title: The therapeutic relationship after psychiatric admission.
abstract: The therapeutic relationship is one of the most central and important factors in the treatment of mental health disorders. A better therapeutic relationship is associated with service engagement, medication adherence, and satisfaction with services. This study aimed to compare the demographic and clinical factors associated with the therapeutic relationship in voluntarily and involuntarily admitted psychiatric service users. We found that individuals who had been admitted involuntarily, who had a diagnosis of a psychotic disorder, and who reported higher levels of perceived pressures on admission were more likely to have a poorer therapeutic relationship with their consultant psychiatrist. Greater levels of insight and treatment satisfaction, together with higher levels of procedural justice experienced on admission, were associated with a better therapeutic relationship. We found that the level of perceived coercion on admission was not related to the therapeutic relationship. Targeted interventions to improve the therapeutic relationship, particularly for involuntarily admitted service users, are discussed.
authors.affiliation: *Cluain Mhuire Community Mental Health Service, Dublin, Ireland; †St Vincent's University Hospital, Dublin, Ireland; and ‡Royal College of Surgeons of Ireland, Dublin, Ireland.
authors.forename: Eric
authors.initials: E
authors.lastname: Roche
authors.forename: Kevin
authors.initials: K
authors.lastname: Madigan
authors.forename: John P
authors.initials: JP
authors.lastname: Lyne
authors.forename: Larkin
authors.initials: L
authors.lastname: Feeney
authors.forename: Brian
authors.initials: B
authors.lastname: O'Donoghue
mesh_terms: D000328:Adult; D003068:Coercion; D003134:Commitment of Persons with Psychiatric Disorders; D005260:Female; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D008605:Mental Health Services / Q000592:standards; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011567:Psychiatric Department, Hospital / Q000592:standards; D011569:Psychiatric Status Rating Scales