title: Therapeutic relationships in vocational rehabilitation: predicting good relationships for people with psychosis.
abstract: Therapeutic relationships between clients and vocational rehabilitation workers have been shown to predict entering competitive employment. We aimed to determine predictors of good relationships, using data from an international randomized controlled trial of supported employment (n=312). Baseline predictors of early therapeutic relationships with vocational workers were assessed, along with the impact of vocational status and changing clinical and social functioning variables on relationship ratings over time. Associations between client and professional relationship ratings were also explored. Better early client-rated therapeutic relationship was predicted by better baseline relationship with the clinical keyworker, being in the Individual Placement and Support (IPS) service, the absence of work history and a greater proportion of care needs being met, whereas over time it was predicted by being in the IPS service. Professional-rated early relationship was predicted by social disability and remission, while over time it was predicted by being the same sex as the client, duration of the relationship and the client's increasing anxiety. Client and professional ratings were positively associated but clients' ratings were higher than professionals', particularly in the IPS service. Relationships were better where clients may have been more motivated to engage, including by their prior experience of a good therapeutic relationship with the clinical keyworker.
authors.affiliation: Division of Mental Health, St. George's, University of London, London SW17 0RE, UK. JocelynCatty@yahoo.co.uk
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Catty
authors.forename: Sarah
authors.initials: S
authors.lastname: White
authors.forename: Marsha
authors.initials: M
authors.lastname: Koletsi
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: D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011369:Professional-Patient Relations; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000534:rehabilitation*; D012044:Regression Analysis; D012050:Rehabilitation, Vocational / Q000379:methods*; D013997:Time Factors