title: Early Therapeutic Alliance, Treatment Retention, and 12-Month Outcomes in a Healthy Lifestyles Intervention for People with Psychotic Disorders.
abstract: Engaging and retaining individuals with psychotic disorders in psychosocial treatments is difficult. Early therapeutic alliance, treatment retention, and 12-month outcomes were examined in a subsample of smokers with a psychotic disorder (N = 178) participating in a healthy lifestyles study comparing a telephone versus face-to-face delivered intervention. Therapeutic alliance was assessed using the Agnew Relationship Measure; primary outcomes were treatment retention and changes in symptoms and health behaviors. Contrary to expectations, early alliance did not predict treatment retention. However, elements of both client- and therapist-rated alliance predicted some clinical outcomes (e.g., higher confidence in the therapeutic alliance at session 1 predicted improvements in 12-month depression). Some modest interactions between early alliance and intervention condition were also identified (e.g., clients initially with lower self-perceived initiative, or higher therapist-perceived bonding benefited preferentially from the telephone-delivered intervention), highlighting the need to further examine the interplay between therapeutic alliance and treatment modality.
authors: *School of Psychology, University of Newcastle, Callaghan; †NHMRC Centre of Research Excellence in Mental Health and Substance Use, School of Medicine and Public Health, University of Newcastle, Callaghan; ‡Centre for Brain and Mental Health Research, University of Newcastle and Hunter New England Mental Health, Newcastle; §School of Public Health and Community Medicine and ‖National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW; ¶Monash Alfred Psychiatry Research Centre (MAPrc), Central Clinical School, Monash University, The Alfred Hospital, Melbourne; #University of Melbourne and Department of Psychiatry, St Vincent's Hospital, Fitzroy, Victoria, Australia; **Division of Addiction Psychiatry, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ; and ††Centre for Nutrition and Physical Activity, University of Newcastle, Callaghan, NSW, Australia.
authors: Michelle
authors: M
authors: Andrews
authors: Amanda L
authors: AL
authors: Baker
authors: Sean A
authors: SA
authors: Halpin
authors: Terry J
authors: TJ
authors: Lewin
authors: Robyn
authors: R
authors: Richmond
authors: Frances J
authors: FJ
authors: Kay-Lambkin
authors: Sacha L
authors: SL
authors: Filia
authors: David
authors: D
authors: Castle
authors: Jill M
authors: JM
authors: Williams
authors: Vanessa
authors: V
authors: Clark
authors: Robin
authors: R
authors: Callister
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D061345:Early Medical Intervention / Q000379:methods*; D005260:Female; D000070497:Healthy Lifestyle; D006801:Humans; D008297:Male; D008875:Middle Aged; D011369:Professional-Patient Relations; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D012054:Reinforcement, Psychology; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome