The Role of the Therapeutic Relationship in Psychopharmacological Treatment Outcomes: A Meta-analytic Review
Open accessAbstract
OBJECTIVE: Patient nonadherence to psychopharmacological treatment is a significant barrier to effective treatment. The therapeutic relationship is known to be a critical component of effective psychological treatment, but it has received limited study. A meta-analysis was conducted to examine the role of the therapeutic relationship in the delivery of effective psychopharmacological treatment. METHODS: PubMed, PsycINFO, CINAHL, Google Scholar, Ingenta, and the Web of Science-Science Citation Index were searched, including reference lists of found articles. Meta-analytic methods were used to examine the association between the physician-patient therapeutic relationship and outcomes in psychopharmacological treatment. RESULTS: Eight independent studies of psychopharmacological treatment reported in nine articles met the inclusion criterion (1,065 participants) of being an empirically based study in which measures of the therapeutic relationship were administered and psychiatric treatment outcomes were assessed. The overall average weighted effect size for the association between the therapeutic relationship and treatment outcomes was z=.30 (95% confidence interval=.20-.39), demonstrating a statistically significant, moderate effect. CONCLUSIONS: Findings indicate that a positive therapeutic relationship or alliance between the physician and the psychiatric patient is associated with patient improvement over the course of psychopharmacological treatment. Results suggest that more attention should be paid to psychiatrist communication skills that may enhance the therapeutic alliance in psychopharmacological treatment.
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It has been demonstrated in many studies that therapeutic relationship and related concepts such as therapeutic alliance and rapport are important factors in determining treatment success.
“It has been demonstrated in many studies that therapeutic relationship and related concepts such as therapeutic alliance and rapport, are important factors in determining treatment success.89-91”
From Best Practice Recommendations for Conducting and Reporting Controlled Trials in Clinical Hypnosis Research (2024) · cites this paper as [91]
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Alliance in individual psychotherapy
Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011) · Psychotherapy · doi:10.1037/a0022186 · Cited by 2,072 · see citing works
Hunter, J. E., & Schmidt, F. L. (2000) · International Journal of Selection and Assessment · doi:10.1111/1468-2389.00156 · Cited by 833 · see citing works
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The therapeutic relationship in cognitive-behavioral therapy and pharmacotherapy for anxious youth.
Cummings, C. M., Caporino, N. E., Settipani, C. A., Read, K. L., Compton, S. N., March, J., Sherrill, J., Piacentini, J., McCracken, J., Walkup, J. T., et al. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0033294 · Cited by 54 · see citing works
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The therapeutic relationship in cognitive-behavioral therapy and pharmacotherapy for anxious youth.
Cummings, C. M., Caporino, N. E., Settipani, C. A., Read, K. L., Compton, S. N., March, J., Sherrill, J., Piacentini, J., McCracken, J., Walkup, J. T., et al. (2013) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0033294 · Cited by 54 · see citing works
Chu, C., Roxas, N., Aguocha, C. M., Nwefoh, E., Wang, K., Dike, C., & Iheanacho, T. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-07703-1 · Cited by 30 · see citing works
“Stigmatizing and negative attitudes toward mental disorders and people with mental illness are also common among health care professionals in Nigeria, which can adversely impact the therapeutic alliance and clinical outcomes [16, 25, 26].”
BackgroundKekecs, Z., Moss, D., Whorwell, P. J., Varga, K., Terhune, D. B., Shenefelt, P. D., Palsson, O. S., Benedittis, G. D., & Elkins, G. (2024) · Journal of Evidence-Based Integrative Medicine · doi:10.1177/2515690x241274538 · Cited by 12 · see citing works
“89-91 Relatedly, in a recent large-scale international survey among hypnosis practitioners, we found that rapport with the client was rated as the most important factor in producing desirable clinical hypnosis therapeutic outcomes.”
Background
- Authors
- Totura, C. M. W., Fields, S. A., & Karver, M. S.
- Affiliations
- University of South Florida (US)
- Venue
- Psychiatric Services
- Published
- 2018-01-01
- Volume
- 69
- Issue
- 1
- Pages
- 41-47
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2756053133
- Cited by
- 76
- References
- 11
- Citations by year
- 2026: 6 · 2025: 15 · 2024: 19 · 2023: 13 · 2022: 8 · 2021: 9 · 2020: 1 · 2019: 4 · 2013: 1
- FWCI
- 0.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Digital Commons - University of South Florida (University of South Florida) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- therapeutic relationship, psychopharmacological treatment, medication adherence, treatment outcomes, physician-patient communication, psychiatric patients
- MeSH terms
- Therapeutic Alliance, Adolescent, Adult, Aged, Aged, 80 and over, Mental Disorders, Combined Modality Therapy, Humans, Middle Aged, Outcome and Process Assessment, Health Care, Physician-Patient Relations, Psychotherapy, Psychotropic Drugs, Young Adult
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