Predictors of sex -related discussions between treatment staff and clients with severe mental illness
Abstract
The purpose of the present study was to investigate the nature of sex-related discussions between staff and clients in mental health treatment facilities and to determine the predictors of more frequent sex-related discussions. Sex-related discussions between treatment staff and clients can help staff assess clients' level of HIV risk, give staff insight into the relationship issues that clients face, and promote open communication between clients and staff regarding personal matters. However, there is evidence that the sexual needs of clients with severe mental illness (SMI) have been neglected and that discussions regarding sex rarely occur between clients and staff for a number of possible reasons. The primary hypothesis of this study was that background characteristics and perceptions of the relationship quality would predict the frequency of sex-related discussions. Additionally, it was hypothesized that the characteristics and perceptions of one dyad member would predict the other's perception of how frequently these discussions were occurring. Clients and staff at three community mental health centers (CMHCs) and two state hospitals were asked to provide background information, perceptions of the quality of their relationship with specific staff members, and their perception of the frequency of sex-related discussions. Results indicate that sex-related discussions are infrequent despite relatively frequent interactions between clients and staff. Female gender, Gay/Lesbian/Bisexual sexual orientation, and recent client sexual activity are the most prominent predictors of frequent sex-related discussions. Clients also reported less frequent sex-related discussions and than staff members did. Staff characteristics and perceptions about clients and the treatment relationship account for the most variance in a model describing sex-related discussion frequency. Finally, perceiving more frequent hassling in the treatment relationship predicts more frequent sex-related discussions among both staff and clients. These results have implications for the role of treatment staff in assuring that clients have an opportunity to discuss sex-related issues, the need for more frequent sex-related discussions between male clients and staff, and the role of informal discussions about sex in HIV risk reduction interventions.
Degree
Ph.D.
Advisors
Bond, Purdue University.
Subject Area
Clinical psychology
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