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The therapeutic relationship in community mental health services: a systematic review of the literature.

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Title: The therapeutic relationship in community mental health services: a systematic review of the literature.
Authors: Marchi, Mattia (AUTHOR), Venturi, Giulia (AUTHOR), Visentini, Chiara (AUTHOR), Pinelli, Margherita (AUTHOR), Priebe, Stefan (AUTHOR), Galeazzi, Gian Maria (AUTHOR)
Source: Social Psychiatry & Psychiatric Epidemiology. May2024, Vol. 59 Issue 5, p731-743. 13p.
Subjects: Community mental health services, Patient-professional relations, Therapeutic communities, People with mental illness, Mental health personnel, Random effects model
Abstract: Purpose: This systematic review aimed to investigate the therapeutic relationship (TR) between mental health professionals (MHPs) and their patients in community mental health services (CMHS). Methods: PubMed (Medline), PsycINFO, CINAHL, CENTRAL, and Web of Science were searched for studies that assessed TR in CMHS using quantitative measures developed specifically for this setting (i.e., Helping Alliance Scale [HAS] and the Scale to Assess the Therapeutic Relationship [STAR]). Studies were included if they considered adult patients with a psychiatric disorder and/or any MHP working in CMHS. Meta-analysis and narrative synthesis assessed the association between patients' and MHPs' ratings and identified predictors of TR. Results: Of 1934 studies, 15 were included in the review, including 3004 patients. A total of 1127 patients and 963 MHPs were considered in the meta-analysis. The heterogeneity of the studies was high, and there was no significant difference between the patients' and MHPs' TR ratings in the random-effects model (standardized mean difference [SMD]: − 0.39 [95% CI: − 1.03; 0.24]). In the multivariable meta-regression, only duration of illness was significantly associated with TR ratings (unstandardized regression coefficient [B]: 0.388 [95% CI: 0.217; 0.558]). A recovery-oriented service, shared decision-making, and the recognition of patient needs contributed to more positive TR ratings. Conclusion: Patients and MHPs converged in their TR ratings, although patients gave lower ratings. Routine assessment of TR in CMHS can inform reflective practice and service development, as TR can be assessed easily and early in the treatment process. Future research should focus on developing and testing interventions to improve TR in CMHS. [ABSTRACT FROM AUTHOR]
Copyright of Social Psychiatry & Psychiatric Epidemiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: The therapeutic relationship in community mental health services: a systematic review of the literature.
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  Data: <searchLink fieldCode="AR" term="%22Marchi%2C+Mattia%22">Marchi, Mattia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Venturi%2C+Giulia%22">Venturi, Giulia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Visentini%2C+Chiara%22">Visentini, Chiara</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pinelli%2C+Margherita%22">Pinelli, Margherita</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Priebe%2C+Stefan%22">Priebe, Stefan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Galeazzi%2C+Gian+Maria%22">Galeazzi, Gian Maria</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Social+Psychiatry+%26+Psychiatric+Epidemiology%22">Social Psychiatry & Psychiatric Epidemiology</searchLink>. May2024, Vol. 59 Issue 5, p731-743. 13p.
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  Data: <searchLink fieldCode="DE" term="%22Community+mental+health+services%22">Community mental health services</searchLink><br /><searchLink fieldCode="DE" term="%22Patient-professional+relations%22">Patient-professional relations</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutic+communities%22">Therapeutic communities</searchLink><br /><searchLink fieldCode="DE" term="%22People+with+mental+illness%22">People with mental illness</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+health+personnel%22">Mental health personnel</searchLink><br /><searchLink fieldCode="DE" term="%22Random+effects+model%22">Random effects model</searchLink>
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  Data: Purpose: This systematic review aimed to investigate the therapeutic relationship (TR) between mental health professionals (MHPs) and their patients in community mental health services (CMHS). Methods: PubMed (Medline), PsycINFO, CINAHL, CENTRAL, and Web of Science were searched for studies that assessed TR in CMHS using quantitative measures developed specifically for this setting (i.e., Helping Alliance Scale [HAS] and the Scale to Assess the Therapeutic Relationship [STAR]). Studies were included if they considered adult patients with a psychiatric disorder and/or any MHP working in CMHS. Meta-analysis and narrative synthesis assessed the association between patients' and MHPs' ratings and identified predictors of TR. Results: Of 1934 studies, 15 were included in the review, including 3004 patients. A total of 1127 patients and 963 MHPs were considered in the meta-analysis. The heterogeneity of the studies was high, and there was no significant difference between the patients' and MHPs' TR ratings in the random-effects model (standardized mean difference [SMD]: − 0.39 [95% CI: − 1.03; 0.24]). In the multivariable meta-regression, only duration of illness was significantly associated with TR ratings (unstandardized regression coefficient [B]: 0.388 [95% CI: 0.217; 0.558]). A recovery-oriented service, shared decision-making, and the recognition of patient needs contributed to more positive TR ratings. Conclusion: Patients and MHPs converged in their TR ratings, although patients gave lower ratings. Routine assessment of TR in CMHS can inform reflective practice and service development, as TR can be assessed easily and early in the treatment process. Future research should focus on developing and testing interventions to improve TR in CMHS. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Social Psychiatry & Psychiatric Epidemiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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              Text: May2024
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