Measuring the therapeutic alliance in general practice
There is mounting evidence that the quality of the therapeutic relationship influences the effectiveness of health care interventions. Most of the work on the therapeutic relationship has been qualitative, thereby adding to the richness of our understanding but not enabling specific comparisons between patients or interventions.
The Working Alliance Inventory for General Practice (WAI-GP) is an adapted survey that can be used to measure the therapeutic alliance between a GP and patient. This tool can be used in research, teaching or clinical settings to better understand how GPs and patients work together.
Based on the Working Alliance theory from Bordin, the WAI-GP measures the three key components for ensuring a strong therapeutic relationship:
- Bond – a warm and respectful approach,
- Goals – collaborative goal setting,
- Tasks – working together on the steps to reached the agreed upon goals.
The WAI-GP has also been translated into Dutch and used in a Belgium primary care research study led by Prof Pauline Boeckxstaens at the University of Ghent.
Availability of the survey tool
The WAI-GP survey (English) is available here (PDF, 0.8 MB). For more information, please contact liz.sturgiss@monash.edu
Citation for English version of WAI-GP: Elizabeth A Sturgiss, Elizabeth Rieger, Emily Haesler, Matthew J Ridd, Kirsty Douglas, Shelley L Galvin, Adaption and validation of the Working Alliance Inventory for General Practice: qualitative review and cross-sectional surveys, Family Practice, Volume 36, Issue 4, August 2019, Pages 516–522, https://doi.org/10.1093/fampra/cmy113
Citation for Dutch version of WAI-GP: Boeckxstaens P, Meskens A, Van der Poorten A, et al Exploring the therapeutic alliance in Belgian family medicine and its association with doctor–patient characteristics: a cross-sectional survey study BMJ Open 2020;10:e033710. doi: 10.1136/bmjopen-2019-033710
Funding
This work was supported by the Chris Silagy Research Scholarship grant from the Royal Australian College of General Practitioners Foundation.
Publications
Elizabeth A Sturgiss, Elizabeth Rieger, Emily Haesler, Matthew J Ridd, Kirsty Douglas, Shelley L Galvin, Adaption and validation of the Working Alliance Inventory for General Practice: qualitative review and cross-sectional surveys, Family Practice, Volume 36, Issue 4, August 2019, Pages 516–522, https://doi.org/10.1093/fampra/cmy113
Sturgiss EA, Sargent GM, Haesler E, Rieger E, Douglas K. Therapeutic alliance and obesity management in primary care - a cross-sectional pilot using the Working Alliance Inventory. Clin Obes. 2016 Dec;6(6):376-379. doi: 10.1111/cob.12167. Epub 2016 Nov 9. PMID: 27863074.
Hunik L, Galvin S, Olde Hartman T, Rieger E, Lucassen P, Douglas K, Boeckxstaens P, Sturgiss E. Exploring the psychometric properties of the Working Alliance Inventory in general practice: a cross-sectional study. BJGP Open. 2021 Feb 23;5(1):bjgpopen20X101131. doi: 10.3399/bjgpopen20X101131. https://bjgpopen.org/content/5/1/bjgpopen20X101131?utm_campaign=BJGP_Open&utm_medium=cpc&utm_source=trendmd
Boeckxstaens P, Meskens A, Van der Poorten A, et al Exploring the therapeutic alliance in Belgian family medicine and its association with doctor–patient characteristics: a cross-sectional survey study BMJ Open 2020;10:e033710. doi: 10.1136/bmjopen-2019-033710
Media
How to make your consults more effective | AusDoc by Dr Liz Sturgiss
GPs can and must do more to tackle obesity crisis | ANU Medical School featuring Dr Liz Sturgiss and Prof Kirsty Douglas