Abstract
The therapeutic alliance between the therapist and the inpatient dually diagnosed with major mental illness and substance abuse disorder has rarely been studied. These dually diagnosed patients constitute a “nontraditional” population for psychotherapy research. The authors used a modified version of the California Psychotherapy Alliance Scale (CALPAS) in this preliminary study to measure the therapeutic alliance between a cohort of 10 inpatient schizophrenic substance abusers and their therapists and examined its relationship with outpatient follow-up. Six patients followed up with outpatient treatment and four did not. Paradoxically, the patients who did not follow up reported a stronger alliance with their inpatient therapists than the patients who did follow up.