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Therapeutic relationships: their specificity in predicting outcomes for people with psychosis using clinical and vocational services

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Objective

To determine the distinctions between the client–keyworker relationship and the client–vocational worker relationship by assessing their impact on clinical outcomes and exploring the associations between the two.

Methods

As part of an international randomised controlled trial of supported employment (n = 312), client–keyworker relationship and client–vocational worker relationship were each tested against clinical and social functioning 6 months later. Associations between the two relationships over time were explored.

Results

Client–keyworker relationship predicted quality of life, while client–vocational worker relationship, as rated by the client, did not predict any clinical or social functioning outcomes. Vocational worker-rated relationship predicted reduced depression. The client–keyworker and client–vocational worker relationships were correlated, but this did not change over time.

Conclusion

The impact of the client–vocational worker is likely to be on the shared task of finding employment, rather than on clinical and social functioning. Good client–vocational worker relationships do not detract from client–keyworker relationships.

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Acknowledgments

This study was funded by a Grant from the European Union, Quality of Life and Management of Living Resources Programme (QLRT 2001-00683). Thanks to Greg McHugo for methodological advice, to Deborah R. Becker and Miles Rinaldi for training the IPS Workers, and to the IPS Workers themselves: Alison Lewis (London), Wulf Dorn and Eva Marischka (Ulm), Donato Piegari (Rimini), Bettina Bartsch and Patric Meyer (Zurich), Anne Mieke Epema, Laureen Jansen and Bea Hummel (Groningen) and Petar Karaginev (Sofia).

Conflict of interest statement

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Mental Health, St. George’s, University of London, London, UK

    Jocelyn Catty, Marsha Koletsi, Sarah White & Pascale Lissouba

  2. Department of Psychiatry II, University of Ulm, BKH Gunzburg, Günzburg, Germany

    Thomas Becker & Rana Kalkan

  3. Programma Salute Mentale, Azienda USL Rimini, Rimini, Italy

    Angelo Fioritti

  4. Psychiatric University Hospital, Zurich, Switzerland

    Christoph Lauber & Wulf Rössler

  5. Bulgarian Institute of Human Relations, Sofia, Bulgaria

    Toma Tomov

  6. University Medical Centre, Groningen, The Netherlands

    Jooske T. van Busschbach & Durk Wiersma

  7. University Department of Psychiatry, Warneford Hospital, Oxford, UK

    Tom Burns

Authors
  1. Jocelyn Catty
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  2. Marsha Koletsi
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  3. Sarah White
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  4. Thomas Becker
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  5. Angelo Fioritti
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  6. Rana Kalkan
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  7. Christoph Lauber
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  8. Pascale Lissouba
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  9. Wulf Rössler
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  10. Toma Tomov
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  11. Jooske T. van Busschbach
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  12. Durk Wiersma
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  13. Tom Burns
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Corresponding author

Correspondence to Jocelyn Catty.

Additional information

For the EQOLISE Group.

Appendix

Appendix

The EQOLISE Group

Tom Burns, Jocelyn Catty, Connie Geyer, Marsha Koletsi, Pascale Lissouba, Miles Rinaldi, Sarah White (London), Thomas Becker, Ulrike Ehiosun, Rana Kalkan, Reinhold Kilian (Ulm), Angelo Fioritti, Denise Manchisi (Rimini), Astrid Niersman, Jooske van Busschbach, Durk Wiersma (Groningen), Christoph Lauber, Wulf Rössler, Ingeborg Warnke (Zurich), Dimitar Germanov, Toma Tomov (Sofia), Adelina Comas, Claire Curran, Martin Knapp (LSE), Anita Patel (Institute of Psychiatry).

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Catty, J., Koletsi, M., White, S. et al. Therapeutic relationships: their specificity in predicting outcomes for people with psychosis using clinical and vocational services. Soc Psychiat Epidemiol 45, 1187–1193 (2010). https://doi.org/10.1007/s00127-009-0163-9

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  • DOI: https://doi.org/10.1007/s00127-009-0163-9

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