Práticas de ensino de habilidades para estabelecimento e manutenção da aliança terapêutica no contexto da psicoterapia: uma revisão da literatura
Abstract
Therapeutic alliance refers to the quality and strength of the collaborative relationship between
client and therapist, which is built as the therapeutic process unfolds. There is evidence that a
well-established therapeutic alliance is one of the main predictors of positive outcomes in the
therapeutic process for the client. However, overall, the skills required to form this bond are
not systematically taught in undergraduate courses, nor are they based on evidence regarding
the effectiveness of methods for teaching thes skills. In light of this, the objectives of the present
study were to analyze the academic literature in order to describe: (a) the scientific rigor of the
study designs employed, (b) the characteristics of intervention programs offered to teach skills
for establishing and maintaining the therapeutic bond to clinical psychology students, and (c)
the effects of the programs on students' repertoire and the quality of the therapeutic alliance
formed with their clients. The method employed was a systematic review, following the
updated version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
The methodological quality of each study was assessed based on the Mixed Methods Appraisal
Tool. A total of 268 publications were identified in four databases (Scientific Electronic
Library Online - SciELO, PsycNET - APA, PubMed, and BVS) and imported into the Rayyan
program. After the identification, screening, and abstract reading stages, 18 studies were
selected for analysis. After reading the full papers to determine eligibility, nine studies were
included in the systematic review. The results show that there are programs for training alliance
skills (alliance focused training - AFT). Some of the skills taught involve building bonds, aswell as skills to repair ruptures in this affective bond. Relationship aspects involving
commitment to the therapeutic process were also addressed. Three main strategies were found
for teaching these skills: video feedbacks and role-plays activities. However, there is limited
evidence regarding the effects of the programs. The main limitation of the review conducted is
the multiplicity of terms being used in this area, so some relevant texts may not have been
identified. In future studies, it will be important to invest in the development of an AFT
program for use in Brazil, verifying the effectiveness of the teaching process with multiple
informants (e.g., supervisors, therapists, clients, and observers not connected to the first three
groups of informants). In this way, it will be possible to contribute to improvements in the
quality of training for Brazilian psychologists and, therefore, to the effects of the
psychotherapeutic services provided
Collections
The following license files are associated with this item: