Talk:Therapeutic relationship

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Patient, Client or Service User? What do you call the people that access psychology services?

Psychiatric Bulletin (2003) 27: 305-308 © 2003 The Royal College of Psychiatrists

Patient, client or service user? A survey of patient preferences of dress and address of six mental health professions

Rebecca McGuire-Snieckus Unit for Social and Community Psychiatry, St Bartholomew’s and the Royal School of Medicine, Queen Mary, University of London, William Harvey House, West Smithfield, London EC1A 7BE

Rosemarie McCabe, Senior Research Fellow Unit for Social and Community Psychiatry, Newham Centre for Mental Health,

Stefan Priebe Unit for Social and Community Psychiatry, Newham Centre for Mental Health

Declaration of interest This survey is part of a 3-year project funded by the special trustees of St Bartholomew’s Hospital, the Joint Research Board.

AIMS AND METHOD

A positive therapeutic relationship is essential to psychiatry and should take into account patients’ preferences. Preferences of 133 community care patients were surveyed regarding dress and forms of address of six professions. Participants’ sex, age, ethnicity and diagnosis were recorded.

RESULTS

Ninety-eight per cent of participants expressed a preference. While most preferred to be called ‘patients’ by general practitioners (75%) and psychiatrists (67%), there was no statistically significant difference in preference for the term ‘patient’ or ‘client’ when used by community psychiatric nurses, occupational therapists, psychologists or social workers. Participants over the age of 40 preferred the term ‘client’. Asymmetrical relationships were preferred with general practitioners and psychiatrists, evidenced by a preference to be addressed by first name (71% and 68%, respectively), to address the professional by title (81% and 80%, respectively), and the professional to be ‘smartly’ dressed (67% and 66%, respectively).

CLINICAL IMPLICATIONS

A more differentiated approach may be suggested by taking professional background and some demographic characteristics into consideration.

A CHALLENGE TO THE VERY CONCEPT OF THERAPEUTIC ALLIANCE

There is nothing here that suggests value in the alliance between the therapist and the "client" that would be better than a teacher and a student, regarding addressing matters of interpersonal concern or other specific learning task or skill. The concept completely leaves out why the mode of treatment visits in mental health is ONE (Boisvert)....maybe it's because MANY don't wish to develop such an alliance--and believe me, the therapists must sneak into this, as many would NEVER go if they knew this was the goal. There is a great deal of healing that is happening despite these alliances. Also, what is the financial cost of a typical therapeutic alliance--perhaps $50,000 to $100,000...and have you ever met someone who was DONE with a therapeutic alliance? The "Therapeutic Alliance" entry MUST be here, as it gives witness to modern day witchcraft.207.178.98.94 03:11, 22 September 2007 (UTC)[reply]

==The opening lines are confusing The alliance is not an equivalent term to the therapeutic relationship. Moreover the material in the article is based on the psychodynamic perspectives on the alliance and is not a good representation on the evolution of the concept post 1985 (e.g., Luborsky, Bordin, Horvath, Hatcher etc). How does one edit or make additions to an article 07:17, 5 January 2011 (UTC) ?Some comments ==

Most of the time we can refer to people either by their names or just by the term people. eg. The people in my care, people with depression, I saw Jack yesterday etc. It is not necessary to use the term patient, client or service user which each have connotations.

This article needs expansion. There is a really good set of references but these don't seem to have been fully utilised in expanding content. I think it is really important that we work on this one.--Vince (talk) 03:16, 26 September 2009 (UTC)[reply]

Informal coercion?

What does this mean: "Informal coercion is common, and may be unintentional on the part of the therapist.[2]" Very unclear. Also seems out of context. If it relates to the outcome research, please connect the dots. If not, let's remove.

See Involuntary treatment for a summary and some pointers into the literature on informal coercion.
Consider an exchange like: "I know how important your housing application is and I want to give you as good a reference as I can. How are you managing your anger recently, have you given any thought to your decision not to take antipsychotics, Andrew."
Of course this all gets subtle, professionals are bound by standards, and social pressures, and the truth is the truth and the way in which others use a health professionals words are often not of their choosing giving them little choice in the matter. There's also a lot of room for implication and plausible deniability. Talpedia (talk) 10:25, 28 December 2021 (UTC)[reply]