The therapeutic relationship in psychiatric settings

OBJECTIVE: To discuss the current climate of research on the therapeutic relationship (TR) in mainstream psychiatric settings. METHOD: Consideration of theoretical frameworks, quantitative and qualitative research methods, along with potentials for interventions. RESULTS: Most of the concepts and methods used to investigate the TR in conventional psychiatric settings have been imported from psychotherapy and, despite significant differences between the two, there is little specific research. A distinction is suggested between therapeutic relationships and patient-clinician interactions. Relationships predict outcome and may be assessed with operationalized methods. Specific communicative skills may be helpful in the treatment of particular illnesses. The feasibility and effectiveness of potential interventions in the TR have rarely been studied. CONCLUSION: Specific conceptual and methodological work is required to develop a better understanding of TRs in psychiatric settings. Further research should include intervention studies and might support a stronger emphasis on TRs in training and supervision.