Therapy process factors in early psychosis: The effect of working alliance on clinical symptoms and cognitive biases in Ultra High Risk young people

P Bagrowska; C Wannan; A Polari; HP Yuen; P Amminger; M Kerr; J Spark; N Wallis; M Shumway; C Carter; L Dixon; TA Niendam; R Loewy; P McGorry; B Nelson

Journal article

Therapy process factors in early psychosis: The effect of working alliance on clinical symptoms and cognitive biases in Ultra High Risk young people

P Bagrowska, C Wannan, A Polari, HP Yuen, P Amminger, M Kerr, J Spark, N Wallis, M Shumway, C Carter, L Dixon, TA Niendam, R Loewy, P McGorry, B Nelson

Schizophrenia Research | Published : 2025

DOI: 10.1016/j.schres.2025.07.031

Abstract

Approximately 25 % of individuals at Ultra High Risk (UHR) transition to a full psychotic disorder. Cognitive biases are thought to play a role in this risk, and improvements in cognitive biases have been associated with better clinical outcomes. Early intervention is crucial, yet no therapeutic approach has proven superior, and treatment adherence remains a challenge. Therapeutic alliance, shown to enhance adherence and clinical outcomes, might also influence depression and cognitive biases, but its role in these domains among UHR patients remains unclear. A total of 202 UHR participants (59.4 % females, mean age 17.4), taking part in the sequential multiple-assignment randomized trial (SMA..

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