
| 15 | 1 | 24 | 51 | 5 | 17.00 | 9.97 | 48.40 | 5.59 | ||
| 16 | 1 | 31 | 56 | 2 | 22.5 | 0.71 | 41.00 | |||
| 17 | 1 | 36 | 53 | 1 | 16.00 | 37.00 | ||||
表1阅读进度反馈信息组与对照组的描述性统计
| 会谈 次数 | 阅读进度反馈信息组 | 对照组 | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| CORE-OM | WAQ | CORE-OM | WAQ | |||||||
| N | M | SD | M | SD | N | M | SD | M | SD | |
| 1 | 263 | 16.33 | 6.28 | 46.16 | 7.56 | 87 | 17.06 | 5.81 | 45.09 | 8.18 |
| 2 | 218 | 15.06 | 6.45 | 47.59 | 7.07 | 76 | 16.01 | 6.11 | 45.68 | 8.69 |
| 3 | 176 | 14.53 | 6.61 | 49.18 | 6.99 | 56 | 16.29 | 5.59 | 45.54 | 9.53 |
| 4 | 138 | 14.49 | 6.64 | 49.80 | 6.23 | 44 | 17.18 | 5.98 | 46.61 | 8.61 |
| 5 | 113 | 14.85 | 7.12 | 51.15 | 6.13 | 40 | 16.14 | 5.94 | 47.88 | 8.00 |
| 6 | 75 | 14.71 | 6.81 | 51.04 | 6.06 | 29 | 14.78 | 6.46 | 50.24 | 7.70 |
| 7 | 30 | 17.93 | 6.49 | 50.9 | 6.75 | 13 | 17.00 | 6.99 | 48.62 | 10.07 |
| 8 | 23 | 16.27 | 8.36 | 51.69 | 6.28 | 12 | 15.00 | 6.39 | 50.00 | 8.80 |
| 9 | 19 | 15.74 | 8.68 | 52.88 | 6.03 | 9 | 16.33 | 4.69 | 48.00 | 7.31 |
| 10 | 14 | 14.71 | 8.55 | 51.33 | 6.65 | 8 | 16.13 | 3.09 | 48.75 | 8.01 |
| 11 | 7 | 13.14 | 9.74 | 51.43 | 5.19 | 8 | 14.38 | 4.75 | 50.86 | 6.09 |
| 12 | 6 | 13.20 | 13.01 | 52.33 | 5.65 | 7 | 16.00 | 4.58 | 51.71 | 6.47 |
| 13 | 3 | 29 | 49.33 | 4.16 | 6 | 15.83 | 5.34 | 51.50 | 5.96 | |
| 14 | 1 | 24 | 49 | 6 | 16.00 | 6.57 | 49.83 | 7.39 | ||
| 15 | 1 | 24 | 51 | 5 | 17.00 | 9.97 | 48.40 | 5.59 | ||
| 16 | 1 | 31 | 56 | 2 | 22.5 | 0.71 | 41.00 | |||
| 17 | 1 | 36 | 53 | 1 | 16.00 | 37.00 | ||||
表2多层线性模型贝叶斯分析的标准化解和置信区间
| 路径和效用 | 标准化解 | 后验SD | 单尾p | 95%置信区间 |
|---|---|---|---|---|
| 阅读进度反馈信息影响模型 | ||||
| 组内水平 | ||||
| 症状的自回归效用（coret-1->coret） | 0.37* | 0.04 | <0.001 | 0.36, 0.53 |
| 工作同盟的自回归效用（wait-1->wait） | 0.61* | 0.04 | <0.001 | 0.49, 0.66 |
| 工作同盟预测症状（wait-1-> coret） | -0.14* | 0.03 | <0.001 | -0.19, -0.07 |
| 症状预测工作同盟(coret-1-> wait-1） | -0.08* | 0.03 | 0.002 | -0.15, -0.03 |
| 组间水平 | ||||
| 工作同盟预测症状(wai-> core） | -0.09 | 0.28 | 0.357 | -0.52, 0.54 |
| 反馈预测症状（feedback-> core） | -0.12 | 0.16 | 0.221 | -0.52, 0.14 |
| 反馈预测工作同盟（feedback-> wai） | 0.38* | 0.16 | 0.008 | 0.07, 0.72 |
| 缺失值检验模型 | ||||
| 组内水平 | ||||
| 症状的自回归效用（coret-1->coret） | 0.53* | 0.06 | <0.001 | 0.42, 0.66 |
| 工作同盟的自回归效用（wait-1->wait） | 0.63* | 0.04 | <0.001 | 0.55, 0.70 |
| 工作同盟预测症状（wait-1-> coret） | -0.12* | 0.03 | <0.001 | -0.17, -0.06 |
| 症状预测工作同盟(coret-1-> wait-1） | -0.08* | 0.02 | <0.001 | -0.13, -0.04 |
| 组间水平 | ||||
| 工作同盟预测症状(wai-> core） | -0.09 | 0.22 | 0.303 | -0.49, 0.38 |
| 反馈预测症状（feedback-> core） | -0.07 | 0.14 | 0.223 | -0.44, 0.15 |
| 反馈预测工作同盟（feedback-> wai） | 0.39* | 0.16 | 0.003 | 0.12, 0.77 |
表2多层线性模型贝叶斯分析的标准化解和置信区间
| 路径和效用 | 标准化解 | 后验SD | 单尾p | 95%置信区间 |
|---|---|---|---|---|
| 阅读进度反馈信息影响模型 | ||||
| 组内水平 | ||||
| 症状的自回归效用（coret-1->coret） | 0.37* | 0.04 | <0.001 | 0.36, 0.53 |
| 工作同盟的自回归效用（wait-1->wait） | 0.61* | 0.04 | <0.001 | 0.49, 0.66 |
| 工作同盟预测症状（wait-1-> coret） | -0.14* | 0.03 | <0.001 | -0.19, -0.07 |
| 症状预测工作同盟(coret-1-> wait-1） | -0.08* | 0.03 | 0.002 | -0.15, -0.03 |
| 组间水平 | ||||
| 工作同盟预测症状(wai-> core） | -0.09 | 0.28 | 0.357 | -0.52, 0.54 |
| 反馈预测症状（feedback-> core） | -0.12 | 0.16 | 0.221 | -0.52, 0.14 |
| 反馈预测工作同盟（feedback-> wai） | 0.38* | 0.16 | 0.008 | 0.07, 0.72 |
| 缺失值检验模型 | ||||
| 组内水平 | ||||
| 症状的自回归效用（coret-1->coret） | 0.53* | 0.06 | <0.001 | 0.42, 0.66 |
| 工作同盟的自回归效用（wait-1->wait） | 0.63* | 0.04 | <0.001 | 0.55, 0.70 |
| 工作同盟预测症状（wait-1-> coret） | -0.12* | 0.03 | <0.001 | -0.17, -0.06 |
| 症状预测工作同盟(coret-1-> wait-1） | -0.08* | 0.02 | <0.001 | -0.13, -0.04 |
| 组间水平 | ||||
| 工作同盟预测症状(wai-> core） | -0.09 | 0.22 | 0.303 | -0.49, 0.38 |
| 反馈预测症状（feedback-> core） | -0.07 | 0.14 | 0.223 | -0.44, 0.15 |
| 反馈预测工作同盟（feedback-> wai） | 0.39* | 0.16 | 0.003 | 0.12, 0.77 |
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