DANA POINT, CA, UNITED STATES, November 20, 2025 /EINPresswire.com/ -- A groundbreaking article, "The Impact of Therapeutic Alliance on AMA Rates," published in the Journal of Behavioral Health, announces a major scientific breakthrough: the development and validation of a new psychometric tool that accurately predicts patient retention outcomes based on a therapist’s interpersonal profile.

The study, authored by Nathan Dean Fitch, Michael Krause, Kinan Moukamal, and Michael Castanon, confirms that a provider’s attachment style and related relational characteristics—previously difficult to measure and operationalize, are a central, quantifiable determinant of whether patients complete treatment or drop out against medical advice (AMA).

The Scientific Breakthrough: The Care Predictor Index (CPI)
The research introduces the Care Predictor Index (CPI), a 234-item assessment that integrates established measures of attachment security, clinical self-efficacy, and personality traits. This novel tool generates multidimensional provider profiles to assess relational competence, which is the foundational element of the therapeutic alliance.

Key Scientific Findings and Predictive Power:
- Therapists with high CPI scores (above 70) demonstrated significantly better patient outcomes across five diverse behavioral health organizations, spanning detox, residential, partial hospitalization (PHP), and outpatient settings.
- Patients treated by high-scoring therapists had a 66.37% treatment completion rate, compared to 53.56% for those served by lower-scoring therapists.
- The rate of patients leaving Against Medical Advice (AMA) was nearly halved for high-scoring therapists (16.06%) compared to low-scoring therapists (28.11%).

"For decades, we’ve known the therapeutic alliance is the cornerstone of effective treatment, but we lacked a scalable, empirical mechanism to identify and cultivate the provider qualities that create it," said Nathan Dean Fitch, MS, LMFT, Principal of Growth & Strategy. "The CPI represents a paradigm shift by moving the measurement of relational competence from an abstract concept to an actionable, predictive metric."

Revolutionary Implications for Behavioral Health:
This research offers a revolutionary solution to the persistent challenge of high dropout rates in behavioral health and substance use disorder (SUD) treatment, which undermines recovery and increases costs.
The study repositions relational competence, rooted in provider attachment-related behaviors, as a top-tier target for organizational improvement. The CPI is not just a research tool; it is proposed as a scalable mechanism for quality assurance and workforce development across the entire continuum of care.

Actionable Insights for the Industry:

Workforce Optimization: Organizations can now integrate the CPI into hiring, supervision, and targeted coaching to ensure staff possess the relational skills empirically linked to patient retention.

Outcome Improvement: The tool provides a pathway for behavioral health organizations to directly influence patient outcomes by focusing professional development on specific areas of growth, such as increasing non-anxious attachment and relational flexibility.

Standardization of Care: The CPI offers a uniform method to assess and improve the provider-level factors that drive successful alliance formation across different organizational models and levels of acuity.

The authors conclude that by focusing on attachment-informed provider assessment, organizations can create a measurable impact on patient retention, leading to better long-term recovery outcomes.

"This research finally gives our industry what it has been missing, a reliable, scalable way to understand and strengthen the relational skills that keep patients engaged in treatment. The CPI doesn’t just validate what we’ve always known matters; it provides a clear pathway for organizations to transform care, elevate workforce performance, and improve outcomes at every level of the continuum," said Michael Castanon, CEO of Care Predictor.

Article Details
Title: The Impact of Therapeutic Alliance on AMA Rates
Authors: Nathan Dean Fitch, Michael Krause, Kinan Moukamal, and Michael Castanon
Journal: Journal of Behavioral Health
Published Date: November 15, 2025
Availability: Open Access under Creative Commons Attribution NonCommercial ShareAlike 4.0

About Care Predictor
Care Predictor is an AI-driven workforce analytics and assessment company dedicated to strengthening the behavioral health workforce through the science of therapeutic alliance. By evaluating provider relational competencies, Care Predictor helps organizations improve patient retention, reduce AMA discharges, and elevate care quality across all levels of behavioral healthcare. More information is available at www.carepredictor.com.

Organizations interested in enhancing workforce performance, improving treatment retention, and reducing AMA rates through validated relational competency assessment are encouraged to connect with the Care Predictor team. We welcome the opportunity to discuss how our tools and insights can support your organization’s mission and outcomes.

Contact info@carepredictor.com or visit www.carepredictor.com to learn more.

Nathan Dean Fitch, MS, LMFT
Care Predictor
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