title: Working Alliance in Patients with Severe Mental Illness Who Need a Crisis Intervention Plan.
abstract: Working alliance has been characterized as an important predictor of positive treatment outcomes. We examined whether illness insight, psychosocial functioning, social support and locus of control were associated with working alliance as perceived by both patient and clinician. We assessed 195 outpatients with psychotic or bipolar disorders. Our findings indicated that patients rated the alliance more positively when they experienced a greater need for treatment, fewer behavioral and social problems, and more psychiatric symptoms. Clinicians rated the alliance more positively in patients who reported fewer social problems and better illness insight. Patients' demographic characteristics, including being female and married, were also positively related to the clinician-rated alliance. Our results suggest that patients and clinicians have divergent perceptions of the alliance. Clinicians may need help developing awareness of the goals and tasks of patients with certain characteristics, i.e., singles, men, those with poor illness insight and those who report poor social functioning.
authors.affiliation: Department of Psychiatry, ESPRi Epidemiological and Social Psychiatric Research Institute, Erasmus University Medical Centre, 's Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. j.ruchlewska@erasmusmc.nl.
authors.forename: Asia
authors.initials: A
authors.lastname: Ruchlewska
authors.affiliation: Department of Psychiatry, ESPRi Epidemiological and Social Psychiatric Research Institute, Erasmus University Medical Centre, 's Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: Astrid M
authors.initials: AM
authors.lastname: Kamperman
authors.affiliation: Parnassia Psychiatric Institute, The Hague, The Netherlands.|VU University and EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.
authors.forename: Mark
authors.initials: M
authors.lastname: van der Gaag
authors.affiliation: Department of Psychiatry, ESPRi Epidemiological and Social Psychiatric Research Institute, Erasmus University Medical Centre, 's Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
authors.forename: André I
authors.initials: AI
authors.lastname: Wierdsma
authors.affiliation: Department of Psychiatry, ESPRi Epidemiological and Social Psychiatric Research Institute, Erasmus University Medical Centre, 's Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.|BavoEuropoort, Rotterdam, The Netherlands.
authors.forename: Niels C L
authors.initials: NC
authors.lastname: Mulder
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology* / Q000628:therapy*; D003299:Cooperative Behavior; D003419:Crisis Intervention; D005260:Female; D006801:Humans; D007389:Internal-External Control; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D011369:Professional-Patient Relations; D011618:Psychotic Disorders / Q000523:psychology* / Q000628:therapy*; D036301:Qualitative Research; D012720:Severity of Illness Index; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: Prediction; Psychosis; Severe mental illness; Therapist patient relationship; Working alliance