- Psychiatrist−patient shared understanding has been associated with improved therapeutic relationships in the treatment of psychosis. At the time of publication, this was the first study to assess an intervention for psychiatrists aimed at enhancing their communication with patients with psychosis.
- Twenty-one psychiatrists were randomized to receive a 4-week communication training or no training. The primary endpoint was “self-repair,” a characteristic of speech that is indicative of engagement with the patient and of efforts on the speaker’s part to establish shared understanding with the patient.
- Assessment approximately 5 months after the intervention showed significant improvements in the number of self-repairs per 1000 words (adjusted mean difference 6.4 self-repairs per 1000 words, P < 0.011 vs control group), psychiatrists’ self-confidence about communicating with patients with psychosis (mean increase of 1.7 points on 0–10 scale, P < 0.01), and the quality of the therapeutic relationship, as assessed by participating psychiatrists (mean difference of 0.20 points on the Scale To Assess Therapeutic Relationship [STAR], P = 0.022) and patients (mean difference: 0.21, P = 0.043).
- The authors concluded that shared understanding is important for improving the therapeutic relationship in the treatment of psychosis and can be targeted in training.
The following is a summary of McCabe R, John P, Dooley J, et al. Training to enhance psychiatrist communication with patients with psychosis (TEMPO): cluster randomised trial. Brit J Psychiatry. 2016; 209: 517–24, which was developed independently of the article authors. Background A better doctor−patient relationship predicts better outcomes in the management of psychosis; yet,…