The relationship between therapeutic alliance and service user satisfaction in mental health inpatient wards and crisis house alternatives: a cross-sectional study.

<h4>Background</h4>Poor service user experiences are often reported on mental health inpatient wards. Crisis houses are an alternative, but evidence is limited. This paper investigates therapeutic alliances in acute wards and crisis houses, exploring how far stronger therapeutic alliance...

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Autores principales:	Angela Sweeney, Sarah Fahmy, Fiona Nolan, Nicola Morant, Zoe Fox, Brynmor Lloyd-Evans, David Osborn, Emma Burgess, Helen Gilburt, Rosemarie McCabe, Mike Slade, Sonia Johnson
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f0ee589f6d154649b845d99cf95162b6
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spelling	oai:doaj.org-article:f0ee589f6d154649b845d99cf95162b62021-11-25T06:08:52ZThe relationship between therapeutic alliance and service user satisfaction in mental health inpatient wards and crisis house alternatives: a cross-sectional study.1932-620310.1371/journal.pone.0100153https://doaj.org/article/f0ee589f6d154649b845d99cf95162b62014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/25010773/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Poor service user experiences are often reported on mental health inpatient wards. Crisis houses are an alternative, but evidence is limited. This paper investigates therapeutic alliances in acute wards and crisis houses, exploring how far stronger therapeutic alliance may underlie greater client satisfaction in crisis houses.<h4>Methods and findings</h4>Mixed methods were used. In the quantitative component, 108 crisis house and 247 acute ward service users responded to measures of satisfaction, therapeutic relationships, informal peer support, recovery and negative events experienced during the admission. Linear regressions were conducted to estimate the association between service setting and measures, and to model the factors associated with satisfaction. Qualitative interviews exploring therapeutic alliances were conducted with service users and staff in each setting and analysed thematically.<h4>Results</h4>We found that therapeutic alliances, service user satisfaction and informal peer support were greater in crisis houses than on acute wards, whilst self-rated recovery and numbers of negative events were lower. Adjusted multivariable analyses suggest that therapeutic relationships, informal peer support and negative experiences related to staff may be important factors in accounting for greater satisfaction in crisis houses. Qualitative results suggest factors that influence therapeutic alliances include service user perceptions of basic human qualities such as kindness and empathy in staff and, at service level, the extent of loss of liberty and autonomy.<h4>Conclusions and implications</h4>We found that service users experience better therapeutic relationships and higher satisfaction in crisis houses compared to acute wards, although we cannot exclude the possibility that differences in service user characteristics contribute to this. This finding provides some support for the expansion of crisis house provision. Further research is needed to investigate why acute ward service users experience a lack of compassion and humanity from ward staff and how this could be changed.Angela SweeneySarah FahmyFiona NolanNicola MorantZoe FoxBrynmor Lloyd-EvansDavid OsbornEmma BurgessHelen GilburtRosemarie McCabeMike SladeSonia JohnsonPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 7, p e100153 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Angela Sweeney Sarah Fahmy Fiona Nolan Nicola Morant Zoe Fox Brynmor Lloyd-Evans David Osborn Emma Burgess Helen Gilburt Rosemarie McCabe Mike Slade Sonia Johnson The relationship between therapeutic alliance and service user satisfaction in mental health inpatient wards and crisis house alternatives: a cross-sectional study.
description	<h4>Background</h4>Poor service user experiences are often reported on mental health inpatient wards. Crisis houses are an alternative, but evidence is limited. This paper investigates therapeutic alliances in acute wards and crisis houses, exploring how far stronger therapeutic alliance may underlie greater client satisfaction in crisis houses.<h4>Methods and findings</h4>Mixed methods were used. In the quantitative component, 108 crisis house and 247 acute ward service users responded to measures of satisfaction, therapeutic relationships, informal peer support, recovery and negative events experienced during the admission. Linear regressions were conducted to estimate the association between service setting and measures, and to model the factors associated with satisfaction. Qualitative interviews exploring therapeutic alliances were conducted with service users and staff in each setting and analysed thematically.<h4>Results</h4>We found that therapeutic alliances, service user satisfaction and informal peer support were greater in crisis houses than on acute wards, whilst self-rated recovery and numbers of negative events were lower. Adjusted multivariable analyses suggest that therapeutic relationships, informal peer support and negative experiences related to staff may be important factors in accounting for greater satisfaction in crisis houses. Qualitative results suggest factors that influence therapeutic alliances include service user perceptions of basic human qualities such as kindness and empathy in staff and, at service level, the extent of loss of liberty and autonomy.<h4>Conclusions and implications</h4>We found that service users experience better therapeutic relationships and higher satisfaction in crisis houses compared to acute wards, although we cannot exclude the possibility that differences in service user characteristics contribute to this. This finding provides some support for the expansion of crisis house provision. Further research is needed to investigate why acute ward service users experience a lack of compassion and humanity from ward staff and how this could be changed.
format	article
author	Angela Sweeney Sarah Fahmy Fiona Nolan Nicola Morant Zoe Fox Brynmor Lloyd-Evans David Osborn Emma Burgess Helen Gilburt Rosemarie McCabe Mike Slade Sonia Johnson
author_facet	Angela Sweeney Sarah Fahmy Fiona Nolan Nicola Morant Zoe Fox Brynmor Lloyd-Evans David Osborn Emma Burgess Helen Gilburt Rosemarie McCabe Mike Slade Sonia Johnson
author_sort	Angela Sweeney
title	The relationship between therapeutic alliance and service user satisfaction in mental health inpatient wards and crisis house alternatives: a cross-sectional study.
title_short	The relationship between therapeutic alliance and service user satisfaction in mental health inpatient wards and crisis house alternatives: a cross-sectional study.
title_full	The relationship between therapeutic alliance and service user satisfaction in mental health inpatient wards and crisis house alternatives: a cross-sectional study.
title_fullStr	The relationship between therapeutic alliance and service user satisfaction in mental health inpatient wards and crisis house alternatives: a cross-sectional study.
title_full_unstemmed	The relationship between therapeutic alliance and service user satisfaction in mental health inpatient wards and crisis house alternatives: a cross-sectional study.
title_sort	relationship between therapeutic alliance and service user satisfaction in mental health inpatient wards and crisis house alternatives: a cross-sectional study.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/f0ee589f6d154649b845d99cf95162b6
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The relationship between therapeutic alliance and service user satisfaction in mental health inpatient wards and crisis house alternatives: a cross-sectional study.

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