Staff and patient perspectives on unmet need and therapeutic alliance in community mental health services.

摘要

BACKGROUND: Therapeutic alliance between clinicians and their patients is important in community mental healthcare. It is unclear whether providing effective interventions influences therapeutic alliance. AIMS: To assess the impact of meeting previously unmet mental health needs on the therapeutic alliance between patients and clinicians. METHOD: Secondary analysis of data from a longitudinal study assessing 101 patients and paired staff. RESULTS: Patient-rated unmet need was negatively associated with patient-rated and staff-rated therapeutic alliance. Staff-rated unmet need was positively associated with patient-rated therapeutic alliance only. Reducing patient-rated unmet need increased patient-rated but not staff-rated therapeutic alliance, even when controlling for other variables. Reducing staff-rated unmet need increased staff-rated but not patient-rated therapeutic alliance, but the effect became insignificant when controlling for other variables. CONCLUSIONS: Patient-rated therapeutic alliancewill be maximised by focusing assessment and interventions on patient-rated rather than staff-rated unmet need.