Therapeutic Relationships

In this chapter, the developers of the transitional discharge model apply principles learned during the pilot study (“Bridge to Discharge” 1993–1996) to test the model with a wider number of psychiatric wards. The transitional discharge model is based on Peplau’s theory of interpersonal relations. It functions on the assumption that the quality of interpersonal relationships has an influence and impact on quality of life and that a supportive social network will promote less need for expensive interventions, such as hospitalization. The transitional discharge model has two components: (a) inpatient staff continue to care for discharged clients until therapeutic relationships are established with community care providers, and (b) a friendship model of peer support. In this study, 26 psychiatric hospital wards were matched with each other to create 13 pairs. Within these pairs, one ward was randomized to the intervention using the transitional discharge model, while the other ward continued with usual care. Although the wards were matched for similar lengths of stay and clinical focus, the wards that implemented the intervention discharged clients 124 days faster than wards that maintained usual care. Other findings related to the early implementation of the transitional discharge model are discussed.