Effective Interaction With Patients With Schizophrenia: Qualitative Evaluation of the Interaction Skills Training Programme

Abstract

PURPOSE. The purpose of this study was to describe experiences of caregivers with the Interaction Skills Training Programme, and to evaluate the training effects observed by caregivers. DESIGN AND METHODS. A qualitative research design was applied. Semistructured interviews were conducted with 17 caregivers who had followed the training program. FINDINGS. The research findings clearly confirm the value of the program. Positive effects of the training were reported in terms of: (a) awareness and insightfulness; (b) the attitude of caregivers; (c) the quality of the therapeutic alliance; and (d) job perception. PRACTICE IMPLICATIONS. Training interactive skills may contribute to a better quality of care for chronic psychiatric patients. Based on the qualitative study, implementation of the skills training program can be recommended.

Therapeutic Alliance in Mental Health Nursing: An Evolutionary Concept Analysis

“…Consumers who are highly psychologically ill are emotionally exhausting to manage on a day-to-day basis, and these consumers are often resistive to close interactions (Pulido, Monari, & Rossi, 2008). Education, training and support assists nurses to overcome these challenges, enhancing capac-ity for therapeutic interaction (Koekkoek et al, 2012;Surtees, 2007;Thurston, 2003;van Meijel et al, 2009). Education and training enhances nursing skills, knowledge, awareness, insight and attitudes, leading to an improved ability to establish and maintain a therapeutic alliance (Brown & Wissow, 2012;Byrne & Deane, 2011;Dickinson & Hurley, 2011;Hewitt & Coffey, 2005;O'Baugh et al, 2009;Ramjan, 2004;Simpson, 1999;van Meijel et al, 2009;Westwood & Kendal, 2012).…”

“…Throughout the literature, certain qualities and characteristics of interactions and relationships are emphasised as necessary for a therapeutic alliance; qualities such as: rapport, understanding, a non-judgemental attitude, friendliness, compassion, acceptance, trust, respect, empathy, honesty, warmth and hope, are frequently cited components of a therapeutic alliance or an effective nursing relationship (Anderson & Funnell, 2008;Bennett, 2012;Brown & Wissow, 2012;Callery & Milnes, 2012;Cravener, 1992;Doherty, 2009Doherty, , 2010Gardner, 2010;Hewitt & Coffey, 2005;Hosking, 1993;Hostick & McClelland, 2002;Madden, 1990;Shattell et al, 2007;Spiers & Wood, 2010). Relationships rich in these characteristics are foundational to facilitating therapeutic change (Anderson & Funnell, 2008;Hosking, 1993), and a nurse's awareness and mastery of the mechanisms of therapeutic interaction is necessary (Hewitt & Coffey, 2005;Hosking, 1993;van Meijel et al, 2009). Effective communication skills, where the nurse exercises sensitivity and consideration towards the consumer are also necessary for a therapeutic alliance (Anderson & Funnell, 2008;Brown & Wissow, 2012;Callery & Milnes, 2012;Conway, 1998;Madden, 1990;O'Baugh, Wilkes, Sneesby, & George, 2009;Shanley & Jubb-Shanley, 2007;Shattell et al, 2007;Spiers & Wood, 2010), even in the presence of a language barrier (Cravener, 1992).…”

“…A cohesive and supportive team approach enhances the capacity of nurses to establish and continue a therapeutic alliance (Pulido et al, 2008;Radcliffe et al, 2012;Surtees, 2007;Thurston, 2003;van Meijel et al, 2009). Effective communication and collaboration within a care team enhances the delivery and process of care, which enables nurses to better effect therapeutic alliances (Hostick & McClelland, 2002;Pulido et al, 2008;Thurston, 2003;van Meijel et al, 2009).…”

“…Not only will the consumer need to possess the capacity for a therapeutic alliance, the nurse must also be a willing and capable partner in the relationship. The nurse must be committed to the establishment of a therapeutic alliance, and possess the interpersonal finesse, attitudes and awareness required for the development of a therapeutic alliance (Anderson & Funnell, 2008;Gardner, 2010;Shanley & Jubb-Shanley, 2007;van Meijel et al, 2009). …”

“…As part of a partnership with the consumer, a nurse focusses on consumer needs and preferences (Anderson & Funnell, 2008;Conway, 1998;Spiers & Wood, 2010); is understanding, flexible and considerate of consumer strengths and weaknesses (Spiers & Wood, 2010;Thurston, 2003;van Meijel et al, 2009); and will not confine care within the limits of a standardised approach or prescribed schedule. The consumer focus is essential, as a fundamental goal of a nursing therapeutic alliance involves assisting the consumer to develop and work towards, an individualised concept of wellbeing (Dubyna & Quinn, 1996;Madden, 1990;Spiers & Wood, 2010); consumers must possess their own idealised concept of wellbeing to work towards and maintain.…”