Development of the Therapeutic Alliance in Alternative Settings to Psychiatric Hospitalization

The therapeutic alliance — the bond between patient and therapist — is one of the strongest predictors of treatment success. This study compared how that alliance develops across traditional psychiatric hospitalization, online/telepsychiatric hospitalization, and Soteria residential care homes. Across all three settings, the alliance grew similarly over time, suggesting that alternatives to traditional inpatient care can foster equally strong therapeutic relationships. These findings support the continued development of flexible, community-based psychiatric care options.