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Qualitative Health Research, Vol. 16, No. 8, 1054-1074 (2006)
DOI: 10.1177/1049732306292100

Developing a Comprehensive Understanding of the Working Alliance in Community Mental Health

Bonnie Kirsh

Department of Occupational Science and Occupational Therapy, Graduate Department of Rehabilitation Science, University of Toronto, Toronto, Ontario

Ellen Tate

Explaining Outcomes Project, Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health, Toronto, Ontario, Faculty of Social Work, University of Toronto

The concept of a working alliance as a key ingredient within therapeutic processes has been emphasized by many community mental health researchers and practitioners. However, few studies have provided insights into the dimensions and operationalization of the concept. To address this gap, the authors analyzed data on the working alliance derived from two qualitative data sets: (a) interviews conducted with 33 users of community mental health services, family members, and service providers; and (b) content extracted from a systematic review of 48 articles in the area of community mental health services. Three superordinate themes emerged: Building and negotiating trust, I’m on your side, and Tools and strategies. The authors discuss implications for community mental health practice.

Key Words: working alliance • therapeutic relationship • community mental health • severe mental illness


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