Attenuated psychosis symptoms are related to working alliance between therapist and service user

• Published in: Early intervention in psychiatry 2024-08, Vol.18 (8), p.659-662
• Main Authors: Cowan, T., Millar, C., O'Donovan, K., Chibani, D., Reeves, G., Redman, S., Fitzgerald, J., Jay, S., Schiffman, J., Rakhshan Rouhakhtar, P.
• Format: Article
• Language: English
• Subjects: Adult; clinical high risk; Cross-Sectional Studies; Female; Gender aspects; Humans; Male; nonspecific factors; Psychosis; Psychotic Disorders - psychology; Psychotic Disorders - therapy; Therapeutic Alliance; therapeutic factors; treatment; Young Adult
• ISSN: 1751-7885; 1751-7893; 1751-7893
• DOI: 10.1111/eip.13552

Aim Many trials have demonstrated the efficacy of specific therapy modalities for individuals with attenuated psychosis symptoms (APS). Less is known regarding mechanisms behind positive outcomes, including the role of nonspecific therapeutic factors. This study explored working alliance (WA) in a clinic serving individuals with APS to see how WA changed across the course of treatment and its relation to APS. Methods Session level APS and WA data was available for 12 individuals of diverse racial and gender identity, (M = 48 sessions each). Multilevel models with random intercepts tested change in WA and APS over time, and cross‐sectional and prospective relations. Results WA increased and APS decreased over time. Cross sectionally, WA and APS were inversely related. Prospective relations were non‐significant. Conclusion When symptoms increase, therapists for individuals with APS should be attentive to potential disruptions in WA, though strong WA may be a cross‐sectional protective factor.