%0 Journal Article
%T Working alliance and its relationship to outcomes in a randomized controlled trial (RCT) of antipsychotic medication
%A Til Wykes
%A Diana Rose
%A Paul Williams
%A Anthony S David
%J BMC Psychiatry
%D 2013
%I BioMed Central
%R 10.1186/1471-244x-13-28
%X Randomized controlled trial with (50) participants with a diagnosis of schizophrenia randomized to risperidone LAI or oral atypical antipsychotic medication. The main outcome was the Working Alliance Inventory (WAI) with background variables (symptoms, side effect, social functioning, quality of life) measured before randomization and at two years.At follow-up (14 risperidone LAI and 16 oral medication) analyses including predictors of missing data and baseline score showed a trend for those on risperidone LAI to reduce WAI score and those on oral medication showing no change. Sensitivity analyses showed (i) a significant detrimental effect of LAI on WAI and (ii) the pattern of results was not affected by change in symptoms over the study.This is the first study to show that the prescription of depot atypical depot medication is associated with detrimental effects on clinical relationships after 2 years of continual treatment.Working alliance is the name given to the therapeutic relationship between a clinician and a patient. A good therapeutic relationship between clinician and patient is purported to be vital for a good outcome [1] and across all psychiatric disorders there is good supporting evidence that working alliance is a significant predictor of broad based outcomes which is not moderated by the severity of the psychiatric disorder [2,3]. Working alliance refers to the relationship between the clinician and the patient on such issues as goals and means of achieving goals.In people with a diagnosis of schizophrenia, therapeutic alliance predicts successful outcome from cognitive behavioural therapy [4,5]. Poorer working alliance has been found to be related to increased symptom severity and, in some studies, reduced social ability [6-9].Evidence for long acting injectable (LAI) or depot medication affecting the therapeutic relationships is mixed. Some patients perceive long-acting depot antipsychotics to be coercive [10,11] while many clinicians maintain tha
%K Injectable medication
%K Patient empowerment
%K Therapeutic alliance
%K Clinical relationship
%K Schizophrenia
%U http://www.biomedcentral.com/1471-244X/13/28