TitleTherapeutic alliance factors in a sample of depressed Latinos receiving brief motivational interviewing
NameHarris, Lina Aldana (author), Fishman, Daniel (chair), Interian, Alejandro (outside member), Rutgers University, Graduate School of Applied and Professional Psychology,
Hispanic Americans--Mental health services,
Motivational interviewing--United States,
Therapeutic alliance--United States,
Depressed persons--United States
DescriptionLatinos underutilize mental health services due to such disadvantages as language barriers, low income, and legal status. Successful ways to increase treatment engagement, retention, and effectiveness with this population are urgently needed. In line with this need, the present research project studied one factor with empirically based potential for enhancing treatment effectiveness with Latinos, namely, the therapeutic alliance as conceptualized by Bordin (1979) and by Horvath and Greenberg (1989). The presence of emotional bonds and clear and agreed upon goals and tasks between client and therapist was examined. This study focused on a convenience sample of low SES, Spanish-speaking Latinos (eight women and two men) with major depressive diagnoses. As part of a larger study, participants received two Motivational Interviewing (MI) sessions designed to increase adherence with anti-depressant medication and lower depression, as measured by the Beck Depression Inventory-II, Spanish Record Form (BDI-II). The first aim of the present study was to evaluate the MI sessions to determine if the Working Alliance Inventory Observer (WAI-O) form adapted by Tichenor and Hill (1989) from Horvath and Greenberg's (1989) measure of strength of alliance (WAI) predicted subsequent degree of improvement in medication adherence and the BDI-II. The second aim was to qualitatively analyze MI session transcripts using a grounded theory approach to identify specific qualitative categories of client-therapist interaction that describe the particular meanings of the WAI-O ratings. The quantitative results revealed moderate positive correlations of .455 and .467, respectively, between WAI-O and the two main outcome measures, both significant at the one-sided, .10 level. The qualitative results yielded three major areas of bonding—such as "acceptance" and "enhancing confidence"—which in turn were divided into eight discreet therapist behaviors, including displays of affirmation, interest, and respect to help the client feel cared for, understood, and validated, as well as one client behavior of expressing belief that the therapist could help. Findings in the goals and tasks domains are also presented. Finally, the overall results are discussed in terms of promoting the tailoring of the therapeutic alliance to the mental health needs and life contexts of disadvantaged, depressed, Spanish-speaking Latinos.
NoteIncludes bibliographical references
Noteby Lina Aldana Harris
CollectionGraduate School of Applied and Professional Psychology Electronic Theses and Dissertations
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.