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‘Like a human being, I was an equal, I wasn't just a patient’: Service users’ perspectives on their experiences of relationships with staff in mental health services
Author(s) -
Bacha Karin,
Hanley Terry,
Winter Laura Anne
Publication year - 2020
Publication title -
psychology and psychotherapy: theory, research and practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.102
H-Index - 62
eISSN - 2044-8341
pISSN - 1476-0835
DOI - 10.1111/papt.12218
Subject(s) - superordinate goals , mental health , transformative learning , psychology , reflexivity , identity (music) , interpretative phenomenological analysis , service (business) , applied psychology , social psychology , psychotherapist , qualitative research , sociology , developmental psychology , social science , physics , economy , acoustics , economics
Objectives The quality of therapeutic relationships in psychiatric services has a significant impact upon the therapeutic outcomes for people diagnosed with a severe mental illness. As previous work has not explicitly explored service users’ in‐depth views about the emotional impact of these relationships, the objective of this work was to bring this perspective to the fore and to gain a greater understanding about which relational components can lead to psychological change. Design The project was conducted alongside a service user organization. An interview design was used to qualitatively explore service users’ experiences and perceptions of their relationships with mental health practitioners. Methods Eight individuals who had experience of the mental health system in the United Kingdom were interviewed. Interpretative phenomenological analysis was used to analyse the data. Findings Three superordinate themes emerged from the analysis. These were (1) Trying to survive: am I a person or just an object in the system? ; (2) Traumatic experiences within relationships ; and (3) Helpful and transformative relationships . Further, the key transformative components of these relationships were power , safety , and identity . Conclusions Mental health services should be more focused upon care , rather than control . The Power Safety Identity ( PSI ) model, a reflexive model based upon key relational components highlighted by participants, is proposed for services and professionals to consider their work. The components of this model are managed by mental health practitioners and can determine whether these relationships maintain, increase, or alleviate psychological distress. Practitioner points Awareness of the relational components of power , safety , and identity has the potential to help practitioners reflect upon the tensions they experience in their relationships with service users. Mental health services and professionals that are sensitive to issues related to power , safety , and identity when responding to the needs of the service users can improve how individuals perceive the quality of care provided by them. Relationships between service users and mental health practitioners can encourage recovery if they are consistent, safe, trusting, provide protective power, and mirror a positive sense of self.