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Helping alliance and early dropout from psychiatric out-patient care

The influence of patient factors

Social Psychiatry and Psychiatric Epidemiology volume 41, pages 140–147 (2006)Cite this article

Abstract

Background

The study examined client factors of relevance in the establishment of helping alliance and in the prediction of dropout from a routine psychiatric setting admitting a variety of diagnoses and staffed with a multiprofessional team.

Method

Newly admitted patients (n=122) and staff completed questionnaires regarding helping alliance, and the patients also completed questionnaires regarding motivation, symptoms and interpersonal problems. The patients were also diagnosed according to ICD-10 and were followed up concerning early dropout.

Results

Several variables correlated with helping alliance, and multivariate analyses showed that cold/distant factor, motivation and interpersonal sensitivity factor were the most important factors in establishing helping alliance. Moreover, it was the alliance as perceived by the patients (and not by the staff) that proved to be the most essential variable. A logistic regression analysis showed that early dropout was predicted by low helping alliance, low age and cold/distant factor.

Conclusion

The most important client factors for establishing helping alliance and for predicting early dropout seem to be those relevant to interpersonal processes. Furthermore, the therapists'/staff's responsiveness to these client factors seems to be of decisive importance.

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Author information

Affiliations

  1. Division of Psychiatry, Lund University Hospital, Storgatan 1-3, 241 30, Eslöv, Sweden

    Håkan Johansson MSc

  2. Dept. of Psychology, Lund University, Lund, Sweden

    Håkan Johansson MSc

  3. Dept. of Health Sciences, Division of Occupational Therapy, Lund University, Lund, Sweden

    Mona Eklund PhD

Authors
  1. Håkan Johansson MSc
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  2. Mona Eklund PhD
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Correspondence to Håkan Johansson MSc.

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Johansson, H., Eklund, M. Helping alliance and early dropout from psychiatric out-patient care. Soc Psychiat Epidemiol 41, 140–147 (2006). https://doi.org/10.1007/s00127-005-0009-z

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Key words

  • helping alliance
  • working alliance
  • therapeutic alliance
  • therapeutic relationship
  • psychiatry
  • psychotherapy
  • psychiatric care
  • patient factors
  • dropout