Negative, not positive symptoms predict the early therapeutic alliance in cognitive behavioral therapy for psychosis.
OBJECTIVE
The strength of therapeutic alliance is consistently associated with therapy outcome. The aim of this study was to identify relevant predictors for early therapeutic alliance in cognitive behavioral therapy for psychosis.


METHODS
Fifty-six patients with schizophrenia spectrum disorders were included in the analysis. Possible predictors (positive and negative symptoms, depression, insight, social functioning, theory of mind, and medication adherence) were assessed at baseline. Alliance was assessed after each therapy session.


RESULTS
Lower negative symptoms significantly predicted higher patient and therapist rated alliance.


CONCLUSIONS
The findings indicate that negative symptoms might be a barrier to the development of therapeutic alliance. Assumed underlying processes and practical implications are discussed.
a Section for Clinical Psychology and Psychotherapy, Department of Psychology , Philipps-Universität Marburg , Marburg , Germany.
Esther
E
Jung
Martin
M
Wiesjahn
Tania M
TM
Lincoln
D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011369:Professional-Patient Relations; D011618:Psychotic Disorders / Q000503:physiopathology / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012559:Schizophrenia / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome