Improving Therapeutic Relationships: Joint Crisis Planning for Individuals With Psychotic Disorders.
Outcomes for individuals with psychosis remain far from acceptable. Recently, prominent psychiatrists have called for an improved understanding of the impact of social contexts, and how social contexts might influence the development and maintenance of mental health problems. A key social context for individuals with psychosis is the therapeutic relationship. As part of a trial of joint crisis planning in England, this qualitative study aimed to determine the mechanism through which joint crisis planning might affect the therapeutic relationship. Results suggest that routine processes in mental health care are affected by policy and organizational requirements for risk mitigation-aspects that undermine person-centered approaches. In contrast, strong therapeutic relationships are characterized by individualized care and reliable and respectful treatment. The Joint Crisis Plan intervention partially succeeded in reducing contextual influences on routine role enactments, facilitating the demonstration of respect and improving the therapeutic relationship.
['Farrelly|Simone|S|', 'Lester|Helen|H|', 'Rose|Diana|D|', 'Birchwood|Max|M|', 'Marshall|Max|M|', 'Waheed|Waquas|W|', 'Henderson|R Claire|RC|', 'Szmukler|George|G|', 'Thornicroft|Graham|G|']
D000328:Adult D001291:Attitude of Health Personnel D019090:Case Management D003134:Commitment of Mentally Ill D003419:Crisis Intervention D004739:England D005260:Female D017144:Focus Groups D066296:Grounded Theory D006801:Humans D008297:Male D008605:Mental Health Services D010358:Patient Participation D018802:Patient-Centered Care D011369:Professional-Patient Relations D011618:Psychotic Disorders D036301:Qualitative Research D012008:Recurrence D013222:State Medicine
risk communication, medical crisis management grounded theory group interaction mental health and illness nursing, community psychiatry qualitative analysis relationships, patient-provider schizophrenia symbolic interactionism