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Cited by 245Psychotherapy Techniques and ApplicationsPsychiatric care and mental health servicesPatient-Provider Communication in Healthcare

The DOI matches its Crossref record; 82 of the 82 references it cites were found in a registry or an index.

Effective nurse–patient relationships in mental health care: A systematic review of interventions to improve the therapeutic alliance

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Hartley, Samantha, Raphael, Jessica, Lovell, Karina, Berry, Katherine·2020·International Journal of Nursing Studies
DOI 10.1016/j.ijnurstu.2019.103490PMC PMC7026691
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Abstract

BACKGROUND: Therapeutic alliance is a core part of the nursing role and key to the attainment of positive outcomes for people utilising mental health care services. However, these relationships are sometimes difficult to develop and sustain, and nursing staff would arguably benefit from evidence-based support to foster more positive relationships. OBJECTIVES: We aimed to collate and critique papers reporting on interventions targeted at improving the nurse-patient therapeutic alliance in mental health care settings. DESIGN: Systematic literature review. DATA SOURCES: The online databases of Excerpta Medica database (Embase), PsycINFO, Medical Literature Analysis and Retrieval System Online (MEDLINE) and Cumulative Index of Nursing and Allied Health Literature (CINAHL) were searched, eligible full text paper references lists reviewed for additional works and a forward citation search conducted. REVIEW METHODS: Original journal articles in English language were included where they reported on interventions targeting the nurse-patient therapeutic relationship and included a measure of alliance. Data were extracted using a pre-determined extraction form and inter-rater reliability evaluations were conducted. Information pertaining to design, participants, interventions and findings was collated. The papers were subject to quality assessment. RESULTS: Relatively few eligible papers (n = 8) were identified, highlighting the limitations of the evidence base in this area. A range of interventions were tested, drawing on diverse theoretical and procedural underpinnings. Only half of the studies reported statistically significant results and were largely weak in methodological quality. CONCLUSIONS: The evidence base for methods to support nursing staff to develop and maintain good therapeutic relationships is poor, despite this being a key aspect of the nursing role and a major contributor to positive outcomes for service users. We reflect on why this might be and make specific recommendations for the development of a stronger evidence base, with the hope that this paper serves as a catalyst for a renewed research agenda into interventions that support good therapeutic relationships that serve both staff and patients.

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Metadata

Authors
Hartley, S., Raphael, J., Lovell, K., & Berry, K.
Affiliations
  • Manchester Academic Health Science Centre (GB)
  • University of Manchester (GB)
Corresponding author
Hartley, Samantha
ORCID
Venue
International Journal of Nursing Studies
Publisher
Elsevier BV
Published
2020-02
Volume
102
Pages
103490
ISSN
0020-7489 (ISSN-L)
DOI
10.1016/j.ijnurstu.2019.103490
PMC
PMC7026691
OpenAlex
W2991412702
Cited by
245
References
82
Citations by year
2026: 43 · 2025: 35 · 2024: 52 · 2023: 39 · 2022: 45 · 2021: 23 · 2020: 7
FWCI
2.96
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Nursing Studies (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (submittedVersion, other-oa)
Funders
National Institute for Health Research
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Keywords
therapeutic relationship, psychiatric nursing, nursing interventions, nurse-patient relationship, mental health services, evidence base, methodological quality
MeSH terms
Therapeutic Alliance, Humans, Mental Health Services, Nurse-Patient Relations

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