Perceptions of schizophrenic patients and their therapists: Application of the semantic differential technique to evaluate the treatment relationship

Hayashi, Naoki; Yamashina, Mitsuru; Ishige, Naoko; Taguchi, Hisako; Igarashi, Yoshito; Hiraga, Masashi; Inoue, Yukiyo

doi:10.1016/S0010-440X(00)90048-8

« Previous Next »Comprehensive Psychiatry
Volume 41, Issue 3 , Pages 197-205, May 2000

Perceptions of schizophrenic patients and their therapists: Application of the semantic differential technique to evaluate the treatment relationship

Naoki Hayashi
- Address reprint requests to Naoki Hayashi, M.D., Ph.D., Tokyo Psychiatric Institute, 2-1-8 Kanukitazawa Setagaya-ku Tokyo,Japa, 156-8585.
- From the epartment of Psychopathology, Tokyo Psychiatric Institute, Tokyo,Japan
- Department of Psychiatry, School of Medicine, Juntendo University, Tokyo,Japan
- Department of Psychiatry Tokyo Metropolitan Matsuzawa Hospital, Tokyo,Japan
- Department of Psychiatry Tokyo Metropolitan Fuchu Hospital, Tokyo,Japan
Mitsuru Yamashina
- From the epartment of Psychopathology, Tokyo Psychiatric Institute, Tokyo,Japan
- Department of Psychiatry, School of Medicine, Juntendo University, Tokyo,Japan
- Department of Psychiatry Tokyo Metropolitan Matsuzawa Hospital, Tokyo,Japan
- Department of Psychiatry Tokyo Metropolitan Fuchu Hospital, Tokyo,Japan
Naoko Ishige
- From the epartment of Psychopathology, Tokyo Psychiatric Institute, Tokyo,Japan
- Department of Psychiatry, School of Medicine, Juntendo University, Tokyo,Japan
- Department of Psychiatry Tokyo Metropolitan Matsuzawa Hospital, Tokyo,Japan
- Department of Psychiatry Tokyo Metropolitan Fuchu Hospital, Tokyo,Japan
Hisako Taguchi
- From the epartment of Psychopathology, Tokyo Psychiatric Institute, Tokyo,Japan
- Department of Psychiatry, School of Medicine, Juntendo University, Tokyo,Japan
- Department of Psychiatry Tokyo Metropolitan Matsuzawa Hospital, Tokyo,Japan
- Department of Psychiatry Tokyo Metropolitan Fuchu Hospital, Tokyo,Japan
Yoshito Igarashi
- From the epartment of Psychopathology, Tokyo Psychiatric Institute, Tokyo,Japan
- Department of Psychiatry, School of Medicine, Juntendo University, Tokyo,Japan
- Department of Psychiatry Tokyo Metropolitan Matsuzawa Hospital, Tokyo,Japan
- Department of Psychiatry Tokyo Metropolitan Fuchu Hospital, Tokyo,Japan
Masashi Hiraga
- From the epartment of Psychopathology, Tokyo Psychiatric Institute, Tokyo,Japan
- Department of Psychiatry, School of Medicine, Juntendo University, Tokyo,Japan
- Department of Psychiatry Tokyo Metropolitan Matsuzawa Hospital, Tokyo,Japan
- Department of Psychiatry Tokyo Metropolitan Fuchu Hospital, Tokyo,Japan
Yukiyo Inoue
- From the epartment of Psychopathology, Tokyo Psychiatric Institute, Tokyo,Japan
- Department of Psychiatry, School of Medicine, Juntendo University, Tokyo,Japan
- Department of Psychiatry Tokyo Metropolitan Matsuzawa Hospital, Tokyo,Japan
- Department of Psychiatry Tokyo Metropolitan Fuchu Hospital, Tokyo,Japan

Abstract

This study is an attempt to evaluate the treatment relationship with schizophrenic patients by examining the patients' and their therapists' perceptions of themselves and each other, which are hypothesized to reflect features of the relationship. One hundred fifty-eight schizophrenic patients and 11 psychiatrists who maintained a supportive relationship with the patients as a therapist estimated their perceptions using the semantic differential (SD) technique with 17 adjective pairs. Eight composite scales with sufficient internal consistency were constructed from the estimations. The interrelationship among the perceptual elements, which was represented by correlation analysis of the composite scale scores, seemed consistent with our clinical experience. A factor-analytic study of the scales yielded 3 orthogonal factors that could be assumed to characterize the treatment relationship. The patient-therapist cooperation factor indicated the degree of trust between the two participants, supposedly the affective or relational aspect of the therapeutic alliance. The therapist passivity factor reflects the therapist's passive role-taking and the clinical stability of the patient. The patient strength factor was related to the condition-related and characterological strength of the patient. It is demonstrated that the estimations performed by patients and therapists are valid and useful for evaluation of the treatment relationship in the current status.

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