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March 1990

The Role of the Therapeutic Alliance in the Treatment of Schizophrenia: Relationship to Course and Outcome

Author Affiliations

From the Brookside Hospital, Nashua, NH (Dr Frank); the Department of Psychiatry, Harvard Medical School, Boston, Mass (Drs Frank and Gunderson); and the McLean Hospital, Belmont, Mass (Drs Frank and Gunderson).

Arch Gen Psychiatry. 1990;47(3):228-236. doi:10.1001/archpsyc.1990.01810150028006

• This study examined the relationship of the therapeutic alliance to the treatment course and outcome of 143 patients with nonchronic schizophrenia. Results showed that patients who formed good alliances with their therapists within the first 6 months of treatment were significantly more likely to remain in psychotherapy, comply with their prescribed medication regimens, and achieve better outcomes after 2 years, with less medication, than patients who did not. These results underscored the prognostic value of assessing the alliance and the need to identify factors that contribute to its development and maintenance with schizophrenic patients.

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