The therapeutic relationship in the context of involuntary treatment orders: the perspective of nurses and patients

Introduction

Involuntary treatment orders (ITO) can impact the nurse-patient therapeutic relationship (TR) negatively. Despite the increasing use of ITOs around the world, few studies have explored their influence on the TR from the perspectives of nurses and patients.

Aim

To describe the TR in the context of ITOs as reported by nurses and individuals living with a mental illness.

Method

Secondary data analysis of qualitative interviews with nurses (n=9) and patients (n=6) was performed using content analysis.

Results

Participants described the TR as fundamentally embedded in a power imbalance amplified by the ITO, which was discussed through the conflicting roles of nurses, the legal constraints imposed on patients and nurses, the complex relation between the ITO and the TR, and the influence of mental health care settings’ context.

Discussion

Nurses and patients’ views were opposed, questioning the authenticity of the relationship.

Implications for Practice

Nurses should be aware of the patients’ lack of faith in the TR to ensure that they are sensitive to patients’ behaviors that may falsely suggest that a relationship is established. Further studies should explore ways to alleviate the burden of the management of ITOs on nurses and allow for a trusting relationship to be build.

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