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Training to enhance psychiatrist communication with patients with psychosis (TEMPO): cluster randomised controlled trial

Training to enhance psychiatrist communication with patients with psychosis (TEMPO): cluster randomised controlled trial
Training to enhance psychiatrist communication with patients with psychosis (TEMPO): cluster randomised controlled trial

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 medium 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.

Adult, Communication, Female, Humans, Male, Middle Aged, Physician-Patient Relations, Psychiatry/education, Psychotic Disorders/therapy, Schizophrenia/therapy, Single-Blind Method
0007-1250
517-524
McCabe, Rose
1f208ed4-66fe-4334-84aa-394ed0da4568
John, Paula
10e3b659-5dc5-42dc-bf1b-a6f8cc0d2759
Dooley, Jemima
d5e139e5-39ed-467f-bd4c-af4edf3124b0
Healey, Patrick
524cb5d6-4d7a-4445-840b-e35368707528
Cushing, Annie
fbc2f677-609b-4795-8fd1-543d7db47ab6
Kingdon, David
14cdc422-10b4-4b2d-88ec-24fde5f4329b
Bremner, Stephen
0e117fa6-27ea-41cc-9523-70f90cd65bc0
Priebe, Stefan
bf2e6c75-7e6e-4e71-8ce3-6f53f0e36d96
McCabe, Rose
1f208ed4-66fe-4334-84aa-394ed0da4568
John, Paula
10e3b659-5dc5-42dc-bf1b-a6f8cc0d2759
Dooley, Jemima
d5e139e5-39ed-467f-bd4c-af4edf3124b0
Healey, Patrick
524cb5d6-4d7a-4445-840b-e35368707528
Cushing, Annie
fbc2f677-609b-4795-8fd1-543d7db47ab6
Kingdon, David
14cdc422-10b4-4b2d-88ec-24fde5f4329b
Bremner, Stephen
0e117fa6-27ea-41cc-9523-70f90cd65bc0
Priebe, Stefan
bf2e6c75-7e6e-4e71-8ce3-6f53f0e36d96

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. The British Journal of Psychiatry, 209 (6), 517-524. (doi:10.1192/bjp.bp.115.179499).

Record type: Article

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 medium 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.

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More information

Accepted/In Press date: 12 December 2015
Published date: 2 December 2016
Keywords: Adult, Communication, Female, Humans, Male, Middle Aged, Physician-Patient Relations, Psychiatry/education, Psychotic Disorders/therapy, Schizophrenia/therapy, Single-Blind Method

Identifiers

Local EPrints ID: 437304
URI: http://eprints.soton.ac.uk/id/eprint/437304
ISSN: 0007-1250
PURE UUID: ad7b767d-a828-4d6f-a664-e9914e492e7a

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Date deposited: 24 Jan 2020 17:30
Last modified: 08 Jan 2022 10:43

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Contributors

Author: Rose McCabe
Author: Paula John
Author: Jemima Dooley
Author: Patrick Healey
Author: Annie Cushing
Author: David Kingdon
Author: Stephen Bremner
Author: Stefan Priebe

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