scholarly journals Examining the Relationship between Choice, Therapeutic Alliance and Outcomes in Mental Health Services

2013 ◽  
Vol 3 (3) ◽  
pp. 191-202 ◽  
Author(s):  
Victoria Stanhope ◽  
Stacey Barrenger ◽  
Mark Salzer ◽  
Stephen Marcus
2020 ◽  
Author(s):  
Eric Badu ◽  
Anthony Paul O’Brien ◽  
Rebecca Mitchell ◽  
Akwasi Osei

Abstract 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.


2013 ◽  
Vol 19 (1) ◽  
pp. 2-10 ◽  
Author(s):  
Elina Baker ◽  
Jason Fee ◽  
Louise Bovingdon ◽  
Tina Campbell ◽  
Elaine Hewis ◽  
...  

SummaryMental health services are increasingly supporting recovery-oriented practice as a basis for service delivery. There is considerable overlap between the values and approaches associated with recovery-based practice and those already endorsed as good psychiatric practice. However, these agreed principles may not be consistently applied and further steps may be needed if the reorientation of the relationship between psychiatrists and people using psychiatric services is to fully reflect recovery principles. This article describes ways in which psychiatric practice could develop, including conceptualising medication as one of many possible recovery tools that a person can actively use to support their well-being, and a range of practices available to professionals to support people in taking up an active stance in relation to medication. It also identifies recovery-supportive practices for when someone is unable to fully participate in decision-making, owing to crisis, loss of capacity or concerns about safety.


2016 ◽  
Vol 22 (1) ◽  
pp. 109-127 ◽  
Author(s):  
Jane EM Callaghan ◽  
Lisa Chiara Fellin ◽  
Fiona Warner-Gale

Policy on Child and Adolescent Mental Health Services (CAMHS) in England has undergone radical changes in the last 15 years, with far reaching implications for funding models, access to services and service delivery. Using corpus analysis and critical discourse analysis, we explore how childhood, mental health and CAMHS are constituted in 15 policy documents, 9 pre-2010 and 6 post-2010. We trace how these constructions have changed over time and consider the practice implications of these changes. We identify how children’s distress is individualised, through medicalising discourses and shifting understandings of the relationship between socio-economic context and mental health. This is evidenced in a shift from seeing children’s mental health challenges as produced by social and economic inequities to a view that children’s mental health must be addressed early to prevent future socio-economic burden. We consider the implications of CAMHS policies for the relationship between children, families, mental health services and the state. The article concludes by exploring how concepts of ‘parity of esteem’ and ‘stigma reduction’ may inadvertently exacerbate the individualisation of children’s mental health.


2015 ◽  
Vol 12 (2) ◽  
pp. 42-44 ◽  
Author(s):  
Roger C. Ho ◽  
Cyrus S. Ho ◽  
Nusrat Khan ◽  
Ee Heok Kua

This article summarises the development of mental health legislation in Singapore in three distinctive periods: pre-1965; 1965–2007 and 2007 onwards. It highlights the origin of mental health legislation and the relationship between mental health services and legislation in Singapore. The Mental Health (Care and Treatment) Act 2008 and Mental Capacity Act 2008 are described in detail.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patricia Penas ◽  
Jose-Juan Uriarte ◽  
Susana Gorbeña ◽  
Mike Slade ◽  
María-Concepción Moreno-Calvete ◽  
...  

Abstract Background Personal recovery has become an increasingly important approach in the care of people with severe mental disorders and consequently in the orientation of mental health services. The objective of this study was to assess the personal recovery process in people using mental health services, and to clarify the role of variables such as symptomatology, self-stigma, sociodemographic and treatment. Methods Standardised measures of personal recovery process, clinical recovery, and internalized stigma were completed by a sample of 312 participants in a Severe Mental Disorder program. Results Users valued most the recovery elements of: improving general health and wellness; having professionals who care; hope; and sense of meaning in life. Significant discrepancies between perceived experience and relative importance assigned to each of the components of the REE were observed. Regression modeling (χ2 = 6.72, p = .394; GFI = .99, SRMR = .03) identified how positive discrepancies were associated with a higher presence of recovery markers (β = .12, p = .05), which in turn were negatively related to the derived symptomatology index (β = −.33, p < .001). Furthermore, the relationship between clinical and personal recovery was mediated by internalized stigma. Conclusions An improvement in psychiatric services should be focused on recovery aspects that have the greatest discrepancy between importance and experience, in particular social roles, basic needs and hope. Personal and clinical recovery are correlated, but the relationship between them is mediated by internalized stigma, indicating the need for clinical interventions to target self-stigma.


1997 ◽  
Vol 60 (12) ◽  
pp. 525-530 ◽  
Author(s):  
Christine M Jensen ◽  
Sheena E E Blair

The relationship between creative writing and mental wellbeing is the subject of much debate and is often founded on conjecture and supposition. The aim of this small study was to explore the relationship between creative writing and mental wellbeing, with the cooperation of 14 adults who had all been users of mental health services and were involved in a creative writing group in the community. Qualitative data were collected from an interview (with the group facilitator), observation (of the group over a period of four group sessions) and the nominal group technique (to elicit the beliefs and opinions of the group itself). The findings of the study were two-fold. Firstly, there was a tension between the cathartic expression of thoughts and feelings and the production of quality writings and, secondly, the notion of stigmatisation as a result of being a user of mental health services emerged. This explorative study, carried out in an urban Scottish context, indicated a covert relationship between creative writing as a product (rhyme) and its therapeutic by-products which affect an individual's mental wellbeing (reason).


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