TY - JOUR
T1 - Helping Alliance and Unmet Needs in Routine Care of People With Severe Mental Illness Across Europe
T2 - A Prospective Longitudinal Multicenter Study
AU - Arnold, Katrin
AU - Loos, Sabine
AU - Mayer, Benjamin
AU - Clarke, Eleanor
AU - Slade, Mike
AU - Fiorillo, Andrea
AU - Del Vecchio, Valeria
AU - Egerhazi, Aniko
AU - Ivanka, Tibor
AU - Munk-Jørgensen, Povl
AU - Bording, Malene Frøkjær Krogsgaard
AU - Kawohl, Wolfram
AU - Rössler, Wulf
AU - Puschner, Bernd
AU - CEDAR Study Group
A2 - Munk-Jørgensen, Povl
A2 - Bording, Malene Frøkjær Krogsgaard
A2 - Sørensen, Helle Østermark
A2 - Larsen, Jens Ivar
PY - 2017
Y1 - 2017
N2 - The helping alliance (HA) refers to the collaborative bond between patient and therapist, including shared goals and tasks. People with severe mental illness have a complex mixture of clinical and social needs. Using mixed-effects regression, this study examined in 588 people with severe mental illness whether an increase in the HA is associated with fewer unmet needs over time, and whether change in the HA precedes change in unmet needs. It was found that a reduction in unmet needs was slower in patients with higher HA (B = 0.04, p < 0.0001) only for patient-rated measures. Improvement in both patient-rated and staff-rated HA over time was associated with fewer subsequent patient-rated (B = -0.10, p < 0.0001) and staff-rated (B = -0.08, p = 0.0175) unmet needs. With positive changes in the HA preceding fewer unmet needs, findings provide further evidence for a causal relationship between alliance and outcome in the treatment of people with severe mental illness.
AB - The helping alliance (HA) refers to the collaborative bond between patient and therapist, including shared goals and tasks. People with severe mental illness have a complex mixture of clinical and social needs. Using mixed-effects regression, this study examined in 588 people with severe mental illness whether an increase in the HA is associated with fewer unmet needs over time, and whether change in the HA precedes change in unmet needs. It was found that a reduction in unmet needs was slower in patients with higher HA (B = 0.04, p < 0.0001) only for patient-rated measures. Improvement in both patient-rated and staff-rated HA over time was associated with fewer subsequent patient-rated (B = -0.10, p < 0.0001) and staff-rated (B = -0.08, p = 0.0175) unmet needs. With positive changes in the HA preceding fewer unmet needs, findings provide further evidence for a causal relationship between alliance and outcome in the treatment of people with severe mental illness.
KW - Journal Article
U2 - 10.1097/NMD.0000000000000650
DO - 10.1097/NMD.0000000000000650
M3 - Journal article
C2 - 28350783
SN - 0022-3018
VL - 205
SP - 329
EP - 333
JO - Journal of Nervous and Mental Disease
JF - Journal of Nervous and Mental Disease
IS - 4
ER -