Assessing relationship quality in mandated community treatment: blending care with control.
Traditional measures of the therapeutic alliance do not capture the dual roles inherent in relationships with involuntary clients. Providers not only care for, but also have control over, involuntary clients. In 2 studies of probationers mandated to psychiatric treatment (n=90; n=322), the authors developed and validated the revised Dual-Role Relationships Inventory (DRI-R). The authors found that (a) relationship quality in mandated treatment involves caring and fairness, trust, and an authoritative (not authoritarian) style, (b) the DRI-R assesses these domains of relationship quality, is internally consistent, and relates in a theoretically coherent pattern with ratings of within-session behavior and with measures of the therapeutic alliance, relationship satisfaction, symptoms, and treatment motivation, and (c) the quality of dual-role relationships predicts future compliance with the rules, as assessed by probation violations and revocation. The DRI-R covaries with multiple domains more strongly than a leading measure of the therapeutic alliance, suggesting that it better captures the nature and effect of relationship quality in mandated treatment.
Skeem
Jennifer L
JL
Department of Psychology and Social Behavior, University of California, Irvine, CA 92697-7083, USA. skeem@uci.edu
Louden
Jennifer Eno
JE
Polaschek
Devon
D
Camp
Jacqueline
J
D000328:Adult; D003156:Community Mental Health Services / Q000379:methods* / Q000706:statistics & numerical data; D003376:Counseling / Q000379:methods / Q000706:statistics & numerical data; D003415:Crime / Q000523:psychology; D004645:Empathy; D005260:Female; D005555:Forensic Psychiatry / Q000379:methods; D006801:Humans; D008297:Male; D037141:Mandatory Programs; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D009042:Motivation; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000523:psychology; D017060:Patient Satisfaction; D011237:Predictive Value of Tests; D011369:Professional-Patient Relations; D011594:Psychometrics; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D015206:Southwestern United States; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology; D035502:Trust / Q000523:psychology