From theory to practice: a critical review and meta-framework for operationalising person-centredness, therapeutic alliance and empathy in pharmacist-led mental health consultations
From theory to practice: a critical review and meta-framework for operationalising person-centredness, therapeutic alliance and empathy in pharmacist-led mental health consultations
Despite their expanding patient-facing roles and increased involvement in mental health services, pharmacists' interactions with clients remain largely medicines-focused. This limitation is compounded by a reported lack of pharmacists’ confidence and inadequate training in both mental health conditions and communication skills. The interrelated concepts of person-centredness, therapeutic alliance, and empathy play a pivotal role in effective mental health consultations, positive client outcomes, and high-quality care delivery. Grounded in the interpretivist and pragmaticist paradigms, this critical review of the literature enabled the development of a meta-framework that unifies this triad. The resulting model conceptualises person-centredness across three interconnected levels: the Consultation (analogous to the therapeutic alliance), the Systems (focusing on multidisciplinary collaboration and leadership), and the Intrapersonal (encompassing the practitioner's intellectual, practical, and phenomenological attributes). Functioning as an integral, unifying component across the entire model, empathy is detailed as a three-stage process at the Consultation level between pharmacist and client, involving exploration, shared understanding, and optional therapeutic action. Presented both as a conceptual model and comprehensive series of targeted recommendations, this work provides timely guidance, enabling pharmacists to deliver high-quality, holistic, and meaningful mental health care, with the aim of improving client outcomes and fostering effective interprofessional working relationships.
Anxiety, Consultation, Depression, Empathy, Framework, Mental health, Patient-centred care, Pharmacist, Professional-patient relations, Review, Therapeutic alliance
Adam, Balazs
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Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
Stevenson, Fiona
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Leydon, Geraldine
c5cdaff5-0fa1-4d38-b575-b97c2892ec40
Adam, Balazs
853e2edd-2034-4c22-b3ef-18a49f4d5537
Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
Stevenson, Fiona
5d627c01-17e9-499c-b6ef-7ccab07a4074
Leydon, Geraldine
c5cdaff5-0fa1-4d38-b575-b97c2892ec40
Adam, Balazs, Ibrahim, Kinda, Stevenson, Fiona and Leydon, Geraldine
(2025)
From theory to practice: a critical review and meta-framework for operationalising person-centredness, therapeutic alliance and empathy in pharmacist-led mental health consultations.
Research in Social and Administrative Pharmacy.
(doi:10.1016/j.sapharm.2025.12.012).
Abstract
Despite their expanding patient-facing roles and increased involvement in mental health services, pharmacists' interactions with clients remain largely medicines-focused. This limitation is compounded by a reported lack of pharmacists’ confidence and inadequate training in both mental health conditions and communication skills. The interrelated concepts of person-centredness, therapeutic alliance, and empathy play a pivotal role in effective mental health consultations, positive client outcomes, and high-quality care delivery. Grounded in the interpretivist and pragmaticist paradigms, this critical review of the literature enabled the development of a meta-framework that unifies this triad. The resulting model conceptualises person-centredness across three interconnected levels: the Consultation (analogous to the therapeutic alliance), the Systems (focusing on multidisciplinary collaboration and leadership), and the Intrapersonal (encompassing the practitioner's intellectual, practical, and phenomenological attributes). Functioning as an integral, unifying component across the entire model, empathy is detailed as a three-stage process at the Consultation level between pharmacist and client, involving exploration, shared understanding, and optional therapeutic action. Presented both as a conceptual model and comprehensive series of targeted recommendations, this work provides timely guidance, enabling pharmacists to deliver high-quality, holistic, and meaningful mental health care, with the aim of improving client outcomes and fostering effective interprofessional working relationships.
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More information
Accepted/In Press date: 19 December 2025
e-pub ahead of print date: 26 December 2025
Additional Information:
For the purpose of open access, the authors have applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.
Keywords:
Anxiety, Consultation, Depression, Empathy, Framework, Mental health, Patient-centred care, Pharmacist, Professional-patient relations, Review, Therapeutic alliance
Identifiers
Local EPrints ID: 509489
URI: http://eprints.soton.ac.uk/id/eprint/509489
ISSN: 1551-7411
PURE UUID: bfd4437a-fa7e-49d9-b156-964bb0864e01
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Date deposited: 24 Feb 2026 17:44
Last modified: 25 Feb 2026 03:10
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Author:
Balazs Adam
Author:
Fiona Stevenson
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