Client predictors of the therapeutic alliance in individual resiliency training for first episode psychosis
Client predictors of the therapeutic alliance in individual resiliency training for first episode psychosis
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DOI：
10.1016/j.schres.2018.07.035
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发表时间：
2019-02-01
影响因子：
4.5
通讯作者：
Penn, David L.
中科院分区：
文献类型：
--
作者：
Browne, Julia;Bass, Emily;Penn, David L.
经历第一次精神病发作（FEP）的人通常不愿意寻求治疗，并且难以参与和保留精神卫生服务。治疗联盟（TA），或治疗师和客户之间的情感和合作的纽带，是预测更好的治疗结果与HP的客户，因此，重要的是要了解TA的预测因素，以确定如何最好地促进与这些人的积极联盟。本研究的主要目的是检查基线客户的特征，包括症状的严重程度，社会功能和洞察力，是否与TA。探索性的目的是检查人口统计学变量（年龄，种族和性别）和TA之间的关联。本研究包括一个子样本的参与者（n = 134）谁接受了个人弹性训练（IRT）的一部分，NAVIGATE治疗的恢复后，初步精神分裂症发作早期治疗计划的研究。四名训练有素的研究助理从IRT的早期录音中对TA进行了评分。采用多层模型，给出了嵌套的数据结构。结果表明，更严重的阳性和不太严重的阴性症状显着和独特的更好的治疗联盟，是女性。研究结果表明，客户端的症状配置文件时，应考虑开发与HP客户TA。(C)2018由Elsevier B.V.出版
Individuals experiencing their first episode of psychosis (FEP) are often reluctant to seek treatment, and are difficult to engage and retain in mental health services. The therapeutic alliance (TA), or the affective and collaborative bond between therapist and client, is predictive of better treatment outcomes for clients with HP; thus, it is important to understand the predictors of the TA in order to determine how best to foster a positive alliance with these individuals. The primary aim of the present study was to examine whether baseline client characteristics, including severity of symptoms, social functioning, and insight, were associated with the TA. The exploratory aim was to examine associations between demographic variables (age, race, and gender) and the TA. The present study included a subsample of participants (n = 134) who received Individual Resiliency Training (IRT) as part of the NAVIGATE treatment in the Recovery After An Initial Schizophrenia Episode Early Treatment Program study. Four trained research assistants rated the TA from early audiotaped sessions of IRT. Multilevel modeling was utilized given the nested data structure. Results indicated that more severe positive and less severe negative symptoms were significantly and uniquely associated with a better therapeutic alliance, as was female gender. The findings suggest that client symptom profiles should be considered when developing a TA with HP clients. (C) 2018 Published by Elsevier B.V.