title: The relevance of professionals' attachment style, expectations and job attitudes for therapeutic relationships with young people who experience psychosis.
abstract: BACKGROUND
  Therapeutic relationships are a central component of community treatment for psychosis and thought to influence clinical and social outcomes, yet there is limited research regarding the potential influence of professional characteristics on positive therapeutic relationships in community care. It was hypothesised that professionals' relating style and attitudes toward their work might be important, and thus this exploratory study modelled associations between these characteristics and therapeutic relationships developed in community psychosis treatment.
  
  
  METHODS
  Dyads of professionals and young patients with psychosis rated their therapeutic relationships with each other. Professionals also completed measures of attachment style, therapeutic optimism, outcome expectancy, and job attitudes regarding working with psychosis.
  
  
  RESULTS
  Professionals' anxious attachment predicted less positive professional therapeutic relationship ratings. In exploratory directed path analysis, data also supported indirect effects, whereby anxious professional attachment predicts less positive therapeutic relationships through reduced professional therapeutic optimism and less positive job attitudes.
  
  
  CONCLUSIONS
  Professional anxious attachment style is directly associated with the therapeutic relationship in psychosis, and indirectly associated through therapeutic optimism and job attitudes. Thus, intervening in professional characteristics could offer an opportunity to limit the impact of insecure attachment on therapeutic relationships in psychosis.
authors.affiliation: University of Sussex and Sussex Partnership NHS Foundation Trust, UK. Electronic address: c.berry@sussex.ac.uk.
authors.forename: C
authors.initials: C
authors.lastname: Berry
authors.affiliation: University of Sussex and Sussex Partnership NHS Foundation Trust, UK.
authors.forename: K
authors.initials: K
authors.lastname: Greenwood
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003156:Community Mental Health Services; D005260:Female; D006801:Humans; D008297:Male; D009769:Object Attachment; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy*; D055815:Young Adult
keywords: Psychometry and assessments in psychiatry; Psychotherapy; Quality of care; Schizophrenia and psychosis; Social and cross-cultural psychiatry