Social inclusion and connectedness for persons with schizophrenia: a cross-sectional, cross-cultural study of therapeutic relationships

The aim of this project is to examine the connectedness between practitioners and persons living with severe mental disorders as the “active ingredient” of effective therapeutic processes.

Conceptually, we use the term connectedness to cover both 1) current measures of the therapeutic relationship as well as 2) those difficult to access or hard to objectify experiences (e.g., attunement, intersubjectivity, embodied relational knowing) that emerges between individuals. An innovative integration of traditional and modern test theory with a focused ethnography will be used to link outcome measures of with those often more fleeting experiences in therapeutic relationships.


Although we know that therapeutic relationships impact on the long term care of individuals with severe and persistent mental illness, we know little about 1) the processes by which individuals form therapeutic relationships across time, and 2) the relationship between measures of the therapeutic relationship and the experiences of provider-client connectedness.


To provide a better understanding of the complexity of processes involved in forming therapeutic relationships, including the tacit or practical knowledge built over time of both providers and clients that could benefit clinical reasoning and refinement of instrumentation. By conducting the study in two different cultural contexts (Montreal, CA and Trondheim, NO), an underlying purpose is to build research and clinical networks that can support internationalization and policy development across institutional settings.


This study will take place over two overlapping phases: 1) two instruments on the therapeutic relationship will be completed by 50 provider-patient dyads in each context, followed by 2) participant observations and narrative interviews of patient participants across service encounters with other practitioners over longer periods with re-administration of the instruments.

Project leaders

Staffan Josephsson & Melissa Park

Collaborating Researchers & Project Assistants

Associate Professor Anders Kottorp 

Associate Professor Sissel Alsaker

Doctoral Student

Lena Ulfseth

Funding Agencies

Forte, Trondheim University College

The project was initiated in 2011.


Ulfseth, L., Josephsson, S. & Alsaker, S. (In press) Social relations in everyday activities among patients with persistent mental illness. Scandinavian journal of Disability Research.