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Home » Substance Misuse and Suicide Prevention » Predicting the Therapeutic Alliance in Mental Healthcare

People seeking treatment for addiction and mental health issues must trust their providers. A new tool can help.

Michael Castanon

CEO, Alter Health Group

“The strength of the therapeutic alliance is vital. Individuals are more inclined to actively participate and adhere to treatment recommendations when they feel understood and supported.”

We’re in the midst of a mental healthcare crisis driven by the lingering aftermath of the global pandemic, exacerbating people’s sense of isolation and fueling an addiction epidemic. Growing dissatisfaction with the work-life balance has pushed even more people to seek mental health services. But a shortage of providers means finding a healthcare professional you trust is a challenge.

“People seeking help with mental health issues have a difficult time finding a therapist they feel connected to, or confident in,” noted Michael Castanon, CEO of Alter Health Group, a mental healthcare and addiction treatment provider. “People must believe that mental healthcare providers believe in them to get better.”

Trust is key

The missing ingredient is the therapeutic alliance — the connection and relationship between a healthcare provider and their patient.

“The number one factor in positive outcomes in behavioral healthcare is the patient’s own internal motivation,” Castanon said. “But the strength of the therapeutic alliance is vital. Individuals are more inclined to actively participate and adhere to treatment recommendations when they feel understood and supported.”

In a healthy therapeutic alliance, people believe their provider sincerely cares about them and shares their treatment and recovery goals. But it’s very difficult to assess the chances of developing that bond ahead of time.

Predicting the alliance

To evaluate and forecast care providers’ ability to create and sustain a therapeutic alliance, Alter Health Group went through an exhaustive review of published studies, focused research, and hundreds of assessments of Alter’s own providers.

“We came up with 25 key variables that are most predictive of establishing an effective therapeutic alliance for positive outcomes,” Castanon explained.

These 25 factors are used to populate Alter’s proprietary algorithm, resulting in an omnibus score that can be used to identify the likelihood that a care provider will form a strong therapeutic alliance with a client. It also provides feedback so the provider can improve and develop.

In addition to improving the quality of care, this approach can also help deal with the shortage of mental healthcare professionals by helping mental healthcare organizations more efficiently identify candidates who are likely to establish strong therapeutic alliances. This will reduce the time and resources required for recruitment, and better-matched providers will experience less burnout, leading to less turnover.

The proof

There’s real-world evidence to back this up. During the global pandemic, the Alter Health Group was given two grants by the Federal Emergency Management Agency (FEMA) and the state of California to provide crisis and emotional support through peer counselors.

“It was a game-changer,” Castanon said. “It has been a real differentiator and has resulted in exceptional care and exceptional outcomes. We’ve done approximately 110,000 care encounters, and 94% of those treated described those encounters as very helpful. That is a very strong indicator that we’re on the right path here. We’re delivering. We’re providing the help seeker with what they’re looking for.”

For Castanon, it really is about making the world a better place. “Our whole intent at Alter is to take people from their pathology to their purpose,” he said. “The faster we can engage with them and support them in a meaningful way, the faster we can get them to a more purposeful life.”

If you’ve struggled to identify the right mental health provider for your needs, click here for more information about Alter Health Group and its unique approach to behavioral health.

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