This article explains the Therapeutic Alliance screening tool. Learn what it is, how it helps assess therapeutic alliance, and how you can use the results to track the provider-patient relationship, build trust, and guide treatment decisions.
Definition and purpose
A 3 question screener used to measure the level of collaboration, partnership, and alignment between the provider and patient. In practice, a strong therapeutic alliance promotes a shift from a one-sided “How are YOU doing?” to a collaborative “How are WE doing?”
Research has shown that strong provider-patient relationships are key to successful mental health treatment, regardless of the patient’s presenting problem or treatment approach. These relationships are built on empathy, genuineness, and unconditional support. Collaboration and agreement on goals are also crucial for progress and healing.
Items and scoring
At Rula, patients are asked 3 questions specific to the alliance between provider and patient.
- I feel I am working together with my provider on mutual goals in treatment.
- I am confident in my provider's ability to help me.
- My provider and I understand each other.
Patients respond to each question using a 5-point Likert scale.
0 = Strongly disagree
1 = Disagree
2 = Neither agree nor disagree
3 = Agree
4 = Strongly agree
Responses are then summed for a total score of between 0 and 12.
Interpreting scores
Higher scores generally mean a better provider-patient relationship. However, look at each answer individually to understand the patient’s experience. If a response suggests a problem (like a “strongly disagree”, “disagree” or “neither agree nor disagree” response to one or more of the 3 questions), the provider may need to address it to strengthen the alliance.
For more on repairing a weak alliance, see this article.
Monitoring
Strong provider-patient relationships are key! Regularly checking in with patients about their satisfaction with treatment helps build trust and keeps everyone on the same page. You can always start measuring this, even with long-term patients.
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