The role of the helping alliance in psychiatric community care. A prospective study.

In this study, we assessed the quality of the helping alliance between patients and clinical case managers in psychiatric community care and examined its value as predictor of treatment outcome. Patients were interviewed about five different aspects of the helping alliance using simple questions and visual analogue scales. The duration and degree of hospitalization and changes in the patients' working and accommodation situations during a 20-month follow-up period were obtained as outcome criteria for 72 patients with mostly psychotic disorders receiving long-term treatment. The patients' general view of the helping alliance was quite positive. Some aspects of the helping alliance were significantly correlated with hospitalization and changes in working situation during the follow-up period, which indicated a better outcome for patients who experienced the helping alliance more positively. The findings suggest that the helping alliance may be a relevant therapeutic factor not only in psychotherapy, but also in complex psychiatric treatment settings.