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Patients’ care dependency in mental health care: Development of a self‐report questionnaire and preliminary correlates
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.
Keywords:care dependency  psychological treatments  side‐effects  symptoms  therapeutic alliance
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