Rosemarie McCabe, BA, PhD
Senior Research Fellow
My research programme has two complementary strands: the first on therapeutic relationships
and interactions in mental health care and the second on interactional markers of schizophrenia.
It draws on concepts and methods from psychology, psychiatry and sociology.
Doctor-patient communication and outcome in the treatment of schizophrenia (MRC)
Providing effective services for people with schizophrenia is a particular challenge making it crucial
that services are tailored to suit their specific needs so that they are satisfied with them and derive
benefit from treatment. People respond to treatment simply by virtue of being treated, through the placebo
effect. Even when no active medication has been given, people show positive psychological and physiological
change. The placebo effect highlights the importance of meaning in treatment and we have found that the meaning
of peoples' experiences in psychotic illness is a concern for them. This multi-centre study explores whether
the effort invested in producing and negotiating meaning (by both patient and psychiatrist) in naturalistic
consultations is associated with the outcome of treatment.
Structured patient-clinician communication and one-year outcome in community mental health care
(European Commission FPV)
A cluster randomised controlled trial to test a new computer-mediated intervention structuring
patient-clinician dialogue (DIALOG) focusing on patients' quality of life and needs for care in 6 countries.
Every 2 months for one year, clinicians ask patients to rate satisfaction with quality of life and treatment,
and request additional/different support. Responses are fed back immediately in screen displays, compared with
previous ratings and discussed. Primary outcome: subjective quality of life. Secondary outcomes: unmet needs
and treatment satisfaction.
Talk about suicide in psychiatric consultations
Using conversation analytic techniques, we are analysing how psychiatrists and patients with a diagnosis
of depression or schizophrenia talk about suicidal ideation in outpatient settings. Current analyses focus on
the conflict between psychiatrists risk assessment, typically delivered in a checklist style, and patients
Specifying interactional markers of schizophrenia
While physical health problems rely mainly on patient reports and physical examination, many psychiatric symptoms
are, by their very nature, interactional. Prima facie, conversation analysis provides a useful approach to mapping
the specific interactional problems that appear to characterise schizophrenic symptomatology.
I focus on the points in naturalistic interaction where clinicians (and carers when co-present) orient to apparent anomalies in
routine conversational structures. I explore the possibility of combining the structural analysis of talk with the content of
talk in the context of psychotic symptoms (e.g. the content of bizarre beliefs) to further our understanding of some of the
basic deficits underlying schizophrenia.
Therapeutic Relationships in Community Mental Health Care (1999-2002) with S. Priebe. St. Bartholomew's Joint Research Board
A Randomised Controlled Trial Evaluating A New Psychiatric Day Hospital For Acute Treatment: One-Year Follow-Up (2000-2003) with S. Priebe & J. Beecham. NHS Executive
Towards More Effective Community Care for People with Psychosis (2002-2005) with J.Bullenkamp, L. Hansson, S. Priebe, W. Rossler, F. Torres & D. Wiersma. European Commission FPV
Implementation Of Routine Outcome Management In Community Mental Health Centres (2003-2004) with S.Priebe Department Of Health
Doctor-patient communication in the treatment of schizophrenia: Is it related to treatment outcome? (2006-2008) with S. Priebe and Vanessa Pinfold, Rethink Medical Research Council
Wolfson,Unit for Social & Community Psychiatry