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Testing the Working Alliance Inventory (WAI) in a French primary care setting

Predictive value and factor structure

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Background

Working alliance has shown a predictive value of the outcome in different therapeutic settings but was not yet studied in a non-medical setting.

Methods

The predictive value and the factor structure of the Working Alliance Inventory (WAI) [36-item client version; as reported by Horvath and Greenberg (J Couns Psychol 36:223–233, 1989)] were studied in a French primary care setting on a sample of 130 adults accessing social services.

Results

The WAI total score completed after the first meeting was positively predictive of quality of the working alliance 4 months later. An exploratory factor analysis produced two orthogonal factors which explained 45.12% of the total variance: a first factor (23 items) labelled ‘positive expectations about the usefulness of help’ and a second factor (13 items) labelled ‘absence of suspicion about the effects of help’.

Conclusions

The WAI is shown to be applicable to primary care social work settings to measure the working alliance phenomenon and predict disruption of practitioner–client relationship.

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Notes

  1. Source: S.S.P., DASES, 2000: 55% families with children, 49% with private home, 33% with a salary.

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Acknowledgements

Our thanks are due to Professor Adam Horvath whose comments were so relevant and helpful and to Professor Hiram Fiztgerald who made important suggestions to improve the manuscript. Our thanks are due to Ms. Gael Baron and Professor Georges Downing for their assistance in the back-translation; to Misses Merrick, Lanneau and Caron (DASES) who made this research possible and accompanied its implementation throughout; to all the social workers in the services involved for their implication; and to Mrs Guillotin-Graf and Anthonioz who ensured the recruiting. Mrs Dugré-Lebigre contributed to the ethical formalities. Angela Swaine-Verdier made the translation.

This project received funding from AP–HP (Assistance Publique des Hôpitaux de Paris), CRC 01003.

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Authors and Affiliations

  1. Dept. of Psychiatry of Adolescent and Young Adult, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France

    Nicole Guédeney MD, PhD & Florence Curt MD, PhD

  2. Laboratoire de Biostatistiques, Hopital Necker, AP-HP, Paris, France

    Jacques Fermanian MD, PhD

  3. Lifespan Research Group, Royal Holloway, University of London, London, UK

    Antonia Bifulco PhD

Authors
  1. Nicole Guédeney MD, PhD
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  2. Jacques Fermanian MD, PhD
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  3. Florence Curt MD, PhD
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  4. Antonia Bifulco PhD
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Correspondence to Nicole Guédeney MD, PhD.

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Guédeney, N., Fermanian, J., Curt, F. et al. Testing the Working Alliance Inventory (WAI) in a French primary care setting. Soc Psychiat Epidemiol 40, 844–852 (2005). https://doi.org/10.1007/s00127-005-0972-4

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