Am J Psychiatry 1989; 146:508-512
Copyright © 1989 by American Psychiatric Association
Ability to form an alliance with the therapist: a possible marker of prognosis for patients with antisocial personality disorder
L Gerstley, AT McLellan, AI Alterman, GE Woody, L Luborsky and M Prout
Department of Psychiatry, Philadelphia VA Medical Center, PA 19104.
Antisocial personality disorder is generally perceived to be refractory to
treatment, particularly psychotherapy. In this study, the ability of 48
patients with this disorder to form a working relationship with a
psychotherapist or drug counselor was examined in relation to outcome of 24
weeks of treatment evaluated at 7-month follow-up. Some antisocial patients
were able to form working relationships with their therapists, and there
was a significant association between the ability to form such a
relationship and treatment outcome. Measures of this ability, such as the
Helping Alliance Questionnaire, may help identify antisocial patients who
can benefit from psychotherapy.
