Predictors of mental health care stigma and its association with the therapeutic alliance during the initial intake session

2014 ◽  
Vol 25 (2) ◽  
pp. 214-221 ◽  
Author(s):  
Ora Nakash ◽  
Maayan Nagar ◽  
Itzhak Levav
Nursing ◽  
2021 ◽  
Vol 51 (10) ◽  
pp. 56-60
Author(s):  
Angel Johann Solorzano Martinez

2020 ◽  
Author(s):  
Simon D'Alfonso ◽  
Reeva Lederman ◽  
Sandra Bucci ◽  
Katherine Berry

UNSTRUCTURED The therapeutic alliance (TA), the relationship that develops between a therapist and a client/patient, is a critical factor in the outcome of psychological therapy. As mental health care is increasingly adopting digital technologies and offering therapeutic interventions that may not involve human therapists, the notion of a TA in digital mental health care requires exploration. To date, there has been some incipient work on developing measures to assess the conceptualization of a digital TA for mental health apps. However, the few measures that have been proposed have more or less been derivatives of measures from psychology used to assess the TA in traditional face-to-face therapy. This conceptual paper explores one such instrument that has been proposed in the literature, the Mobile Agnew Relationship Measure, and examines it through a human-computer interaction (HCI) lens. Through this process, we show how theories from HCI can play a role in shaping or generating a more suitable, purpose-built measure of the digital therapeutic alliance (DTA), and we contribute suggestions on how HCI methods and knowledge can be used to foster the DTA in mental health apps.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Tinashe Dune ◽  
Peter Caputi ◽  
Beverly M. Walker ◽  
Katarzyna Olcon ◽  
Catherine MacPhail ◽  
...  

Abstract Background The development of cultural competence is central to the therapeutic alliance with clients from diverse backgrounds. Given that the majority of Australia’s population growth is due to migration, mental health practitioner construing of non-White and White people has a significant role and impact on client engagement. Method To examine the impact of mental health practitioner construing on their strategies for cultural competence and the therapeutic alliance, 20 White and non-White mental health practitioners and trainees providing mental health services were purposively sampled and interviewed face-to-face or via videoconferencing. Data was analysed thematically and the impact of construing on practitioner cultural competence and the therapeutic alliance were interpreted using Personal Construct Psychology. Results Practitioners demonstrated cultural competence in their acknowledgement of the impact of negative construing of ethnic, cultural, religious, social, racial and linguistic diversity on client wellbeing. Practitioners sought to address these negative impacts on clients by drawing on the client-practitioner relationship to improve the therapeutic alliance. Conclusions The results reinforce the need for mental health care workers to develop cultural competence with a focus on developing awareness of the impact of frameworks of Whiteness on the experiences of non-White people. This is central to the development of a therapeutic alliance where clients feel understood and assured that their mental health concerns will not be constructed (and treated) through a framework that constrains both White and non-White people’s opportunities for improved mental health and wellbeing.


2021 ◽  
Author(s):  
Tinashe Dune ◽  
Ritesh Chimoriya ◽  
Peter Caputi ◽  
Catherine MacPhail ◽  
Katarzyna Olcon ◽  
...  

Abstract Background Racial, ethnic, religious, and cultural diversity in Australia is rapidly increasing. Although Indigenous Australians account for only approximately 3.5% of the country’s population, over 50% of Australians were born overseas or have at least one migrant parent. Migration accounts for over 60% of Australia’s population growth, with migration from Asia, Sub-Saharan African and the Americas increasing by 500% in the last decade. Little is known about Australian mental health care practitioners’ attitudes toward this diversity and their level of cultural competence. Aim Given the relationship between practitioner cultural competence and an effective therapeutic alliance with diverse clients, this study aimed to identify factors that influence non-White and White practitioner cultural competence and therapeutic alliance. Methods An online questionnaire was completed by 139 Australian mental health practitioners. The measures included: the Multicultural Counselling Inventory (MCI); the Color-blind Racial Attitudes Scale (CoBRAS); and the Balanced Inventory of Desirable Responding (BIDR). Descriptive statistics were used to summarise participants’ demographic characteristics. One-way ANOVA and Kruskal-Wallis tests were conducted to identify between-group differences (non-White compared to White practitioners) in cultural competence, therapeutic alliance, and racial and ethnic blindness. Correlation analyses were conducted to determine the effect of participants’ gender or age on cultural competence and therapeutic alliance. Hierarchical multiple regression analyses were conducted to predict cultural competence and therapeutic alliance. Results The study demonstrates that higher MCI total scores (measuring cultural competence and therapeutic alliance) were associated with being non-White, older age, greater attendance of cultural competence-related trainings and increased awareness of general and pervasive racial and/or ethnic discrimination. Practitioners with higher MCI total scores were also likely to have higher self-deceptive positive enhancement scores on the BIDR than those with lower MCI total scores. Conclusion The findings highlight that the current one-size-fits-all and skills-development approach to cultural competence training ignores the significant role that practitioner diversity and differences play in the therapeutic alliance. The recommendations from this study can inform clinical educators and supervisors about the importance of continuing professional development relevant to practitioners’ age, racial/ethnic background and professional experience.


2017 ◽  
Vol 7 (1) ◽  
pp. 14-20
Author(s):  
Samantha M. Hack ◽  
Anjana Muralidharan ◽  
Clayton H. Brown ◽  
Alicia A. Lucksted ◽  
Jennifer Patterson

Current research has found that higher rates of patient-centered care (PCC) are associated with greater treatment adherence and positive treatment outcomes. However, the instruments used to access PCC primarily collect data on provider behavior, rather than consumer participation in PCC, despite the necessary co-equal and collaborative nature of PCC interactions.Cross-sectional survey data was collected from 82 mental health care consumers receiving services at two Veterans Health Administration (VHA) facilities. Participants completed surveys on perceptions of PCC, consumer involvement in care, therapeutic alliance, medication adherence, and mental health care system mistrust.Pearson correlations examined associations between scales. Multiple regression analyses were used to test whether person-centeredness and consumer involvement in care are significant independent explanatory predictors of the identified outcome variables. Significant correlation between the consumer participation and PCC subscales was mixed. Higher levels of PCC were associated with greater therapeutic alliance, less suspicion of mental health care systems, less perception of lack of support from providers, and less beliefs about group disparities in care. Consumer involvement was only significantly related to suspicion of mental health care systems.Perceived PCC was a better explanatory variable than consumer involvement in care for most of the dependent variables. This may be a function of the locus of each outcome variable. When selecting PCC measures, researchers may wish to consider whether the variables of interest are related to the consumer-/provider-as-person or the consumer-provider relationship in order to inform instrument selection.


10.2196/21895 ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. e21895
Author(s):  
Simon D'Alfonso ◽  
Reeva Lederman ◽  
Sandra Bucci ◽  
Katherine Berry

The therapeutic alliance (TA), the relationship that develops between a therapist and a client/patient, is a critical factor in the outcome of psychological therapy. As mental health care is increasingly adopting digital technologies and offering therapeutic interventions that may not involve human therapists, the notion of a TA in digital mental health care requires exploration. To date, there has been some incipient work on developing measures to assess the conceptualization of a digital TA for mental health apps. However, the few measures that have been proposed have more or less been derivatives of measures from psychology used to assess the TA in traditional face-to-face therapy. This conceptual paper explores one such instrument that has been proposed in the literature, the Mobile Agnew Relationship Measure, and examines it through a human-computer interaction (HCI) lens. Through this process, we show how theories from HCI can play a role in shaping or generating a more suitable, purpose-built measure of the digital therapeutic alliance (DTA), and we contribute suggestions on how HCI methods and knowledge can be used to foster the DTA in mental health apps.


1996 ◽  
Vol 24 (3) ◽  
pp. 274-275
Author(s):  
O. Lawrence ◽  
J.D. Gostin

In the summer of 1979, a group of experts on law, medicine, and ethics assembled in Siracusa, Sicily, under the auspices of the International Commission of Jurists and the International Institute of Higher Studies in Criminal Science, to draft guidelines on the rights of persons with mental illness. Sitting across the table from me was a quiet, proud man of distinctive intelligence, William J. Curran, Frances Glessner Lee Professor of Legal Medicine at Harvard University. Professor Curran was one of the principal drafters of those guidelines. Many years later in 1991, after several subsequent re-drafts by United Nations (U.N.) Rapporteur Erica-Irene Daes, the text was adopted by the U.N. General Assembly as the Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care. This was the kind of remarkable achievement in the field of law and medicine that Professor Curran repeated throughout his distinguished career.


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