title: Therapeutic relationships: their specificity in predicting outcomes for people with psychosis using clinical and vocational services.
abstract: OBJECTIVE
  To determine the distinctions between the client-keyworker relationship and the client-vocational worker relationship by assessing their impact on clinical outcomes and exploring the associations between the two.
  
  
  METHODS
  As part of an international randomised controlled trial of supported employment (n = 312), client-keyworker relationship and client-vocational worker relationship were each tested against clinical and social functioning 6 months later. Associations between the two relationships over time were explored.
  
  
  RESULTS
  Client-keyworker relationship predicted quality of life, while client-vocational worker relationship, as rated by the client, did not predict any clinical or social functioning outcomes. Vocational worker-rated relationship predicted reduced depression. The client-keyworker and client-vocational worker relationships were correlated, but this did not change over time.
  
  
  CONCLUSIONS
  The impact of the client-vocational worker is likely to be on the shared task of finding employment, rather than on clinical and social functioning. Good client-vocational worker relationships do not detract from client-keyworker relationships.
authors.affiliation: Division of Mental Health, St. George's, University of London, London, UK. JocelynCatty@yahoo.co.uk
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Catty
authors.forename: Marsha
authors.initials: M
authors.lastname: Koletsi
authors.forename: Sarah
authors.initials: S
authors.lastname: White
authors.forename: Thomas
authors.initials: T
authors.lastname: Becker
authors.forename: Angelo
authors.initials: A
authors.lastname: Fioritti
authors.forename: Rana
authors.initials: R
authors.lastname: Kalkan
authors.forename: Christoph
authors.initials: C
authors.lastname: Lauber
authors.forename: Pascale
authors.initials: P
authors.lastname: Lissouba
authors.forename: Wulf
authors.initials: W
authors.lastname: Rössler
authors.forename: Toma
authors.initials: T
authors.lastname: Tomov
authors.forename: Jooske T
authors.initials: JT
authors.lastname: van Busschbach
authors.forename: Durk
authors.initials: D
authors.lastname: Wiersma
authors.forename: Tom
authors.initials: T
authors.lastname: Burns
mesh_terms: D000293:Adolescent; D000328:Adult; D003156:Community Mental Health Services / Q000379:methods; D016832:Employment, Supported / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007391:International Cooperation; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011369:Professional-Patient Relations; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000523:psychology / Q000534:rehabilitation* / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012050:Rehabilitation, Vocational / Q000379:methods* / Q000523:psychology; D012944:Social Support; D016896:Treatment Outcome