Zur Bedeutung der therapeutischen Beziehung in der Behandlung von Patienten mit hoher Inanspruchnahme psychiatrischer Versorgungsleistungen - Eine längsschnittliche Untersuchung
Objective: The therapeutic relationship (TP) between patient and therapist is the process variable, which has most frequently been studied in psychotherapy research. Its effect on treatment outcome has sufficiently been proven. Less known is the concept as research subject in the psychiatry, especially in the long-term treatment of high utilisers of psychiatric services. Methods: The aim of the present paper is to evaluate the course of TP from the perspective of high utilisers and whether certain predictors influence its development. Furthermore, it was tested whether the TP and symptom severity have an indirect, mediating effect between social relationships and quality of life. In addition, it is analysed whether different classes of TP can be found and whether class membership can be predicted by certain person characteristics. These questions are analysed via latent growth curve modelling and latent class analysis. Results: Data from 491 high utilisers are included. The intercept of the latent growth curve of the TP shows a high mean with significant interindividual variance. The slope growths significantly over time, no interindividual variance was found. Number of admissions during the last two years, educational degree, living situation and diagnosis are significant predictors for the intercept; number of admissions during last two years and work situation are significant predictors for the slope. When examining the latent growth curve mediator model, some significant direct effects are found, only one partial model effect is determined. Four different classes of the TP are identified, nationality, diagnosis and living situation predicted class membership. Discussion: It can be assumed that high utilisers with a high frequency in change of treatment settings are able to form a long-term and stable, TP to their clinician which positively develops over time. The findings are discussed against the background of a patient-oriented treatment.
Subject HeadingsInteraktion [GND]
Professional-patient relation [MeSH]
Psychotic disorders [MeSH]