Measuring working alliance and technical alliance from the perspective of healthcare professionals working with people with mild intellectual disabilities: adaptation, factor structure and reliability.

The participants were recruited by convenience sampling, so professionals with positive attitudes toward eHealth may have been more likely to respond, and the scores may not represent all healthcare professionals working with people with mild intellectual disabilities. The design was cross-sectional and collected no client information or reasons for support, so it cannot show how client characteristics or support needs relate to alliance scores. Professionals rated a specific client from memory, which may introduce recall bias and be less accurate than rating during or after actual support or therapy. The study tested only factor structure and reliability; it did not show that the scales predict outcomes, improve care, or can be used to make clinical decisions. For the eHealth scale, item 9 was removed after fit problems, and the final model relied on modifications, so the structure needs replication in new samples. Participants evaluated different kinds of eHealth tools, so the scores cannot be attributed to any one tool. The instruments capture professionals' perceptions of clients' alliance, not clients' own views.

The research was funded by care provider ASVZ.

Do not read these scales as proof that a stronger working or eHealth alliance improves care or outcomes for people with mild intellectual disabilities. The study only checked whether professionals' ratings were consistent and matched the intended item structure.