title: Perceptions Among Psychiatric Staff of Creating a Therapeutic Alliance With Patients on Community Treatment Orders.
abstract: A therapeutic alliance with a continuing collaboration between a patient and psychiatric staff is a resource for helping patients cope with the demands of coercive legislation. Knowledge exists describing coercion in inpatient care while the knowledge regarding the perceptions of creating a therapeutic alliance with patients on Community Treatment Orders (CTO) among psychiatric staff is scarce. To describe perceptions among psychiatric staff of creating a therapeutic alliance with patients on CTOs, an exploratory design using a phenomenographic method was employed. Thirteen semi-structured audio-taped interviews were conducted with psychiatric staff responsible for patients on CTOs. The staff worked in five different outpatient clinics and the interviews were conducted at their workplaces. The analysis resulted in in four metaphors: the persevering psychiatric staff, the learning psychiatric staff, the participating psychiatric staff, and the motivating psychiatric staff. Patients on CTOs were more time-consuming for psychiatric staff in care and treatment. Long-term planning is required in which the creation of a therapeutic alliance entails the patient gradually gaining greater self-awareness and wanting to visit the outpatient clinic. The professional-patient relationship is essential and if a therapeutic alliance is not created, the patient's continued care and treatment in the community is vulnerable.
authors.affiliation: a Jönköping University , School of Health and Welfare , Jönköping , Sweden.|b Linkoping University , Psychiatry Section, Department of Medical and Health Sciences , Linkoping , Sweden.
authors.forename: Susanne
authors.initials: S
authors.lastname: Jansson
authors.affiliation: a Jönköping University , School of Health and Welfare , Jönköping , Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Fridlund
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D001291:Attitude of Health Personnel; D003068:Coercion; D003156:Community Mental Health Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010551:Personality; D024382:Professional Role; D011369:Professional-Patient Relations; D013548:Sweden