Recovery and forensic care: Recent advances and future directions

In other medical fields, 'shared decision making' (a strategy for including patients in therapeutic decision processes) has been studied for several years now. This survey presents the potential of shared decision making for psychiatry. Literature search. Research in other medical fields shows that shared decision making positively influences patients' satisfaction as well as health outcomes. The application of shared decision making to psychiatry is still in the initial stage. Evidence that shared decision making can be successfully practiced in psychiatry would contribute to an improved inclusion of psychiatric patients in therapeutic decisions and thereby help to implement basic rights of a group of patients who have not sufficiently benefited from consumer empowerment in other medical fields.

A variety of conceptualizations of the relationship between therapist and client, as well as the impact the quality of this relationship has on the client, are reviewed. Different hypotheses about bow the alliance might influence therapeutic progress are also presented. The review pays attention to both the historical and conceptual dimensions of this issue, and provides a summary of the empirical bases of the claims made of the value of a good alliance. The article concludes with a discussion of an integrated model of the alliance and a discussion of the clinical and training implications of our current understanding of this concept.