Structuring patient-clinician dialogue to focus on patients' views positively influenced quality of life, needs for care and treatment satisfaction.

This study points to the suggestion that mental health care staff may hold negative attitudes and beliefs about people with mental illness with tentative implications for treatment of the patient and development and implementation of evidence-based services. Since patients and staff in most respects share these beliefs, it is essential to develop interventions that have an impact on both patients and staff, enabling a more recovery-oriented staff-patient relationship.

The Manchester Short Assessment of Quality of Life (MANSA) is a short interview, which has received a recent interest in research investigating quality of life in people with mental illness. In the present study, the Swedish version of MANSA is examined with regard to reliability, in terms of internal consistency and construct validity. Ninety-two persons with severe mental illness were interviewed regarding quality of life, social network, psychosocial functioning, psychiatric symptoms, needs for care, empowerment and experiences of stigma. Internal consistency was adequate (alpha = 0.81). Positive correlations were found between MANSA and social network, empowerment and psychosocial functioning, and negative correlations with psychopathology, number of needs for care, perceived devaluation and discrimination, and rejection experiences. Social network, psychosocial functioning and beliefs of devaluation and discrimination altogether explained 67% of the variance in quality of life. The Swedish version of MANSA showed a satisfactory reliability in terms of internal consistency. The construct of validity of the scale was satisfactory insofar as associations with validation measures were of considerable magnitude and in expected directions.

A total of 26 schizophrenic and other long-term mentally ill patients receiving cognitive therapy sessions twice a week in the context of a comprehensive in-patient treatment programme were assessed every 5 weeks with regard to therapeutic alliance. The therapists rated the alliance according to the Psychotherapy Status Report and the patients rated it according to the Patient Collaboration Scale. The results showed either good or fair and stable therapeutic alliance for the majority of the patients throughout the treatment period. Few correlations were found between patient characteristics and initial alliance. The therapists' ratings showed a positive relationship between initial alliance and a favourable outcome of treatment at discharge.

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