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Be Good to Your Patient: How the Therapeutic Relationship in the Treatment of Patients Admitted to Assertive Outreach Affects Rehospitalization

Fakhoury, Walid K. H. MPH, PhD*; White, Ian PhD; Priebe, Stefan MD*PLAO Study Group

The Journal of Nervous and Mental Disease: September 2007 - Volume 195 - Issue 9 - p 789-791
doi: 10.1097/NMD.0b013e318142cf5e
Brief Report

We investigated whether the quality of the therapeutic relationship (TR) between patient and clinician predicts rehospitalization in patients in assertive outreach treatment. Analyses were conducted on 332 “established” (equal to in care for ≥3 months) and 150 “new” (equal to in care for <3 months) patients with severe mental illness sampled from 24 assertive outreach teams in London, England. TR was assessed at baseline using the clinician version of the Helping Alliance Scale. Rehospitalization was assessed over a 9-month follow-up period. Controlling for other predictors, a more positive TR was found to predict fewer hospitalizations in new patients but not in established ones.

*Unit for Social and Community Psychiatry, St. Bartholomew's Medical School, Queen Mary, University of London; and †MRC Biostatistics Unit, Institute of Public Health, Cambridge, United Kingdom.

The work was conducted at the Unit for Social and Community Psychiatry, Barts' and The London School of Medicine, Queen Mary, University of London.

Send reprint requests to Walid K. H. Fakhoury, MPH, PhD, IMS Health, Level 3, Lee House, 109 Hammersmith Road, London W14 0QH, UK. E-mail:

© 2007 Lippincott Williams & Wilkins, Inc.