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Keywords:

  • nurse–patient relations;
  • professional–patient alliance;
  • schizophrenia;
  • therapeutic alliance;
  • working alliance

Accessible summary

  • • 
    The working alliance between chronic psychiatric patients and their case managers is an important vehicle for successful treatment and support.
  • • 
    A good working alliance has a positive effect on the patient's functioning.
  • • 
    The quality of a working alliance depends on both patient characteristics and the case manager's behaviour.
  • • 
    The results indicate that working alliances are established in the first 3 months of a patient–case manager relationship.
  • • 
    Further research into the development of working alliances is necessary.

Abstract

The concept of a working alliance is rooted in psychotherapy and has been studied extensively in that field. Much less research has been conducted into working alliances between chronic psychiatric patients and their case managers. The aim of this review was to identify what is known about the working alliance between chronic psychiatric patients and their case managers. An extensive survey of the literature produced 14 articles for this review. The results of studies conducted show that a good working alliance has positive effects on the functioning of patients, and that the quality of the alliance depends on both patient characteristics and the behaviour of the case managers. The results also indicate that the working alliance is largely determined in the first 3 months of the contact. Further research into the development of working alliances is necessary.