Veale David, Miles Sarah, Naismith Iona, Pieta Maria, Gilbert Paul
Institute of Psychiatry, Psychology & Neuroscience, King's College London.
University of Derby, UK.
BJPsych Bull. 2016 Feb;40(1):12-9. doi: 10.1192/pb.bp.114.048736.
Aims and method The aims of the study were to develop a scale sensitive enough to measure the interpersonal processes within a therapeutic environment, and to explore whether the new scale was sensitive enough to detect differences between settings, including a community based on compassionate mind and contextual behaviourism. The Therapeutic Environment Scales (TESS) were validated with 81 participants in three different settings: a specialist service for anxiety disorders, a specialist in-patient ward and a psychodynamic therapeutic community. Results TESS was found to be reliable and valid. Significant differences were seen between the services on the dimensions of compassion, belongingness, feeling safe, positive reinforcement of members' acts of courage, extinction and accommodation of unhelpful behaviours, inconsistency and high expressed emotion. These processes were over time associated with improved outcomes on a specialist service for anxiety disorders. Clinical implications The TESS offers a first step in exploring important interpersonal relationships in therapeutic environments and communities. An environment based on a compassionate mind and contextual behaviourism offers promise for the running of a therapeutic community.
目的与方法 本研究的目的是开发一种足够敏感的量表，以测量治疗环境中的人际过程，并探讨新量表是否足够敏感，能够检测不同环境之间的差异，包括基于慈悲心和情境行为主义的社区。治疗环境量表（TESS）在三种不同环境中对81名参与者进行了验证：焦虑症专科服务机构、专科住院病房和心理动力治疗社区。结果 发现TESS可靠且有效。在同情心、归属感、安全感、对成员勇敢行为的积极强化、对无益行为的消退和包容、不一致性以及高表达情绪等维度上，不同服务机构之间存在显著差异。随着时间的推移，这些过程与焦虑症专科服务机构的改善结果相关。临床意义 TESS为探索治疗环境和社区中重要的人际关系提供了第一步。基于慈悲心和情境行为主义的环境为治疗社区的运营带来了希望。
