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

Relationship between the nursing practice environment and the therapeutic relationship in acute mental health units: A cross‐sectional study

“…In centres where nurses perceived more optimal staffing and resource adequacy, there was greater nurse-patient agreement on tasks. Indeed, one of the organizational barriers repeatedly mentioned in the literature is nurses' lack of time to establish an adequate TR in acute mental health units (Harris & Panozzo 2019;Pazargadi et al 2015;Felton et al 2018;Moreno-Poyato et al 2016). Nurses stress the lack of nursing staff and the constant increase in administrative tasks that take time away from quality relationships (Felton et al 2018;Moreno-Poyato et al 2016).…”

Barriers to recovery‐focused care within therapeutic relationships in nursing: Attitudes and perceptions

“…This situation is compounded by changes in the nursing role, with increasingly more time spent on medication administration and related assessment and documentation over the past 20 years. Nurses, such as the one quoted at the start of this paper, report that these tasks place demands on their time, consequently impacting relationship building (Harris & Panozzo, ; Perraud et al, ). It has also been identified that nurses may create a bubble around themselves to protect themselves from the stress of balancing the emotional needs of patients and other demands of practice, such as documentation and paperwork, resulting in lack of attention to the patient (Gerace et al, ).…”

“…Recent studies of therapeutic relationship between mental health professionals and consumers suggest severe behavioural manifestations on the part of consumers, such as those that create communication barriers, lead to providers rating quality of the therapeutic relationship lower than when consumers had less severe manifestations of illness (Cavelti, et al , ; Johansen et al, ). Of note, in studies in which both consumers and providers rated their shared relationships, severity of illness presentation was only a significant factor in providers' ratings; consumers' ratings did not vary in association with illness severity (Harris & Panozzo, ). It is important for nurses to be aware of the possibility that a severely ill consumer's behaviours may negatively impact their perception of the potential for relationship and detract from motivation to engage in relationship with the client.…”

“…This paper argues that the greatest barriers psychiatric nurses encounter during engagement in therapeutic relationships with consumers in acute care settings are often not the most apparent ones. While barriers such as time pressure and policy‐prescribed actions have been documented in the literature, it is argued here that nurses' lack of awareness of how their experiences and responses to these become barriers in their own right is critical (Harris & Panozzo, ; Zuaboni et al , ; Zugai, et al , ). The first quote above provides an example of how this can occur in the practice setting; phrases such as ‘tend to limit communication', ‘avoiding patients' and ‘forgetting to build alliances' suggest that nurses' perceptions of and responses to these barriers influence their priorities and appraisals of what they deem worthwhile or possible.…”

Underestimating or overestimating the power of therapeutic nurse–patient interactions

“…A search of the term therapeutic relationship forwards the idea that the relationship is about engaging with others to effect beneficial change. Harris and Panozzo (2018) warn that any phenomena which is difficult to empirically evaluate is studied less and a chain begins: fewer study results in less generation of knowledge for practice and the therapeutic potential of the intervention becomes diminished or even lost. Also while the therapeutic relationship is alive in theory, in reality, it may be weighted down with attributes that are difficult to define and operationalize; qualities such as being genuine, promoting equality, or demonstrating respect (Browne et al, 2012).…”