Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2013 Jan 15:13:28.
doi: 10.1186/1471-244X-13-28.

Working alliance and its relationship to outcomes in a randomized controlled trial (RCT) of antipsychotic medication

Til Wykes  1 , Diana Rose, Paul Williams, Anthony S David
Affiliations
Randomized Controlled Trial

Working alliance and its relationship to outcomes in a randomized controlled trial (RCT) of antipsychotic medication

Til Wykes et al. BMC Psychiatry. .

Abstract

Background: Long acting injections (LAI) have been associated with perceptions of coercion in cross sectional studies but there have been no longitudinal studies of the effects on clinical relationships with newer depot medications.

Method: Randomized controlled trial with (50) participants with a diagnosis of schizophrenia randomized to risperidone LAI or oral atypical antipsychotic medication. The main outcome was the Working Alliance Inventory (WAI) with background variables (symptoms, side effect, social functioning, quality of life) measured before randomization and at two years.

Results: At follow-up (14 risperidone LAI and 16 oral medication) analyses including predictors of missing data and baseline score showed a trend for those on risperidone LAI to reduce WAI score and those on oral medication showing no change. Sensitivity analyses showed (i) a significant detrimental effect of LAI on WAI and (ii) the pattern of results was not affected by change in symptoms over the study.

Conclusion: This is the first study to show that the prescription of depot atypical depot medication is associated with detrimental effects on clinical relationships after 2 years of continual treatment.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Predicted mean WAI scores at time 2 from the regression model after adjusting for trial arm, exacerbations at 12 weeks and baseline WAI scores.
See this image and copyright information in PMC

Comment in

References

    1. Horvath AO, Luborsky L. The role of the therapeutic alliance in psychotherapy. J Consult Clin Psychol. 1993;61(4):561–573. - PubMed
    1. Martin DJ, Garske JP, Davis MK. Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review. J Consult Clin Psych. 2000;68(3):438–450. - PubMed
    1. Frank AF, Gunderson JG. The Role of the Therapeutic Alliance in the Treatment of Schizophrenia - Relationship to Course and Outcome. Arch Gen Psychiat. 1990;47(3):228–236. doi: 10.1001/archpsyc.1990.01810150028006. - DOI - PubMed
    1. Davis LW, Lysaker PH. Therapeutic alliance and improvements in work performance over time in patients with schizophrenia. J Nerv Ment Dis. 2007;195(4):353–357. doi: 10.1097/01.nmd.0000261954.36030.a1. - DOI - PubMed
    1. Dunn H, Morrison AP, Bentall RP. The relationship between patient suitability, therapeutic alliance, homework compliance and outcome in cognitive therapy for psychosis. Clin Psychol Psychot. 2006;13(3):145–152. doi: 10.1002/cpp.481. - DOI

Publication types