What Makes a Quality Therapeutic Relationship in Psychiatric/Mental Health Nursing: A Review of the Research Literature. The Internet Journal of Advanced. Bo Dinga & Outi Karvinen. Title. Building Therapeutic Relationships with Mental Health Clients in Primary Care Settings - A Literature Review. The importance of relationships in mental health care: A qualitative highlights the importance of the therapeutic relationship in providing a.
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.
Therapeutic Relationship of Nurses in Mental Health-A Review
Alcohol abuse in Russia: Laschober TC, et al. Baggio S, et al. Pathological video game use among young Swiss men: The use of monothetic and polythetic formats to distinguish between pathological, excessive and normal gaming. Maarefvand M, et al. Sexual activities in methamphetamine users: A qualitative study on a sample of Iranian methamphetamine users in Tehran.
Cultural factors, motivations and impacts on quality of life. Sprong ME, et al. Establishing the behavioral function of video game use: Development of the video game functional assessment. Causative agents of substance induced psychotic disorder amongst inpatients and outpatients of a South East Asian tertiary addictions management service. Co-curricular drug abuse treatment in a university: Lambert-Harris C, et al. A manual-guided therapy for co-occurring substance use and psychiatric disorders delivered by community addiction counselors: Are outcomes different from psychotherapy delivered by mental health professionals?
Onifade PO, et al. Koukia E, et al. Internet addiction and psychopathological symptoms in Greek university students. Davis SJ, et al. College student reactions to drug prevention messages. Yildiz F, et al. DeMuro JP, et al. Use of dexmedetomidine for the management of excited delirium in a polysubstance dependence trauma patient.
On The essence of drunkenness and the pathway to addiction: Diehl A, et al. Sexual behaviours and condom use in a sample of Brazilian crack cocaine smokers. Sumanasekera W, et al.
Nicotine in cigarette smoke: Addiction, health effects, detection methods and smoking cessation. Corcella C, et al. Geographical distribution of office based opioid treatment with buprenorphine in Ohio. Sumanasekera WK, et al. Psychoactive properties, addiction, therapeutic uses, and toxicity. Zullino D, et al. Irrationality in South African crime of possession and use of nyaope and its possible influences on the missing health oriented state interventions for nyaope addicts.
Cornelius JR, et al. A review of the literature of mirtazapine in co-occurring depression and an alcohol use disorder. Farran CJ, et al. Effect of moderate to vigorous physical activity intervention on improving dementia family caregiver physical function: A randomized controlled trial.
J Alzheimers Dis Parkinsonism. Mangezi W, et al. Mental health nursing training in Zimbabwe. The issues affecting mental health nursing in Uganda. Noh JY, et al. Perception and core competencies of disaster nursing in South Korea.
Van den Heever AE.
Psychosocial nursing students reflect on their clinical placement, South Africa. The future of nursing: Assumption of new roles and responsibilities. J Comm Pub Health Nurs. Chaya PS, Noronha R. Addressing two problems at par: Human resources for health crisis and inability to pay school fees for nursing candidates in Tanzania. Case report of elderly female.
J Gerontol Geriatr Res. Kabanya CN, et al. Socio-demographic determinants of satisfaction with training process among final year nursing students at Kenya medical training college. Ishii A, et al. Consciousness and knowledge of nursing home workers about oral malodor. J Oral Hyg Health. Yaprak A The effect of quality accreditation programs on patient safety experiences in nursing services.
J Health Educ Res Dev. Anxiety and depression in caregivers of chronic mental illness. Einhellig K, et al. Social justice in nursing education: Costa IAP, et al. Brazilian nursing technology production: Timpo P, et al. Women leaders in Oxford house. Consistency and recanting of ever-smoking status reported by self and proxy respondents one year apart.
Kulesza M, et al. Stigma among individuals with substance use disorders: Does it predict substance use, and does it diminish with treatment? Shame and sex addiction: Through a cinematic lens. Norberg MM, et al. The first mHealth app for managing cannabis use: Gauging its potential helpfulness. Dotson DG, et al. Get ready for the boom: Why rehabilitation professionals should expect to see older adults with addiction related disorders and what needs to be done to be prepared to serve them well.
Melvin AM, et al. Notable rule bending was an intervention used by experienced practitioners rather than inexperienced staff . Doing things for and with the patient; such as fetching a blanket sharing a cup of tea or taking a patient shopping  were also suggested to demonstrate support.
Mothering vulnerable patients involved a protective nurturing role and while not readily described in research literature review was believed to be extremely therapeutic in the applicable context. Support in the research literature also encompasses physical support. Physical support is manifested through the use of touch . For example Shattell et al. Importantly, the literature suggested that therapeutic touch is a skill dependent on different clinical situations and practitioners.
For instance, physical touch to provide support was often elicited in studies for depressed and vulnerable patients. Further, McAllister et al. This finding suggests that the use of physical touch to provide support is related to the individuals involved; and that touch is not a generic therapeutic relationship skill but one that requires individualized application.
How the time spent with the patient was utilized was seen as important.Mental Health Nursing: Nurse-Client Relationship
Further patients noted they appreciated the time spent listening to them . Likewise, another sample of patients noted that they would not trust a therapist who intervened too quickly and made faulty interpretations . Similarly, patients considered assistance important to strengthen the therapeutic relationship . Patients described knocking on the nursing station door only to be dismissed by staff .
In the community, Adams et al. Significantly managing time to spend an extra five or ten minutes with the patient has been reported to make all the difference to the patient . Similarly, Scanlon  found that genuineness was expressed by fulfilling stated tasks. In the pursuit of being open and honest, Shattell et al. Importantly, Forchuk et al. An important element of being open and honest is self-disclosure. Self-disclosure is also essential to therapeutic relationship development because as the relationship grows patients are reluctant to give any more information if they feel the relationship is too one sided .
In contrast, Forchuk et al. When used judiciously, power can be a prevailing tool to drive the success of the therapeutic relationship. Successful applications of power include offering expert knowledge through teaching and mentoring patients to problem solve and assume control over their lives . Power can also be used as a benevolent action to protect the patient from harm . References of power misuse include denying requests for help avoiding interactions enforcing rules in a demoralizing manner  being rude and condescending  and projecting a superior attitude .
Patients were dissatisfied when the relationship was characterised by control, leading to a deterioration of the therapeutic relationship . To promote equality in the therapeutic relationship, the substantive literature revealed the importance of acknowledging the relationship as mutually beneficial. Minimizing visibility entails such actions as making assessments an unobtrusive process that occurs in the context of ordinary conversation.
Minimizing visibility also involves being sensitive to power issues. In addition, accepting the patient with their faults and problems  is vital to convey respect; helping the patient see themselves as worthy and worthwhile .
Notably these behaviours are echoed throughout the applications of other attributes. Demonstrating clear boundaries Attributes such as understanding, being there, being genuine, and interacting in an equal partnership are maintained through boundaries. For instance, limit setting helps to shield the patient from embarrassing behaviour  and instills the patient with feelings of safety and containment .
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Accordingly, a delicate balance is required between attributes such as understanding, being there, being genuine, and practicing in an equal partnership and boundaries. Thus, the application of a range of highly developed skills is required. Similarly, Scanlon  concluded the interpersonal skills to form relationships with patients were acquired through learning about oneself. While the reviewed literature did not specify how self awareness is manifested, many studies referred to the use of clinical supervision to support therapeutic relationship development, which may foster self awareness.
For example clinical supervision was found to provide the opportunity for nurses to reflect on the relationship to improve clinical skills and to help repair difficult relationships .
Berg and Hallberg  suggested that the being aspects of the relationship are more difficult to grasp and articulate than the doing aspects. This assertion tends to explain the paucity of papers devoted to the application of self awareness in the research literature.
In addition, attributes can be self-contradictory.