Client predictors of the therapeutic alliance in individual resiliency training for first episode psychosis

Individuals experiencing their first episode of psychosis (FEP) are often reluctant to seek treatment, and are difficult to engage and retain in mental health services. The therapeutic alliance (TA), or the affective and collaborative bond between therapist and client, is predictive of better treatm...

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Bibliographic Details
Published in:Schizophrenia research 2019-02, Vol.204, p.375-380
Main Authors: Browne, Julia, Bass, Emily, Mueser, Kim T., Meyer-Kalos, Piper, Gottlieb, Jennifer D., Estroff, Sue E., Penn, David L.
Format: Article
Language:English
Subjects:
Adult
Early intervention
Early Medical Intervention
Female
First episode psychosis
Humans
Male
Observer-rated therapeutic alliance
Outcome and Process Assessment, Health Care
Psychotic Disorders - physiopathology
Psychotic Disorders - therapy
Resilience, Psychological
Schizophrenia
Schizophrenia - physiopathology
Schizophrenia - therapy
Severity of Illness Index
Therapeutic Alliance
Young Adult
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Summary:Individuals experiencing their first episode of psychosis (FEP) are often reluctant to seek treatment, and are difficult to engage and retain in mental health services. The therapeutic alliance (TA), or the affective and collaborative bond between therapist and client, is predictive of better treatment outcomes for clients with FEP; thus, it is important to understand the predictors of the TA in order to determine how best to foster a positive alliance with these individuals. The primary aim of the present study was to examine whether baseline client characteristics, including severity of symptoms, social functioning, and insight, were associated with the TA. The exploratory aim was to examine associations between demographic variables (age, race, and gender) and the TA. The present study included a subsample of participants (n = 134) who received Individual Resiliency Training (IRT) as part of the NAVIGATE treatment in the Recovery After An Initial Schizophrenia Episode Early Treatment Program study. Four trained research assistants rated the TA from early audiotaped sessions of IRT. Multilevel modeling was utilized given the nested data structure. Results indicated that more severe positive and less severe negative symptoms were significantly and uniquely associated with a better therapeutic alliance, as was female gender. The findings suggest that client symptom profiles should be considered when developing a TA with FEP clients.
ISSN:0920-9964
1573-2509
DOI:10.1016/j.schres.2018.07.035