The recovery alliance theory (RAT) is a mid-range theory of mental health nursing based on humanistic philosophy. The conception of the RAT was the outcome of collaboration among service users, practising mental health nurses, educationalists and managers and was developed in the context of a number of political and social changes as well as changes in the mental health field. The theory is composed of six constructs: humanistic philosophy, recovery, partnership relation, strengths focus, empowerment and common humanity. The derivation of three concepts from these constructs, namely coping, self-responsibility/control and working alliance, forms the basis for the translation of the constructs into a system of mental health nursing practice [Partnership in Coping system (PinC)]. The constructs underpinning the RAT were clearly demonstrated in a preliminary trial of the PinC system.
The paper describes the results of a preliminary trial of a system of mental health nursing, the Partnership in Coping system, based on the subjective experiences of the participating mental health nurses and service users. The community mental health study involved action research, with data being collected through individual interviews and focus groups. Data analysis, using thematic content analysis, resulted in the emergence of two main dimensions. These dimensions are centred around a shift in responsibility from the service to the service user, and the authentication and clarification of the roles of the nurse and the service user.
The aim of this paper was to describe a newly-developed system of mental health nurse counselling (coping focus counselling (CFC)) for people with serious and complex mental health needs. The system is based on the recovery alliance theory (RAT) of mental health nursing. The paper identifies shortcomings in current practices in psychotherapy and counselling in the exclusive use of techniques from a single approach, for example, cognitive behaviour therapy, client-centred therapy, attachment theory, or Gestalt theory. It also discusses the opposite dangers of the use of many techniques from different approaches, without a clear rationale for their selection. CFC was developed to avoid these practices. It accommodates the selective use of techniques from different approaches. Techniques selected are viewed as deriving their meanings from the theoretical framework into which they are assimilated, namely RAT, and no longer take the same meaning from the theory from which they originated. Central to this integrative process is the use of the concept of coping. Other distinguishing features of CFC are the use of everyday language in using the system and the reaffirmation of the nurse-client relationship within a working alliance as the basis in which the CFC operates.
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