Helping alliance and unmet needs in routine care of people with severe mental illness across Europe: a prospective longitudinal multicenter study

Arnold, Katrin; Loos, Sabine; Mayer, Benjamin; Clarke, Eleanor; Slade, Mike; Fiorillo, Andrea; Del Vecchio, V.; �gerh�zi, Anik�; Iv�nka, T.; Munk-J�rgensen, Povl; Bording, Malene Krogsgaard; Kawohl, Wolfram; R�ssler, Wulf; Puschner, Bernd

Abstract

The helping alliance (HA) refers to the collaborative bond between patient and therapist including shared goals and tasks. People with severe mental illness have a complex mixture of clinical and social needs. Using mixed-effects regression, this study examined in 588 people with severe mental illness whether an increase in the HA is associated with fewer unmet needs over time, and whether change in the HA precedes change in unmet needs. It was found that a reduction of unmet needs was slower in patients with higher HA (B=0.04, p<.0001) only for patient-rated measures. Improvement in both patient-rated and staff-rated HA over time was associated with fewer subsequent patient- (B=-0.10, p<0.0001) and staff-rated (B=-0.08, p=0.0175) unmet needs. With positive changes in the HA preceding fewer unmet needs, findings provide further evidence for a causal relationship between alliance and outcome in the treatment of people with severe mental illness.

Citation

Arnold, K., Loos, S., Mayer, B., Clarke, E., Slade, M., Fiorillo, A., Del Vecchio, V., Égerházi, A., Ivánka, T., Munk-Jørgensen, P., Bording, M. K., Kawohl, W., Rössler, W., & Puschner, B. (2017). Helping alliance and unmet needs in routine care of people with severe mental illness across Europe: a prospective longitudinal multicenter study. Journal of Nervous and Mental Disease, 205(4), 329-333. https://doi.org/10.1097/NMD.0000000000000650

• Journal Article Type: Article
• Acceptance Date: Nov 16, 2016
• Publication Date: Apr 30, 2017
• Deposit Date: Nov 21, 2016
• Publicly Available Date: Apr 30, 2017
• Journal: Journal of Nervous and Mental Disease
• Print ISSN: 0022-3018
• Electronic ISSN: 1539-736X
• Publisher: Lippincott, Williams & Wilkins
• Peer Reviewed: Peer Reviewed
• Volume: 205
• Issue: 4
• Pages: 329-333
• DOI: https://doi.org/10.1097/NMD.0000000000000650
• Keywords: Helping alliance; Unmet needs; Severe mental illness; Prospective observational study
• Public URL: https://nottingham-repository.worktribe.com/output/857950
• Publisher URL: http://insights.ovid.com/crossref?an=00005053-201704000-00016
• Additional Information: This is not the final published version.
• Contract Date: Nov 21, 2016