Rosemarie McCabe

Bio: Rosemarie McCabe is an academic researcher from University of Exeter. The author has contributed to research in topics: Mental health & Therapeutic relationship. The author has an hindex of 36, co-authored 71 publications receiving 3744 citations. Previous affiliations of Rosemarie McCabe include Memorial Hospital of South Bend & Centre for Mental Health.

The Therapeutic Relationship in the Treatment of Severe Mental Illness: A Review of Methods and Findings:

Abstract: Aims: To review the methods and findings from studies of the therapeutic relationship (TR) in the treatment of severe mental illness.Method: A literature search was conducted to identify all studies that used an operationalised measurement of the TR in the treatment of severe mental illness. Results: Fifteen scales–the majority of which were developed for psychotherapy–and the expressed emotion index have been used. Most scales have acceptable internal, inter-rater and test–retest reliability. As none of the scales has been used in more than five studies, no single scale is widely established in psychiatric research. A more positive relationship consistently predicts a better short-and long-term outcome. It appears that a large global factor accounts for the greatest proportion of the variance in the therapeutic relationship.Conclusions: The therapeutic relationship is a reliable predictor of patient outcome in mainstream psychiatric care. Valid assessments may need to take account of different, specific ...

Explanatory models of illness in schizophrenia: comparison of four ethnic groups

Abstract: Background Explanatory models of illness may differ between ethnic groups and influence treatment satisfaction and compliance. Aims To compare explanatory models among people with schizophrenia from four cultural backgrounds and explore their relationship with clinical and psychological characteristics. Method Explanatory models, insight, treatment compliance, health locus of control, quality of life, treatment satisfaction, therapeutic relationships and symptomatology were assessed in UK Whites and Bangladeshis, African–Caribbeans and West Africans. Results When biological and supernatural causes of illness were compared, Whites cited biological causes more frequently than the three non-White groups, who cited supernatural causes more frequently. When biological and social causes were compared, Whites cited biological causes more frequently than African–Caribbeans and Bangladeshis, who cited social causes more frequently. A biological explanatory model was related to enhanced treatment satisfaction and therapeutic relationships but not treatment compliance. Conclusions Explanatory models of illness contribute to patient satisfaction with treatment and relationships with clinicians.

A new scale to assess the therapeutic relationship in community mental health care: STAR

Abstract: Background. No instrument has been developed specifically for assessing the clinician-patient therapeutic relationship (TR) in community psychiatry. This study aimed to develop a measure of the TR with clinician and patient versions using psychometric principles for test construction. Method. A four-stage prospective study was undertaken, comprising qualitative semi-structured interviews about TRs with clinicians and patients and their assessment of nine established scales for their applicability to community care, administering an amalgamated scale of more than 100 items, followed by Principal Components Analysis (PCA) of these ratings for preliminary scale construction. test-retest reliability of the scale and administering the scale in a new sample to confirm its factorial structure. The sample consisted of patients with severe mental illness and a designated key worker in the care of 17 community mental health teams in England and Sweden. Results. New items not covered by established scales were identified, including clinician helpfulness in accessing services, patient aggression and family interference. The new patient (STAR-P) and clinician scales (STAR-C) each have 12 items comprising three subscales: positive collaboration and positive clinician input in both versions, non-supportive clinician input in the patient version, and emotional difficulties in the clinician version. Test-retest reliability was r = 0(.)76 for STAR-P and r = 0(.)68 for STAR-C. The factorial structure of the new scale was confirmed with a good fit. Conclusions. STAR is a specifically developed, brief scale to assess TRs in community psychiatry with good psychometric properties and is suitable for use in research and routine care. (Less)

Engagement of patients with psychosis in the consultation: conversation analytic study.

Abstract: Objective: To investigate how doctors engage with patients with psychotic illness in routine consultations. Design: Conversation analysis of 32 consultations between psychiatrists and patients with schizophrenia or schizoaffective disorder. Setting: Two psychiatric outpatient clinics in east London and south west London. Participants: 7 psychiatrists and 32 patients with schizophrenia or schizoaffective disorder. Main outcome measure: Mutual engagement in communication during the consultation. Results: Patients actively attempted to talk about the content of their psychotic symptoms in consultations by asking direct questions, repeating their questions and utterances, and producing these utterances in the concluding part of the consultation. In response, doctors hesitated, responded with a question rather than with an answer, and smiled or laughed (when informal carers were present), indicating that they were reluctant to engage with patients9 concerns about their psychotic symptoms. Conclusions: Patients repeatedly attempted to talk about the content of their psychotic symptoms, which was a source of noticeable interactional tension and difficulty. Addressing patients9 concerns about their illness may lead to a more satisfactory outcome of the consultation and improve engagement of such patients in the health services.

Structured patient–clinician communication and 1-year outcome in community mental healthcare: Cluster randomised controlled trial

Abstract: Background Patient-clinician communication is central to mental healthcare but neglected in research. Aims To testa new computer-mediated intervention structuring patient-clinician dialogue (DIALOG) focusing on patients' quality of life and needs for care. Method In a cluster randomised controlled trial, 134 key workers in six countries were allocated to DIALOG or treatment as usual; 507 people with schizophrenia or related disorders were included. Every 2 months for I year, clinicians asked patients to rate satisfaction with quality of life and treatment, and request additional or different support. Responses were fed back immediately in screen displays, compared with previous ratings and discussed. Primary outcome was subjective quality of life, and secondary outcomes were unmet needs and treatment satisfaction. Results Of 507 patients, 56 were lost to follow-up and 451 were included in intention-to-treat analyses. Patients receiving the DIALOG intervention had better subjective quality of life, fewer unmet needs and higher treatment satisfaction after 12 months. Conclusions Structuring patient clinician dialogue to focus on patients' views positively influenced quality of life, needs for care and treatment satisfaction.

打磨Using Language,倡导新理念

Abstract: 人教版高中英语新课程教材中,语言运用（Using Language）是每个单元必不可少的部分,提供了围绕单元中心话题的听、说、读、写的综合性练习,是单元中心话题的延续和升华.如何设计Using Language部分的教学,使自己的教学模式既不落俗套,又能真正体现新课程标准所倡导的教学理念,正是广大一线英语教师一直努力探索的问题.

The alliance in adult psychotherapy: A meta-analytic synthesis.

Abstract: The alliance continues to be one of the most investigated variables related to success in psychotherapy irrespective of theoretical orientation. We define and illustrate the alliance (also conceptualized as therapeutic alliance, helping alliance, or working alliance) and then present a meta-analysis of 295 independent studies that covered more than 30,000 patients (published between 1978 and 2017) for face-to-face and Internet-based psychotherapy. The relation of the alliance and treatment outcome was investigated using a three-level meta-analysis with random-effects restricted maximum-likelihood estimators. The overall alliance-outcome association for face-to-face psychotherapy was r = .278 (95% confidence intervals [.256, .299], p < .0001; equivalent of d = .579). There was heterogeneity among the effect sizes, and 2% of the 295 effect sizes indicated negative correlations. The correlation for Internet-based psychotherapy was approximately the same (viz., r = .275, k = 23). These results confirm the robustness of the positive relation between the alliance and outcome. This relation remains consistent across assessor perspectives, alliance and outcome measures, treatment approaches, patient characteristics, and countries. The article concludes with causality considerations, research limitations, diversity considerations, and therapeutic practices. (PsycINFO Database Record (c) 2018 APA, all rights reserved).