What characterizes a good mental health professional in court-mandated treatment settings?: Findings from a qualitative study with older patients and mental health care professionals

BMC Psychology

Michael Liebrenz¹  Monika Egli-Alge²  Tenzin Wangmo³  Helene Seaward³  Bernice S. Elger⁴  Tobias Vogel⁵  Marc Graf⁵ 

[1]Department of Forensic Psychiatry, Institute of Forensic Medicine, University of Bern, Bern, Switzerland

[2]Forensisches Institut Ostschweiz Forio, Frauenfeld, Switzerland

[3]Institute for Biomedical Ethics, University Basel, Bernoullistrasse 28, 4056, Basel, Switzerland

[4]Institute for Biomedical Ethics, University Basel, Bernoullistrasse 28, 4056, Basel, Switzerland

[5]Center for Legal Medicine (CURML), Medical Faculty, University of Geneva, Geneva, Switzerland

[6]Psychiatric Hospital of the University of Basel, Forensic Psychiatric Hospital, Basel, Switzerland

关键词: Prison;    Offender;    Forensic;    Involuntary;    Coercion;    Court-mandated treatment;    Qualitative;    Interview;    Therapist-characteristics;    Common factors;   

DOI  :  10.1186/s40359-021-00624-4

来源: Springer

【 摘 要 】

BackgroundTherapist-related activities and characteristics such as empathy and genuineness are factors that significantly contribute to psychotherapy outcome. As they play a role in psychotherapy more generally, it can be expected that they are equally important in the treatment of court-mandated patients more specifically. At the same time, these treatment settings come with specific challenges—e.g. due to coercion and control—and it could thus be that some therapist-related characteristics might have a different empathy on the therapy. This interview study sought to investigate service providers’ and users’ perspectives on therapist-related characteristics in the context of detention.MethodsWe conducted a qualitative interview study with 41 older incarcerated persons mandated to treatment, and 63 mental health professionals (MHP). The data analysis followed thematic analysis.ResultsPatients and experts both emphasized the importance of treating patients with respect by taking a humanistic approach, that is, condemn the deeds but embrace the person and display genuine interest in supporting patients with any issue or concern that is of relevance to them. Furthermore, interviewees underscored that the coerciveness of the therapy context required to incorporate patients’ wishes into treatment planning, recognize and respond to the patients’ needs, and allow some choice within the given framework. Such inclusive attitude was deemed critical to engage and motivate patients to participate in treatment. In addition, it was emphasized that feedback and advice by the therapists need to be concrete, detailed and applied to each person’s current situation. Lastly, patients questioned MHP’s qualification when they did not progress in therapy.DiscussionOur findings indicate that some therapist-related activities and characteristics are of particular importance in court-mandated settings. These include genuine interest in the patient, a respectful and positive attitude, as well as the capacity to target sensitive issues in a directive but non-confrontational manner. Further research needs to identify specific expressions and behaviors that are linked to the aforementioned characteristics in the forensic context. Our study therefore contributes to much-needed empirical research on clinician and patient perspectives on therapist characteristics and activities in the treatment of court-mandated patients.

【 授权许可】

CC BY