Role of therapeutic relationship within mental health nursing

Research is a significant component of the educational process and is essential for current and future professional nursing practice (Tingen, 2009). To describe what nursing research is, Tingen (2009) uses a definition by Polit and Beck (2006, p4) who describe it as a:

‘Systematic inquiry designed to develop knowledge about issues of importance to nurses, including nursing practice, nursing education and nursing administration.’

Without research, nurses would not be able to practice evidence based care, the importance of which is stated within the Code of Conduct (Nursing and Midwifery Council 2008). According to Haynes and Haines (1998) evidence based practice aims to integrate current best evidence from research with clinical policy and practice.

It is important to critically evaluate any research study to establish the significance and worth of each individual publication (Hek, 1996). For the purpose of this assignment I will use a universal critical appraisal tool that can be used to evaluate any type of research, which can be located in Appendix 1. It has been adapted and devised using appraisal tools from Hawker et al (2002) and the Critical Appraisal Skills Programme (CASP) (Public Health Resource Unit, 2007).

Background

I have chosen to review the topic of therapeutic relationships within the field of mental health nursing. I feel this is a vital component in the nursing role, and something every mental health nurse should be skilled in. Literature states that the therapeutic relationship is a central element of care through which many aspects of mental health nursing is carried out (Priebe and McCabe, 2006).

Search strategy

My question is ‘what role does the therapeutic relationship have within mental health nursing?’ I carried out my literature search using the Cinahl database. Although there are a variety of database choices, Cinahl produced ample results so other database searches were not required. Table 1 summarises my literature search results.

Table 1: literature search strategy

database name

key words/phrases used

database headings used

search limits (inclusions/exclusions)

no. results

Cinahl

(Search was conducted on 1st April 2011)

‘therapeutic relationship’ and ‘mental health’

None

Primary research

English language

Peer reviewed

64

‘Therapeutic relationship’ and ‘psychiatric’

None

Primary research

English language

Peer reviewed

68

I searched the terms ‘mental health’ and ‘psychiatric’ separately but in conjunction with the words ‘therapeutic relationship’ to ensure a more in-depth search as both terms are used interchangeably within literature. The three papers I have selected to review are Johansson and Eklund (2003), Scanlon (2006) and Forchuk et al. (2005). They were chosen so that both qualitative and quantitative research is included and that differing perspectives on the therapeutic relationship were researched. A summary of the relevant information from each article can be found in a critical appraisal grid in Appendix 2. Elements of the summary will be referred to in the following discussion.

Critical Review:

Research aims

Any research paper should make clear the purpose of the study being reported so that the reader can establish whether or not it is relevant to them (Couchman and Dawson, 1990). It is suggested that an abstract or summary is a good way to give a brief overview of the content of the paper (Couchman and Dawson, 1990). Greenhalgh (2010) recommends that the introductory sentence of a research paper should state the background to the research. All three highlighted papers clearly set out their aims and give background information as to the importance of their study and why it has been chosen. The Forchuk et al. (2005) study aims to replicate a successful pilot study conducted several years earlier, but seemingly on a larger scale.

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