Staff expressed emotion and causal attributions for client problems on a low security unit: an exploratory study

Area of Science:

• Psychiatry
• Clinical Psychology
• Mental Health Nursing

Background:

• Assessing formal caregiver-patient relationships in severe mental illness is complex.
• Understanding staff-patient dynamics is crucial for effective inpatient care.
• Previous research often focuses on familial caregivers, leaving gaps in understanding professional relationships.

Purpose of the Study:

• To explore measures of staff-patient relationships in a low-security inpatient setting for severe mental illness.
• To investigate expressed emotion (EE), attributions, and subjective feelings within staff-patient dyads.
• To examine the correlation between staff-patient relationship quality and subsequent patient behavior.

Main Methods:

• Exploratory study involving 20 staff members and their designated patients.
• Utilized Camberwell Family Interview (CFI) for expressed emotion (EE) assessment.
• Assessed spontaneous attributions and self-report measures of staff and patient feelings/thoughts.

Main Results:

• No staff met criteria for high EE, but variability in relationship quality was observed via self-report.
• Patient perceptions of staff feelings significantly correlated with staff EE and self-report measures.
• Staff attributing patient behaviors to controllable factors were more critical, and these patients showed more behavioral disturbances.

Conclusions:

• Patient perceptions are sensitive indicators of staff feelings in severe mental illness care.
• Attributional styles of staff influence their attitudes and potentially predict patient behavioral outcomes.
• Further research is needed to refine the assessment of formal caregiver-patient relationships.