Article Review: Browne, J., Mueser, K. T., Meyer-Kalos, P., Gottlieb, J.D., Estroff, S. E., & Penn, D. L. (2019). The therapeutic alliance in individual resiliency training for first episode psychosis: Relationship with treatment outcomes and therapy participation.

When thinking about attending therapy, people sometimes have different worries come to mind. Am I going to like my therapist?  What if I do not get along with my therapist?  Is this the best fit and can the best fit with a therapist affect my outcome?  Research has shown that the therapeutic alliance is an important part of the change process as it helps allow the client to engage in a more meaningful fashion in therapy (Tsai et al., 2019).  The current study is looking to see how the therapeutic alliance impacts individuals who are in therapy who are experiencing a first episode psychosis (FEP).

Research has been conducted on the specialized early intervention services with individuals who have experienced the first episode psychosis.  The previous research has examined why there has been a high amount of dropouts in the early intervention services.  Research has shown that there has been around 30% of a drop out rate for individuals who receive early intervention services for a first episode psychosis (Dixon, Holoshitz, & Nossel, 2016).  The previous research that has been conducted has looked at other factors that might have contributed to the dropout rate in this population and what could be viewed as a risk factor in the future.  Previous research has focused on factors such as substance use, not having a support system involved in treatment, past forensic history, and less severe illness severity (Conus et al., 2010; Miller et al., 2009).  The current research wanted to look at the therapeutic alliance relationship as a factor in the outcome for individuals who have experienced a first episode psychosis.  The research wanted to look at how the alliance impacts the recovery of the individual (for instance, the psychological well-being, quality of life, and mental health recovery) and if the alliance impacted participation in therapy (Browne et al., 2019).

The research found that overall a better alliance between the therapist and the patient was related to better outcomes with the patient (Browne et al., 2019).  The better outcomes included the patient experiencing an increase in their psychological well-being, quality of life at the end of treatment, and mental health recovery (Browne et al., 2019).   Previous research has suggested that one of the reasons why stronger therapeutic alliance is helpful is that the therapists who created stronger alliances helped the patients master their skills which created greater improvement, and the therapists therapy skills might have played a roll, as well (Zilcha-Mano, 2017).

Browne, J., Mueser, K. T., Meyer-Kalos, P., Gottlieb, J.D., Estroff, S. E., & Penn, D. L. (2019).  The therapeutic alliance in individual resiliency training for first episode psychosis:  Relationship with treatment outcomes and therapy participation.  Journal of Consulting and clinical Psychology

Conus, P., Lambert, M., Cotton, S., Bonsack, C., McGorry, P.D., & Schimmelmann, B. G. (2010).  Rate and predictors of service disengagement in an epidemiological first-episode psychosis cohort.  Schizophrenia Research, 118, 256-263.

Dixon, L. B., Holoshitz, Y., & Nossel, I. (2016). Treatment engagement of individuals experiencing mental illness:  Review and update.  World Psychiatry, 15, 13-20.

Tsai, M., Yoo, D., Hardebeck, E. J., Loudon, M. P., & Kohlenberg, R.J. (2019).  Creating safe, evocative, attuned, and mutually vulnerable therapeutic beginnings:  Strategies from functional analytic psychotherapy.  Psychotherapy, 56(1), 55-61.

Zilcha-Mano, S. (2017).  Is t he alliance really therapeutic?  Revisiting this question in light of recent methodological advances.  American Psychologist, 72, 311-325.

Hannah Sutherland, MA, LPA (Temp)
WKPIC Doctoral Intern

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