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What Mechanisms of the Helping Relationship Promote Personal Recovery? A Critical Realist Qualitative Research

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Abstract

The helping relationship is central in mental health interventions and a good relationship is instrumental in achieving numerous outcomes, including personal recovery. However, scant research has been conducted on the mechanisms of the helping relationship that promote mental health recovery. A study was undertaken to describe these mechanisms through the lens of critical realism by crossing the views of persons in recovery with those of their service professionals. In a cross-sectional qualitative study, semi-structured interviews were conducted with 15 persons in recovery and 15 professionals providing them with health and social services in private practice or the public or community sectors. Thematic analysis was used to identify and describe different interpersonal mechanisms and their interconnections. Seven mechanisms of the helping relationship that promote recovery were identified: presence, trust, communication, emotional support, problem-focused support, influence, and transcending the professional role. Agreement was explored between the people in recovery and their professionals on 12 social support functions. Their views coincided on most, except reciprocity and the power balance in the relationship. Some themes run counter to the traditional role of the professional and highlight both the balance that professionals must strike between maintaining a professional distance and disclosing parts of their personal life and on the role of influence and reciprocity. Results present an interdisciplinary model of the helping relationship that transcends the framework of psychotherapy without excluding it. Also, these relational components might serve to operationalize the recovery-oriented helping relationship.

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Notes

  1. The PHQ-9 measures severity of depressive symptoms. It comprises nine items rated from 0 to 3 yielding a total score of 0 to 27. A score of 20 or over indicates a severe level (Hayes & Roberge, 2015). The GAD-7 measures severity of anxiety symptoms. It comprises seven items rated from 0 to 3 yielding a total score of 0 to 21. A score of 15 or over indicates a severe level (Hayes & Roberge, 2015).

  2. Only results concerning professionals are reported in this article.

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  1. Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada

    François Lauzier-Jobin & Janie Houle

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  1. François Lauzier-Jobin
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Lauzier-Jobin, F., Houle, J. What Mechanisms of the Helping Relationship Promote Personal Recovery? A Critical Realist Qualitative Research. J. Psychosoc. Rehabil. Ment. Health 11, 67–82 (2024). https://doi.org/10.1007/s40737-022-00324-1

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