Tools used to measure the therapeutic relationship between staff and service users in adult mental health care: A scoping review.

BACKGROUND

Therapeutic relationships are key to both service user recovery and the safety of staff and service users in adult mental health care. However, staff over-involvement (crossing professional boundaries including sexual and emotional exploitation) and under-involvement (staff disinterest, avoidance or neglect) is often a cause for concern within mental health care. Little is known about measuring and assessing over / under involvement. This scoping review provides a broad understanding of existing tools used to measure this in adult mental health care.

OBJECTIVE

To explore what measures are used, and the characteristics of the identified measures, to understand the therapeutic relationship between staff and adult service users in mental health care settings.

DESIGN

Scoping review.

SETTING(S): Adult mental health settings.

PARTICIPANTS

Service users and staff.

METHODS

This review is guided by Levac et al.'s six stage methodology of scoping review frameworks. The reporting of this review has been guided by the PRISMA-ScR.

RESULTS

Of 2863 papers found, 23 were eligible for inclusion. The papers identified 14 scales. No tool specifically measured over- or under- involvement. Finally, data indicates that scales should be specific to their intended setting as the nature of therapeutic relationships may vary by setting.

CONCLUSIONS

Definitions of therapeutic relationships and over- and under-involvement relevant to different settings are needed. There is a need to develop setting-specific scales to measure therapeutic involvement and definitions for over- and under- involvement. This would enhance care provided to service users and encourage staff members to challenge their own boundary setting practices.

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