• Question: Is it better for people with mental health issues to have little influence over their treatment or would you say patient input is important for a successful treatment

    Asked by knit353sun to Robert, Olly, Nicola, Jasmin, Dennis, Caroline on 18 Jun 2019.
    • Photo: Robert Dempsey

      Robert Dempsey answered on 18 Jun 2019:


      I think it’s always better to have the person involved in their decisions about their treatments where possible, otherwise it may be difficult to engage them in the therapeutic work or treatment you’re trying to deliver. Psychological therapies especially wouldn’t work without the person being engaged – a lot of therapies require the person to think about and reflect on their behaviour, thoughts and feelings, and often there’s ‘homework’ to do between sessions. So if someone doesn’t want to engage in this work then the therapy itself isn’t likely to work. There might be other aspects to someone’s therapy, such as managing your activity levels or keeping a diary of your moods (again, if someone doesn’t want to engage in this then I think the therapeutic work won’t be effective). A lot of people I’ve worked with are good at tracking what works for them (e.g. specific medications, talking therapies) and why certain treatments have/haven’t worked for them – so it’s important to listen to their experiences and work out what is best for that person.

    • Photo: Jasmin Moon

      Jasmin Moon answered on 18 Jun 2019:


      Most mental health care plans are based around something called a ‘care programme approach’, which advocates for the service user being involved in their care and letting health professionals know what they need to help them get better.
      If health professionals know what works for that person, there is a much better chance that the treatment will work and the service user will feel listened to and supported, which is really important. You can read more about this here: https://www.rethink.org/advice-information/living-with-mental-illness/treatment-and-support/care-programme-approach-cpa/

    • Photo: Dennis Relojo-Howell

      Dennis Relojo-Howell answered on 18 Jun 2019:


      Hi knit353sun. I see psychological treatment as a collaborative process between the person and the therapist. It is important that the person is involved in this process. As what Robert and Jasmin mentioned, it will be rather difficult to do this if the person is not willing to be involved. As to the degree of the influence, I’d say that both the person and the therapist should have an equal involvement in it.

    • Photo: Caroline Brett

      Caroline Brett answered on 18 Jun 2019:


      It is definitely better for people to have a say in their treatment; if they don’t have a say then they’re less likely to engage with the treatment. This applies to psychological therapies in particular but even things like medication – if someone doesn’t believe the treatment is going to work, or had no say, then they’re less likely to take their medication as prescribed. There is a lot of research about the therapeutic alliance (I.e. the relationship between the healthcare professional and the patient) and how important this is for effective treatment; if someone has a say in their treatment then they are more likely to develop a good working relationship with a healthcare professional (either therapist, counsellor, or even a gp).

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