Progress feedback and its effects on working alliance and treatment outcomes

doi:10.3724/SP.J.1041.2021.00349

Abstract

Abstract:

The purpose of progress feedback is to correct the bias of the therapist’s subjective evaluation of the treatment effect and to improve the treatment outcomes. Considering that the standard “face-to-face” progress feedback procedure of therapists and clients does not conform to the social and cultural habits of our country, this paper analyzes the influence of non-face-to-face progress feedback on working alliance and treatment effect in a natural setting using multi-level structural equation model. The results showed that at the between-person level, the quality of working alliance was better in the feedback group, and at the within-person level, the relationship between working alliance and symptom was reciprocal. At the end of the case, the feedback group was better at the helpfulness of therapy rated by clients and decreased more at the depressive symptoms. The conclusion is that progress feedback has a positive influence on working alliance and treatment effect. The study expands the literature on the mechanism of progress feedback from the perspective of working alliance and Chinese Guanxi, providing empirical evidence for the application of progress feedback in natural settings.

Key words: progress feedback, working alliances, treatment outcome, multi-level structural equation modeling

SUN Qiwu, WU Caizhi, YU Lixia, WANG Weixin, SHEN Guocheng. (2021). Progress feedback and its effects on working alliance and treatment outcomes. Acta Psychologica Sinica, 53(4), 349-361.

Figures/Tables 4

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session	Group reading progress feedback					Control Group
	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

session	Group reading progress feedback					Control Group
	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

Path and effect	standardized solution	Posterior SD	one-tail p	95% confidence interval
The model of reading information of progress feedback
		within-person level
Autoregressive effect of symptoms (core_t-1-> core_t)	0.37*	0.04	<0.001	0.36, 0.53
Autoregressive effect of working alliance (Wai_t-1-> Wai_t)	0.61*	0.04	<0.001	0.49, 0.66
Alliance predicts symptoms (wai_t-1-> core_t)	-0.14*	0.03	<0.001	-0.19, -0.07
Symptoms predicts alliance(core_t-1-> wai_t-1）	-0.08*	0.03	0.002	-0.15, -0.03
		between-person level
Alliance predicts symptoms (wai-> core)	-0.09	0.28	0.357	-0.52, 0.54
Feedback predicts symptoms (feedback-> core)	-0.12	0.16	0.221	-0.52, 0.14
Feedback predicts alliance (feedback-> wai)	0.38*	0.16	0.008	0.07, 0.72
Model testing the effect of missing values
		within-person level
Autoregressive effect of symptoms (core_t-1-> core_t)	0.53*	0.06	<0.001	0.42, 0.66
Autoregressive effect of working alliance (Wai_t-1-> Wai_t)	0.63*	0.04	<0.001	0.55, 0.70
Alliance predicts symptoms (wai_t-1-> core_t)	-0.12*	0.03	<0.001	-0.17, -0.06
Symptoms predicts alliance(core_t-1-> wai_t-1）	-0.08*	0.02	<0.001	-0.13, -0.04
		between-person level
Alliance predicts symptoms (wai-> core)	-0.09	0.22	0.303	-0.49, 0.38
Feedback predicts symptoms (feedback-> core)	-0.07	0.14	0.223	-0.44, 0.15
Feedback predicts alliance (feedback-> wai)	0.39*	0.16	0.003	0.12, 0.77

Path and effect	standardized solution	Posterior SD	one-tail p	95% confidence interval
The model of reading information of progress feedback
		within-person level
Autoregressive effect of symptoms (core_t-1-> core_t)	0.37*	0.04	<0.001	0.36, 0.53
Autoregressive effect of working alliance (Wai_t-1-> Wai_t)	0.61*	0.04	<0.001	0.49, 0.66
Alliance predicts symptoms (wai_t-1-> core_t)	-0.14*	0.03	<0.001	-0.19, -0.07
Symptoms predicts alliance(core_t-1-> wai_t-1）	-0.08*	0.03	0.002	-0.15, -0.03
		between-person level
Alliance predicts symptoms (wai-> core)	-0.09	0.28	0.357	-0.52, 0.54
Feedback predicts symptoms (feedback-> core)	-0.12	0.16	0.221	-0.52, 0.14
Feedback predicts alliance (feedback-> wai)	0.38*	0.16	0.008	0.07, 0.72
Model testing the effect of missing values
		within-person level
Autoregressive effect of symptoms (core_t-1-> core_t)	0.53*	0.06	<0.001	0.42, 0.66
Autoregressive effect of working alliance (Wai_t-1-> Wai_t)	0.63*	0.04	<0.001	0.55, 0.70
Alliance predicts symptoms (wai_t-1-> core_t)	-0.12*	0.03	<0.001	-0.17, -0.06
Symptoms predicts alliance(core_t-1-> wai_t-1）	-0.08*	0.02	<0.001	-0.13, -0.04
		between-person level
Alliance predicts symptoms (wai-> core)	-0.09	0.22	0.303	-0.49, 0.38
Feedback predicts symptoms (feedback-> core)	-0.07	0.14	0.223	-0.44, 0.15
Feedback predicts alliance (feedback-> wai)	0.39*	0.16	0.003	0.12, 0.77