Study highlights importance of bonding between young mental health patients and nurses

The relationships between young mental health patients and the nurses looking after them is an overlooked treatment in its own right, according to new research.

The qualitative study of eight young people, eight family members and eight nursing staff by psychologists from The University of Manchester and Pennine Care NHS Foundation Trust is published in high profile journal PLOS ONE.

The professional connection between a clinician and a patient – known as a therapeutic relationship – can help improve outcomes for mental health patients say the research team.

Progress in psychotherapy and mental health care in general has previously been shown to strongly link to the therapeutic relationship between clinical professionals and service users.

However, the study highlights how nursing staff sometimes do not have the time or support to develop therapeutic relationships with their patients.

To achieve that, the researchers urge the employment of adequate staff numbers, focused training and time in cultivating connections between nursing staff and their patients.

“This research underlines the established point that therapeutic relationships between patients and staff are just as important as the specific treatment they are receiving, if not more so,” said Dr Sam Hartley, an honorary clinical lecturer at The University of Manchester and Principal Clinical Psychologist with Pennine Care NHS Foundation Trust.

The young people, all based within child and adolescent mental health services across four sites in the UK, described how their relationships with nursing staff could impact on their progress through treatment.

The researchers interviewed the participants at length, and identified six themes which described therapeutic relationships, their development and maintenance.

One of the themes was centred around the feeling that therapeutic relationships are a treatment in their own right.

Dr Harley said: “Therapeutic relationships are particularly pertinent in child and adolescent mental health inpatient services where relationships are especially complex and difficult to develop and maintain.

“Our analysis indicates that young people, families and nursing staff all agree these relationships are crucial to good outcomes. These groups would be better served by a system that prioritises the formation and maintenance of effective therapeutic relationships.

“This requires adequate staff numbers, training and time in cultivating connection and doing ‘normal’ things together.

“Consideration should also be given to aspects of the workforce that might impact on this being successful, such as staff retention, where continuity of care and relationships might be impeded.”

She added: “The balance between being human and professional is a tricky one and could benefit from ‘live’ focused staff support alongside more static training and supervision.

“We hope that the testimonies of these patients, nurses and parents, and our analysis will serve to drive policy makers, service managers and clinicians to focus on therapeutic relationships, as essential to quality inpatient care, and afford them the structures, support and significance they deserve.”

Citation: Hartley S, Redmond T, Berry K (2022) Therapeutic relationships within child and adolescent mental health inpatient services: A qualitative exploration of the experiences of young people, family members and nursing staff. PLOS ONE 17(1): e0262070. https://doi.org/10.1371/journal.pone.0262070

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