• To consider what constitutes effective therapeutic engagement between mental health nurses and service users
• To understand how therapeutic engagement can have a positive effect on the overall ward environment and service users’ dignity, as well as providing them with a voice regarding their care pathway
• To appreciate the value of collaborative care plans that can support service users when they become unwell
Background Effective therapeutic engagement between mental health nurses and service users is associated with enhanced service user satisfaction and clinical outcomes and reduced rehospitalisation rates, and is essential to support service users’ recovery.
Aim To measure therapeutic engagement in adult acute inpatient wards in Finland from the perspectives of service users and nurses using the Therapeutic Engagement Questionnaire (TEQ) and to identify areas where the quality of this engagement may be enhanced.
Method Nurses (n =47) and service users (n=123) from 13 acute inpatient wards in two healthcare organisations in Finland – Helsinki University Hospital (which oversees 23 hospitals in different locations) and Aurora Hospital, a municipal psychiatric hospital in Helsinki – completed the TEQ. The TEQ is designed specifically for use in acute mental health inpatient settings to objectively measure nurses’ therapeutic contribution to service users’ recovery, as perceived by both groups, and to give service users an active voice regarding their care pathway. Respondents rate a series of statements, two on a visual analogue scale and 40 on a four-point Likert scale. Higher scores indicate better therapeutic engagement. Statements with the greatest number of ‘strongly disagree’ responses indicate potential areas for improvement.
Results Both groups of respondents highly rated the effects of nursing staff and named nurses on service users’ recovery through therapeutic engagement, overall ward environment and atmosphere, preserving service users’ dignity and nurses’ professional behaviour. Low ratings were awarded by both groups to nursing staff’s and named nurses’ support with planned care risks and stepping out of their (service users’) comfort zone, and fostering service users’ confidence to create practical and realistic care plans for achieving their goals. Statements with the greatest number of ‘strongly disagree’ ratings by service users included that ‘[my named nurse] works with me to plan my care in advance of me being unwell’ and ‘[the nursing staff] help me to have control over my care plan’.
Conclusion Service users and nurses regard therapeutic engagement as important in supporting service users’ recovery. However, nurses should be supported to develop collaborative, practical and realistic care plans that support service users with planned care risks, expand their care comfort zone and incorporate advance care planning should the service user become unwell.
Mental Health Practice. doi: 10.7748/mhp.2024.e1709
Peer reviewThis article has been subject to external double-blind peer review and checked for plagiarism using automated software
Correspondence Conflict of interestThis study was supported by Helsinki University Hospital’s Department of Psychiatry. Two of the authors, Mary Chambers and Francesca Taylor, are supported by the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care
Askola R, Hottinen A, Turunen J et al (2024) Exploring therapeutic engagement in Finnish adult acute inpatient mental health settings. Mental Health Practice. doi: 10.7748/mhp.2024.e1709
AcknowledgementsThe authors are grateful to the service users and nurses who participated in the study. They would also like to thank Paula Reiterä for statistical consultation
Published online: 24 September 2024
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