Therapeutic Alliance and Treatment Outcome

Study Overview
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Brief Summary
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This study aims to inform scientific understanding of the impact of the therapeutic alliance and the transition from inpatient to outpatient care.

Official Title
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Therapeutic Alliance and Treatment Outcome: A Study of the Private Clinic Hohenegg

Conditions
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Therapeutic Alliance

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients admitted to in-patient treatment in the private psychiatric clinic Hohenegg (PKH) from November 2021 onwards Exclusion Criteria: Due to the naturalistic approach of the study, there will be no selection or exclusion made
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline psychological distress on Brief Symptom Checklist (BSCL, German version) at post-treatment and follow-up | The BSCL is a 53-item self-report questionnaire that measures psychological distress and symptoms in the last seven days. Each item is rated on a 5-point Likert scale ranging from 0 = not at all to 4 = extremely. The BSCL consists of nine different subscales: somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. Moreover, three global indices can be calculated: The Global Severity Index (GSI), providing information on psychological distress, the Positive Symptom Distress Index (PSDI), measuring the intensity of the reported symptoms, and the Positive Symptom Total (PST), indicating the number of present symptoms. | Baseline, post-treatment (after 6-8 weeks) and follow-up (after 2-4 months) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline quality of life on short version of the Incongruence Questionnaire (K-INK) at post-treatment and follow-up. | The K-INK is a 23-item questionnaire and was developed as a short version of the INK with 93 items. It is based on the psychological construct of incongruence which is described as unsatisfactory realization of personal goals. These goals are based on the four basic psychological human needs, defined by Grawe, 1998 (Orientation and Control, Pleasure and Avoidance of pain, Self-Enhancement, Attachment). The items enquire information respective to these needs and are grouped in 14 respectively 9 scales: approach driven goals (one item per scale in the K-INK) and avoidance driven goals (one item per scale in the K-INK). Each item is rated on a 5-point Likert scale ranging from 0 = (too) little to 4 = sufficient/satisfactory. | Baseline, post-treatment (after 6-8 weeks) and follow-up (after 2-4 months) | 
| Change from baseline quality of life on the short version of the World Health Organization Quality of Life Instrument-Abbreviated Version (EUROHIS-QOL, German version) at post-treatment and follow-up | The EUROHIS-QOL 8-Item Index is a short version of the WHOQOL-BREF containing 26 items grouped in four domains: physical, psychological, social relationships and environment. The EUROHIS-QOL 8-Item Index is composed of 2 items for each domain. The items are answered on a 5-point scale. | Baseline, post-treatment (after 6-8 weeks) and follow-up (after 2-4 months) | 
| Change from post-treatment therapeutic alliance (inpatient treatment) on the short version of the Working Alliance Inventory - short revised (WAI-SR, German version) at follow-up (outpatient treatment) | The WAI is a 12-item self-report questionnaire that measures the quality of alliance based on the following three aspects: the bond, the agreement on goals and the agreement on tasks. Each item is rated on a 5-point Likert scale ranging from 0 = never to 5 = always. The WAI provides three subscales: bond, tasks and goals and one total scale. | Post-treatment (after 6-8 weeks) and follow-up (after 2-4 months) | 
| Perceived social support in inpatient setting at post-treatment on the Fellow Patient Social Support (FEPB) | The FEPB is a self-reported questionnaire and measures various aspects of the patient's social network during the clinical stay. In our study, we will use the 11th section, which assesses the overall impression of all relationships with fellow patients. The 11th section contains of eight items, whereby we will exclude item 4 and item 6 , because they do not fit the clinical.received by or due to fellow patients, each rated on a 5-point Likert scale ranging from 0 = not at all to 4 = very much, as well as an item with an open question to qualitatively assess perceived support and distress from fellow patients. Moreover, the influence of fellow patients on treatment outcome is rated on a 5-point Likert scale from 0 = very much worse to 4 = very much improved. | Post-treatment (after 6-8 weeks) | 
| Perceived social support in outpatient setting at follow-up on the short version Social Support Questionnaire (F-SozU K-14, German Version) | The F-SozU is a 14-item, self-reported questionnaire that measures perceived social support, whereby each item is rated on a 5-point Likert scale ranging from 1 = not at all to 5 = completely. The questionnaire provides a global scale to assess the perceived social support based on emotional support, practical support and social integration. | follow-up (after 2-4 months) | 
| Perceived helpfulness of therapy for therapist effect at post-treatment on a single item | A single item, about the helpfulness of the different forms of therapy, rated on a 7-point Likert scale ranging from not at all to extremely. | Post-treatment (after 6-8 weeks) | 
| Perceived experience of loneliness at follow-up on the short version of the UCLA loneliness scale (UCLA, German version) | The UCLA short version is a self-reported questionnaire that measures the feeling of loneliness with three items, each of which rated on a 3-point Likert scale ranging from 1 = hardly ever to 3 = often. The UCLA yields a single scale, with higher scores indicating higher levels of loneliness. | follow-up (after 2-4 months) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Therapeutic Alliance, Treatment Outcome