Case managers’ perspectives on the therapeutic alliance: a qualitative study

Abstract

The current qualitative findings suggest that current constructions and measures of the therapeutic alliance developed in psychotherapy research are not fully capturing the ways in which the unique structure and constraints of intensive case management influence relationships between workers and consumers.

Co‐morbid personality disorder in early intervention psychosis clients is associated with greater key worker emotional involvement

“…Expressed emotion in relationships between psychiatric staff and people with psychosis tends to be low, but high frequency of contacts is associated with difficulties in keeping professional distance . The EIPS model involves assertive outreach and an intense 3‐year relationship with a key worker, and we know that concerns about the development of dependency on ongoing emotional support are common during the first 9 months of a therapeutic relationship …”

“…46 The EIPS model involves assertive outreach and an intense 3-year relationship with a key worker, and we know that concerns about the development of dependency on ongoing emotional support are common during the first 9 months of a therapeutic relationship. 47 Increased key worker emotional involvement in the form of worry and tension may be understood as secondary to transference: clinicians working with clients with PD report thoughts, feelings, motivations and behaviours that reflect the client's enduring patterns of relating to others, 48,49 especially among professionals who have not received specialist training. 50 Other explanations may lie in the higher frequency of early traumatic experiences (e.g.…”

Mental Health Care Providers’ Views of Their Work with Consumers and Their Reports of Recovery-Orientation, Job Satisfaction, and Personal Growth

“…Writings on recovery also describe the detrimental impact of directive or coercive relationships between mental health providers and adults living with mental illness Farkas et al 2005). However, factors that shape the nature of professional relationships between consumers and providers working in a recovery model of service delivery are not well understood (Nath et al 2012).…”

Patients’ care dependency in mental health care: Development of a self‐report questionnaire and preliminary correlates

“…More recently, it has been suggested that the mental health care context can elicit patients’ dependency on professional treatments. For example: as a result of the identification of new psychological disorders by mental health care professionals, or the institutions that make help available on demand for 24/7, or the need of psychotherapists to be needed (e.g., Berk & Parker, ; Bressi Nath, Alexander, & Solomon, ; Bystedt, Rozental, Andersson, Boettcher, & Carlbring, ; Clemens, ; Hutschemaekers, ; Leitner et al., ; Linden, ; Tait, ).…”