Strong Alliance Research Articles

The relationship between youth involvement, alliance and outcome in trauma-focused cognitive behavioral therapy

ABSTRACT Objective Research suggests that combining the trauma-specific elements with a strong alliance helps optimize treatment outcomes in Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) for youth. Building on this, we investigate whether more positive and less negative involvement behaviors during trauma narration are associated with a stronger alliance and predict fewer posttraumatic stress symptoms (PTSS). Method Participants were 65 youth (M age = 15.5, SD = 2.2; 77% girls) receiving TF-CBT. Both youth self-report (Child PTSD Symptom Scale and Therapeutic Alliance Scale for Children) and observer ratings (Client Involvement Rating Scale) were used, and relationships were investigated with correlations and regression analyses. Results The positive involvement behaviors demonstration of treatment understanding and self-disclosure predicted fewer PTSS but were not associated with the alliance – while initiation of discussions and showing enthusiasm predicted more PTSS but were associated with a stronger alliance. The negative involvement behaviors passivity and avoidance did not predict PTSS but were negatively associated with the alliance. Conclusion The relationships between traumatized youths’ positive and negative involvement behaviors, alliance and PTSS outcomes appear mixed. The combination of a clear understanding of why processing the trauma can be helpful, more trauma-related self-disclosure and a stronger alliance seem favorable for alleviating PTSS. Trial registration: ClinicalTrials.gov identifier: NCT00635752..

Study on multi-subject behavior game of CCUS cooperative alliance

As a carbon reduction technology, CCUS (Carbon Capture, Utilization and Storage) is an important way to achieve the goal of “carbon peak and carbon neutrality” in China. In order to change the situation of slow commercialization and large-scale development of CCUS, this paper proposes to establish a CCUS cooperative alliance. Taking alliance organizers, institutional investors, upstream operators and downstream operators as research objects, the evolutionary game model is developed to reveal the dynamic evolution mechanism of CCUS cooperative alliance and analyze the impact of exogenous variables on the strategic choices of alliance members. The results show that: (1) establishing a strong market-oriented alliance can promote the large-scale deployment and commercialization of CCUS, (2) when return on investment is greater than or equal to 6%, it can effectively promote the investment of institutional investors in CCUS field, (3) when the government subsidy rate is greater than or equal to 75%, the willingness of downstream operators to operate independently is significantly enhanced. This study reveals the operation mechanism of the alliance, provides theoretical and methodological support for the operation and management of the alliance, and is of great significance to promote the cooperative operation and development of the alliance.

Art and Rebellion

The aim of this article is to document, contextualise, and theorise the rebellious actions carried out by artists in Slovenia in 2020–2021, and to present these actions as a continuation of the avant-garde movements of the twentieth century. We focus on the diverse actions and protests carried out by a strong alliance of artists, anti-capitalists, anti-fascists, ecological movements, and other civil structures that continue to challenge the oppressive autocratic powers. When art becomes confrontational, it fights for its autonomy and its production can achieve an aesthetic revolutionary potential. So when it demands the impossible, it fights for its space and position and becomes life itself, it becomes avant-garde. We could therefore say that the politics of aesthetics has a way of producing its own politics, proposing to re-arrange politics, re-configure art as a political issue or assert itself as true politics.

Building strong therapeutic relationships quickly: The effect of the perceived working alliance on veterans' intensive PTSD treatment outcomes.

Intensive treatment programs (ITPs) are successful at reducing posttraumatic stress disorder (PTSD) and depression symptoms in veterans. However, the role of the working alliance in the context of ITPs is largely unexplored. The purpose of this study was to examine veteran-rated working alliance with their individual cognitive processing therapy (CPT) provider as a predictor of changes in PTSD and depression symptoms as well as negative posttrauma cognitions in two unique ITP formats. Data were collected from 128 veterans who completed a 2-week ITP, involving 2 × individual CPT/day, as well as 73 veterans who completed a 3-week ITP, involving 1 × group CPT/day and 1 × individual CPT/day. Both ITPs included adjunctive wellness, skills, and psychoeducation services in addition to CPT. Linear mixed-effects models were used to determine whether changes in working alliance predicted changes in PTSD and depression symptoms. Stronger veteran-reported working alliance with their individual CPT therapist, most notably agreement on tasks, predicted significant reductions in both the 2-week and 3-week programs in PTSD (ps = .012 and .002, respectively) and depression symptoms (ps = .009 and .007, respectively) and negative posttrauma cognitions (ps = .009 and .016, respectively). These results highlight the importance of veterans' perceived working alliance with their individual treatment therapists in ITPs. Results suggest that a strong working alliance that is meaningful for treatment outcomes can be developed quickly despite the brevity of this intensive treatment format. Future research should examine ways to facilitate the development of a strong working alliance prior to or as early as possible in ITPs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Impact of the Recent South Korean Presidency Change on Security Relationship with North Korea

Tensions in the Korean Peninsula have soared with the advancement of North Korea’s (DPRK) nuclear weapons development. Along with Russia’s invasion of Ukraine in early 2022, DPRK’s 7th nuclear test is impending. In the era of a “new Cold War,” the presidency of South Korea (ROK) changed in May 2022. This study examined how the recent ROK presidency change affects its security relationship with DPRK. To analyze this, I performed a literature review of DPRK-related policies that former ROK presidents implemented. I used qualitative data from my three in-depth interviews that focused on Yoon’s policy initiatives in three aspects: DPRK policy, US-ROK alliance, military defense. To obtain updated information on ROK’s international situation, I conducted a debriefing of the 8th Yonhap News Symposium on Korean Peace (June 2022). Throughout past ROK governments, the strategies toward DPRK differed significantly between progressive and conservative parties. Inter-Korean relations were stronger under progressive party governments, but neither made progress towards DPRK’s denuclearization. President Yoon stated his policy would be principled and consistent, with a strong US-ROK alliance and international cooperation. Yoon planned the implementation of ROK’s 3-axis system and the establishment of the Military Strategic Headquarters, including advanced detection and precision strike counter-force capabilities. If he can achieve a US-ROK alliance and attain non-nuclear deterrence, ROK’s security relationship with DPRK will likely be safer than in the past. My research addresses a detailed question that is part of a larger global landscape to analyze ROK’s international affairs and gain insight into effective security policies.

Who Is Treating the Children? Training Child and Family Psychoanalytic Psychotherapists in China

ABSTRACT This article traces the development and evolution of The Psychodynamic Couple and Family Therapy Continuous Training Program in Beijing, China since its founding in 2009 as a two-year series of four immersion experiences in couple therapy training. The program’s learning components include a live clinical demonstration, didactic lectures, and small process learning groups. In the past 10 years, program faculty opted to include a child and family focus to address the relative absence of child psychodynamic psychotherapy training in China and the increasing mental health needs of Chinese children. Research on the training’s effectiveness is presented, highlighting the importance of the live clinical demonstration to the group’s learning, and supporting the importance of showing clinical theory and technique in action. Required adaptations from an in-person to an online training format owing to COVID are discussed. Examples drawn from the clinical demonstration, small process learning groups, and later emerging consultation groups are offered to show applications of the training model, challenges in learning, and cultural differences. The author contends that this training program and its extensions rely on the strong working alliance of its founders and illustrate the value of cross-cultural collaboration in training and treatment efforts.

Counsellors' lived experiences of empathy & compassion: An interpretive phenomenological inquiry

AbstractEmpathy and compassion are critical elements in counselling presence and practice. The present interpretive phenomenological study explored counsellor lived experiences of empathy and compassion. Through interpretative phenomenological analysis, findings highlighted how counsellors experience compassion and empathy, how boundaries shape wellness and practice with clients, and the impact of empathy and compassion over a career. The findings suggest that self‐other differentiation is key while using empathy to develop a strong therapeutic alliance and counsellor self‐care. Implications inform how counsellors can maintain wellness and learn to foster empathy and compassion in practice.

National Hypertension Guidelines: A Review of the India Hypertension Control Initiative (IHCI) and Future Prospects.

Hypertension is a silent killer; however, the treatment of hypertension is simple, effective, readily available, and needs to be continued lifelong. It is a significant health problem that is included under the umbrella of non-communicable disease conditions and has a strong alliance with cardiovascular morbidity and mortality. The India Hypertension Control Initiative (IHCI) is an extensive program in India that involves the Indian Council of Medical Research, the Ministry of Health and Family Welfare (Government of India), the state governments of India, and World Health Organization Country Office for India (WHO-India). The IHCI is a multi-partner initiative carried forward systemically across various states. The states are categorized into Grade I and Grade II. There is the involvement of specialized teams of cardiovascular experts and health officials to insure precise execution and seamless healthcare service. The implementation of the free and easy-to-use mobile application and software, Simple (Resolve to Save Lives, New York City, United States), in the analysis and storage of data, is a novel step taken to insure safe record keeping and follow-ups. Emphasis is on the adoption of demography-specific interventional methods and drugs, and proper acquisition and storage of these drugs is the key step. Treatment modalities involve the adoption of medicines and lifestyle modifications as a combined recipe. Advancements have been made in the area of drug development like gene therapies but they seem to show low success rates at the given moment. Adoption of lifestyle modifications along with medications is the gold standard treatment option. This review article aims to shed light on the current status of IHCI, its milestones, and the future of the initiative in India.

A strong alliance is not enough: Item-level variation in an alliance measure moderates the alliance strength and client outcome relationship.

[Retraction notice: A retraction for this article was reported in Vol 70(4) of Journal of Counseling Psychology (see record 2023-89440-002). The following article (https://doi .org/10.1037/cou0000629) is being retracted. This retraction is at the request of coauthors Kivlighan and Hill after the results of an investigation by the University of Maryland Institutional Review Board (IRB). The IRB found that the study included data from between one and four therapy clients of the Maryland Psychotherapy Clinic and Research Laboratory (MPCRL) who either had not been asked to provide consent or had withdrawn consent for their data to be included in the research. An was not responsible for obtaining and verifying participant consent but agreed to the retraction of this article.] This study investigated within-client effects of session-to-session working alliance (WA) strength (mean of client's and therapists' ratings of Working Alliance Inventory [WAI] items for a session; WAI-M) and intra-individual variance of working alliance (WAI-IIV; variation in how the same individual responds to different items in the WAI for a session) of therapist and client on overall client functioning. Specifically, we explored how the strength and intra-individual variance for therapist and client working alliance at a previous session (Time t-1) would relate to overall client functioning at a current session (Time t). We also explored whether the effect of WA-M on overall client functioning would be different at different levels of WAI-IIV. The dynamic structural equation modeling (Asparouhov et al., 2018) was used to analyze longitudinal data from 4,489 sessions at a university clinic where 17 doctoral student therapists provided low-cost, open-ended, individual psychodynamic psychotherapy to 135 adult community clients. We found that client-rated WAI-M and WAI-IIV had positive within-client main effects on next-session client functioning when controlling for autoregressive effects. Findings on WAI-M by WAI-IIV interaction effects revealed that the relationship between WAI-M at a previous session and client functioning at a current session was significant only when WAI-IIV was low (i.e., high intra-individual consistency across WAI items). Therapists' WAI-M, WAI-IIV, and interaction of WAI-M and WAI-IIV did not predict the next session client functioning significantly. Limitations and implications of the present research are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Pandemic Perils and Promise: Implementation of a Virtual Parenting Intervention during COVID-19 among Children with Early Neurological Conditions

ABSTRACT Objective In this study, we examined feasibility, acceptability, and preliminary efficacy of a telepsychological positive parenting intervention (I–InTERACT-North, Internet-basedInteracting Together Everyday: Recovery After Childhood Traumatic Brain Injury) during the COVID-19 pandemic among Canadian families of children at-risk for neurodevelopmental challenges given congenital or neonatal conditions. I–InTERACT-North was developed to improve behavioral and emotional outcomes in children with neurological conditions by utilizing and adapting parenting strategies from several established family-focused programmes. Methods A pragmatic prospective pre-post single-site pilot study design was used to assess feasibility, acceptabilty, and preliminary efficacy of I-InTERACT North during the COVID-19 pandemic. Results Thirty-five families of children ages three to nine years were referred between March 2020 and January 2021. Eighteen families enrolled, and 12 (67% adherence) completed the programme. Parents reported strong therapeutic alliance and programme acceptability with barriers due to competing time demands. Therapists reported high acceptability but perceived parental burnout. Parenting confidence (d = 0.70), and child behavior (d = 1.30) improved following the intervention. Conclusions Results demonstrate the programme’s value to families during the pandemic, while underscoring unique participation barriers. Future research and clinicial implications are discussed.

Trainee Therapists' Perceptions of a Blended Intervention to Promote Resilience after a Natural Disaster: A Qualitative Case Study.

Background: Natural disasters happen in an increased frequency, and telemental health interventions could offer easily accessible help to reduce mental health symptoms experienced by survivors. However, there are very few programs offered to natural disaster survivors, and no research exists on therapists’ experiences with providing blended interventions for natural disaster survivors. Aims: Our qualitative case study aims to describe psychologists’ experiences with an online, therapist-assisted blended intervention for survivors of the Fort McMurray wildfires in Alberta, Canada. Method: The RESILIENT intervention was developed in the frames of a randomized controlled trial to promote resilience after the Fort McMurray wildfires by providing survivors free access to a 12-module, therapist-assisted intervention, aiming to improve post-traumatic stress, insomnia, and depression symptoms. A focus group design was used to collect data from the therapists, and emerging common themes were identified by thematic analysis. Results: Therapists felt they could build strong alliances and communicate emotions and empathy effectively, although the lack of nonverbal cues posed some challenges. The intervention, according to participating therapists, was less suitable for participants in high-stress situations and in case of discrepancy between client expectations and the intervention content. Moreover, the therapists perceived specific interventions as easy-to-use or as more challenging based on their complexity and on the therapist support needed for executing them. Client engagement in the program emerged as an underlying theme that had fundamental impact on alliance, communication, and ultimately, treatment efficiency. Therapist training and supervision was perceived as crucial for the success of the program delivery. Conclusions: Our findings provided several implications for the optimalization of blended interventions for natural disaster survivors from our therapists’ perspective.

Clinician experiences of homework in couples and family therapy: A survey of perceived impact on the working alliance.

The process of engaging clients in homework assignments has been studied extensively in research settings, but rarely have the challenges in the implementation of the science been considered in couples and family therapy. A survey was conducted of 226 clinicians regarding (1) their experience of homework adherence (quantity and quality) with couple and family clients, and (2) their experience of the impact of homework non-completion (IHN) on the working alliance. Clinicians working with families reported less overall homework quantity and quality. However, across both couples and family clients, more negative IHN was reported among clinicians experiencing less homework quantity, both in terms of IHN bond (couple ρ = 0.71, p < 0.001; family ρ = 0.78, p < 0.001) and IHN agreement (couples ρ = 0.25, p < 0.001; ρ = 0.19, p = 0.006), and among clinicians with fewer years of clinical experience (r = 0.19, n = 136, p < 0.05). The present findings suggest that, in the context of couples and family therapy, there is a risk of perceived negative IHN on the working alliance. There would be merit to future investigations examining the processes of facilitating homework engagement within the context of a strong working alliance.

Therapists' experiences of a brief case formulation and alliance focused pre‐treatment training session (CALL)

AbstractObjectiveA general lack of supervision outcome studies and new advancements within therapist training methods inspired us to develop a randomised controlled trial, Case formulation and ALLiance (CALL), testing the efficacy of a brief pre‐treatment training session. CALL combines generic case formulation and alliance principles with the supervision of a specific client. This qualitative study acts as a preliminary to the randomised controlled trial and aims to explore psychologists' experiences of participating in CALL.MethodSemi‐structured interviews were conducted with seven psychologists in private practice, who participated in CALL between January and May 2020. The transcribed interviews were analysed using thematic analysis.ResultsThe psychologists described CALL as a clinically useful and collegial experience but simultaneously conveyed a lack of recollection of the training session and doubts as to its enduring utilisation.ConclusionCALL has the potential to positively influence the process and outcome of therapy through the fostering of case formulation and alliance management skills, as well as a strong supervisory alliance. However, the familiar content or brief format of the session, and participants' memory bias, may have limited the utilisation and recall of the intervention.

THE EXISTENCE OF THE ACEH GOVERNMENT IN REDUCING ACEH'S FOREST DAMAGE

ABsTRAK&#x0D; The role of the Aceh government in reducing forest degradation has not been maximized, it is proven that there are still many disasters that occur, the bad impact is that ecological disasters are increasing. This research is: How is the existence of the Regional Government in reducing forest destruction in Aceh?; How is the coordination of problem solving carried out by the Aceh Government to reduce the damage to Aceh's forests?. Researchers used empirical juridical research methods. Primary and secondary legal materials are the main materials and primary data is obtained through interviews. Data analysis was carried out qualitatively. The results of the study show that: the coordination carried out by the Aceh government is: monitoring / monitoring, protection, law enforcement, recovery, boundary demarcation, guidelines implementation, policy formulation, settlement. It is recommended to the Aceh government that the DPRA evaluate various policies and systems of Aceh's forest management. involving the community as subjects and part of the holder of sovereignty over forest area management. There is a need for Coordination of the Government of Aceh with other Agencies, building strong alliances with local civil society groups&#x0D; &#x0D; Keyword : The Authority of the Aceh Government, Reducing, Destruction of Aceh’s Forests&#x0D;

A qualitative study of medical students' perceptions of resident feedback.

Residents play a pivotal role in medical students' clinical education. From a feedback lens, the near-peer relationship between student and resident holds the potential to foster an educational alliance that could influence learning. We undertook the current qualitative study to explore medical students' perceptions of feedback experiences with residents, addressing when, how and why (and conversely when not and why not) resident feedback plays a role in their clinical education. Our methodology was qualitative interpretive description, informed by phenomenology. We conducted 24 semi-structured interviews with third and fourth year medical students at one institution. The interviews aimed to foster rich discussion about students' feedback experiences with residents during clinical rotations. Data collection and analysis proceeded iteratively. Initial interviews were independently open-coded by three investigators and then collaboratively refined. Codes were applied to subsequent interviews, and new codes were developed. During the final stages of analysis, we organised our themes by drawing on a sociocultural perspective to examine students' perceptions of relationship-building with residents and when and how this influenced feedback and learning. From the students' perspectives, when residents contributed to building interpersonal relationships with students, this in turn influenced students' receptivity to both encouraging and constructive feedback conversations. In the context of resident-student relationships that were perceived as supportive, resident feedback influenced how students approached learning and working in the clinical environment, as well as students' visions of their future selves. In unsupportive relationships, students were less inclined to engage in feedback with residents and students noted resident behaviours that they wanted to avoid in themselves. Residents are uniquely positioned to create a strong educational alliance with students in which feedback conversations can flourish. Focusing educational efforts on resident feedback conversations has the potential to significantly impact the feedback culture of our clinical environments.

Alliance-focused safety planning and suicide risk management.

Patients' interpersonal vulnerabilities and problems represent major distal and proximal risk factors in the etiology of suicide. These can be triggered by the interpersonal demands of therapy and safety planning and impede the development of a strong therapeutic alliance, and thus, the effectiveness of safety planning. This article proposes that the principles put forth by the Alliance-Focused Training (AFT; Eubanks-Carter et al., 2015; Muran & Eubanks, 2020), which view the therapeutic alliance both as a precondition to therapy and as an active change mechanism, present an ideal framework for addressing patients' interpersonal challenges in the context of safety planning and suicide risk management. After discussing the relevance of AFT principles to safety planning, we will propose an approach to incorporate AFT techniques into evidence-based safety planning interventions and to monitor their impact on the therapeutic alliance and treatment outcome. Last, we will provide a brief clinical report to illustrate the principles and techniques described in the article. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Spanish Far-Right Party “Vox”: Its Role in Shaping of the EU Regional Agenda

The “Vox” party has turned into an influential actor of the European politics due to its electoral success; institutional and ideological adaptation to the country’s changing party landscape; attempts to create its own institutional, organizational, informational, and creative resources; as well as its policy of forming strong alliances with European and American rightwing conservative forces. Based on the spatial approach (categories of political space and political identity) and discourse-analysis, the author tries to comprehend the policy guidelines of “Vox”; determines the place of the party in the political system and the media sphere of Spain; defines the role that “Vox” plays in shaping the regional agenda of the EU. The study focuses on the political and institutional aspects of how “Vox” strengthens its relations with similar EU parties based on partisan and ideological identity, designing alternative projects of European integration, and establishing a new, ideologized format for the relations of Spain (and more broadly - the EU) and the Ibero-American countries. The author concludes about the structuring and the formal institutionalization of communications and political interactions between the far-right political elites which carries risks for the EU’s efforts to create a macropolitical identity and the metanarrative of memory, therefore, potentially leading to political divisions in the EU.

Effect of Umwalimu SACCO Services on Socio-Economic Development of Teachers in Rwanda

The services provided Umwalimu SACCO in Rwanda play a significant role in improvement of living standard of teachers. Hence, the study sought to determine the relationship between Umwalimu SACCO and Socio-economic development of teachers in Rusizi district in Rwanda. Correlation research design was employed. The population of study consisted of 2503 teachers and staff of the UMWALIMU SACCO Rusizi district branch. The sample size was (98) determined by using the Yamane’s formula. Questionnaires, interview guides and documentary reviews were utilized as primary and secondary data collection instruments. The study findings revealed that the majority of respondents (97.95%) stated that their income increased after getting loan from UMWALIMU SACCO Rusizi district. 47.95% strongly agreed that small projects have improved their children's schooling and 46.93% strongly agreed that small businesses have improved children's access to education, have been able to pay for health insurance and have improved their access to food security because of income received from their businesses. It was found there is a is high correlation between UMWALIMU SACCO services (Credit Provision, Savings, business loans, -housing loans, -Small project loans, Savings platform-SACCO services) and socio-economic development of teachers (Increase of income, education facilities, food security, building houses, increased household savings). The Pearson correlation(r) coefficient was 0.787 with a P-value of 0.000. The study recommended the management of Umwalimu SACCO should create awareness campaigns, increase loans to their customers and train them on how to start small projects. The government and development partners should create a strong supportive policy framework, increasing public awareness and understanding of micro insurance at both regulator and other stakeholder’s levels, and building strong strategic partnerships and alliances. Moreover, the members of Umwalimu SACCO and teachers should also work hand in hand with the managerial staff to improve the services offered in their institution. Keywords: Umwalimu SACCO, Socio-economic development, teachers and cooperative, Rwanda

Engaging youth in stakeholder analysis for developing community-based digital innovations for mental health of young people in Ingwavuma community, in KwaZulu-Natal Province, South Africa.

South Africa faces a critical shortage of mental health service professionals and support for young people with common mental health disorders is inadequate. Social relationships that provide support to adolescents in South African communities are increasingly declining due to socio-economic pressures. Developing ethical digital mental health innovations has potential to address provide services particularly in rural communities where mental health facilities are scarce. The active involvement of young people is critical to maximising uptake and reducing apathy on the use of digital innovations for mental health. Using the nominal group technique this study engaged young people in identifying stakeholders for setting up a community-based mental health intervention in a rural community. Use of nominal group technique for stakeholder analysis proved to a useful tool for engaging young people. The stakeholder identification and analysis provided a base for inclusivity in developing digital innovations for mental health through identifying multi-sector community stakeholders. It revealed that young people in the community have varying perceptions about the level of power and interest which their peers, family members, local leaders, health workers and social development organisations have in developing digital mental health interventions. This research contributes to our understanding of the ways in which to leverage young people's participation in project planning and decision-making and building strong teams and alliances for developing digital innovations for mental health in marginalised rural communities.

A Practical Guide on Problem-Solving Teleconsultation in Schools

ABSTRACT School consultants often use problem-solving consultation when working with educators and caregivers to support the behavioral and academic outcomes of students. Considering some of the well-known limitations to in-person service delivery, consultants have increasingly relied on telecommunications as a medium through which to deliver problem-solving consultation, namely teleconsultation. Thus, this paper serves as a practical guide for school consultants, who work with educators and caregivers, on how to implement each stage of the problem-solving teleconsultation process. With an emphasis given to supports delivered through technology, we provide general guidance and empirically-supported recommendations for how to develop and maintain a strong working alliance with consultees, engage in effective communication practices, strive for equitable practices when collaborating with ethnically and racially diverse populations, monitor treatment progress and deliver performance feedback, and deliver teleconsultation in accordance with state and federal law.