ABSTRACT
This study explores early alliance formation between adult consumers with schizophrenic-spectrum disorders and their case managers from the consumers’ perspectives using a prospective, cohort design. While quantitative studies have demonstrated positive links between the alliance and some client outcomes, such methods cannot reveal in concrete and authentic ways what consumers want in the case management relationship. This study finds that consumers can provide tangible and insightful information about the specifics of their case management relationships, confirming previous findings about the desire for connection with others, while extending it to include the desire for connection to the social world through the case manager relationship.
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Alexander, L. B., & Solomon, P. (2004). Ready for prime time: Two measures of the alliance for case managers and clients. In L. B. Alexander (convener), New developments in the assessment of client/worker relationships in community settings. Symposium conducted at the annual conference of the Society for Social Work Research, New Orleans, Louisiana
Brems C., Johnson M. E., Corey S., Podunovich A., Burns R. (2004). Consumer perspectives on services needed to prevent psychiatric hospitalization. Administration and Policy in Mental Health 32:57–61
Campbell D. T. (1988). Qualitative knowing in action research. In: Campbell D. T. (eds), Methodology and Epistemology for Social Science. Chicago, University of Chicago Press, pp. 360–376
Chinman M. J., Rosenheck R., Lam J. A. (1998): The development of relationships between homeless mentally ill clients and their case managers. Psychiatric Rehabilitation Journal 23:47–55
Chinman M. J., Rosenheck R., Lam J. A. (2000): The case management relationship and outcomes of homeless persons with serious mental illness. Psychiatric Services 51:1142–1147
Cleary P. D. (2003). A hospitalization from hell: a patient’s perspective on quality. Annals of Internal Medicine 138:33–39
Cleary P. D., Edgman-Levitan S. (1997): Health care quality: Incorporating consumer perspectives. Journal of the American Medical Association 278:1608–1612
Coffey D. S. (2003). Connection and autonomy in the case management relationship. Psychiatric Rehabilitation Journal 26:404–412
Connors G. J., Carroll K. M., DiClemente C. C, Longabaugh R., Donovan D. M. (1997). The therapeutic alliance and its relationship to alcoholism treatment participation and outcome. Journal of Consulting and Clinical Psychology 65:588–598
Corrigan, P., Mueser, K., Bond, G., Drake, R., & Solomon, P. (in press). Case management, the complete textbook on psychiatric rehabilitation. New York: Guilford Publications, Inc
Crane-Ross D., Roth D., Lauber B. G. (2000). Consumers and case managers perceptions of mental health and community support services. Community Mental Health Journal 36:161–178
Dixon L., Turner J., Kraus N., Scott J., McNary S. (1999). Case managers and clients perspectives on a representative payee program. Psychiatric Services 60:781–786
Donnell C. M., Strauser D. R., Lustig D. C. (2004). The working alliance: Rehabilitation outcomes for persons with severe mental illness. Journal of Rehabilitation 70:12–18
Draine J., Solomon P. (1996). Case manager alliance with clients in an older cohort. Community Mental Health Journal 32:152–134
Elbogen E. B., Swanson J. W., Swartz M. S. (2003). Effects of legal mechanisms on perceived coercion and treatment adherence among persons with severe mental illness. Journal of Nervous & Mental Disease 191:629–637
Endicott J., Spitzer R. L., Fleiss J. L., Cohen J. (1976). The Global Assessment Scale: A procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry 33:766–771
Fitzpatrick M. R., Iwakabe S., Stalikas A. (2005). Perspective divergence in the working alliance. Psychotherapy Research 15:69–79
Florsheim P., Shotorbani S., Guest-Warnick G., Barratt T., Hwang W. C. (2000). Role of the working alliance in the treatment of delinquent boys in community-based programs. Journal of Clinical Child Psychology 29:94–107
Frank A. F., Gunderson J. G. (1990). The role of the therapeutic alliance in the treatment of schizophrenia: Relationship to course and outcome. Archives of General Psychiatry 47:228–236
Gehrs M., Goering P. (1994). The relationship between the working alliance and rehabilitation outcomes of schizophrenia. Psychosocial Rehabilitation Journal 18:43–54
Goldberg R. W., Rollins A. L., McNary S. W. (2004). The working alliance inventory: modification and use with people with serious mental illness in a vocational rehabilitation program. Psychiatric Rehabilitation Journal 27:267–270
Horvath A. O., Greenberg L. S. (1989). Development and validation of the working alliance inventory. Journal of Counseling Psychology 36:223–233
Horvath A. O., Greenberg L. S. (eds) (1994). The working alliance: Theory, research, and practice. New York, John Wiley & Sons
Howgego I. M., Yellowlees P., Owen C., Meldrum L., Dark F. (2003). The therapeutic alliance: The key to effective patient outcome? A descriptive review of the evidence in community mental health case management. Australian and New Zealand Journal of Psychiatry 37:169–183
Jacobson N., Greenley D. (2001). What is recovery? A conceptual model and explication. Psychiatric Services 52:482–85
Klinkenberg W.D., Calsyn R.J., Morse G.A. (1998): The helping alliance in case management for homeless persons with severe mental illness. Community Mental Health Journal 34:569–578
Lang M. A., Davidson L., Bailey P., Levine M. S. (1999). Clinicians and clients perspectives on the impact of assertive community treatment. Psychiatric Services 50:1331–1340
Lipsky M. (1980). Street-Level Bureaucracy: Dilemmas of the Individual in Public Services. New York, Russell Sage Foundation
Luborsky L., Barber J. P., Siqueland L., Johnson S., Najavits L. M., Frank A., Daley D. (1996). The revised Helping Alliance Questionnaire (HAq-II): Psychometric properties. Journal of Psychotherapy Practice and Research 5:260–271
Martin D., Garske J. P., Davis K. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytical review. Journal of Consulting and Clinical Psychology 68:438–450
McCabe R., Priebe S. (2004). The therapeutic relationship in the treatment of severe mental illness: A review of methods and findings. International Journal of Social Psychiatry 50:115–128
McGrew J. H., Wilson R. G., Bond G. R. (1996): Client perspectives on helpful ingredients of assertive community treatment. Psychosocial Rehabilitation Journal 19:13–21
McGrew J. H., Wilson R. G., Bond G. R. (2002): An exploratory study of what clients like least about assertive community treatment. Psychiatric Services 53:761–763
Neale M. S., Rosenheck R. A., (1995). Therapeutic alliance and outcome in a VA intensive case management program. Psychiatric Services 46:719–721
Overall J. E., Gorham D. R. (1962). Brief Psychiatric Rating Scale. Psychological Reports 10:799–812
Patton M.Q. (2001). Qualitative Research & Evaluation Methods, Third Edition. Thousand Oaks CA, Sage Publications
Schaedle R., Epstein I. (2000). Specifying intensive case management: A multiple stakeholder approach. Mental Health Services Research 2:95–105
Scheyette, A. M. (2005). Recovery and relationship: The role of the working alliance in the recovery of individuals with severe mental illness. Unpublished paper. Chapel Hill, NC: University of North Carolina at Chapel Hill
Solomon P., Draine J., Delaney M. A. (1995). The working alliance and consumer case management. Journal of Mental Health Administration 22:126–134
Smith T., Sells S., Clevenger T. (1994). Ethnographic content analysis of couple and therapist perceptions in a reflective team setting. Journal of Marital and Family Therapy 20:267–286
Strauss A.L., Corbin J. (1990). Basics of qualitative Research: Grounded Theory Procedures and Techniques. Sage, Thousand Oaks, CA
Toland P. H., Hanish L. D., McKay M. M., Dickey M. H. (2002). Evaluating process in child and family interventions: Aggression prevention as an example. Journal of Family Psychology 16:220–236
Ware N. C., Tugenberg T., Dickey B. (2003). Ethnography and measurement in mental health: Qualitative validation of a measure of continuity of care (CONNECT). Qualitative Health Research 13:1393–1406
Ware N. C., Tugenberg T., Dickey B. (2004). Practitioner relationships and quality of care for low-income persons with serious mental illness. Psychiatric Services 55:555–559
Watts J., Priebe S. (2002). A phenomenological account of user’s experiences of assertive community treatment. Bioethics 16:439–454
Acknowledgments
This research was funded in part under a grant with the Pennsylvania Department of Health, NIMH Grant R03MH52734-02, and a faculty research award from Bryn Mawr College, all to Leslie B. Alexander.
The authors would like to thank Martha Dore and Phyllis Solomon for their insightful comments on earlier drafts. Special thanks also go to Anneliese Butler for her assistance with coding, and to Patrice Gammon, Christopher Nelson, Michael Pfeiffer and Stacey Uhl for their helpful comments along the way.
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Buck, P.W., Alexander, L.B. Neglected Voices: Consumers with Serious Mental Illness Speak About Intensive Case Management. Adm Policy Ment Health 33, 470–481 (2006). https://doi.org/10.1007/s10488-005-0021-3
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DOI: https://doi.org/10.1007/s10488-005-0021-3