Building the bond: Predictors of the alliance in neurorehabilitation

• Published in: NeuroRehabilitation (Reading, Mass.) Vol. 46; no. 3; pp. 271 - 285
• Main Authors: Rowlands, Leanne, Coetzer, Rudi, Turnbull, Oliver H.
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2020; IOS Press BV
• Subjects: Brain injury; Cognitive ability; Memory; Neurology; Rehabilitation; Short term memory; Therapeutic alliance; group interventions; acquired brain injury; cognitive predictors; working alliance; neurorehabilitation; group psycho-education
• ISSN: 1053-8135; 1878-6448
• DOI: 10.3233/NRE-193005

BACKGROUND: Neurorehabilitation services are often delivered through group psycho-education programmes. However, little is known about the therapeutic process at work during such sessions. The present study is the first to gain insight into the therapeutic alliance, during a seven-session group programme. In addition, cognitive, emotional, and demographic predictors of the alliance, and participants’ feelings towards their group members, were investigated, together with predictors of patient engagement. METHODS: Forty-five participants with an acquired brain injury completed a series of questionnaires, and neuropsychological assessment, following group psycho-education. The group facilitator completed a parallel therapeutic alliance questionnaire, and rated participants’ engagement. RESULTS: Results demonstrated that a strong alliance can be formed in seven group sessions. Notably, no demographic or cognitive factors appear to pose a barrier to developing a therapeutic alliance, nor to group attraction. CONCLUSION: High levels of depression, however, may be a challenge, and clinicians may need to tailor their clinical skills to ensure a good therapeutic relationship with such patients. To promote engagement, clinicians may also need to provide additional support to patients with lower levels of education, working memory, and episodic memory impairment.