title: Therapeutic alliance and obesity management in primary care - a cross-sectional pilot using the Working Alliance Inventory.
abstract: Therapeutic alliance is a well-recognized predictor of patient outcomes within psychological therapy. It has not been applied to obesity interventions, and Bordin's theoretical framework shows particular relevance to the management of obesity in primary health care. This cross-sectional study of a weight management programme in general practice aimed to determine if therapeutic alliance was associated with patient outcomes. The Working Alliance Inventory short revised version (WAI-SR) was administered to 23 patients and 11 general practitioners (GPs) at the end of a 6-month weight management programme. Use of the WAI-SR indicated that the strength of therapeutic alliance varied between different patient-GP relationships in this pilot intervention. A robust therapeutic alliance was strongly associated with patient engagement in the weight management programme indicated by number of appointments. It was also associated with some general health and quality of life outcomes. These are promising results that require confirmation with larger studies in primary health care. The measurement of therapeutic alliance using the WAI-SR may predict patient attendance and outcomes in obesity interventions in primary healthcare settings.
authors.affiliation: Academic Unit of General Practice, Australian National University Medical School, Canberra, Australia.
authors.forename: E A
authors.identifier: http://orcid.org/0000-0003-4428-4060
authors.initials: EA
authors.lastname: Sturgiss
authors.affiliation: Research School of Population Health, College of Medicine, Biology and Environment, Australian National University, Canberra, Australia.
authors.forename: G M
authors.initials: GM
authors.lastname: Sargent
authors.affiliation: Academic Unit of General Practice, Australian National University Medical School, Canberra, Australia.
authors.forename: E
authors.initials: E
authors.lastname: Haesler
authors.affiliation: Research School of Psychology, Australian National University, Canberra, Australia.
authors.forename: E
authors.initials: E
authors.lastname: Rieger
authors.affiliation: Academic Unit of General Practice, Australian National University Medical School, Canberra, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Douglas
mesh_terms: D000328:Adult; D001315:Australia; D001521:Behavior Therapy; D003299:Cooperative Behavior; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology / Q000628:therapy*; D017060:Patient Satisfaction; D010865:Pilot Projects; D011320:Primary Health Care; D011369:Professional-Patient Relations; D011788:Quality of Life; D015203:Reproducibility of Results
keywords: Obesity; physician-patient relations; primary care; professional-patient relations