title: Training to enhance psychiatrist communication with patients with psychosis (TEMPO): cluster randomised controlled trial.
abstract: A better therapeutic relationship predicts better outcomes. However, there is no trial-based evidence on how to improve therapeutic relationships in psychosis.
  
  
  
  To test the effectiveness of communication training for psychiatrists on improving shared understanding and the therapeutic relationship (trial registration: ISRCTN94846422).
  
  
  
  In a cluster randomised controlled trial in the UK, 21 psychiatrists were randomised. Ninety-seven (51% of those approached) out-patients with schizophrenia/schizoaffective disorder were recruited, and 64 (66% of the sample recruited at baseline) were followed up after 5 months. The intervention group received four group and one individualised session. The primary outcome, rated blind, was psychiatrist effort in establishing shared understanding (self-repair). Secondary outcome was the therapeutic relationship.
  
  
  
  Psychiatrists receiving the intervention used 44% more self-repair than the control group (adjusted difference in means 6.4, 95% CI 1.46-11.33, P<0.011, a large effect) adjusting for baseline self-repair. Psychiatrists rated the therapeutic relationship more positively (adjusted difference in means 0.20, 95% CI 0.03-0.37, P = 0.022, a medium effect), as did patients (adjusted difference in means 0.21, 95% CI 0.01-0.41, P = 0.043, a medium effect).
  
  
  
  Shared understanding can be successfully targeted in training and improves relationships in treating psychosis.
authors.affiliation: Rose McCabe, PhD, University of Exeter Medical School, Exeter; Paula John, Dipl-Psych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London; Jemima Dooley, BA, University of Exeter Medical School, Exeter; Patrick Healey, PhD, Cognitive Science Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London; Annie Cushing, PhD, Centre for Medical Education, Institute of Health Sciences Education, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, St Bartholomew's Hospital, London; David Kingdon, MD, Department of Psychiatry, University of Southampton, Southampton; Stephen Bremner, PhD, Stefan Priebe, FRCPsych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK r.mccabe@exeter.ac.uk.
authors.forename: Rose
authors.initials: R
authors.lastname: McCabe
authors.affiliation: Rose McCabe, PhD, University of Exeter Medical School, Exeter; Paula John, Dipl-Psych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London; Jemima Dooley, BA, University of Exeter Medical School, Exeter; Patrick Healey, PhD, Cognitive Science Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London; Annie Cushing, PhD, Centre for Medical Education, Institute of Health Sciences Education, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, St Bartholomew's Hospital, London; David Kingdon, MD, Department of Psychiatry, University of Southampton, Southampton; Stephen Bremner, PhD, Stefan Priebe, FRCPsych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Paula
authors.initials: P
authors.lastname: John
authors.affiliation: Rose McCabe, PhD, University of Exeter Medical School, Exeter; Paula John, Dipl-Psych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London; Jemima Dooley, BA, University of Exeter Medical School, Exeter; Patrick Healey, PhD, Cognitive Science Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London; Annie Cushing, PhD, Centre for Medical Education, Institute of Health Sciences Education, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, St Bartholomew's Hospital, London; David Kingdon, MD, Department of Psychiatry, University of Southampton, Southampton; Stephen Bremner, PhD, Stefan Priebe, FRCPsych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Jemima
authors.initials: J
authors.lastname: Dooley
authors.affiliation: Rose McCabe, PhD, University of Exeter Medical School, Exeter; Paula John, Dipl-Psych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London; Jemima Dooley, BA, University of Exeter Medical School, Exeter; Patrick Healey, PhD, Cognitive Science Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London; Annie Cushing, PhD, Centre for Medical Education, Institute of Health Sciences Education, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, St Bartholomew's Hospital, London; David Kingdon, MD, Department of Psychiatry, University of Southampton, Southampton; Stephen Bremner, PhD, Stefan Priebe, FRCPsych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Patrick
authors.initials: P
authors.lastname: Healey
authors.affiliation: Rose McCabe, PhD, University of Exeter Medical School, Exeter; Paula John, Dipl-Psych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London; Jemima Dooley, BA, University of Exeter Medical School, Exeter; Patrick Healey, PhD, Cognitive Science Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London; Annie Cushing, PhD, Centre for Medical Education, Institute of Health Sciences Education, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, St Bartholomew's Hospital, London; David Kingdon, MD, Department of Psychiatry, University of Southampton, Southampton; Stephen Bremner, PhD, Stefan Priebe, FRCPsych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Annie
authors.initials: A
authors.lastname: Cushing
authors.affiliation: Rose McCabe, PhD, University of Exeter Medical School, Exeter; Paula John, Dipl-Psych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London; Jemima Dooley, BA, University of Exeter Medical School, Exeter; Patrick Healey, PhD, Cognitive Science Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London; Annie Cushing, PhD, Centre for Medical Education, Institute of Health Sciences Education, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, St Bartholomew's Hospital, London; David Kingdon, MD, Department of Psychiatry, University of Southampton, Southampton; Stephen Bremner, PhD, Stefan Priebe, FRCPsych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Kingdon
authors.affiliation: Rose McCabe, PhD, University of Exeter Medical School, Exeter; Paula John, Dipl-Psych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London; Jemima Dooley, BA, University of Exeter Medical School, Exeter; Patrick Healey, PhD, Cognitive Science Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London; Annie Cushing, PhD, Centre for Medical Education, Institute of Health Sciences Education, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, St Bartholomew's Hospital, London; David Kingdon, MD, Department of Psychiatry, University of Southampton, Southampton; Stephen Bremner, PhD, Stefan Priebe, FRCPsych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Bremner
authors.affiliation: Rose McCabe, PhD, University of Exeter Medical School, Exeter; Paula John, Dipl-Psych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London; Jemima Dooley, BA, University of Exeter Medical School, Exeter; Patrick Healey, PhD, Cognitive Science Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London; Annie Cushing, PhD, Centre for Medical Education, Institute of Health Sciences Education, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, St Bartholomew's Hospital, London; David Kingdon, MD, Department of Psychiatry, University of Southampton, Southampton; Stephen Bremner, PhD, Stefan Priebe, FRCPsych, Newham Centre for Mental Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
authors.forename: Stefan
authors.initials: S
authors.lastname: Priebe
mesh_terms: D000328:Adult; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D011570:Psychiatry / Q000193:education*; D011618:Psychotic Disorders / Q000628:therapy*; D012559:Schizophrenia / Q000628:therapy*; D016037:Single-Blind Method