Preorientation, Orientation, Working and Terminating Phases Learn with flashcards, This phase is the final, integral phase of the nurse-patient relationship. The concept of therapeutic interpersonal relationships is not confined to any specific . Satisfaction of over 3, patients was assessed pre- and . The definition of acute care for this review included medical, surgical, . Therapeutic working relationships with people with schizophrenia: literature review. Therapeutic relationship in psychiatric nursing. and emotionally” DEFINITION OF THERAPEUTIC NURSE PATIENT RELATIONSHIP; 5. Preinteraction/ Preorientation phase • Get available information about the patient.
Methods Integrative review process An integrative review is a research strategy involving the review, synthesis, and critique of extant literature.
In addition, the reference lists of potential papers retrieved were examined to identify any further material that met the inclusion criteria. Both versions of British and American spellings were used to construct the search strategy as to reflect a systematic and comprehensive approach. The concept of therapeutic interpersonal relationships is not confined to any specific time period or type of peer-reviewed publication, and so no limitations were placed on these parameters to ensure a broad and diverse scope of knowledge.
Papers that focused on pediatrics and adolescence were also excluded as this review focused on adult patient—staff interaction. In addition, papers involving student cohorts were also excluded as were papers that reported solely on satisfaction surveys.
Data evaluation The search strategy initially identified papers after removal of duplicates Figure 1. The authors RK and KW independently identified 37 potential papers for inclusion based on titles and abstracts.
The authors RK, KW, and JD independently appraised the 37 identified papers based on the inclusion and exclusion criteria. Disagreements that arose were resolved by debate and consensus. Thirty studies were subsequently excluded, leaving a total of seven. They based their analysis on the first four sessions of short-term therapy and focused their attention on the third pattern, in that this appeared to be correlated with the best therapeutic outcomes.
In further studies of this development pattern, Stiles et al. Unlike Kivlighan and Shaughnessy, these authors considered therapies consisting of 8 and 16 sessions, using the ARM to rate the therapeutic bond, partnership, and confidence, disclosure, and patient initiative.
No significant correlation was observed between any of the four patterns and the therapeutic outcome. However, the authors observed a cycle of therapeutic alliance rupture—repair events in all cases: On the basis of this characteristic, the authors hypothesize that the V-shaped alliance patterns may be correlated with positive outcomes.
In particular, Stiles et al.
The results of the study by De Roten et al. According to De Roten et al. De Roten et al. According to Castonguay et al.Therapeutic Relationships in Nursing: The Client and Nurse Perspective (Part 2)
This has supported the idea that therapeutic alliance may be characterized by a variable pattern over the course of treatment, and led to the establishment of a number of research projects to study this phenomenon. Discussion and Conclusion According to their meta-analysis based on the results of 24 studies, Horvath and Symonds demonstrate the existence of a moderate but reliable association between good therapeutic alliance and positive therapeutic outcome.
More recent meta-analyses of studies examining the linkage between alliance and outcomes in both adult and youth psychotherapy Martin et al. Thus, it is not by chance that in their meta-analysis, Horvath and Luborsky conclude that two main aspects of the alliance were measured by several scales regardless of the theoretical frameworks and the therapeutic models: This accounts for the difficulties associated with the concept of alliance, which is built interactively, and so any assessment must also consider the mutual influence of the participants.
In a helpful contribution, Hentschel points out that the problematic aspect of empirical studies investigating the alliance is their tendency to view the alliance construct as a treatment strategy and a predictor of therapeutic outcome: The use of neutral observers or the creation of counterintuitive studies is therefore recommended.
From this historical excursus, it is clear that research into the assessment of the psychotherapeutic process is alive and well. The development of a dynamic vision of the concept of therapeutic alliance is also apparent. The work of theorists and researchers has contributed toward enriching the definition of therapeutic alliance, first formulated in Research aimed at analyzing the components that make up the alliance continues to flourish and develop.
Numerous rating scales have been designed to analyses and measure the therapeutic alliance, scales that have enabled us to gain a better understanding of the various aspects of the alliance and observe it from different perspectives: Attention has recently turned toward the role of the therapeutic alliance in the various phases of therapy and the relationship between alliance and outcome. So far, few studies have regarded long-term psychotherapy involving many counseling sessions.
This topic, along with a more detailed examination of the relationship between the psychological disorder being treated and the therapeutic alliance, will be the subject of future research projects. Equally important, in our opinion, will be the findings of studies regarding drop-out and therapeutic alliance ruptures, which must necessarily consider the differences between that perceived by the patient and that perceived by the therapist.
Conflict of Interest Statement The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Acknowledgments The authors thank Mauro Adenzato for his valuable comments and suggestions to an earlier version of this article. A Research Handbook, eds Greenberg L. Guilford Press;— Bibring E.
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