Nursing and Psychiatric/mental Health

Introduction/ BackgroundThe establishment of a quality nurse-patient relationship is considered important in most nursing situations (1). However, in psychiatric/mental therapeutic relationship a fundamental element of mental health care (4). Indeed, the therapeutic relationship employed in mental health care has been associated with therapeutic outcomes across a range of clinical settings and patient populations (5). lronically, despite the therapeutic relationship being vital to treatment outcomes, he formation of a quality therapeutic relationship between the psychiatric/mental health nurse and patient is not an instinctive occurrence and requires great skill to be established (6).

Berg and Hallberg (7) found that caring for people with mental illness ‘demands an intensified presence, not allowing one to glide away, close the door or Just disappear’ (p. 329). The daily work demand requires psychiatric/mental health nurses have the capacity to handle continually new and unpredictable experiences (7). This endeavour is made more difficult because in some situations sychiatric/mental health nurses are faced with the paradox of providing therapeutic care in conjunction with involuntary treatment (8) and detainment (9). In short, psychiatric/mental health nurses require specialized skills in order to develop and maintain therapeutic relationships with patients. The specialized skills required by psychiatric/mental health nurses to develop therapeutic relationships are elusive (10).

Weissmark and Giacomo (11) concluded in their discussion of measuring therapeutic relationships, that although global rating methods can use items such as warmth” and “Judgementalness’ to distinguish good from poor relationships, these terms do not specify what the therapist does to establish a therapeutic relationship. As long as these interpersonal attributes remain vague, opportunities for high level practice and research will be lost. The purpose of this paper is to review the research literature in psychiatric/mental health nursing to develop a typology of the components that constitute one of the main tools of psychiatric/mental health nursing; that of the therapeutic relationship with a patient.

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