Staff and patient perspectives on unmet need and therapeutic alliance in community mental health services.
BACKGROUND
Therapeutic alliance between clinicians and their patients is important in community mental healthcare. It is unclear whether providing effective interventions influences therapeutic alliance.


OBJECTIVE
To assess the impact of meeting previously unmet mental health needs on the therapeutic alliance between patients and clinicians.


METHODS
Secondary analysis of data from a longitudinal study assessing 101 patients and paired staff.


RESULTS
Patient-rated unmet need was negatively associated with patient-rated and staff-rated therapeutic alliance. Staff-rated unmet need was positively associated with patient-rated therapeutic alliance only. Reducing patient-rated unmet need increased patient-rated but not staff-rated therapeutic alliance, even when controlling for other variables. Reducing staff-rated unmet need increased staff-rated but not patient-rated therapeutic alliance, but the effect became insignificant when controlling for other variables.


CONCLUSIONS
Patient-rated therapeutic alliance will be maximised by focusing assessment and interventions on patient-rated rather than staff-rated unmet need.
Junghan
Ulrich M
UM
University Hospital of Psychiatry, Unit of Community Psychiatry, Laupenstrasse 49, CH-3010 Bern, Switzerland. junghan@spk.unibe.ch
Leese
Morven
M
Priebe
Stefan
S
Slade
Mike
M
D000328:Adult; D003156:Community Mental Health Services / Q000379:methods / Q000592:standards* / Q000600:supply & distribution; D003430:Cross-Sectional Studies; D005260:Female; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D011369:Professional-Patient Relations; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires