Therapeutic relationships: their specificity in predicting outcomes for people with psychosis using clinical and vocational services.
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.
Catty
Jocelyn
J
Division of Mental Health, St. George's, University of London, London, UK. JocelynCatty@yahoo.co.uk
Koletsi
Marsha
M
White
Sarah
S
Becker
Thomas
T
Fioritti
Angelo
A
Kalkan
Rana
R
Lauber
Christoph
C
Lissouba
Pascale
P
Rössler
Wulf
W
Tomov
Toma
T
van Busschbach
Jooske T
JT
Wiersma
Durk
D
Burns
Tom
T
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