Contact first, protocols second: How to establish a therapeutic alliance in team-based care for severe mental illness according to mental health professionals?

Intro: The therapeutic alliance (TA) is a well-established predictor of treatment outcomes, yet traditional conceptualizations are usually dyadic. For individuals with severe mental illness (SMI), contemporary care is primarily delivered in multidisciplinary teams, raising questions about how the TA is established when responsibility is shared across providers. Qualitative research on this topic remains scarce.