Personal relationships: their role in shaping both cause

and cure of mental health disorders

Stefan PriebeQueen Mary University of London

Main factors associated with mental disorders

1. Adverse childhood conditions2. Poverty3. War experience and torture4. Social isolation5. Social inequality

Prevention

• Safe and supportive upbringing conditions• No social isolation• Strong and weak ties

Mental disorders as social phenomena

• Defined in social interactions• Occurring in interactions• Related to interactions

• Diagnosed in interactions• Treated in interactions

Evidence for the benefits of

• Various direct social support• Larger social networks• More supportive relationships in networks• Family interventions

Therapeutic relationship

• Defining element of health care• In patient surveys consistently reported as

the most important component of care• Predictor of adherence and outcomes• Along with expectations, most important

non-specific factor for outcomes

Deficit or resource?

• Medical treatment focuses on deficit or dysfunction

• There is also some tradition of treatment utilising resources

• Independent of diagnostic categories

Resource oriented models

• Befriending• Client centered therapy• Creative music therapy• Open dialogue• Peer support workers• Positive psychotherapy

• Self help groups• Solution focused

therapy• Systemic family therapy• Therapeutic

communities

Priebe et al., Br J Psychiatr, 2014

Resource-oriented themes  Social 

relationships

Decision-making ability

Knowledge

Individual strengths

Recreational activities

Self-actualising

Befriending Client-centred therapy Creative music therapy Open dialogue Peer support workers Positive psychotherapy Self-help groups Solution-focused therapy

Systemic family therapy 

Therapeutic communities

Types of social relationships  Professionals Peers Friends Family

 Befriending 

Client-centred therapy Creative music therapy Open dialogue

Peer support workers Positive psychotherapy Self-help groups Solution-focused therapy Systemic family therapy Therapeutic communities

Personal relationships

• Are part of quality of life• Are influenced by and influence experience

and skills• Contribute to mental health• Are crucial to overcoming distress• Are facilitated by context factors