2012 issue 4

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Volume 21, issue 4

Original article

Therapeutic relationship factors as perceived by the mentally ill and their therapists – results of a study in mental health community-based care and outpatient clinic settings

Małgorzata Sosnowska1, Katarzyna Prot1,2, Agnieszka Chojnowska3, Jan Kobayashi3, Krystyna Nurowska3, Antoni Kalinowski3, Alfreda Ruzikowska3, Beata Kasperek-Zimowska3
1. Zespół Leczenia Domowego Ursynów-Wilanów, Instytut Psychiatrii i Neurologii, Warszawa
2. Akademia Pedagogiki Specjalnej im. Anny Grzegorzewskiej, Warszawa
3. Poradnia Przykliniczna, Instytut Psychiatrii i Neurologii, Warszawa
Postępy Psychiatrii i Neurologii 2012; 21(4): 259–267
Keywords: therapeutic relationship, schizophrenia, community psychiatry, outpatient psychiatric care

Abstract

Objectives. To examine the relation between therapeutic relationship and continuity of extra-hospital mental health care.
Method. Two groups participated in the study: 64 patients and 10 professionals from the Community Mental Health Team (CMHT), and 25 patients and 9 professionals from the Outpatient Mental Health Clinic. The patients had been diagnosed with psychotic spectrum disorders according to the ICD-10 criteria. Symptom severity was measured using the PANSS, therapeutic relationship – by means of the STAR scale, while continuity of care was assessed with a questionnaire developed by the authors and based on a Canadian program. In the statistical analysis Spearman's rank correlation and the Kruskal-Wallis test were applied.
Results. Therapeutic relationship was rated higher by professionals if mental health care was provided to the patient by the same person (provider continuity). Therapeutic relationship with patients manifesting less severe psychotic symptoms was rated higher by professionals in both types of settings, i.e. in the community-based and outpatient care. Moreover, professionals perceived less emotional difficulties in their work with patients diagnosed with more numerous psychotic symptoms. Older patients tended to give higher ratings of the therapeutic relationship and some of its dimensions, such as "positive co-operation" and "positive interventions". Higher ratings of their interventions provided to the patients were given by older psychiatrists and therapists.
Conclusions. Provider continuity is important for professionals' assessment of therapeutic relationship in general and of its aspects such as "positive cooperation" and "positive effects of intervention".

Address for correspondence:
Dr Małgorzata Sosnowska
Zespół Leczenia Domowego Ursynów-Wilanów
Instytut Psychiatrii i Neurologii
ul. Sobieskiego 9, 02-957 Warszawa
tel./fax: 22 458 28 55