Helping alliance and early dropout from psychiatric out-patient care The influence of patient factors.

In English Background The study examined client factors
of relevance in the establishment of helping alliance
and in the prediction of dropout from a routine
psychiatric setting admitting a variety of diagnoses and
staffed with a multiprofessional team. Method Newly
admitted patients (n=122) and staff completed questionnaires
regarding helping alliance, and the patients
also completed questionnaires regarding motivation,
symptoms and interpersonal problems. The patients
were also diagnosed according to ICD-10 and were
followed up concerning early dropout. Results Several
variables correlated with helping alliance, and multivariate
analyses showed that cold/distant factor, motivation
and interpersonal sensitivity factor were the
most important factors in establishing helping alliance.
Moreover, it was the alliance as perceived by the patients
(and not by the staff) that proved to be the most
essential variable. A logistic regression analysis showed
that early dropout was predicted by low helping alliance,
low age and cold/distant factor. Conclusion The
most important client factors for establishing helping
alliance and for predicting early dropout seem to be
those relevant to interpersonal processes. Furthermore,
the therapists’/staff’s responsiveness to these
client factors seems to be of decisive importance.