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Title: Individual psychological therapy in acute inpatient settings : service user and psychologist perspectives
Author: Small, C. S.
ISNI:       0000 0004 7230 883X
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2016
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AIM: This review aimed to critically evaluate research investigating the therapeutic alliance in the psychological treatment of psychosis. It examined the measurement of the alliance, the relationship between alliance and outcomes, and key predictors of the alliance in the psychological treatment of psychosis. METHOD: Studies were identified through a systematic search of PsycINFO, PubMed and a citation search on Web of Science. The review used a vote counting method (Hedges & Olkin, 1980) to collate and assess the evidence across studies. RESULTS: Twenty-one studies were reviewed: eight examined the relationship between alliance and outcomes, and 18 examined predictors of the alliance. The majority of studies used the WAI or CALPAS rated from both client and therapist perspectives. A broad array of psychological functioning and adherence outcome measures were used; there were no consistent associations between alliance and outcomes across studies. The most frequently studied predictor variables were symptoms, insight, and cognitive and global functioning; the most consistent finding was that greater insight was associated with stronger client-rated alliance. CONCLUSIONS: Most standardised therapeutic alliance measures have been established in outpatient settings and require greater assessment of their psychometric properties in severe and enduring populations and settings. There was little agreement across the studies in the type of outcome and predictor measures used to examine the association with the therapeutic alliance. Studies also varied widely in their methodological quality and rigour. These problems are likely to have contributed to the inconsistent findings. The association between insight and the alliance should be investigated in future research.
Supervisor: Pistrang, N. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available