title: Patient-Provider Therapeutic Alliance Contributes to Patient Activation in Community Mental Health Clinics.
abstract: Patient activation, often conceptualized as an individual trait, contributes to mental health outcomes. This study assessed the relational contributors to activation by estimating the longitudinal association of patient-provider communication and two factors of therapeutic alliance (agreement on tasks/goals and bond), with patient activation. Participants were patients (n = 264) from 13 community-based mental health clinics across the United States. In multivariate models, controlling for patients' individual and clinical characteristics, the task/goal factor of therapeutic alliance emerged as a significant and independent predictor of greater change in patient activation scores. Improving patient activation may require addressing patient-provider interactions such as coming to collaborative agreement on the tasks/goals of care.
authors.affiliation: Department of Family Medicine and Community Health, Program in Health Disparities Research, University of Minnesota, 717 Delaware St. SE, Suite 166, 55414, Minneapolis, MN, USA. miallen@umn.edu.
authors.forename: Michele L
authors.initials: ML
authors.lastname: Allen
authors.affiliation: Center for Multicultural Mental Health Research, Cambridge Health Alliance, Somerville, USA.|Department of Psychiatry, Harvard Medical School, Boston, USA.
authors.forename: Benjamin Lê
authors.initials: BL
authors.lastname: Cook
authors.affiliation: Center for Multicultural Mental Health Research, Cambridge Health Alliance, Somerville, USA.|Department of Psychiatry, Harvard Medical School, Boston, USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Carson
authors.affiliation: VA New Jersey Health Care System, Lyons, NJ, USA.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Interian
authors.affiliation: Department of Psychiatry, Harvard Medical School, Boston, USA.|Boston Children's Hospital, Boston, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: La Roche
authors.affiliation: Center for Multicultural Mental Health Research, Cambridge Health Alliance, Somerville, USA.|Department of Psychiatry, Harvard Medical School, Boston, USA.
authors.forename: Margarita
authors.initials: M
authors.lastname: Alegría
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003142:Communication; D003155:Community Mental Health Centers / Q000458:organization & administration; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D010358:Patient Participation; D010817:Physician-Patient Relations; D055815:Young Adult
keywords: Mental health; Patient activation; Professional-patient relations