Sarita A Sanches1, Jooske T van Busschbach1, Harry W C Michon1, Jaap van Weeghel1, Wilma E Swildens1. 1. Ms. Sanches and Dr. van Weeghel are with the School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands. Ms. Sanches is also with Altrecht Mental Health Care, Utrecht, the Netherlands, where Dr. Swildens is affiliated. Dr. van Weeghel is also with the Parnassia Group, Dijk en Duin, the Netherlands. Dr. van Busschbach is with the Rob Giel Research Center, University Center of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands, and with the University of Applied Sciences Windesheim, Zwolle, the Netherlands. Dr. Michon is with the Department of Long-Term Care and Reintegration, Trimbos Institute, Utrecht.
Abstract
OBJECTIVE: A key aspect of psychiatric rehabilitation is supporting individuals with serious mental illness in reaching personal goals. This study aimed to investigate whether various aspects of the working alliance predict successful goal attainment and whether goal attainment improves subjective quality of life, independent of the rehabilitation approach used. METHODS: Secondary analyses were conducted of data from a Dutch randomized clinical trial on goal attainment by individuals supported with the Boston University approach to psychiatric rehabilitation (N=80) or a generic approach (N=76). Working alliance was measured with the Working Alliance Inventory (WAI) from the practitioner's perspective. Rehabilitation practitioners had backgrounds in social work, nursing, or vocational rehabilitation. Multiple logistic regression and multiple regression analyses explored effects of working alliance on goal attainment and of goal attainment on subjective quality of life at 24 months. Analyses were controlled for client- and process-related predictors, baseline quality of life, and rehabilitation approach. RESULTS: The WAI goal subscale predicted goal attainment at 24 months. No effect was found for the bond or task subscale. Goal attainment significantly predicted quality of life at 24 months. These effects were independent of the rehabilitation approach used. CONCLUSIONS: A good bond between client and practitioner is not enough to attain successful rehabilitation outcomes. Findings suggest that it is important to discuss clients' wishes and ambitions and form an agreement on goals. Attaining rehabilitation goals directly influenced the subjective quality of life of individuals with serious mental illness, which underscores the importance of investing in these forms of client support.
RCT Entities:
OBJECTIVE: A key aspect of psychiatric rehabilitation is supporting individuals with serious mental illness in reaching personal goals. This study aimed to investigate whether various aspects of the working alliance predict successful goal attainment and whether goal attainment improves subjective quality of life, independent of the rehabilitation approach used. METHODS: Secondary analyses were conducted of data from a Dutch randomized clinical trial on goal attainment by individuals supported with the Boston University approach to psychiatric rehabilitation (N=80) or a generic approach (N=76). Working alliance was measured with the Working Alliance Inventory (WAI) from the practitioner's perspective. Rehabilitation practitioners had backgrounds in social work, nursing, or vocational rehabilitation. Multiple logistic regression and multiple regression analyses explored effects of working alliance on goal attainment and of goal attainment on subjective quality of life at 24 months. Analyses were controlled for client- and process-related predictors, baseline quality of life, and rehabilitation approach. RESULTS: The WAI goal subscale predicted goal attainment at 24 months. No effect was found for the bond or task subscale. Goal attainment significantly predicted quality of life at 24 months. These effects were independent of the rehabilitation approach used. CONCLUSIONS: A good bond between client and practitioner is not enough to attain successful rehabilitation outcomes. Findings suggest that it is important to discuss clients' wishes and ambitions and form an agreement on goals. Attaining rehabilitation goals directly influenced the subjective quality of life of individuals with serious mental illness, which underscores the importance of investing in these forms of client support.
Entities:
Keywords:
Community mental health services; Rehabilitation/psychosocial; Schizoaffective disorders; Schizophrenia; Staff relationships/roles
Authors: Pauline Boeckxstaens; Annelou Meskens; Aline Van der Poorten; Anne-Catherine Verpoort; Elizabeth Ann Sturgiss Journal: BMJ Open Date: 2020-02-05 Impact factor: 2.692
Authors: Martin Lambert; Pedro Sanchez; Paul Bergmans; Srihari Gopal; Maju Mathews; Annette Wooller; Katalin Pungor Journal: Neuropsychiatr Dis Treat Date: 2020-12-23 Impact factor: 2.570
Authors: Sarita A Sanches; Wilma E Swildens; Barbara Schaefer; Mirjam Moerbeek; Talitha L Feenstra; Antoinette D I van Asselt; Unna N Danner; Jaap van Weeghel; Jooske T van Busschbach Journal: Front Psychiatry Date: 2020-09-23 Impact factor: 4.157