A preliminary study of therapeutic alliance and dually diagnosed inpatients

The therapeutic alliance between the therapist and the inpatient dually diagnosed with major mental illness and substance abuse disorder has rarely been studied. These dually diagnosed patients constitute a 'nontraditional' population for psychotherapy research. The authors used a modified version of the California Psychotherapy Alliance Scale (CALPAS) in this preliminary study to measure the therapeutic alliance between a cohort of 10 inpatient schizophrenic substance abusers and their therapists and examined its relationship with outpatient follow-up. Six patients followed up with outpatient treatment and four did not. Paradoxically, the patients who did not follow up reported a stronger alliance with their inpatient therapists than the patients who did follow up.