Courses of helping alliance in the treatment of people with severe mental illness in Europe: a latent class analytic approach

• Published in: Social Psychiatry and Psychiatric Epidemiology 2015-03, Vol.50 (3), p.363-370
• Main Authors: Loos, Sabine, Arnold, Katrin, Slade, Mike, Jordan, Harriet, Vecchio, Valeria Del, Sampogna, Gaia, Süveges, Ágnes, Nagy, Marietta, Krogsgaard Bording, Malene, Østermark Sørensen, Helle, Rössler, Wulf, Kawohl, Wolfram, Puschner, Bernd
• Format: Article
• Language: English
• Subjects: Adult; Analysis; Care and treatment; Child & adolescent psychiatry; Cooperative Behavior; Epidemiology; Europe; Female; Humans; Latent class analysis; Male; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Mental disorders; Mental Disorders - psychology; Mental Disorders - therapy; Mental health; Mental health care; Mental illness; Mentally ill; Middle Aged; Original Paper; Professional-Patient Relations; Psychiatric services; Psychiatry; Psychotherapy; Psychotherapy - methods; Psychotherapy research; Quality of Life - psychology; Therapists
• ISSN: 0933-7954; 1433-9285
• DOI: 10.1007/s00127-014-0963-4

Purpose The helping alliance (HA) between patient and therapist has been studied in detail in psychotherapy research, but less is known about the HA in long-term community mental health care. The aim of this study was to identify typical courses of the HA and their predictors in a sample of people with severe mental illness across Europe over a measurement period of one year. Methods Self-ratings of the HA by 588 people with severe mental illness who participated in a multicentre European study (CEDAR; ISRCTN75841675) were examined using latent class analysis. Results Four main patterns of alliance were identified: (1) high and stable (HS, 45.6 %), (2) high and increasing (HI, 36.9 %), (3) high and decreasing (HD, 11.3 %) and (4) low and increasing (LI, 6.1 %). Predictors of class membership were duration of illness, ethnicity, and education, receipt of state benefits, recovery, and quality of life. Conclusions Results support findings from psychotherapy research about a predominantly stable course of the helping alliance in patients with severe mental illness over time. Implications for research and practice indicate to turn the attention to subgroups with noticeable courses.