Effective nurse–patient relationships in mental health care: A systematic review of interventions to improve the therapeutic alliance

Hartley, Samantha; Raphael, Jessica; Lovell, Karina; Berry, Katherine

doi:10.1016/j.ijnurstu.2019.103490

Cited by 107 publications

(158 citation statements)

References 68 publications

Supporting

Mentioning

153

Contrasting

Order By: Relevance

“…respecting consumers privacy/con dentiality, dignity, preferences, informed consent, comfort as well as, religion, gender, age, belief systems). Consistent with previous ndings (4,6,15), the program theory demonstrated that the therapeutic alliance equipped consumers in illness management, for example, adhering to medications. The therapeutic alliance were also relevant in promoting the personal recovery for consumers, thus, improving their knowledge and understanding, feeling a sense of acceptance, hope and expectations as well as active participation in mental health services.…”

Section: Cmo Con Guration 1: Technical Competency Stimulates Evidencesupporting

confidence: 80%

See 1 more Smart Citation

A realistic evaluation of evidence-based therapeutic processes in mental health services– Context-Mechanisms-Outcomes

Badu

O’Brien²,

Mitchell

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Evidence-based clinical practice is an inherent component of developed countries mental health professional practice, however, little is known about Ghana mental health professional perspectives on evidence-based practice. This paper outlines the processes involved in the delivery of best practice in Ghana. The paper describes a realistic evaluation of mental health nurses and allied health opinions regarding the evidenced-based therapeutic process in Ghana mental health facilities. Methods A purposive sample of 30 Mental Health Professionals (MHPs) was recruited to participate in semi-structured in-depth interviews. Thematic analysis was used to analyse the data. A programme theory of Context + Mechanism = Outcome (CMO) configuration was developed from the analysis. Results The thematic analysis identified two CMO configurations: 1) technical competency stimulates evidence-based mental health services; and, 2) therapeutic alliance-building ensures effective interaction. The study demonstrated that contextual factors (technical competencies and therapeutic alliance building) together with mechanisms (intentional and unintentional) help to promote the quality of mental health services. However, contextual factor such as the lack of sign language interpreters yielded an unintended outcome such as consumer-provider communication barrier for consumers with hearing impaired and those from linguistically minority background. Conclusion We conclude that government stakeholders and policymakers should prioritize policy documents, periodic monitoring and adequate financial incentives to support the on-going mechanisms that promote mental health professional technical competence and therapeutic alliance building.

show abstract

Section: Cmo Con Guration 1: Technical Competency Stimulates Evidencesupporting

confidence: 80%

“…Research have highlighted that the therapeutic relationship could have a positive impact on the quality of mental health services (1,8,15). For example, such therapeutic relationship promotes personal recovery, increased service satisfaction, quality of life, reduced symptoms, and consumers functionality (4,15,16).…”

Section: Introductionmentioning

confidence: 99%

A realistic evaluation of evidence-based therapeutic processes in mental health services– Context-Mechanisms-Outcomes

Badu

O’Brien²,

Mitchell

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Nurses spending time building therapeutic relationships with consumers is an investment in consumers' recovery (Keefe, Cardemil, & Thompson, 2020), leading to improved clinical outcomes and consumer satisfaction (Hartley, Raphael, Lovell, & Berry, 2020). Research exploring consumers' perceptions of how therapeutic relationships with nurses enhance consumers' recovery is ongoing and will add to knowledge in this area (Chambers et al., 2019).…”

Section: Discussionmentioning

confidence: 99%

Nurses' influence on consumers' experience of safety in acute mental health units: A qualitative study

Cutler

Sim

Halcomb

et al. 2020

Journal of Clinical Nursing

View full text Add to dashboard Cite

Aims and objectives: To explore how nurses influence the perceptions and experience of safety among consumers who have been admitted to an acute mental health unit. Background: Safety is a priority in acute mental health inpatient units, yet consumers do not always experience acute units as safe. Despite being primary stakeholders, little is known about what safety means for consumers in acute mental health units. Design: A qualitative descriptive study informed by naturalistic enquiry was conducted and is reported using the COREQ checklist. Methods: Fifteen consumers with experience of mental illness participated in semistructured individual interviews. These interviews explored what safety meant for them during their acute mental health unit admissions. Thematic analysis was used to analyse the data. Findings: The theme Influence of Nurses reflected that the way nurses engaged in acute mental health units had a profound impact on participants' sense of safety. Three sub-themes emerged as follows: (a) Availability: "It's about nurses spending time with you"; (b) Being responsive: "They would listen if you had a concern"; and (c) Caring: "Little acts of kindness." Conclusions: These findings challenge the dominant discourse around safety in mental health organisations, in which nursing practice is often oriented towards the management of risk, rather than the promotion of safety. The findings demonstrate that, through their clinical practice, nurses can enhance consumers' feelings of safety in the acute mental health unit. Relevance to clinical practice: Nurses play a key role in providing care within acute mental health units. It is vital that the behaviours and actions nurses can enact in order to promote feelings of safety among consumers in this setting are enabled at individual, unit and organisational levels.

show abstract

“…TA, to a large extent, is designed to capture the human aspect of the relationship between the clinician and the client. There are thousands of correlational studies that have established that TA is a predictor of treatment outcomes (Flückiger et al 2018 ); however, there are few studies of interventions that show a causal connection between TA and outcomes (e.g., Hartley et al 2020 ). Moreover, the very nature of TA as trait-like or state-like, which is central to causal assumptions, is being questioned and is subject to new research approaches (Zilcha-Mano 2017 ) as well as to questions about how it should be measured (Bickman and Athay 2012 ) Regardless of my doubts about the importance of TA, the Fluckiger et al ( 2018 ) meta-analysis found similar effect sizes ( r = 0.275) for the alliance-outcome relationship in online interventions and in traditional face-to-face therapies.…”

Section: Ai and The Future Of Mental Health Servicesmentioning

confidence: 99%

Improving Mental Health Services: A 50-Year Journey from Randomized Experiments to Artificial Intelligence and Precision Mental Health

Bickman

2020

Adm Policy Ment Health

View full text Add to dashboard Cite

This conceptual paper describes the current state of mental health services, identifies critical problems, and suggests how to solve them. I focus on the potential contributions of artificial intelligence and precision mental health to improving mental health services. Toward that end, I draw upon my own research, which has changed over the last half century, to highlight the need to transform the way we conduct mental health services research. I identify exemplars from the emerging literature on artificial intelligence and precision approaches to treatment in which there is an attempt to personalize or fit the treatment to the client in order to produce more effective interventions. Keywords Mental health services • Artificial intelligence • Machine learning • Precision mental health • Randomized clinical trials (RCTs) • Precision medicine "AI will bring many wonders. It may also destabilize everything from nuclear détente to human friendships. We need to think much harder about how to adapt... it is changing human knowledge, perception and reality-and, in so doing, changing the course of human history. We seek to understand it and its consequences and encourage others across the disciplines to do the same."-Kissinger et al. 2019, pp. 24-26 "AI is one of the most profound things we're working on as humanity. It's more profound than fire or electricity."-Alphabet CEO Sundar Pichai, in Thompson and Bodoni 2020. This article is part of a special issue, Festschrift for Leonard Bickman: The Future of Children's Mental Health Services.

show abstract

Effective nurse–patient relationships in mental health care: A systematic review of interventions to improve the therapeutic alliance

Cited by 107 publications

References 68 publications

A realistic evaluation of evidence-based therapeutic processes in mental health services– Context-Mechanisms-Outcomes

A realistic evaluation of evidence-based therapeutic processes in mental health services– Context-Mechanisms-Outcomes

Nurses' influence on consumers' experience of safety in acute mental health units: A qualitative study

Improving Mental Health Services: A 50-Year Journey from Randomized Experiments to Artificial Intelligence and Precision Mental Health

Contact Info

Product

Resources

About