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Trust, deals and authority. Community mental health professionals' experiences of influencing reluctant patients

Trust, deals and authority. Community mental health professionals' experiences of influencing reluctant patients
Trust, deals and authority. Community mental health professionals' experiences of influencing reluctant patients
The emphasis on care in the community in current mental health policy poses challenges for community mental health professionals with responsibility for patients who do not wish to receive services. Previous studies report that professionals employ a range of behaviors to influence reluctant patients. We investigated professionals' own conceptualizations of such influencing behaviors through focus groups with community teams in England. Participants perceived that good, trusting relationships are a prerequisite to the negotiation of reciprocal agreements that, in turn, lead to patient-centred care. They described that although asserting professional authority sometimes is necessary, it can be a potential threat to relationships. Balancing potentially conflicting processes-one based on reciprocity and the other on authority-represents a challenge in clinical practice. By providing descriptive accounts of micro-level dynamics of clinical encounters, our analysis shows how the authoritative aspect of the professional role has the potential to undermine therapeutic interactions with reluctant patients. We argue that such micro-level analyses are necessary to enhance our understanding of how patient-centered mental health policy may be implemented through clinical practice
0010-3853
886-895
Rugkåsa, J.
aba777de-90dd-4474-a810-152e447bc8c3
Canvin, K.
b972afd2-1dd9-4fb4-ac79-2e39eb393237
Sinclair, J.
be3e54d5-c6da-4950-b0ba-3cb8cdcab13c
Sulman, A.
d5bceb02-9107-4faa-9faa-f162cf24ddc9
Burns, T.
f570817b-410b-491a-a4d1-ed943149ef6b
Rugkåsa, J.
aba777de-90dd-4474-a810-152e447bc8c3
Canvin, K.
b972afd2-1dd9-4fb4-ac79-2e39eb393237
Sinclair, J.
be3e54d5-c6da-4950-b0ba-3cb8cdcab13c
Sulman, A.
d5bceb02-9107-4faa-9faa-f162cf24ddc9
Burns, T.
f570817b-410b-491a-a4d1-ed943149ef6b

Rugkåsa, J., Canvin, K., Sinclair, J., Sulman, A. and Burns, T. (2014) Trust, deals and authority. Community mental health professionals' experiences of influencing reluctant patients. Community Mental Health Journal, 50 (8), 886-895. (doi:10.1007/s10597-014-9720-0). (PMID:24664366)

Record type: Article

Abstract

The emphasis on care in the community in current mental health policy poses challenges for community mental health professionals with responsibility for patients who do not wish to receive services. Previous studies report that professionals employ a range of behaviors to influence reluctant patients. We investigated professionals' own conceptualizations of such influencing behaviors through focus groups with community teams in England. Participants perceived that good, trusting relationships are a prerequisite to the negotiation of reciprocal agreements that, in turn, lead to patient-centred care. They described that although asserting professional authority sometimes is necessary, it can be a potential threat to relationships. Balancing potentially conflicting processes-one based on reciprocity and the other on authority-represents a challenge in clinical practice. By providing descriptive accounts of micro-level dynamics of clinical encounters, our analysis shows how the authoritative aspect of the professional role has the potential to undermine therapeutic interactions with reluctant patients. We argue that such micro-level analyses are necessary to enhance our understanding of how patient-centered mental health policy may be implemented through clinical practice

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Published date: November 2014
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 372256
URI: http://eprints.soton.ac.uk/id/eprint/372256
ISSN: 0010-3853
PURE UUID: a673425c-2628-4033-91ae-7c0d5d25c8fa
ORCID for J. Sinclair: ORCID iD orcid.org/0000-0002-1905-2025

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Date deposited: 04 Dec 2014 14:26
Last modified: 31 Jul 2019 00:49

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Contributors

Author: J. Rugkåsa
Author: K. Canvin
Author: J. Sinclair ORCID iD
Author: A. Sulman
Author: T. Burns

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