Client Predictors of the Therapeutic Alliance in Individual Resiliency Training

Undergraduates: Emily Bass, Julia Browne

Faculty Advisor: David Penn
Department: Psychology & Neuroscience

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People with first episode psychosis (FEP) are often reluctant to seek treatment, resulting in difficulties engaging clients and high dropout rates. The therapeutic alliance (TA), the affective and collaborative bond between therapist and client, is predictive of better treatment outcomes for clients with FEP; thus, it is valuable to study the predictors of the TA to elucidate how best to foster a positive alliance and identify strategies to effectively engage these individuals in treatment. The current study examined baseline client characteristics including severity of symptoms, social functioning, duration of untreated psychosis, and demographic factors (age, race), as potential predictors of the TA within Individual Resiliency Training (IRT), the individual therapy developed for the NIMH Recovery After An Initial Episode Early Treatment Program. Subjects (n=146) were assigned to a trained IRT therapist, and sessions were audio recorded. Four undergraduate students were trained in using the Vanderbilt Therapeutic Alliance Scale to rate the TA between client and therapist for session 3 of IRT. Results indicated a significant positive relationship (t(137) = 2.91, p = 0.004) between positive symptoms, a significant negative relationship between negative symptoms and the TA (t(138) = -3.49, p = 0.0007) as well as excitative symptoms and the TA (t(137) = -3.02), p = 0.003), and a significant positive relationship between age and the TA (t(132) = 2.34, p = 0.02).