Tohar Dolev1, Sigal Zilcha-Mano1, Harold Chui2, Marna S Barrett3, Kevin S McCarthy4, Jacques P Barber5. 1. The Department of Psychology, University of Haifa. 2. The Department of Psychology, Chinese University of Hong Kong. 3. Department of Psychiatry, University of Pennsylvania. 4. Department of Psychology, Chestnut Hill College. 5. The Derner Institute of Advanced Psychological Studies, Adelphi University.
Abstract
OBJECTIVE: Better understanding of the connection between therapeutic processes and outcomes in minority groups can help design and use culturally-adapted treatments. METHOD: To explore the active ingredient in the therapeutic process, the present case study compared two ethnic minority male clients, recruited as part of a randomized controlled trial (RCT), one with a good outcome, the other with a poor one. The 12-item Working Alliance Inventory-Observer (S-WAI-O) coding system was used to capture the process of change, alongside a qualitative analysis of content. The cases were identified based on their change in pre- to post-treatment scores on the Beck Depression Inventory (BDI) and the Hamilton Rating Scale for Depression (HRSD). RESULTS: The findings suggest a rupture-resolution process in the good outcome case, including a process of negotiation of the alliance and work on issues of trust. In contrast, the poor outcome case showed strong and steady alliance, but context analysis pointed to withdrawal ruptures. CONCLUSIONS: Although it is difficult to generalize from a two-case study analysis, the present work suggests that building and negotiating alliance with minority clients has a potential for treatment success.
OBJECTIVE: Better understanding of the connection between therapeutic processes and outcomes in minority groups can help design and use culturally-adapted treatments. METHOD: To explore the active ingredient in the therapeutic process, the present case study compared two ethnic minority male clients, recruited as part of a randomized controlled trial (RCT), one with a good outcome, the other with a poor one. The 12-item Working Alliance Inventory-Observer (S-WAI-O) coding system was used to capture the process of change, alongside a qualitative analysis of content. The cases were identified based on their change in pre- to post-treatment scores on the Beck Depression Inventory (BDI) and the Hamilton Rating Scale for Depression (HRSD). RESULTS: The findings suggest a rupture-resolution process in the good outcome case, including a process of negotiation of the alliance and work on issues of trust. In contrast, the poor outcome case showed strong and steady alliance, but context analysis pointed to withdrawal ruptures. CONCLUSIONS: Although it is difficult to generalize from a two-case study analysis, the present work suggests that building and negotiating alliance with minority clients has a potential for treatment success.
Entities:
Keywords:
Alliance; Case studies; Ethnic minority groups; Psychodynamic treatment; Rupture resolution processes; Therapeutic process
Authors: Mario Cruz; John Scott; Patricia Houck; Charles F Reynolds; Ellen Frank; M Katherine Shear Journal: Psychiatr Serv Date: 2007-05 Impact factor: 3.084