title: Predictors of the therapeutic alliance in group therapy for individuals with treatment-resistant auditory hallucinations.
abstract: OBJECTIVE
  This study hypothesized that several baseline client characteristics (i.e. age, symptoms, insight, social functioning) would significantly predict client-rated group alliance in out-patients with schizophrenia spectrum disorders.
  
  
  METHODS
  Hierarchical linear modeling (HLM) was used to evaluate the contributions of selected baseline individual client characteristics and group level characteristics to client-rated group alliance at the sixth session of group therapy. The effect of treatment type (CBT vs. ST) on group alliance and interaction with predictor variables were also analysed. Finally, correlations were computed to explore the relationship between group alliance, attendance, and treatment engagement.
  
  
  METHODS
  Sixty-three out-patients who had treatment-resistant auditory hallucinations were randomly assigned to either group CBT, which targeted reduction of distress associated with hallucinations, or group ST, which focused on improving social integration.
  
  
  RESULTS
  Results indicate that a stronger group alliance at the mid-point of treatment was associated with overall higher levels of group insight, and lower individual autistic preoccupation and social functioning at the baseline assessment. In addition, stronger group alliance was significantly correlated with higher attendance rates and therapists' ratings of treatment compliance.
  
  
  CONCLUSIONS
  These findings have implications for determining group composition and identifying clients low in therapeutic engagement. Suggestions for future research on group alliance are also discussed.
authors: Department of Psychology, University of North Carolina, Chapel Hill, NC 27599-3270, USA.
authors: David P
authors: DP
authors: Johnson
authors: David L
authors: DL
authors: Penn
authors: Daniel J
authors: DJ
authors: Bauer
authors: Piper
authors: P
authors: Meyer
authors: Elizabeth
authors: E
authors: Evans
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D001294:Attitude to Health; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003299:Cooperative Behavior; D004351:Drug Resistance; D005260:Female; D006212:Hallucinations / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010358:Patient Participation; D011369:Professional-Patient Relations; D011613:Psychotherapy / Q000379:methods*; D011615:Psychotherapy, Group / Q000379:methods*; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D012917:Social Adjustment; D016896:Treatment Outcome