Adapting the 'Working Alliance Inventory' to measure therapeutic alliance in general practice

Abstract

Therapeutic alliance is a term that describes the relationship between a health practitioner and their patient, and is a recognised mediator of patient behaviour change. Objective: To adapt the "Working Alliance Inventory" so that it is feasible to use in the general practice setting. Design: The WAI, previously validated in psychology, was adapted for use in Australian general practice via two rounds of qualitative online surveys from both patients and GPs. The adapted tool will be used in a general practice with 150 GP-patient dyads, alongside measures of Functional status, shared decision making (Dyadic OPTION), personal health and Patient-Doctor Depth of Relationship (PDDR) scale. Two social desirability scales will also be used. A confirmatory factor analysis will determine if the original three-factor structure (goals, tasks and bonds) is replicated and whether a higher-order factor of overall therapeutic alliance emerges. The internal consistency of the scale will be evaluated using Cronbach's alpha. Outcome Measures: Face validity of adapted WAI; secondary measure concurrent validity with other measured tools. Results: We hypothesise that the WAI will correlate with validated tools measuring shared-decision making and doctor-patient relationships. Measuring the therapeutic alliance between patients and their GP will be helpful in research and clinical settings. Show more