Helping alliance and ward atmosphere in psychiatric in‐patient care

Abstract

The findings emphasize that a holding environment is important in establishing a good helping alliance, which is consistent with results from the psychotherapy area. Since helping alliance is known to have a most important influence on therapy outcome, one conclusion must be that the staff, in their endeavour to strengthen the supportive element of the ward atmosphere, may improve the therapeutic outcome as well.

Helping alliance and early dropout from psychiatric out-patient care

“…In accordance with earlier research from both psychotherapy and psychiatry, our result showed that a positive alliance was correlated with older age. Regarding type of disorder, there have been some findings indicating that people with personality disorders tend to have greater difficulties in establishing a good helping alliance (21,28), but in this outpatient sample we found no significant differences between the diagnostic groups. This finding is consistent with other results from psychiatric and psychotherapeutic research, showing that the diagnosis is of relatively limited importance for establishing the therapeutic alliance (2,26).…”

“…Apart from its association with outcome, little is known about how the alliance varies between different psychiatric settings and diagnostic groups and how it is influenced by different mediating and moderating factors (26). Studies have indicated that a positive alliance is associated with less severe problems (5,7,(26)(27)(28), and age (28,29). As in psychotherapy research, there is a weak tendency that patients with borderline and other personality disorders have greater difficulties in establishing a good therapeutic alliance (21,28).…”

“…Studies have indicated that a positive alliance is associated with less severe problems (5,7,(26)(27)(28), and age (28,29). As in psychotherapy research, there is a weak tendency that patients with borderline and other personality disorders have greater difficulties in establishing a good therapeutic alliance (21,28). To our knowledge, only one study (26) has compared the therapeutic relationship for different diagnostic groups in a variety of routine psychiatric settings for in-and outpatients.…”

Institutional Therapeutic Alliance in Multi-Professional Treatments with Severely Disturbed Patients

“…But not an optimal bond among the patient and the various figures involved in the treatment, like the alliance with the main or the co therapists, but between the patient and the staff perceived as a whole, as a cohesive and unitary therapeutic system. In fact, recently Johansson and Eklund (2004) offer support for this thesis correlating some dimensions of ward atmosphere and the helping alliance perceived by the patient. In this sense, ward atmosphere and therapeutic alliance can be two different ways to understand the same phenomenon.…”

Associations between ward climate and patient characteristics in a secure forensic mental health service

“…Research encouragingly suggests that ward climate is associated with patient satisfaction (Rossberg & Friis, 2004), motivation, engagement, therapeutic alliance (Johanson & Eklund, 2004;Long, Anagnostakis, et al, 2011), and functional improvement (Melle et al, 1996). Based on these data, some have proposed that by improving ward climate, we could improve the treatment alliance, and thereby improve patient outcome (Johansson & Eklund, 2004). Improved understanding of the determinants and influences on ward climate therefore holds considerable potential to improve forensic mental health services.…”