Working alliance inventory - short revised - observer (WAI-SR-O): adaptação transcultural e análise das propriedades psicométricas da versão brasileira para usuários de álcool

Abstract

Studies regarding interventions for alcohol dependents have prioritized understanding psychotherapeutic process active ingredients, being therapeutic alliance (TA) one of these mechanisms. The measures which are evaluated by a clinical observer have been widely recommended to assess TA. However, it is observed the absence of observational measures of TA in Brazil, and its study is still incipient. Aim: The present work encompasses two studies: 1) developing a literature review to characterize the TA instruments; 2) to conduct the Working Alliance Inventory - Short Revised Observer (WAI-SR-O) cross-cultural adaptation and investigate its validity evidences for alcohol dependents on brief cognitive-behavioral treatment. Method: Bibliometric data were collected and thematic content analysis was performed on literature review study. On the second study, the WAI-SR-O were submitted to the analysis of reliability evidences based on the internal structure, evidence of validity based on relations with external variables, evaluation of inter and intra raters mean differences, and Intraclass Correlation Coefficient (ICC) of the WAI in the therapist and client versions. Results: Literature review indicates TA instruments in various versions, assessed from different perspectives and based in a whole range of theoretical models. They presented appropriated psychometric properties although important factorial structure issues were indentified. In the second study, the WAI-SR-O were translated, backtranslated and evaluated by experts. Observer raters training was carried out, resulting in some adjustments on instrument. The results pointing out good psychometric properties, with a high Cronbach’s alpha (α = 0.86), convergent validity evidences among WAI-SR-O and WAI-Therapist and high ICC intra raters for general scale and subscales. Discussion: Problems in the TA instruments factorial structure raised on the first study could be a explanation for the observer difficulties in differenciate the WAI-SR-O dimensions. On the whole, the adapted WAI-SR-O initial psychometric properties shows its may be a promising instrument for studying of psychotherapeutic process in the Brazil.