Case managers' perspectives on the therapeutic alliance: a qualitative study.

Purpose: In order to understand the nature of the therapeutic alliance in intensive case management, this study used qualitative methods to assess the dynamics of the case managers' relationships with their consumers by examining their perspectives on their own and their consumers' likeability, how helpful consumers perceive them to be, as well as their expectations for their relationships with their consumers.

Methods: The study employed content analysis of open-ended responses from 49 intensive case managers about their consumers.

Results: From case managers' responses, four themes emerged describing the dynamics of the case manager/consumer relationship: motivation, monitoring, creating dependency, and being there.

Conclusions: The current qualitative findings suggest that current constructions and measures of the therapeutic alliance developed in psychotherapy research are not fully capturing the ways in which the unique structure and constraints of intensive case management influence relationships between workers and consumers.