The therapeutic relationship in the context of involuntary treatment orders : the perspective of nurses and patients

Abstract

ntroduction: Involuntary treatment orders (ITO) can impact the nurse–patient ther-apeutic relationship (TR) negatively. Despite the increasing use of ITOs around theworld, few studies have explored their influence on the TR from the perspectives ofnurses and patients.Aim: To describe the TR in the context of ITOs as reported by nurses and individualsliving with a mental illness.Method: Secondary data analysis of qualitative interviews with nurses (n = 9) andpatients (n = 6) was performed using content analysis.Results: Participants described the TR as fundamentally embedded in a power im-balance amplified by the ITO, which was discussed through the conflicting roles of nurses, the legal constraints imposed on patients and nurses, the complex relationbetween the ITO and the TR, and the influence of mental healthcare settings' context.Discussion: Nurses and patients' views were opposed, questioning the authenticityof the relationship.Implications for Practice: Nurses should be aware of the patients' lack of faith in theTR to ensure that they are sensitive to patients' behaviours that may falsely suggestthat a relationship is established. Further studies should explore ways to alleviate theburden of the management of ITOs on nurses and allow for a trusting relationship tobe build.