Training to Enhance Psychiatrist Communication with patients with Psychosis (TEMPO): A Cluster Randomized Controlled Trial
British Journal of Psychiatry
Royal College of Psychiatrists
Reason for embargo
Background: A better therapeutic relationship predicts better outcomes. However, there is no trial based evidence on how to improve therapeutic relationships in psychosis. Aims: To test the effectiveness of communication training for psychiatrists on improving shared understanding and the therapeutic relationship. Methods: In a cluster randomized controlled trial in the U.K., 21 psychiatrists were randomized. 97 (51% of those approached) outpatients with schizophrenia/schizoaffective disorder were recruited. 64 (66% of the sample recruited at baseline) were followed up after 5 months. The intervention group received four group and one individualized session. The primary outcome, rated blind, was psychiatrist effort in establishing shared understanding, self-repair. Secondary outcome was the therapeutic relationship. Results: Psychiatrists receiving the intervention used 44% more self-repair than the control group (6.4, 95% CI 1.46 to 11.33, p<.011, a large effect) adjusting for baseline self-repair. Psychiatrists rated the therapeutic relationship more positively (0.20, 95%CI 0.03 to 0.37, p=.022, a large effect), as did patients (0.21, 95% CI 0.01 to 0.41, p=.043, a medium effect). Conclusions: Shared understanding can be successfully targeted in training and improves relationships in treating psychosis. Trial Registration: Current Controlled Trials ISRCTN94846422
National Institute for Health Research (NIHR)
This is the author accepted manuscript. The final version is available from the Royal College of Psychiatrists via the DOI in this record.
Published online 21 July 2016