Therapeutic alliance in forensic psychiatric hospitals: An empirical study

Abstract

This paper presents the first results of an application of empirical research methods of psychotherapy in forensic psychiatric hospitals in Germany.1 Data were collected in a study on therapeutic alliance conducted in four forensic facilities in Bavaria, Baden-Württemberg and Hesse in the summer of 1994, comprising 137 patients and their therapists. Quality of therapeutic alliance was rated by therapists and patients. By means of a cluster-analytic procedure four kinds of therapeutic co-operation (clusters) were identified. By use of methods of variance and discriminant analysis, differences between die clusters were found in perceived amount of time of therapy, gender of die therapist, some forensic characteristics of the patients and therapists' rating of die probability of a criminal relapse. No clear association was found between quality of therapeutic alliance and the frequency and duration of therapy and years of professional experience. Data demonstrate that psychotherapeutic research is feasible in forensic psychiatric hospitals and that further research on therapeutic alliance seems to be warranted with regard to both the therapeutic process and forensic psychiatry in general. Therapeutic alliance and its bearing on criminal prognosis might turn out to be a point of special interest.