Development of an inpatient treatment alliance scale

Although alliance has been one of the most widely investigated variables in outpatient treatment research, its role in inpatient care has received little attention. One factor likely contributing to the lack of inpatient alliance research is the burdensome quality of most alliance scales. Guided by the existing alliance literature, we developed a brief 10-item scale that is designed to measure patients' overall level of alliance to their inpatient care. This new scale was administered to 140 inpatients receiving standard inpatient care early in their hospitalization. Seventy-two patients completed the scale a second time at discharge. The scale demonstrated strong psychometric properties including internal consistency, adjusted item-to-scale correlations, and test-retest reliability. Scores from the inpatient alliance scale were meaningfully related to multiple outcome and treatment variables. Overall, this study demonstrates both the feasibility and potential benefit of exploring the effect of alliance on the process and outcome of inpatient treatment.