Effects of Client Perceptions of Therapeutic Alliance, Empowerment, Attitudes Toward Medication and Insight on Functioning
Bibliographic record
Abstract
Background : Limited research is available on how Assertive Community Treatment (ACT) clients’ cognitions, attitudes and behaviours experienced over time during the therapeutic process and recovery, affect functioning. Aims : This prospective study investigated whether changes in 1) clients’ ratings of therapeutic alliance, sense of empowerment over their illness, attitudes toward medication and insight, 2) clinicians’ assessment of medication adherence and 3) delivered services predicted functioning of ACT clients in southern Ontario, Canada. Method : Hierarchical Linear Modelling was used to assess time-varying and invariant predictors of overall functioning, over a two-year follow-up period. Results : The study found that during each 6 month follow-up time period about 90% of clients achieved successful community tenure and overall functioning increased between baseline and year 1 and decreased between baseline and year 2. Clients’ ratings of therapeutic alliance on functioning were moderated by previous lifetime days in hospital, while change in ratings of empowerment was moderated by age and previous lifetime days in hospital. Improved insight and medication adherence predicted functioning. Number of client contacts by ACT staff was not associated with functioning. Conclusions : These findings suggest that changes in client’s cognitions, attitudes and behaviours experienced during the therapeutic process and recovery can predict client functioning.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".