Working Relationship, Participation and Outcome in a Psychiatric Day Care Unit Based on Occupational Therapy

Abstract

A process-outcome study was conducted in a psychiatric day care unit based on occupational therapy for long-term patients with severe mental illness. The development of the working relationship was explored. Most of the patients and staff rated the quality of the working relationship as good. The study also investigated whether working relationship and participation factors were related to outcome concerning psychiatric symptoms, global mental health, and occupational functioning. A group of patients with a positive development in working relationships from their own perspective showed greater improvement in global mental health and the habituation aspects of occupational functioning than another group with a less positive development. Patients' assessment of a better working relationship vis-à-vis the main therapist compared to the other occupational therapists was reflected in a greater improvement in global mental health and occupational functioning. There were no clear-cut linear relationships between specific levels of the working relationship and outcome. Patient participation, especially in a psychological sense, was positively related to occupational functioning. It was concluded that further investigations are needed before any general statements can be made regarding which treatment processes play a role in and have an influence on the outcome of occupational therapy.

Key Words:

• group treatment
• psychiatric day care
• therapeutic alliance
• therapeutic process