ISSN 0439-755X
CN 11-1911/B

中国科学院心理研究所

• 研究报告 •

阅读进度反馈信息对工作同盟和咨询效果的影响

1. 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

1. 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:2020-07-01 Online:2021-04-25 Published:2021-04-07
• Contact: YU Lixia E-mail:yulixia@mail.ccnu.edu.cn

Abstract:

Progress feedback involves collecting patients’ ratings on treatment outcome by session and providing feedback to therapists on patient progress. Research has indicated that the positive effect of progress feedback on psychotherapy outcome is a promising advancement. However, a recent meta-analysis showed that progress feedback may only have a small to medium effect for non-severe patients. Also, the theory which explains the effect of progress feedback is very much limited. Before implementing progress feedback in China, it is necessary to test its effect on working alliance and treatment outcomes in a natural setting.
It is believed that Chinese are taught to obey their parents, respect elders, and restrain themselves to keep family harmony. Such schemas are subsequently transferred to their social life in the forms of respecting authority/superior, maintaining interpersonal harmony, which will lead to an indirect style of communication. Progress feedback from patients’ weekly reports can be used as a correction method for incongruences between therapists and patients without discussing it immediately and face-to-face, and thus can improve the quality of working alliance and treatment outcomes. The current study used a culturally-adapted version of progress feedback in a university counseling center. Research assistants collected patients’ ratings on working alliance and treatment outcomes and emailed the results with interpretations to the therapists, who were then encouraged to use feedback information to improve treatment outcomes.
The participants included 48 therapists and 445 patients (of which 350 were used for analysis). Post survey indicated that 80% therapists read progress feedback information based on which they were divided into feedback and non-feedback group. CORE-OM10 was used to evaluate symptoms before each session, and WAQ was used to evaluate the working alliance after each session. PHQ-9, GAD-7, and CORE-OM-34 were used before and after treatment. Multi-level structural equation models were used to analyze the data. Results showed that progress feedback had a medium effect on working alliance but no effect on treatment outcomes (measured by CORE-OM) at the between-person level. At the within-person level, the results affirmed the reciprocal model of alliance-outcome, which indicated that the model is consistent and steady across cultures. In addition, the feedback group had better treatment outcomes measured by PHQ-9 and self-rated helpfulness measured after treatment.
The results were discussed under the three possible mechanisms of progress feedback. Progress feedback may correct the bias of the therapist’s self-evaluation on treatment process, as well as the incongruence and alliance ruptures between therapists and patients. The cultural-specific factors may also contribute to the effect of progress feedback (e.g., indirect communication style). The support from regular supervision for therapists under progress feedback was emphasized as well. Overall, the present study suggested the positive effect of progress feedback on the working alliance and treatment outcomes in a Chinese counseling center based on practical evidence.