Abstract
Past research has found that a positive working alliance between clients and their case managers is modestly correlated with client outcomes. The current study tried to identify the predictors of the working alliance in a sample of 115 clients who were receiving services from Assertive Community Treatment (ACT) teams. All of the clients suffered from severe mental illness, had a substance use disorder and were homeless at baseline. Both the client’s rating and the case manager’s rating of the working alliance were assessed at 3 months and 15 months post baseline. Client characteristics, particularly motivation to change, explained more of the variance of the client’s rating of the alliance than treatment variables or client change on the outcome variables. On the other hand, treatment variables (e.g., the amount of transportation services provided) and client change on the outcome variables explained more of the variance of the case manager’s rating of the alliance.
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Acknowledgments
The authors thank the study participants for their cooperation in this study; we hope that their lives have improved as a result of their participation. We also appreciate the cooperation of the many agencies that provided treatment to the study participants, particularly Community Alternatives, Places for People, and Peter and Paul Community Services. The following individuals were critical to the execution of the project: Ruth Smith, Mary Maguire, Bill Tourville, Joris Miller, Gretchen Gerteis, Gail Saulnier, Kecia Smith, Dorothy Gano, Melinda Bowen and Jean Mayo. Financial support was provided by the National Institute of Mental Health and the University of Missouri-St. Louis. However, the views expressed in this paper are the sole responsibility of the authors.
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Dr. Robert J. Calsyn and Mr. Lemming are affiliated with the University of Missouri-St. Louis. Dr. Gary A. Morse is affiliated with the Community Alternatives. Dr. W.D. Klinkenberg is affiliated with the Missouri Institute of Mental health.
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Calsyn, R.J., Klinkenberg, W.D., Morse, G.A. et al. Predictors of the Working Alliance in Assertive Community Treatment. Community Ment Health J 42, 161–175 (2006). https://doi.org/10.1007/s10597-005-9022-7
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DOI: https://doi.org/10.1007/s10597-005-9022-7