Therapeutic relationships: their specificity in predicting outcomes for people with psychosis using clinical and vocational services.

Journal article

OBJECTIVE: To determine the distinctions between the client-keyworker relationship and the client-vocational worker relationship by assessing their impact on clinical outcomes and exploring the associations between the two. METHODS: As part of an international randomised controlled trial of supported employment (n = 312), client-keyworker relationship and client-vocational worker relationship were each tested against clinical and social functioning 6 months later. Associations between the two relationships over time were explored. RESULTS: Client-keyworker relationship predicted quality of life, while client-vocational worker relationship, as rated by the client, did not predict any clinical or social functioning outcomes. Vocational worker-rated relationship predicted reduced depression. The client-keyworker and client-vocational worker relationships were correlated, but this did not change over time. CONCLUSION: The impact of the client-vocational worker is likely to be on the shared task of finding employment, rather than on clinical and social functioning. Good client-vocational worker relationships do not detract from client-keyworker relationships.

Authors: Catty, J; Koletsi, M; White, S; Becker, T; Fioritti, A

• Publication status: Published
• Journal: Social psychiatry and psychiatric epidemiology
• Volume: 45
• Issue: 12
• Pages: 1187-1193
• Publication date: 2010-12-01
• DOI: 10.1007/s00127-009-0163-9
• EISSN: 1433-9285
• ISSN: 0933-7954
• Language: English
• Keywords: Psychiatric Status Rating Scales; Randomized Controlled Trials as Topic; Multicenter Studies as Topic; Adolescent; Professional-Patient Relations; Follow-Up Studies; Social Support; Rehabilitation, Vocational; Community Mental Health Services; Patient Satisfaction; Humans; International Cooperation; Psychotic Disorders; Physician-Patient Relations; Employment, Supported; Adult; Treatment Outcome; Prognosis