The Impact of Treatment Frequency on Therapeutic Alliance and Clinical Outcomes in Acupuncture for Gulf War Illness

PurposeThis study evaluates the development of therapeutic alliance (TA) and its clinical influence on acupuncture treatments for Gulf War Illness (GWI). MethodsData were collected from a 3.5-year US Army-funded randomized clinical trial (RCT) involving thirty-two experienced acupuncturists who provided individualized treatments over approximately six months. To measure improvements, paired-sample t-tests compared Working Alliance Inventory (WAI-SR) scores across task, bond, and goal factors from baseline to endpoint (6 months). Hierarchical linear regression analyses assessed the mediating effects of therapeutic alliance variables on pain and functional outcomes at the six-month mark. ResultsBoth groups had similar WAI-SR scores at the endpoint (6 months); however, initial scores in all three factors were lower in the low-dose (weekly acupuncture) group compared to the higher-dose (biweekly acupuncture) group. The weekly treatment group exhibited significant improvements in WAI-SR scores across all factors from baseline (2 months) to endpoint (6 months) (p < 0.01). Linear regression analyses indicated that biweekly treatments were associated with significantly lower pain levels at six months. ConclusionThese findings suggest that the frequency of acupuncture treatments influences the development of the therapeutic alliance and clinical outcomes.