Developing the therapeutic alliance in acute mental health care

2003 ◽  
Vol 17 (3) ◽  
pp. 190-205 ◽  
Author(s):  
Ian Thurston
2017 ◽  
Vol 54 (4) ◽  
pp. 445-465 ◽  
Author(s):  
Gesine Sturm ◽  
Zohra Guerraoui ◽  
Sylvie Bonnet ◽  
Françoise Gouzvinski ◽  
Jean-Philippe Raynaud

This article presents the recently created intercultural consultation at the Medical and Psychological Health Care Service (CMP) of the University Hospital la Grave at Toulouse. The approach of the intercultural consultation was elaborated in response to the increasing diversity of children and families using the service in Toulouse. It is also based on local research that indicates the difficulties service providers encounter when trying to establish a solid therapeutic alliance with families with complex migration backgrounds who accumulate different disadvantaging factors. The intercultural consultation adapts existing models of culture-sensitive consultations in child mental health care in France and Canada to the local context in Toulouse. We describe the underlying principles of the intercultural consultation work, the therapeutic and mediation techniques used, and the way the work is integrated into the global service provision of the CMP. The process is illustrated with a case study followed by a discussion of the innovations.


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.


Nursing ◽  
2021 ◽  
Vol 51 (10) ◽  
pp. 56-60
Author(s):  
Angel Johann Solorzano Martinez

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.


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.


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