Stability of therapeutic alliance and its relationship to outcome in short-term inpatient psychiatric care.
The relationship of therapeutic alliance to patient and treatment characteristics and to outcome, was studied in a sample of 106 patients consecutively admitted to a short-term psychiatric ward. The main finding was that a better therapeutic alliance at discharge was related to a greater improvement in symptoms during treatment. A multivariate model for prediction of outcome revealed a significant contribution from therapeutic alliance at discharge but not from alliance at admission or from changes in alliance during treatment. Improvement in alliance was seen in 41.5% of the patients, no change in 28.3% and a deterioration in 30.2%. Patients who improved their alliance did not differ from the others in background characteristics, but were more often subject to psychopharmacological treatment and were more often treated in a basic activation group. Patients with a stable poor alliance more often stated physically oriented target complaints at admission while patients with a stable satisfactory alliance more often presented interpersonally related complaints. It is concluded that further research in the field would benefit from a closer description of the change in the alliance and its relationship to treatment characteristics and outcome.
Hansson
L
L
Department of Psychiatry, University Hospital Lund, Sweden.
Berglund
M
M
D005260:Female; D006304:Health Status; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D019964:Mood Disorders / Q000175:diagnosis* / Q000534:rehabilitation / Q000628:therapy; D010349:Patient Compliance; D010358:Patient Participation; D010552:Personality Assessment; D010817:Physician-Patient Relations; D011569:Psychiatric Status Rating Scales; D013548:Sweden