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@ARTICLE{Saxler:271144,
      author       = {Saxler, Eva and Schindler, Theresa and Philipsen, Alexandra
                      and Schulze, Marcel and Lux, Silke},
      title        = {{T}herapeutic alliance in individual adult psychotherapy: a
                      systematic review of conceptualizations and measures for
                      face-to-face- and online-psychotherapy},
      journal      = {Frontiers in psychology},
      volume       = {15},
      issn         = {1664-1078},
      address      = {Lausanne},
      publisher    = {Frontiers Research Foundation},
      reportid     = {DZNE-2024-01012},
      pages        = {1293851},
      year         = {2024},
      abstract     = {The therapeutic alliance (TA) is a robust and
                      pantheoretical predictor of treatment outcome in
                      Face-to-Face- (F2F-) and Online-psychotherapy (Online-PT).
                      Many authors have proposed several conceptualizations of TA,
                      which are oftentimes operationalized. The resulting
                      diversity of conceptualizations and measures is presented in
                      this review.We performed a three-parted literature search
                      for self-report-instruments of TA in individual, voluntary
                      F2F-PT with adults (1. utilization of past reviews, 2.
                      systematic literature search yielding 5,205 articles, 3.
                      reference lists). Analogously, we conducted a systematic
                      literature search for instruments of TA in the
                      Online-setting (yielding 200 articles). Additionally, we
                      analyzed the content of the instruments qualitatively.A
                      current overview of 48 instruments for measuring TA (46 for
                      F2F-PT, 2 for Online-PT) including their conceptual
                      backgrounds, characteristics and main content aspects is
                      presented. Most instruments (n = 24) operationalize one or
                      more theoretical conceptualizations of TA. Other instruments
                      are adaptation/syntheses of existing measures (n = 14),
                      based on literature searches (n = 3) or on an empirical
                      survey (n = 3) and two instruments provide no conceptual
                      background information. The content of the instruments
                      mainly focused on the following aspects: 1. Self-disclosure
                      and authenticity; 2. Agreement; 3. Active participation,
                      motivation and compliance; 4. Trust and secure attachment;
                      and 5. Considering needs/abilities/wishes of the patient.
                      Additionally, a narrative review of various approaches to
                      conceptualize TA is presented and linked to respective
                      corresponding instruments.The broad variety of
                      conceptualizations and measures of TA makes coherent
                      research on TA difficult. There are conceptual challenges
                      such as the role of attachment style in TA that remain to be
                      clarified. The current conceptualizations and measures do
                      not incorporate the practical experience and expertise of
                      psychotherapists and patients sufficiently. A
                      metatheoretical conceptualization and measure of TA based on
                      an empirical survey of psychotherapists and patients could
                      address these issues.},
      keywords     = {conceptualizations (Other) / measurements (Other) /
                      psychotherapy (Other) / systematic review (Other) /
                      therapeutic alliance (Other)},
      cin          = {AG Amin},
      ddc          = {150},
      cid          = {I:(DE-2719)1710010},
      pnm          = {351 - Brain Function (POF4-351)},
      pid          = {G:(DE-HGF)POF4-351},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:38993343},
      pmc          = {pmc:PMC11238262},
      doi          = {10.3389/fpsyg.2024.1293851},
      url          = {https://pub.dzne.de/record/271144},
}