title: Can the therapeutic relationship predict 18 month outcomes for individuals with psychosis?
abstract: Therapeutic relationships (TRs) are considered a key component of good psychiatric care, yet its association with outcomes for individuals with psychosis remains unclear. Five hundred and sixty-nine service users with psychotic disorders and care coordinators in community settings rated their therapeutic relationship; outcomes were assessed 18 months later. In multivariate analyses, a small but significant association was found between service user ratings and instances of psychiatric hospital admissions, self harm and suicide attempts over an 18 month period. Care coordinator ratings were associated with instances of psychiatric hospital admissions and harm to others over the 18 months and level of functioning at 18 months. The differential findings and small effect size suggests that the therapeutic relationship needs further definition for this patient group in this setting. Nevertheless, clinicians should prioritise interactions that strengthen therapeutic relationships.
authors.affiliation: Health Service and Population Research Department, King׳s College London, Institute of Psychiatry, UK. Electronic address: simone.farrelly@kcl.ac.uk.
authors.forename: Simone
authors.initials: S
authors.lastname: Farrelly
authors.affiliation: Division of Psychiatry, School of Medicine, University of Manchester, Manchester, UK.
authors.forename: Gill
authors.initials: G
authors.lastname: Brown
authors.affiliation: Health Service and Population Research Department, King׳s College London, Institute of Psychiatry, UK.
authors.forename: George
authors.initials: G
authors.lastname: Szmukler
authors.affiliation: Health Service and Population Research Department, King׳s College London, Institute of Psychiatry, UK.
authors.forename: Diana
authors.initials: D
authors.lastname: Rose
authors.affiliation: Division of Health and Wellbeing, Warwick Medical School, University of Warwick, UK.
authors.forename: Max
authors.initials: M
authors.lastname: Birchwood
authors.affiliation: Division of Psychiatry, School of Medicine, University of Manchester, Manchester, UK.
authors.forename: Max
authors.initials: M
authors.lastname: Marshall
authors.affiliation: Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK.
authors.forename: Waquas
authors.initials: W
authors.lastname: Waheed
authors.affiliation: Health Service and Population Research Department, King׳s College London, Institute of Psychiatry, UK.
authors.forename: Graham
authors.initials: G
authors.lastname: Thornicroft
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008297:Male; D011369:Professional-Patient Relations; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy*; D013406:Suicide, Attempted / Q000523:psychology*
keywords: Outcome; Schizophrenia; Therapeutic relationship