Empathic approaches, open-minded conversations and other strategies can help re-build positive therapeutic relationships with patients who are being treated involuntarily, according to a study by Australian researchers in the Journal of Mental Health Nursing.
The researchers conducted interviews with twenty-five involuntary psychiatric patients about their experiences, and then looked for common themes and issues of concern.
“There is increasing evidence that an involuntary hospital admission and treatment can undermine the therapeutic relationship,” the researchers wrote. “While good relationships with staff are important factors influencing long-term recovery, there is little information on how people experience their relationships with staff while under an involuntary treatment order.”
Participants described involuntary treatment as “daunting and frightening,” and said that staff behaviors and attitudes towards them were fundamental to shaping their experiences in hospital. The patients emphasized the “importance of staff listening to their concerns” and being able to “look beyond their illness and diagnosis.” They also highlighted the “importance of having a space to make sense of their experiences” while feeling like they were “working in partnership” with their caregivers.
“These findings highlight that when using recovery principles, such as an empathic engagement with the patients’ lived experience, forging partnerships with patients in treatment decision-making to enhance agency, an involuntary treatment order does not have to limit the ability to establish positive relationships,” concluded the researchers.
Wyder, Marianne, Robert Bland, Andrew Blythe, Beth Matarasso, and David Crompton. “Therapeutic Relationships and Involuntary Treatment Orders: Service Users’ Interactions with Health-Care Professionals on the Ward.” International Journal of Mental Health Nursing, 2015, n/a – n/a. doi:10.1111/inm.12121. (Abstract)