Therapeutic alliance and improvements in work performance over time in patients with schizophrenia

While therapeutic alliance (TA) in schizophrenia has been linked with treatment adherence and outcome, less is known about its relationship to rehabilitation outcome. To examine this issue, we classified persons who had been enrolled in a rehabilitation study as having higher or lower levels of TA based on an observer assessment midway through treatment and compared their work performance at weeks 1, 11, and 23. Repeated measures analysis of variance found group effects for Work Quality and Personal Presentation with the higher TA group having better overall performance on both. Time effects were found for Work Quality and Personal Presentation with the sample overall showing improvement over the course of rehabilitation. Interactions were found for Cooperativeness and Work Quality with the higher TA group showing steady increases, whereas the lower TA group showed initial improvement followed by a decline. Results suggest that forming a strong TA may enhance rehabilitation among persons with schizophrenia.