The therapeutic relationship in psychiatric settings.

Therapeutic alliance, relationship building, and communication strategies-for the schizophrenia population: An integrative review

Mixed Methods Studies, which combine qualitative and quantitative research methods, are widely used across disciplines. However, in health promotion, quantitative methods dominate in most cases and qualitative methods are considered as an ‘add on’. By means of a Mixed Methods Study about the living situation of young people from refugee backgrounds, aged between 11 and 21 years, in an administrative district in Germany, in which quantitative and qualitative research methods are considered coequal, the issue of Mixed Methods Studies potential in health promotion is discussed. In this study, the perspectives of the young people from refugee backgrounds, their social workers from youth welfare office and local providers have been gathered. The young people from refugee backgrounds and their social workers have been consulted with a qualitative interview, whereas the local providers have been consulted in a standardised manner. The combination of qualitative and quantitative research methods to analyse the living situation of young people from refugee backgrounds gives a holistic and comprehensive insight in social, cultural and structural frame conditions, social policy’s challenges as well as individual requirements. Such Mixed Methods Studies prove suitable for health-related research, especially when it comes to quickly changing structural conditions, a difficultly accessible target group and highly personal issues.

Purpose: This study aims to critically analyze research methods and explore the misperceptions surrounding statistical analysis. The importance of methodology cannot be overemphasized in any research. It is the heart of a study, enhances the reproducibility of a study, and is the bedrock on which the research findings can be generalizable. Methodology: The literature review form method was used to identify the strengths and weaknesses of quantitative, qualitative, and mixed research methods, including their differences and applications. Findings: Research designs, including case studies, grounded theory, ethnographies, phenomenologies, and narratives, are used in the qualitative method to comprehend relationships and behaviors. Because the quantitative research method is rooted in scientific discovery, it has become the standard in the research community. Different viewpoints exist about the required sample size, the statistical model employed for data evaluation, and the nature of the data. For this study, statistical misperceptions are categorized under descriptive statistics, design techniques, inferential statistics, and regression. A thorough explanation of statistical misperceptions under these three categories is believed to be sufficient to cover fundamental areas of statistical analysis. Certain conceptual and statistical presumptions must be satisfied for any statistical approach's findings to be considered plausible. Having a sound knowledge of fundamental areas for statistical data analysis will enhance a more plausible result in research. Originality/value: The quantitative research method entails more rigorous statistical tests than the qualitative research method. Using both research methods is referred to as a mixed research method. The biases in qualitative and quantitative methods can be surmounted by using mixed methods.

Introduction: Aggression is a professional hazard for those who are employed in the psychiatric setting. There is evidence that 52% of the nurses working in the emergency department experience physical or other violence from clients. There are not many studies conducted in India regarding the application of aggression management training in a psychiatric setting. Material and Method: A quantitative method was used for implementing a participatory training programme. There were 44 trainer group nurses and 138 trainee group nurses from psychiatric, emergency and intensive care settings. The trainer group nurses were trained by the investigator and the trainee group nurses were trained by the trainer group nurses. An interpretive exercise was developed and validated to assess the competency of the nurses on aggression management and violence prevention. There were two posttests for the trainer group nurses and there was one posttest for the trainee group nurses. Results: Among the trainer group nurses, majority (93.2%) of the nurses were non-competent during the pre-test. But all the nurses (100%) were competent during the post-test one and the post-test two. Among the trainee group nurses, majority (97.1%) of the nurses were non-competent during the pre-test and all the nurses (100%) were competent during the post-test. Majority of the key personnel (82%) opined that, their staff perform better aggression management practices after the training programme. Conclusion: An aggression management and violence prevention (AMVP) training programme based on participatory approach was found to be more effective to empower the nurses to work in psychiatric and emergency settings.

Qualitative Versus Quantitative The literature on methodology distinguishes between qualitative and quantitative research methods. The term ‘qualitative’ does not refer to the quality of methods. Qualitative methods are those that are oriented towards the discovery of qualities of things – that is, the properties of objects, phenomena, situations, people, meanings and events. In contrast, quantitative methods are oriented towards the number or amount of these qualities. This chapter discusses a number of qualitative research methods that can be used in FPS projects. For quantitative research methods, we refer the reader to textbooks on social science methodology, such as those by Cooper and Schindler (2014) and Hair et al. (2005). Imagine marketing managers who would like to know the opinions of potential customers about a television commercial. They could ask some respondents to talk freely about their feelings with regard to the commercial, their associations, what they like about it and what they do not, and so on. Such a study would be qualitative in nature, since it aims to uncover the characteristics of people, in this case their attitude towards the commercial. The same marketing manager could also use a standardized questionnaire and ask respondents to express the degree to which they understand and like the commercial on a fivepoint scale. Such a study would be quantitative in nature, since it measures the value of a particular property in numbers. Qualitative research methods are particularly appropriate for studying people, groups, organizations and societies – for example, if you want to learn how people interpret their own situation, what their goals in life and work are and what strategies they employ to reach those goals. Such understanding is needed in most business problem-solving projects. Because there can be large and multifaceted differences between people and situations, it is often not effective to employ (only) a standardized measuring instrument. Qualitative research methods are relevant within more fields than just the social sciences. The natural and technical sciences use qualitative methods as well. Hendrik Casimir, a respected physicist and long-time director of Philips Laboratories, has stated: For although it is certainly true that quantitative measurements are of great importance, it is a grave error to suppose that the whole of experimental physics can be brought under this heading.

1. Michelle Butina, PhD, MLS(ASCP)CM[⇑][1] 1. University of Kentucky, College of Health Sciences, Lexington, KY 2. Suzanne Campbell, PhD, MLS(ASCP)CM 1. Seward County Community College/Area Technical School, Liberal, KS 3. Wendy Miller, EdD, MT(ASCP)SI 1. Elgin Community College, Elgin, IL <!-- --> 1. Address for Correspondence: Michelle Butina, PhD, MLS(ASCP)CM, Assistant Professor and Program Director, Medical Laboratory Science, University of Kentucky, College of Health Sciences, 900 South Limestone Street, CTW Bldg. Rm. 126E, Lexington, KY 40536-0200, (859) 218-0852, Michelle.Butina{at}uky.edu 1. Compare and contrast qualitative and quantitative research methods and their uses. 2. Identify the five commonly used qualitative research methods. > "Within the last twenty years qualitative research has become a mature field of study with its own literature base, research journals, special interest groups, and regularly scheduled conferences". > > - Dr. Sharan B. Merriam, professor of adult education and continuing education, University of Georgia, 2009 INTRODUCTION Medical laboratory practitioners know how to perform experiments and have participated in surveys. However qualitative research and its methods remain an unknown to many in the medical laboratory science profession. This series provides readers with an introduction to qualitative research methods. A simple definition of qualitative research is not possible; therefore a description of its purpose and characteristics is provided. As Merriam (2009) described, "Qualitative researchers are interested in understanding how people interpret their experiences, how they construct their worlds, and what meaning they attribute to their experiences." The primary characteristics of qualitative research include: 1) the focus on understanding peoples' experiences with intent to convey experiences into meaning, 2) the researcher is the key instrument for data collection and analysis, 3) the research process is inductive and not deductive, and 4) the product of qualitative research is richly descriptive. Other characteristics of qualitative research include that the study design is often emergent and flexible, data is often collected in the natural setting, multiple forms of data may be collected, and sample selection is usually purposeful and small.1,2 Qualitative versus Quantitative There are three approaches to research, qualitative, quantitative and mixed methods. The qualitative research approach was introduced and described in the section above. A… 1. Compare and contrast qualitative and quantitative research methods and their uses. 2. Identify the five commonly used qualitative research methods. [1]: #corresp-1

In this study, I utilized an embodied artistic inquiry self-study to explore my experience of attachment in the therapeutic movement relationships (TMR) created as a dance/movement therapy intern at a psychiatric residential treatment center for children. The research was guided by three questions: How do I experience the TMR with children in a psychiatric residential treatment setting using attachment theory? How is my personal attachment style influencing and guiding the therapeutic relationship? How does my identification of salient moments relate to my own attachment style and aesthetic preference? Data were collected using journal entries that reflected on the researcher’s experience of attachment, saliency, and Tortora’s D.A.N.C.E. qualities of attachment (Clin Soc Work J 38(1):37–50, https://doi.org/10.1007/s10615-009-0254-9, 2010). I analyzed the data using discussion and Authentic Movement with a research consultant in order to synthesize and describe the experience of each salient moment. Repeated movements included grounded and unstable walking, changing of levels, core-distal movements, circling and carving arms, and recuperation. The themes that resulted from repeated movements and discussion with the research consultant include foundational movements, holding discomfort, connection to a specific client, and playfulness. These results reinforced the importance of stability and self-awareness for a therapist especially in relationship to how their movement and nonverbal preferences may have been learned from attachment relationships. Furthermore, results show the impact of saliency and the clinician’s aesthetic preference. In addition, the results reflected the strong relationship among nonverbal qualities of attachment and the TMR. These results suggested that qualities of attachment underlie the effectiveness of the TMR. Although limitations of the study prevented me from drawing correlative conclusions, the therapist may be able to strengthen the therapeutic relationship by targeting primary attachment models, and suggestions for further research are included.

The Strengths and Limitations of Qualitative and Quantitative Research Methods: A Systematic Review

Purpose This scoping review provides an overview of empirical studies investigating therapeutic relationships between speech-language pathologists (SLPs), clients, and caregivers across all ages and clinical areas, and identifies areas of future research. Method The Joanna Briggs Institute’s (JBI) scoping review method was employed. Systematic searches were conducted across seven databases and four grey literature databases. Research published in English and German until 3 August 2020 was included. Data were extracted for the primary aim, terminology and theoretical foundations, research design, and focus. Central findings concerning the input-, process-, outcome-, and output-level of speech-language pathology were categorised. Result Of 5479 articles, 44 articles were included in the analysis. Psychotherapy was the leading discipline for the theoretical foundation and measurement of relationship quality. Most findings focused on therapeutic attitudes, qualities, and relational actions to build the basis of a positive therapeutic relationship. A small number of studies indicated connections between clinical outcomes and the quality of the relationships. Conclusion Future research needs to address precision of terminology, expansion of qualitative and quantitative research methods, development and psychometric examination of measuring instruments specific to SLPs and the development and evaluation of concepts to support professional relationship building in speech-language pathology training and everyday work.

Mental health care is delivered through a relationship between a clinician and a patient. Although this therapeutic relationship is of central importance for mental health care, it appears to be relatively neglected in psychiatric research. Empirical research has for the most part adopted concepts and methods developed in psychotherapy and general medical practice. Hence, unpacking the presuppositions that have informed research on the therapeutic relationship to date may be a useful first step in developing this field. A review of the literature was carried out. Six central theories are identified as framing the definitions and methods on this topic: role theory, psychoanalysis, social constructionism, systems theory, social psychology and cognitive behaviourism. To date, role theory, psychoanalysis and systems theory appear to be the frameworks most often applied in research in this field. Each perspective offers a unique emphasis in the analysis of the therapeutic relationship, which is reflected in the empirical work from each perspective discussed herein. None of the theories identified have been fully specified and comprehensively investigated in psychiatric settings. However, more than one approach may be used for thinking about relationships, depending on the treatment situation. Further specification and testing of the theories in psychiatric practice--taking account of the specific context--is warranted to underpin more pragmatic research. A stronger link between fundamental psychological and sociological research and applied health care research would advance our understanding of which elements of positive therapeutic relationships are instrumental in improving patient outcome and ultimately contribute to improving mental health care.

To review the methods and findings from studies of the therapeutic relationship (TR) in the treatment of severe mental illness. A literature search was conducted to identify all studies that used an operationalised measurement of the TR in the treatment of severe mental illness. Fifteen scales--the majority of which were developed for psychotherapy--and the expressed emotion index have been used. Most scales have acceptable internal, inter-rater and test-retest reliability. As none of the scales has been used in more than five studies, no single scale is widely established in psychiatric research. A more positive relationship consistently predicts a better short- and long-term outcome. It appears that a large global factor accounts for the greatest proportion of the variance in the therapeutic relationship. The therapeutic relationship is a reliable predictor of patient outcome in mainstream psychiatric care. Valid assessments may need to take account of different, specific aspects of the relationship in psychiatric settings such as greater heterogeneity of treatment components and goals, increased variability of setting and the statutory responsibility of the clinician. Methodological progress may require conceptual work to ensure valid assessments of this central element of treatment.

Responding effectively to a patient request for physician-assisted suicide (PAS) is an important clinical skill that involves careful evaluation. Clinician responses to PAS requests, however, have only been described using data obtained from clinicians. To describe qualities of clinician-patient interactions about requests for PAS that were valued by patients and their family members. Intensive qualitative case study involving multiple longitudinal interviews conducted prospectively with patients pursuing PAS and with their family members and retrospectively with family members of deceased patients who seriously pursued PAS. The study setting was community based. Participants were recruited through patient advocacy organizations, hospices, and grief counselors. A total of 35 cases were studied: 12 were prospective and 23 were retrospective. Study procedures involved semistructured interviews that were audiotaped, transcribed, reviewed, and analyzed by a multidisciplinary research team. Three themes were identified that describe qualities of clinician-patient interactions that were valued by patients and family members: (1) openness to discussions about PAS; (2) clinician expertise in dealing with the dying process; and (3) maintenance of a therapeutic clinician-patient relationship, even when clinician and patient disagree about PAS. These patient and family accounts reveal missed opportunities for clinicians to engage in therapeutic relationships, including discussions about PAS, dying, and end-of-life care. Clinicians responding to patients requesting PAS need communication skills enabling them to discuss PAS and dying openly, as well as expertise in setting reasonable expectations, individualizing pain control, and providing accurate information about the lethal potential of medications.

Bu makalede sosyal bilimler ve kütüphanecilik alanında kullanılan nicel ve nitel araştırma yöntemleri birbiriyle karşılaştırılmakta ve nitel yöntemlerin özellikleri ayrıntılı olarak incelenmektedir. Kütüphanecilikte nitel yöntemlerin kullanılmasıyla ilgili araştırmalara kısaca değinilerek Türk kütüphaneciliğinde nicel ve nitel yöntemlerin kullanımını değerlendiren belli başlı içerik analizi çalışmaları özetlenmektedir.

The researchers of various disciplines often use qualitative and quantitative research methods and approaches for their studies. Some of these researchers like to be known as qualitative researchers; others like to be regarded as quantitative researchers. The researchers, thus, are sharply polarised; and they involve in a competition of pointing out the benefits of their own preferred methods and approaches. But, both the methods and approaches (qualitative and quantitative) have pros and cons. This study, therefore, aims to discuss the advantages and disadvantages of using qualitative and quantitative research approaches and methods in language testing and assessment research. There is a focus on ethical considerations too. The study found some strengths of using qualitative methods for language “assessment and testing” research—such as, eliciting deeper insights into designing, administering, and interpreting assessment and testing; and exploring test-takers’ behaviour, perceptions, feelings, and understanding. Some weaknesses are, for instance, smaller sample size and time consuming. Quantitative research methods, on the other hand, involve a larger sample, and do not require relatively a longer time for data collection. Some limitations are that quantitative research methods take snapshots of a phenomenon: not in-depth, and overlook test-takers’ and testers’ experiences as well as what they mean by something. Among these two research paradigms, the quantitative one is dominant in the context of language testing and assessment research.

Background: The therapeutic relationship and its importance for psychotherapy outcome have been the subject of extensive research over the last decades. An acute psychiatric inpatient setting is a unique environment where severely ill patients receive intensive treatment over a limited, relatively short, period of time. This renders establishing a good therapeutic relationship difficult for various reasons. It seems likely, however, that the therapeutic relationship in such a setting plays a vital role on factors such as clinical outcome, patient satisfaction, and rehospitalization rates. Little information is available on special attributes and caveats of building and maintaining a good therapeutic relationship in an acute psychiatric setting, neither on its influence on therapy success.Methods: An extensive systematic literature search was performed using PubMed, science direct, psyc info, and google scholar databases. Keywords used were therapeutic alliance, therapeutic relationship, psychiatry, emergency, acute, coercion, autonomy, involuntary, closed ward. RCTs, observational studies, reviews, meta-analyses, and economic evaluations were included, case reports and opinion papers were excluded. Factors specific to an acute psychiatric setting were identified, and the available information was categorized and analyzed accordingly. The PRISMA statement guidelines were followed closely upon research and preparation of the present review.Results: A total of 48 studies were selected based on their relevance as well as design. They demonstrated that several factors related to setting, patient attributes, staff attributes, admission circumstances, and general situation, render building and maintaining a good therapeutic relationship difficult in an acute psychiatric setting compared to scheduled, long-term therapeutic sessions. The available literature on how to overcome this dilemma is scarce. Interventions involving staff and/or patients have been shown to be effective in terms of relevant outcome parameters.Conclusions: Increasing research efforts, as well as raising awareness and providing specific competencies amongst clinicians and patients in terms of nurturing a good therapeutic relationship in acute settings, are necessary to improve clinical outcome, economic factors, quality of patient care and patient as well as staff satisfaction.