Enhancing the Therapeutic Relationship Between Mental Health Case Managers and Individuals With Serious Mental Health Conditions: A Participatory Action Research Study in Community-Based Services.
Martí Subías-Miquel, Ana Ventosa Ruiz, Sara Sánchez-Balcells and 4 others
PMID 41951554WHAT IT FOUND
Mental health case managers described changes in building therapeutic relationships: choosing patient-selected places, using tone of voice, and planning gradual discharge.
Patients valued individualization, empathy and honesty. No patient outcomes were measured.
Key findings
01Case managers reported holding first visits near the patient, such as in the neighbourhood or home, and using active listening, respect, presence and empathy to build an initial bond.
02In support visits with a third party, they used tone of voice and physical proximity to mediate and encourage engagement.
03At discharge, they chose comfortable spaces, reviewed achieved objectives, set limits, and recommended telematic support for gradual disengagement.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
It was conducted in one region of Spain, so transferability to other services is limited. Participants were case managers, not patients, and the study did not measure patient outcomes. The findings were reported for all case managers together, not separately for occupational therapists. The brochure redesign and reflective supervision groups were implemented within a broader participatory process, so the contribution of any single component cannot be separated. The study relied on self-reported reflective diaries and focus groups, and some case managers dropped out because of organizational changes.
Declared interests
Funding came from three Spanish grants: the Official College of Nurses of Barcelona, Parc Sanitari SJD and SJD Foundation, and the Institute of Health Research Marqués de Valdecilla. The declared grant amounts were €3300, €5000 and €4000.
The easy way to misread this
Do not read the reported improvements in awareness, confidence or practice as evidence that patients' mental health or recovery improved. The study involved case managers and did not measure patient outcomes.