The influence of control attributions on staff-patient relationships in psychosis

Literature suggests the importance of staff-patient relationships on the outcome in psychosis, whereas research on aspects influencing these relationships is rather sparse. The aim of this study was to examine to what degree attributions of control (AC) made by staff correlated to their relationship with the patient. Further correlations between AC and staff perceptions were investigated via measures of therapeutic alliance and criticism. Five-minute speech samples of 23 members of staff were analysed for AC and results were correlated with staff measures of stress, therapeutic alliance, and criticism. Patients were asked to fill out the Positive and Negative Syndromes Scale (PANNS) and to rate their relationship with the member of staff. Bivariate correlation and partial correlation analyses revealed a negative correlation between AC and staff therapeutic alliance. This was not found for the client alliance though. Staff criticism did not significantly correlate with AC, whereas the staff’s perception of their client’s criticism did positively increase AC. Furthermore, staff stress and patient symptoms did not significantly contribute to AC. Results suggest that reducing AC may lead to improved staff-patient relationships. Additional research in this domain is needed, particularly in relation to the investigation of long-term effects of AC.