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The Therapeutic Relationship

Enhancing Referrals

Coyle, Mary Kathleen, PhD, RN, PMHCNS-BC1

doi: 10.1097/rnj.0000000000000160

Purpose This article focuses on the ways rehabilitation nurses use the therapeutic relationship to lessen barriers some veterans experience when a referral to mental health treatment is recommended.

Design Veterans presenting with posttraumatic stress symptoms are discussed, and possible interventions within the therapeutic relationship are proposed.

Method Veterans’ perception of mental health stigma, building a collaborative therapeutic relationship, recommending a referral and assessments of stress responses, posttraumatic stress symptoms, suicide risk, and intervention strategies are proposed.

Findings When changes in functioning and suicidality occur in veterans with posttraumatic stress disorder symptoms, it is important to screen and engage veterans at risk.

Conclusions and Clinical Relevance When veterans in the rehabilitation process present with a need for mental health referral, barriers to treatment may include the stigma of mental health treatment. Rehabilitation nurses using the therapeutic relationship act as change agents to assist veterans in overcoming these barriers to treatment. The therapeutic relationship provides nurses with a foundation to provide opportunities for veterans to be supported and to seek treatment.

1 Department of Nursing, Shepherd University, Shepherdstown, WV, USA.

Correspondence: Mary Kathleen Coyle, PhD, RN, PMHCNS-BC, Department of Nursing, Shepherd University, P.O. Box 5000, Shepherdstown, WV 25443. E-mail:

Accepted February 15, 2018

Cite this article as: Coyle, M.K. (2018). The therapeutic relationship: enhancing referrals. Rehabilitation Nursing, 43(6), E18–E24. doi: 10.1097/rnj.0000000000000160

© 2018 Association of Rehabilitation Nurses.
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