Predictors of mental health care stigma and its association with the therapeutic alliance during the initial intake session

Abstract: Objective: We investigated the association between socio-demographic and clinical variables with mental health care stigma, and the impact of the latter on the quality of the therapeutic alliance measured at intake. Method: Consecutive clients (N = 236) filled questionnaires upon accessing services for a new episode of care. Immediately following the intake, a randomly selected sample of clients and their corresponding therapists (n = 102) completed the Working Alliance Inventory – Bond Scale. Results: Lower mean years of education and higher emotional distress (both partial r =.17) were significantly associated with higher stigma. Higher care stigma negatively correlated with therapists' ratings of the therapeutic alliance during the intake (partial r = −.22), but not with those of clients. Conclusions: Care stigma is present among service-users and may affect outcomes of the intake.