Time Perspective Matters for Working Alliance in Schizophrenia Care: Insights From the DiAPAson Project

The time perspective dimensions and balanced time perspective (BTP) may play a crucial role in the therapeutic process of individuals with schizophrenia spectrum disorders (SSDs). This study aimed to investigate the relationship between BTP, working alliance (WA) and psychiatric symptomatology in individuals with SSD.

A total of 313 residential patients with SSD were recruited from 98 residential facilities in Italy. Clinicians completed the Brief Psychiatric Rating Scale (BPRS) and the Brief Negative Symptom Scale (BNSS), while patients completed the Zimbardo Time Perspective Inventory (ZTPI) and the Working Alliance Inventory-Short Form (WAI). Deviation from Balanced Time Perspective-revised (DBTP-r) was applied as an estimate of unbalanced TP. Statistical analyses included Pearson correlations and mediation models. Age, sex, illness duration and years of education were controlled in mediation analyses.

DBTP-r showed significant negative correlations with WAI total and positive correlations with BPRS and BNSS. ZTPI-Present Fatalistic negatively correlated with WAI-Goal. The WAI partially mediated the effect of DBTP-r on both BPRS and BNSS, while DBTP-r partially mediated the impact of WAI on both BPRS and BNSS.

BTP played a dual role, acting both as a contributing factor to and a result of the WA. The present-fatalistic TP emerged as a key factor in shaping WA concerning therapeutic goals. Findings underscore the importance of considering (B)TP as both a potential resource and a therapeutic target in treating SSD.