Evidence map›Paper›PMID 38308411›Full record

ArticleJournal of genetic counseling2025

Measuring the therapeutic bond in genetic counseling: Testing measurement error in the bond subscale of the Working Alliance Inventory.

Elizabeth Broadbridge, Debra L Roter, Susan Persky, Lori H Erby

Open access · hybridAbstract read
In one paragraph

Article in Journal of genetic counseling, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Elizabeth BroadbridgeDepartment of Communication, Rutgers University, New Brunswick, New Jersey, USA.ORCID 0000-0003-4121-3697
Debra L RoterDepartment of Health Behavior and Society, Johns Hopkins University, Baltimore, Maryland, USA.ORCID 0000-0003-2203-9697
Susan PerskySocial and Behavioral Research Branch, National Human Genome Research Institute, NIH, Bethesda, Maryland, USA.ORCID 0000-0002-7768-5744
Lori H ErbyMedical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, NIH, Bethesda, Maryland, USA.ORCID 0000-0001-6200-9033
Johns Hopkins University · USNational Human Genome Research Institute · USRutgers, The State University of New Jersey · US

Funding

Genomic Ascertainment - Molecular and Genetic AspectsZIAHG200359 · NHGRI · NATIONAL HUMAN GENOME RESEARCH INSTITUTE · PI BIESECKER, LESLIE · 2009 to 2025
$19.7M
NHGRI/DIR Genetic Counseling Training ProgramZIEHG200353 · NHGRI · NATIONAL HUMAN GENOME RESEARCH INSTITUTE · PI ERBY, LORI · 2010 to 2025
$16.9M
Genomic Ascertainment - Clinical and Behavioral AspectsZIAHG200387 · NHGRI · NATIONAL HUMAN GENOME RESEARCH INSTITUTE · PI BIESECKER, LESLIE · 2013 to 2025
$15.5M
Interventions in Genetic CounselingZIAHG200317 · NHGRI · NATIONAL HUMAN GENOME RESEARCH INSTITUTE · PI BIESECKER, BARBARA BOWLES · 2009 to 2018
$7.6M
Communication of genomic information in clinical, community, and digital contextsZIAHG200383 · NHGRI · NATIONAL HUMAN GENOME RESEARCH INSTITUTE · PI PERSKY, SUSAN · 2012 to 2025
$3.5M
Interventions in Genetic CounselingZ01HG200317 · NHGRI · NATIONAL HUMAN GENOME RESEARCH INSTITUTE · PI BIESECKER, BARBARA BOWLES · 2004 to 2008
$1.7M
Intramural NIH HHS Z01 HG200317Intramural NIH HHS ZIA HG200317Intramural NIH HHS ZIA HG200359Intramural NIH HHS ZIA HG200387NHGRI NIH HHS HG200317NHGRI NIH HHS HG200359NHGRI NIH HHS HG200387
6 · The paper itself

Abstract

The therapeutic relationship is a key component of successful genetic counseling. In psychotherapy, a strong therapeutic relationship can improve patient health outcomes and a poor relationship can worsen psychological functioning. Investigation of the therapeutic relationship in genetic counseling has shown evidence for a similar pattern. Reliable measurement of the therapeutic relationship is necessary for consistency across studies in the genetic counseling context. One measure that has been adapted for use in genetic counseling is the Working Alliance Inventory (WAI). However, there have been no studies of the factor structure or item-level method bias analyses for the genetic counseling-adapted version of the WAI. The goal of this study was to test the factor structure of the WAI observer version (WAI-O) bond subscale and assess method bias in a genetic counseling context. We hypothesized that differences in factor structures would exist for items that were positively (n = 9) versus negatively (n = 3) worded (reverse coded). Secondary data analysis was performed on two data sets that utilized the WAI-O in genetic counseling contexts. Data set 1 used simulated genetic counseling sessions that were judged by analog clients recruited through crowdsourcing platforms (N = 861). Data set 2 was conducted with genetic counseling clients, and sessions were evaluated by a research team (N = 120). Principal axis factor analysis with oblique oblimin rotation supported a two-factor solution for the WAI-O bond subscale across data sets. Items factored based on wording, with the positively worded items loading together and the negatively worded items loading on the second factor. Confirmatory factor analyses supported the removal of all negatively worded items from the instrument across data sets. Results suggest that the negatively worded items on the WAI-O may be capturing a construct inconsistent with the positively worded items and support rewording and/or excluding them from use for a more reliable measure of the therapeutic bond.

Indexed as

Genetic CounselingTherapeutic AllianceAdultFemaleHumansMalecommunicationgenetic counselinggenetic counselorsmethod biastherapeutic bondworking alliance

Identifiers

PMID38308411
PMCPMC11294495
OpenAlexW4391512613

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.