Self-rated therapeutic alliance as a predictor of drop-out from a day treatment program

Abstract

Self-reported quality of the therapeutic alliance has consistently proved to predict outcome y of individual psychotherapy. It has been unclear, however, to what extent self-reporting could give an overall measure of therapeutic alliance in hospital settings. In a study of 22 non-psychotic patients in a day unit, the 16-item Helping Alliance Questionnaire of Luborsky proved to measure 2 dimensions: alliance and self-sufficiency. All but 1 of the 11 patients with a high alliance score were discharged in a normal manner, whereas all but 2 with a low score either dropped out or were “thrown out” (that is, discharged against their own wish) from the ward. The self-sufficiency score distinguished well among the irregularly discharged patients: the four patients who dropped out had a high score, whereas the three who were thrown out had a low score. Those who dropped out had a higher score on self-sufficiency than on alliance. For the “thrown out” group it was the other way round.

Key Words:

• Day unit
• Drop-out
• Helping alliance