The factor structure of the Working Alliance Inventory short-form in youth psychotherapy: an empirical investigation
Open accessAbstract
Objective: The Working Alliance Inventory short form (WAI-S) is one of the most commonly used alliance measures with adolescents. Yet, its factor structure has received minimal attention in the youth alliance literature. This study investigated the factor structure of the WAI-S in psychotherapy for adolescent depression and explored its measurement invariance across time, therapeutic approaches and patients’ and therapists’ perspectives. The existence of method effects associated with the negatively worded items of the scale was also assessed.Method: The setting of this study is the IMPACT trial, a randomized controlled trial assessing the effects of three therapeutic interventions in the treatment of adolescent depression. The WAI-S was completed at 6, 12 and 36 weeks after randomization by 338 adolescents and 159 therapists. Data were analysed using confirmatory factor analysis.Results: The hypothesized Bond-Task-Goal alliance structure was not supported and a general, one-factor model was found to be more psychometrically valid. The existence of a method effect and measurement invariance across time and treatment arms were also found.Conclusions: While the distinction between the specific alliance dimensions is conceptually and clinically interesting, at an empirical level the alliance features of the WAI-S in youth psychotherapy remain strongly intercorrelated.
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WAI-SR has demonstrated adequate psychometric properties.
“The WAI-SR has demonstrated adequate psychometric properties [73].”
From Measuring the Effect of the Early assessment Team (MEET) for patients referred to outpatient mental health care: a study protocol for a randomised controlled trial (2024) · cites this paper as [73]
The Therapeutic alliance section reports good validity and reliability for the WAI-S, the scale studied here. The Discussion identifies the WAI-SR as a revised version with different item wording, but does not assess its psychometric properties. The findings for WAI-S therefore do not verify the claim about WAI-SR; no page numbers are available in our copy. (LLM, conf=0.78)
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“The WAI-SR has demonstrated adequate psychometric properties [73].”
Method
- Authors
- Cirasola, A., Midgley, N., Fonagy, P., Impact Consortium, & Martin, P.
- Affiliations
- Anna Freud Centre (GB)
- Corresponding author
- Cirasola, Antonella
- Venue
- Psychotherapy Research
- Publisher
- Informa UK Limited
- Published
- 2020-05-15
- Volume
- 31
- Issue
- 4
- Pages
- 535-547
- ISSN
- 1050-3307 (ISSN-L)
- 1468-4381
- OpenAlex
- W3024334490
- Cited by
- 42
- References
- 55
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 7 · 2023: 5 · 2022: 17 · 2021: 6
- FWCI
- 2.80
- Type
- journal article
- Language
- en
- Open access
- green
- discovery.ucl.ac.uk
- Locations
- Psychotherapy Research (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institute for Health Research
- Health Technology Assessment
- British Association of Counselling and Psychotherapy
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Counseling Practices and Supervision
- Keywords
- therapeutic relationship, adolescents, adolescent depression, factor structure, measurement invariance, method effects, negatively worded items, therapist perspectives, psychotherapy outcome assessment
- MeSH terms
- Adolescent, Existentialism, Factor Analysis, Statistical, Humans, Motivation, Professional-Patient Relations, Psychotherapy
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