A cross sectional survey examining the association between therapeutic relationships and service user satisfaction in forensic mental health settings.

Douglas Macinnes,Daniel Bressington,Dominic Beer,Helen Courtney,Tracy Flanagan

doi:10.1186/1756-0500-7-657

Abstract

BackgroundThis small-scale study examines an often neglected patient group (service users in forensic mental health settings). The research investigates their therapeutic relationship with staff and which therapeutic relationship factors are associated with their level of satisfaction with services.MethodsA cross sectional survey was undertaken in two medium secure units in the UK with seventy seven participants completing self-report measures examining service user satisfaction with services and their therapeutic relationship with staff. Multiple regression analysis was used to identify the main predictor variables associated with satisfaction with the service provided.ResultsThe respondents had a generally positive view of services and also of their therapeutic relationships with staff. However, the therapeutic relationship scores were lower than those recorded in community samples. One predictor variable was significantly associated with service user satisfaction; feeling respected and well regarded.ConclusionsThe therapeutic relationship domain of being respected and well regarded by staff was identified as the most significant factor among the therapeutic relationship domains when examining the association with satisfaction with services. The important role mental health clinicians play in enabling service users to recognize they are being treated respectfully is noted as service users judge the degree of honesty, caring and interest that staff show in them. Staff also need to be available and accessible while having good listening and information giving skills. The importance of having both positive therapeutic relationships and service user satisfaction in forensic settings is also discussed.

Highlights

IntroductionIntroduction to Psychological MeasurementNew York: McGraw-Hill; 1978. 31. Training IBMAdvanced Statistical Methods for Healthcare Research
Introduction to Psychological MeasurementNew York: McGraw-Hill; 1978. 31
The findings indicate that all three therapeutic relationship domains positively impacted upon service user satisfaction, being respected and well regarded was the most significant factor

Summary

Introduction

Introduction to Psychological MeasurementNew York: McGraw-Hill; 1978. 31. Training IBMAdvanced Statistical Methods for Healthcare Research. This small-scale study examines an often neglected patient group (service users in forensic mental health settings). The research investigates their therapeutic relationship with staff and which therapeutic relationship factors are associated with their level of satisfaction with services. The Best Practice Guidelines in Medium Secure Units [2] state the therapeutic alliance between staff and patients is at the centre of high-quality care and treatment in secure settings. In the Department of Health guide to relational security an appropriate relationship was viewed as being professional, therapeutic, and purposeful with understood limits [5] This emphasises the need for staff members within a secure setting to be aware of the nature and boundaries of any therapeutic relationship. Dissatisfaction with forensic services is often related to service user’s concerns about therapeutic relationships highlighting the importance of this relationship and its association with service satisfaction [6]

Results

Discussion

Conclusion