McCabe, Rose, John, Paula, Dooley, Jemima, Healey, Patrick, Cushing, Annie, Kingdon, David, Bremner, Stephen and Priebe, Stefan (2016) Training to enhance psychiatrist communication with patients with psychosis (TEMPO): cluster randomised controlled trial. British Journal of Psychiatry, 209 (6). pp. 517-524. ISSN 1472-1465

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Abstract

Background: A better therapeutic relationship predicts better outcomes. However, there is no trial-based evidence on how to improve therapeutic relationships in psychosis.

Aims: To test the effectiveness of communication training for psychiatrists on improving shared understanding and the therapeutic relationship (trial registration: ISRCTN94846422).

Method: In a cluster randomised controlled trial in the UK, 21 psychiatrists were randomised. Ninety-seven (51% of those approached) out-patients with schizophrenia/schizoaffective disorder were recruited, and 64 (66% of the sample recruited at baseline) were followed up after 5 months. The intervention group received four group and one individualised session. The primary outcome, rated blind, was psychiatrist effort in establishing shared understanding (self-repair). Secondary outcome was the therapeutic relationship.

Results: Psychiatrists receiving the intervention used 44% more self-repair than the control group (adjusted difference in means 6.4, 95% CI 1.46–11.33, P<0.011, a large effect) adjusting for baseline self-repair. Psychiatrists rated the therapeutic relationship more positively (adjusted difference in means 0.20, 95% CI 0.03–0.37, P = 0.022, a large effect), as did patients (adjusted difference in means 0.21, 95% CI 0.01–0.41, P = 0.043, a medium effect).

Conclusions: Shared understanding can be successfully targeted in training and improves relationships in treating psychosis.

Item Type:	Article
Schools and Departments:	Brighton and Sussex Medical School > Brighton and Sussex Medical School Brighton and Sussex Medical School > Primary Care and Public Health
Depositing User:	Rosie Harvey
Date Deposited:	03 Nov 2016 09:59
Last Modified:	28 Sep 2017 09:54
URI:	http://srodev.sussex.ac.uk/id/eprint/65241

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