Therapeutic Alliance Building During the Child Psychiatric Intake: Does VTC Make a Difference?

Abstract Background Evidence-based clinical practice is an inherent component of developed countries mental health professional practice, however, little is known about Ghana mental health professional perspectives on evidence-based practice. This paper outlines the processes involved in the delivery of best practice in Ghana. The paper describes a realistic evaluation of mental health nurses and allied health opinions regarding the evidenced-based therapeutic process in Ghana mental health facilities. Methods A purposive sample of 30 Mental Health Professionals (MHPs) was recruited to participate in semi-structured in-depth interviews. Thematic analysis was used to analyse the data. A programme theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis. Results The thematic analysis identified two CMO configurations: 1) technical competency stimulates evidence-based mental health services; and, 2) therapeutic alliance-building ensures effective interaction. The study demonstrated that contextual factors (technical competencies and therapeutic alliance building) together with mechanisms (intentional and unintentional) help to promote the quality of mental health services. However, contextual factor such as the lack of sign language interpreters yielded an unintended outcome such as consumer-provider communication barrier for consumers with hearing impaired and those from linguistically minority background. Conclusion We conclude that government stakeholders and policymakers should prioritize policy documents, periodic monitoring and adequate financial incentives to support the on-going mechanisms that promote mental health professional technical competence and therapeutic alliance building.

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The Influence of Patient’s Interpersonal Schemas on Early Alliance Building

Swiss Journal of Psychology ◽

10.1024/1421-0185.64.1.13 ◽

2005 ◽

Vol 64 (1) ◽

pp. 13-20 ◽

Cited By ~ 9

Author(s):

Véronique Beretta ◽

Yves de Roten ◽

Michael Stigler ◽

Martin Drapeau ◽

Mélanie Fischer ◽

...

Keyword(s):

Therapeutic Alliance ◽

Interpersonal Problems ◽

Helping Alliance ◽

Inventory Of Interpersonal Problems ◽

Relationship Themes ◽

Diminished Capacity ◽

Interpersonal Schemas ◽

Interpersonal Characteristics ◽

Alliance Building ◽

Conflictual Relationship

Influence of patient’s interpersonal schemas on the establishment of the therapeutic alliance is examined on a sample of 60 outpatients during first dynamic psychotherapy sessions. To assess interpersonal characteristics, we used the Inventory of Interpersonal Problems (Horowitz et al., 1988) and the patient’s conflictual relationship themes (CCRT; Luborsky & Crits-Christoph, 1998). Alliance was measured with the Helping Alliance Questionnaire. The results show that therapeutic alliance is associated with patient’s wish to be close, to perceive others as being trustworthy and as helpful. Patients with low alliance more often express the wish to be close to others, but perceive others’ responses more negatively, as indicated by their representations of others as “hurtful and untrustworthy” and “unhelpful”. They also present more interpersonal problems linked to a diminished capacity for affiliation. Clinical implications of the results are discussed.

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Understanding the secondary system of therapeutic alliance in autism interventions from the perspectives of parents and caregivers

International Journal of Child Care and Education Policy ◽

10.1186/s40723-021-00094-6 ◽

2022 ◽

Vol 16 (1) ◽

Author(s):

John Robert C. Rilveria

Keyword(s):

Therapeutic Alliance ◽

Treatment Compliance ◽

Skills Training ◽

Secondary System ◽

Compliance Level ◽

Explanatory Mixed Methods ◽

Compliance To Treatment ◽

Autism Interventions ◽

Alliance Building ◽

Parents And Caregivers

AbstractThis study utilized a sequential explanatory mixed-methods design in understanding the secondary system of therapeutic alliance from the perspectives of parents and caregivers of children with autism. In the quantitative phase, data from the accomplished questionnaires of 124 parent–caregiver dyads were collected and analyzed. Four factors extracted from the literature: treatment attitude, treatment compliance, level of stress, and perceived autism severity were examined as possible predictors of parent–therapist alliance, caregiver–therapist alliance, and parent–caregiver alliance. In the qualitative phase, eight parent–caregiver dyads (who both scored high in their alliance with therapist, alliance with each other, treatment attitude, treatment compliance, and level of stress) were interviewed to probe on their experiences of alliance-building, parenting, and caregiving. The integration of both quantitative and qualitative data led to the formulation of a conceptual framework that explains how the factors influence the secondary system of therapeutic alliance. These findings emphasize that tapping into the personal experiences of parents and caregivers can help in identifying what they value in a working, therapeutic relationship. Moreover, communication, skills training, and feedback among therapists, parents, and caregivers are essential to enhance positive attitude toward treatment, promote compliance to treatment recommendations, and address sources of personal stress. Nevertheless, this study calls for future studies to build into the factors associated with the systemic therapeutic alliance and to implement intervention programs that may target issues relating to attitude toward treatment, compliance to treatment, and experience of parental and caregiver stress.

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