Psychology

Understanding barriers and facilitators to therapeutic relationships in state psychiatric hospitals

Document Type

Article

Abstract

Objective(s): This qualitative study aimed to elucidate barriers and facilitators faced by individuals with serious mental illness in establishing positive therapeutic relationships within the public sector. Method: Twenty-two individuals, receiving inpatient treatment and near discharge from three state psychiatric facilities, participated. The sample was diverse with respect to gender (60 % male) and race/ethnicity, with a mean age of 40 years (standard deviation = 12.91). Thematic analysis and a contextualist lens were used to analyze the data. Results: Results indicated that inadequate meeting time, lack of clinically relevant communication, and discrepancies in client/provider perspectives, impeded positive therapeutic relationships. Facilitators to therapeutic relationships included feelings heard and understood by providers, comprehensive, timely discharge plans, and thinking broadly about aftercare. Conclusions: Cultivating positive therapeutic relationships is especially difficult in resource-challenged settings. Enhanced client–provider communication and individually tailored aftercare planning can enhance inpatient therapeutic relationships, convey a greater sense of understanding of clients, and facilitate client–provider collaboration.

Publication Title

Journal of Clinical Psychology

Publication Date

2020

Volume

76

Issue

1

First Page

195

Last Page

209

ISSN

0021-9762

DOI

10.1002/jclp.22866

Keywords

decision making in psychotherapy, patient preferences, serious mental illness, therapeutic relationship

Link to Full Text

Share

COinS