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The Therapist—Patient Relationship with Schizophrenic Patients

Published online by Cambridge University Press:  06 October 2014

F.-Michael Stark
F.-Michael Stark*
Affiliation:
University Hospital Eppendorf, Hamburg
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Abstract

Schizophrenic patients seem to react sensitively to expressed affect. Expressed emotion research has shown the negative impact of specific family communication styles on the course of illness. This paper reviews and discusses related research on the therapist–patient relationship. Two studies by the author are presented. The first study is an examination of therapist rating of the therapist–patient relationship, the interaction between therapist's ratings and patient's psychopathology, and the prediction of the course of illness from therapist ratings. The second study assesses the therapist–relative–patient triad using EE measures, as well as dyadic assessment of the therapist–patient relationship.

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Type
Special Issue: Behaviour Therapy and Schizophrenia — Part One
Information
Behaviour Change , Volume 11 , Issue 4: Special Issue: Behaviour Therapy and Schizophrenia – Part One , December 1994, pp. 234 - 241
Copyright
Copyright © The Author(s) 1994

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References

REFERENCES

Ball, R.A., Moore, E., & Kuipers, L. (1992). Expressed emotion in community care staff: A comparison of patient outcome in a nine month follow-up of two hostels. Social Psychiatry and Psychiatric Epidemiology, 27, 35–39.Google Scholar
Barrett-Lennard, G. (1962). Dimensions of therapist response as causal factors in therapeutic change. Psychological Monograph, 67, (43, Whole No.).Google Scholar
Benedetti, G. (1987). Psychotherapeutische Behandlungsmethoden [Psychotherapeutic approaches]. In Kisker, K.P. (Hg.), Psychiatrie der Gegenwart: 4. Schizophrenien (3. Auflage). Berlin: Springer.Google Scholar
Berkowitz, R., & Leff, J. (1984). Clinical teams reflect family dysfunction. Journal of Family Therapy, 6, 79–89.Google Scholar
Birchwood, M., & Cochrane, R. (1990). Families coping with schizophrenia: Coping styles, their origins and correlates. Psychological Medicine, 20, 857–865.Google Scholar
Bleuler, M. (1972). Die schizophrenen Geistesstörungen im Lichte langjähriger Kranken und Familiengeschichten [Schizophrenie disorders and long-term follow-ups of the history of the course of illness and family development]. Stuttgart: Thieme.Google Scholar
Böker, W. (1992). A call for partnership between schizophrenic patients, relatives and professionals. British Journal of Psychiatry, 18, 10–12.Google Scholar
Buchkremer, G., & Fiedler, P.A. (1987). Kognitive versus handlungsorientierte Therapie. Ein Vergleich zweier psychotherapeutischer Methoden zur Rezidivprophylaxe bei schizophrenen Patienten [Cognitive vs. action-oriented therapy: A comparison of two therapeutic approaches to reduce relapses in schizophrenic patients]. Nervenarzt, 58, 481–488.Google Scholar
Buchkremer, G., & Rath, N. (Hrsg.). (1989). Therapeutische Arbeit mit Angehörigen schizophrener Patienten. Meßinstrumente, Methoden, Konzepte. [Therapeutic approaches to families of schizophrenic patients: Instruments, methods, and concepts]. Bern: Huber Verlag.Google Scholar
Buchkremer, G., Strieker, K., Rook, A., & Schulze-Mönking, H. (1988). Der ätiologische Zusammenhang zwischen emotionaler Familienatmosphäre und Rezidivraten bei schizophrenen Patienten. [Etiology of families emotional atmosphere and relapse rates of schizophrenic patients] In Böker, F. & Weig, W. (Hrsg.) Aktuelle Kernfragen in der Psychiatrie. Berlin, Heidelberg: Springer.Google Scholar
Buchkremer, G., & Windgassen, K. (1987). Leitlinien des psychotherapeutischen Umgangs mit schizophrenen Patienten. Was ist den verschiedenen Schulen und Methoden gemeinsam? [Guidelines to therapeutic approaches with schizophrenic patients: What have different schools and methods in common?]. Psychotherapie und medizinische Psychologie, 37, 407–412.Google Scholar
Ciompi, L. (1980). Catamnestic long-term studies on the course of life of schizophrenics. Schizophrenia Bulletin, 6, 606–618.Google Scholar
Ciompi, L. (1987). Toward a coherent multi-dimensional understanding and therapy of schizophrenia. In Strauss, J.S., Böker, W., & Brenner, H.D. (Eds.), Psychosocial Treatment of Schizophrenia. Toronto: Huber.Google Scholar
Cournos, F. (1987). The impact of environmental factors on outcome in residential programs. Hospital and Community Psychiatry, 8, 848–852.Google Scholar
Falloon, I.R.H. (1988). Expressed emotion: Current status. Psychological Medicine, 18, 269–274.CrossRefGoogle ScholarPubMed
Falloon, I.R.H., Boyd, J.L., McGill, C.W., Williamson, M., Razani, J., Moss, H.B., Gildermann, A.M., & Simpson, G.M. (1985). Family management in the prevention of morbidity in schizophrenia: Clinical outcome of a two-year longitudinal study. Archives of General Psychiatry, 42, 887–896.Google Scholar
Goering, P.N., Stylianos, S.K. (1988). Exploring the helping relationship between the schizophrenic client and the rehabilitation therapist. American Journal of Orthopsychiatry, 58, 271–280.Google Scholar
Halford, W.K. (1994). Family factors in psychiatry. Current Opinion in Psychiatry, 7, 186–191.Google Scholar
Hartley, D.E. (1985). Research on the therapeutic alliance in psychotherapy. In Hales, R. & Frances, A. (Eds.), Psychiatry update. American Psychiatric Association Annual Review, Vol. 4. Washington: APA.Google Scholar
Herzog, T. (1985). Expressed Emotion auf Station: Kritische, ablehnende, emotional überinvolvierte und empathisch-wertschǎtzende Gefühlsǎußerungen von Pflegepersonen gegenüber überwiegend schizophrenen Patienten [Expressed emotion on the ward: Critical, rejecting, emotional overinvolved and epathically supportive expressed feelings of nurses towards mostly schizophrenic patients]. Unpublished diploma thesis, University of Heidelberg, Department of Psychology.Google Scholar
Hogarty, G.E., Anderson, C.M., Reiss, D.J., Kornblith, S.J., Greenwald, D.P., Ulrich, R.F., & Carter, M. (1991). Family psychoeducation, social skills training and maintenance chemotherapy in the aftercare of schizophrenia: II. Two year effects of a controlled study on relapse and adjustment: Environmental-personal indicators in the course of schizophrenia (EPICS) Research Group. Archives of General Psychiatry, 48, 340–347.Google Scholar
Hogarty, G.E., Anderson, C.M., Reiss, D.J., Kornblith, S.J., Greenwald, P., Javan, C.D., & Manonia, M.J. (1986). Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia. Archives of General Psychiatry, 43, 633–642.Google Scholar
Huber, G., Gross, G., Schüttler, R., & Linz, M. (1980). Longitudinal studies of schizophrenic patients. Schizophrenia Bulletin, 6, 592–605.Google Scholar
Kavanagh, D.J. (1992). Recent developments in expressed emotion and schizophrenia. British Journal of Psychiatry, 160, 601–620.CrossRefGoogle ScholarPubMed
Kuipers, L., & Bebbington, P. (1988). Expressed emotion research in schizophrenia: Theoretical and clinical implications. Psychological Medicine, 18, 893–909.Google Scholar
Liberman, R.P. (1982). Social factors in schizophrenia. In Greenspoon, L. (Ed.), Psychiatry Annual Review. Washington, DC: American Association of Psychiatry.Google Scholar
Liberman, R.P., Wallace, C.J., Vaughn, C.E., Snyder, K.S., & Rust, C. (1980). Social and family factors in the course of schizophrenia: Toward an interpersonal problem-solving therapy for schizophrenics and their relatives. In Strauss, J., Fleck, S., & Bowers, M.B. (Eds.), Psychotherapy of schizophrenia: Current status and new directions. New York: Plenum.Google Scholar
Lorr, M. (1965). Client perceptions of therapists: A study of therapeutic relation. Journal of Consulting Psychology, 29, 146–149.Google Scholar
Magaňa, A.B., Goldstein, M.J., Karno, M., Miklowitz, D.J., Jenkins, J., & Falloon, I.R.H. (1986). A brief method for assessing expressed emotion in relatives of psychiatric patients. Psychiatric Research, 17, 203–212.Google Scholar
Milgram, N.A. (1960). Cognitive and empathic factors in role-taking by schizophrenic and brain-damaged patients. Journal of Abnormal and Social Psychology, 60, 219–224.Google Scholar
Moore, E., Kuipers, L., & Ball, R. (1992). Staff–patient relationships in the care of the long-term adult mentally ill: A content analysis of expressed emotion interviews. Social Psychiatry and Psychiatric Epidemiology, 27, 28–34.CrossRefGoogle ScholarPubMed
Nuechterlein, K.H., & Dawson, M.E. (1984). A heuristic vulnerability/stress model of schizophrenic episodes. Schizophrenia Bulletin, 10, 300–312.Google Scholar
Nuechterlein, K.H., Dawson, M.E., Gitlin, M., Ventura, J., Goldstein, M.J., Snyder, K.S., Yee, C.M., & Mintz, J. (1992). Developmental processes in schizophrenic disorders: Longitudinal studies of vulnerability and stress. Schizophrenia Bulletin, 18, 387–426.Google Scholar
Parker, G., Hadzi-Pavlovic, D. (1990). Expressed emotion as a predictor of schizophrenic relapse: An analysis of aggregated data. Psychological Medicine, 20, 961–965.Google Scholar
Simpson, R.B. (1989). Expressed emotion and nursing the schizophrenic patient. Journal of Advances in Nursing, 14, 459–466.Google Scholar
Soldz, S. (1990). The therapeutic interaction: Research perspectives. In Wells, R.A. & Gianette, V.J. (Eds.), Handbook of the Brief Psychotherapies. New York: Plenum.Google Scholar
Stark, F.-M. (1991). Schizophrenic patients caught between family and therapists. Psychotherapia, 77, 23–28.Google Scholar
Stark, F.-M., & Buchkremer, G. (1992). Das Fünfminuteninterview. Eine Kurzfassung zur Erfassung des Expressed Emotion Status [The five-minute speech sample: A short version to assess the EE status]. Nervenarzt, 63, 42–45.Google Scholar
Stark, F.-M., Lewandowski, L., & Buchkremer, G. (1992). Therapist–patient relationship as a predictor of the course of schizophrenic illness. European Psychiatrist, 7, 161–169.Google Scholar
Stark, F.-M., Liberman, R.P., & Corrigan, P.W. (1992). Schizophrenic patients' attitudes to therapists using behavioral and holistic-humanistic techniques. Journal of Psychotherapy, Practice and Research, 1, 8–85.Google Scholar
Stark, F.-M., & Siol, T. (in press). Expressed emotion in the therapeutic relationship with schizophrenic patients. European Psychiatrist.Google Scholar
Strachan, A.M., Leff, J., Goldstein, M.J., Doane, J.A., & Burtt, C. (1986). Emotional attitudes and direct communication in the families of schizophrenics: A cross-national replication. British Journal of Psychiatry, 149, 279–287.Google Scholar
Truax, C.B. (1970). Effects of client-centered psychotherapy with schizophrenic patients: Nine years post therapy hospitalization. Journal of Consulting and Clinical Psychology, 35, 417–422.Google Scholar
Truax, C.B., & Carkhoff, R.R. (1967). Toward Effective Counselling and Psychotherapy. Chicago: Aldine.Google Scholar
Vaughan, K., Doyle, M., McConaghy, N., Blaszczynski, A., Fox, A., & Tarrier, N. (1992). The relationship between relatives' expressed emotion and schizophrenic relapse: An Australian replication. Social Psychiatry and Psychiatric Epidemiology, 27, 10–15.Google Scholar
Vaughn, C.E., & Leff, J.P. (1976). The measurement of expressed emotion in families of psychiatric patients. British Journal of Social and Clinical Psychology, 15, 157–165.Google Scholar
Vaughn, C.E., & Leff, J.P. (1981). Patterns of emotional response in relatives of schizophrenic patients. Schizophrenia Bulletin, 7(1), 43–44.Google Scholar
Venables, P.H. (1987). Cognitive and attentional disorders in the development of schizophrenia. In Haefner, H., Gattaz, W.F., & Janzarik, W. (Eds.), Search for the Causes of Schizophrenia. Berlin: Springer.Google Scholar
Whitehorn, J.C., & Betz, B.J. (1954). A study of psychotherapeutic relationships between physicians and schizophrenic patients. American Journal of Psychiatry, 3, 321–331.Google Scholar
Zimmer, D. (1983). Methodische Fragen bei der empirischen Erforschung der Therapeut-Klient-Beziehung [Methodological issues of empirical research on the therapist–client relationship]. In Zimmer, D. (Hrsg.), Die Therapeutische Beziehung. Texte zur klinischen Psychologie (S. 5–11). Weinheim: Edition Psychologie.Google Scholar
Zubin, J., & Spring, B. (1977). Vulnerability: A new view of schizophrenia. Journal of Abnormal Psychology, 86, 103–126.Google Scholar