Relationships between working alliance and outcomes in group therapy for people diagnosed with schizophrenia

ABSTRACT

Working alliance (WA) is an important predictor of treatment outcomes in therapy. Forming a strong WA can be challenging with people diagnosed with schizophrenia, and differences between client-rated and clinician-rated WA have been found in this population. This project examined WA in people diagnosed with schizophrenia who completed a skills training and attention shaping group intervention. Paired-samples t-tests revealed differences between client and clinician ratings on the Working Alliance Inventory Short Form (WAI-S). Clinician-rated WAI-S scores were related to symptom severity, cognitive functioning and attention during group sessions. Yet, the primary hypothesis was not supported as WAI-S scores were unrelated to clients’ treatment response. Clinician-rated WAI-S was found to partially mediate the relationship between negative symptoms and overall attention. Client-rated WAI-S scores were associated with client measures of self-efficacy and mastery. Results reinforce the importance of working alliance in the treatment of those diagnosed with schizophrenia and indicate clinical and functional factors that may influence the quality of WA.

KEYWORDS:

• Working alliance
• schizophrenia
• negative symptoms
• attention shaping

Disclosure statement

All authors declare no conflicts of interest in the current study.

Additional information

Funding

This research was supported by grant R01MH074650 from the National Institutes of Mental Health to Steven M. Silverstein.