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Can the therapeutic relationship predict 18 month outcomes for individuals with psychosis?
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Farrelly, Simone, Brown, Gill, Szmukler, George, Rose, Diana, Birchwood, M. J., Marshall, Max, Waheed, Waquas and Thornicroft, Graham (2014) Can the therapeutic relationship predict 18 month outcomes for individuals with psychosis? Psychiatry Research: Neuroimaging, Volume 220 (Number 1-2). pp. 585-591. doi:10.1016/j.psychres.2014.07.032 ISSN 1872-7506.
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Official URL: http://dx.doi.org/10.1016/j.psychres.2014.07.032
Abstract
Purpose
Recent legislation and guidance in England emphasises the importance of service user choice in care planning. However, it is not obvious how best to facilitate choices in care planning, and some clinicians are concerned that service users may make ‘unwise’ decisions. This study aimed to examine mental health service users’ preferences and priorities in the event of a future mental health crisis or relapse.
Method
Thematic analysis of 221 joint crisis plans (JCP) developed by service users and their clinical team as part of the CRIMSON randomised controlled trial. Participants had a diagnosis of a psychotic disorder, at least one psychiatric admission in the past 2 years, contact with a community mental health team, and complex care needs.
Results
Two major categories of preferences were identified: first the manner in which crisis care would be delivered; and second, specific treatment interventions. Most service users requested full involvement in decisions about their care, clear and consistent treatment plans, access to familiar clinicians who knew them well, and to be treated with respect and compassion. Some service users requested hospitalisation, but the majority preferred alternatives. The most frequently preferred intervention was care by a home treatment team. Just under half made a treatment refusal, the majority being for specific medications, alternatives were offered.
Conclusions
Joint crisis planning resulted in service users making choices that were clinically reasonable. The technique employed by JCPs appeared to empower service users by engaging them in a productive dialogue with their clinicians.
| Item Type: | Journal Article | ||||||
|---|---|---|---|---|---|---|---|
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||
| Journal or Publication Title: | Psychiatry Research: Neuroimaging | ||||||
| Publisher: | Elsevier Ireland Ltd | ||||||
| ISSN: | 1872-7506 | ||||||
| Official Date: | 15 December 2014 | ||||||
| Dates: |
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| Volume: | Volume 220 | ||||||
| Number: | Number 1-2 | ||||||
| Page Range: | pp. 585-591 | ||||||
| DOI: | 10.1016/j.psychres.2014.07.032 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Restricted or Subscription Access |
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