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Influences of Attribution and Stigma on Working Relationships with Providers Practicing Western Psychiatry in the Taiwanese Context

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Abstract

This study examined influences of causal attributions of schizophrenia and perceived and internalized mental illness stigma on perceived working alliance with, and informational support received from doctors practicing Western psychiatry in the Taiwanese social-cultural context. This cross-sectional quantitative study used a non-probability, purposive sampling technique to recruit 212 Taiwanese diagnosed with schizophrenia from Taiwanese Alliance of the Mentally Ill, 4 community mental health rehabilitation centres and 2 psychiatric hospitals between July 2012 and March 2013. Linear regression models were used for analysis. The results showed that environmental attributions were positively associated with both perceived working alliance and perceived informational support, while supernatural attributions were negatively associated with perceived working alliance and perceived informational support. Perceived stigma had a negative association with perceived working alliance. The discrimination domain of internalized stigma specifically had a positive association with perceived working alliance, while the withdraw domain had a negative association with perceived informational support. Findings inform the importance of culturally sensitive practices in developing an effective working relationship. Western psychiatric care providers need to explore consumers’ casual attributions of mental illness and understand the impact of stigma so that providers may successfully engage consumers in care and provide tailored illness education and information.

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Acknowledgements

The authors thank the Alliance for the Mentally Ill of Taiwan for contributing to data collection. This study was funded by the National Taiwan University.

Conflict of interest

Drs. Fang-pei Chen, Hui-Ching Wu, and Chun-Jen Huang declare that they have no conflict of interest.

Ethical standards and Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all participants for being included in the study.

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Authors and Affiliations

  1. Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA

    Fang-pei Chen

  2. Department of Social Work, National Taiwan University, No. 1, Sec. 4, Roosevelt Road, Taipei, 10617, Taiwan, ROC

    Hui-Ching Wu

  3. Department of Psychiatry, College of Medicine, Kaohsiung Medical University, No.100, Tzyou 1st Road Kaohsiung 807, Kaohsiung, Taiwan

    Chun-Jen Huang

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  1. Fang-pei Chen
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Correspondence to Hui-Ching Wu.

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Chen, Fp., Wu, HC. & Huang, CJ. Influences of Attribution and Stigma on Working Relationships with Providers Practicing Western Psychiatry in the Taiwanese Context. Psychiatr Q 85, 439–451 (2014). https://doi.org/10.1007/s11126-014-9304-8

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  • DOI: https://doi.org/10.1007/s11126-014-9304-8

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