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Objective: Team formulation is advocated to improve quality of care in mental health care and evidence from a recent U.K.-based trial supports its use in inpatient settings. This study aimed to identify the effects of formulation on practice from the perspectives of staff and patient participating in the trial, including barriers and enhancers to implementing the intervention., Method: We carried out semistructured interviews with 57 staff and 20 patients. Data were analyzed using thematic analysis., Results: Main outcomes were: improved staff understanding of patients, better team collaboration and increased staff awareness of their own feelings. Key contextual factors were as follows: overcoming both staff and patient anxiety, unwelcome expert versus collaborative stance, competing demands, and management support., Conclusion: Team formulation should be implemented to improve quality of care in inpatient settings and larger definitive trials should be carried out to assess the effect of this intervention on patient outcomes., (© 2016 Wiley Periodicals, Inc.)

The attachment styles of psychiatric staff are likely to impact on their capacity to form positive therapeutic relationships with patients with psychosis. Twenty staff completed a measure assessing levels of attachment anxiety and avoidance. Staff and patients completed a measure of patients' interpersonal problems and staff completed the Five-Minute Speech Sample, which was used to derive ratings of psychological mindedness and therapeutic relationships. Higher staff avoidance was associated with greater discrepancies in staff and patient ratings of patients' interpersonal problems and poorer staff psychological mindedness. Lower staff anxiety and avoidance were associated with positive therapeutic relationships. Findings warrant replication in larger samples, but suggest that staff attachment style may be important in the development of better quality staff and patient relationships.