The therapeutic relationship in secondary mental health care: a conceptual review of measures


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Abstract

ObjectiveThe study aimed to determine the conceptual basis of measures of the patient–professional relationship used in routine mental health services research by reviewing their face, content and construct validity.MethodA comprehensive literature search identified measures of the relationship used in mental health services research. The conceptual basis of each identified measure was identified by a review of measures' authors assessments of face, content and construct validity plus item analysis of the measures themselves.ResultsThe search identified 15 measures. The seven developed in psychotherapy were likely to be better validated conceptually; most were based on therapeutic alliance models. Measures developed specifically for mental health services were based on a wider range of models including global assessments of the relationship.ConclusionMost of the better validated measures originate in psychotherapy, but there is limited evidence for their validity in general mental health services. Four measures are recommended.

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