Patients' care dependency in mental health care: Development of a self-report questionnaire and preliminary correlates

Naline Geurtzen, Ger P J Keijsers, Johan C Karremans, Giel J M Hutschemaekers

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVES: Patients' dependency on the therapist or treatment has received little empirical attention. To examine care dependency, we aimed to develop a theory-driven questionnaire based on three hypothetical dimensions (passive-submissive dependency; active-emotional dependency; and lack of perceived alternatives) and to provide a preliminary exploration of several correlates of care dependency.

METHOD: Care dependency, perceived social support, therapeutic alliance, remoralization, and symptom severity were measured in a large cross-sectional sample of 742 outpatients with various psychiatric disorders. Test-retest reliability was established in a smaller patient sample.

RESULTS: Findings indicated a reliable questionnaire measuring three unidimensional subscales of care dependency (i.e., submissive dependency, need for contact, and lack of perceived alternatives; α's .74, .81, and .86 respectively; rt1,t2 's .78, .76, and .80, respectively). These subscales were all positively correlated with each other and with patients' self-proclaimed care dependency, but divergent from patients' trait dependency and symptoms of a dependent personality disorder. Moreover, higher levels of care dependency were correlated with lower levels of remoralization and more symptoms severity, and with a better therapeutic alliance.

CONCLUSIONS: A reliable and valid questionnaire was developed to measure patients' care dependency. Future studies are needed to determine whether care dependency covers an unwanted side-effect or a crucial ingredient of an effective treatment.

Original languageEnglish
Pages (from-to)1189-1206
Number of pages18
JournalJournal of Clinical Psychology
Volume74
Issue number7
DOIs
Publication statusPublished - Jul 2018

Keywords

  • Journal Article
  • WORKING ALLIANCE INVENTORY
  • side-effects
  • VALIDATION
  • PSYCHOTHERAPY
  • MODEL
  • care dependency
  • symptoms
  • INTERPERSONAL DEPENDENCY
  • therapeutic alliance
  • COMMITMENT
  • PERSPECTIVES
  • ALTERNATIVES
  • PERCEIVED SOCIAL SUPPORT
  • MULTIDIMENSIONAL SCALE
  • psychological treatments

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