self reflection mental health essay

Unconscious

What is self-reflection and why it matters for wellness, want to know why you do the things you do learn how to self-reflect..

Posted October 7, 2019 | Reviewed by Lybi Ma

So many of our habits, patterns of behavior, and pre-set programming are buried in our subconscious . They operate in a sort of “control room”, directing how we think, feel, and act, often times hurting our well-being (take this well-being quiz to see how you're doing). If we want to be in control, we need to see into the "control room", beyond the conscious mind, and change some of the programming we no longer benefit from. One way to access the unconscious is through self-reflection—i.e., putting a mirror up to ourselves and analyzing what we see or feel as objectively as possible so that we can better understand ourselves and how think, feel, and behave. But how do we engage in this type of deep self-reflection?

Setting the Stage for Self-Reflection

While doing research for my new book, Outsmart Your Smartphone , it became clear to me that we are super busy, distracted, and therefore, seem to have a harder time with self-reflection. That's because self-reflection requires a reasonably tranquil mind . Some self-reflectors begin with a short meditation , maybe several deep breaths, or some rhythmic breathing to quiet their thoughts. Perhaps you prefer to imagine yourself pulling on imaginary reins to quiet your prancing mind, or some other creative imagination activity appropriate to you that mellows your mind.

Of course, penetrating the unconscious can be illusive. Sometimes deep self-reflection may feel like you are trying to tame a raging sea, so talk yourself down, if that helps, and ask yourself questions to get at the heart of your matter. If answers are not forthcoming, then give it some time, and return to any thoughts or questions later when you are feeling open to learning more about yourself. Let busy thoughts fly away and focus on your goal—to know yourself better.

Identify The "What" of Self-Reflection

Once you feel calm and quiet, direct your focus inward. Choose a particular issue you want to change. Pull up a memory of an important incident.

Ask yourself:

• What impressions arise as you focus on this issue?
• What does it make you feel?
• What does it make you think?

Identify the "Why" of Self-Reflection

With your mind quieted, try to look deeper. Intend to go back to the most pivotal point related to this memory. What did you feel, think, or do? Now, go a layer deeper, and ask yourself: Why did you think, feel, or do these things?

These kinds of inner search-and-discovery missions through self-reflection can get gnarly, so take your time. Once you have opened the cork on this Genie’s bottle, the work has begun and it will most likely continue until some major issues are better understood, if not completely resolved.

Observe Yourself with This New Insight

Next, observe yourself living your life, in the present. Try to "catch yourself" when your unconscious is in control, leading you to feel, think, and act in ways that bother you. Through self-reflection your self-awareness will grow. Once you are aware of your inner programming, you are on the path to authenticity and greater control over your life .

Use Self-Reflection as a Tool for Change

The next step is to cultivate the desire to change behaviors that bother you. After identifying any problematic aspects of yourself, take the wheel and slowly shift your behavior in ways that better represent how you want to be.

If you thought “that issue” was “fixed” but it comes back, self-reflect once again to see if you missed something important. It’s not easy to change ourselves/our behavior, and it may take several attempts to get it “right”, so keep at it each time a behavior you don’t like surfaces.

Self-Reflect with Self-Compassion

Be gentle with yourself as you self-reflect. The goal is not to judge your past choices, but to reflect on them, learn from them, and make whatever changes you feel are appropriate for you in the here and now. As you build new habits through self-awareness, you can become more balanced, healthy, and happy .

Tchiki Davis, Ph.D. , is a consultant, writer, and expert on well-being technology.

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Mental Health Essay

Introduction

Mental health, often overshadowed by its physical counterpart, is an intricate and essential aspect of human existence. It envelops our emotions, psychological state, and social well-being, shaping our thoughts, behaviors, and interactions. With the complexities of modern life—constant connectivity, societal pressures, personal expectations, and the frenzied pace of technological advancements—mental well-being has become increasingly paramount. Historically, conversations around this topic have been hushed, shrouded in stigma and misunderstanding. However, as the curtains of misconception slowly lift, we find ourselves in an era where discussions about mental health are not only welcomed but are also seen as vital. Recognizing and addressing the nuances of our mental state is not merely about managing disorders; it's about understanding the essence of who we are, how we process the world around us, and how we navigate the myriad challenges thrown our way. This essay aims to delve deep into the realm of mental health, shedding light on its importance, the potential consequences of neglect, and the spectrum of mental disorders that many face in silence.

Importance of Mental Health

Mental health plays a pivotal role in determining how individuals think, feel, and act. It influences our decision-making processes, stress management techniques, interpersonal relationships, and even our physical health. A well-tuned mental state boosts productivity, creativity, and the intrinsic sense of self-worth, laying the groundwork for a fulfilling life.

Negative Impact of Mental Health

Neglecting mental health, on the other hand, can lead to severe consequences. Reduced productivity, strained relationships, substance abuse, physical health issues like heart diseases, and even reduced life expectancy are just some of the repercussions of poor mental health. It not only affects the individual in question but also has a ripple effect on their community, workplace, and family.

Mental Disorders: Types and Prevalence

Mental disorders are varied and can range from anxiety and mood disorders like depression and bipolar disorder to more severe conditions such as schizophrenia.

• Depression: Characterized by persistent sadness, lack of interest in activities, and fatigue.
• Anxiety Disorders: Encompass conditions like generalized anxiety disorder, panic attacks, and specific phobias.
• Schizophrenia: A complex disorder affecting a person's ability to think, feel, and behave clearly.

The prevalence of these disorders has been on the rise, underscoring the need for comprehensive mental health initiatives and awareness campaigns.

Understanding Mental Health and Its Importance

Mental health is not merely the absence of disorders but encompasses emotional, psychological, and social well-being. Recognizing the signs of deteriorating mental health, like prolonged sadness, extreme mood fluctuations, or social withdrawal, is crucial. Understanding stems from awareness and education. Societal stigmas surrounding mental health have often deterred individuals from seeking help. Breaking these barriers, fostering open conversations, and ensuring access to mental health care are imperative steps.

Conclusion: Mental Health

Mental health, undeniably, is as significant as physical health, if not more. In an era where the stressors are myriad, from societal pressures to personal challenges, mental resilience and well-being are essential. Investing time and resources into mental health initiatives, and more importantly, nurturing a society that understands, respects, and prioritizes mental health is the need of the hour.

• World Leaders: Several influential personalities, from celebrities to sports stars, have openly discussed their mental health challenges, shedding light on the universality of these issues and the importance of addressing them.
• Workplaces: Progressive organizations are now incorporating mental health programs, recognizing the tangible benefits of a mentally healthy workforce, from increased productivity to enhanced creativity.
• Educational Institutions: Schools and colleges, witnessing the effects of stress and other mental health issues on students, are increasingly integrating counseling services and mental health education in their curriculum.

In weaving through the intricate tapestry of mental health, it becomes evident that it's an area that requires collective attention, understanding, and action.

  Short Essay about Mental Health

Mental health, an integral facet of human well-being, shapes our emotions, decisions, and daily interactions. Just as one would care for a sprained ankle or a fever, our minds too require attention and nurture. In today's bustling world, mental well-being is often put on the back burner, overshadowed by the immediate demands of life. Yet, its impact is pervasive, influencing our productivity, relationships, and overall quality of life.

Sadly, mental health issues have long been stigmatized, seen as a sign of weakness or dismissed as mere mood swings. However, they are as real and significant as any physical ailment. From anxiety to depression, these disorders have touched countless lives, often in silence due to societal taboos.

But change is on the horizon. As awareness grows, conversations are shifting from hushed whispers to open discussions, fostering understanding and support. Institutions, workplaces, and communities are increasingly acknowledging the importance of mental health, implementing programs, and offering resources.

In conclusion, mental health is not a peripheral concern but a central one, crucial to our holistic well-being. It's high time we prioritize it, eliminating stigma and fostering an environment where everyone feels supported in their mental health journey.

Frequently Asked Questions

• What is the primary focus of a mental health essay?

Answer: The primary focus of a mental health essay is to delve into the intricacies of mental well-being, its significance in our daily lives, the various challenges people face, and the broader societal implications. It aims to shed light on both the psychological and emotional aspects of mental health, often emphasizing the importance of understanding, empathy, and proactive care.

• How can writing an essay on mental health help raise awareness about its importance?

Answer: Writing an essay on mental health can effectively articulate the nuances and complexities of the topic, making it more accessible to a wider audience. By presenting facts, personal anecdotes, and research, the essay can demystify misconceptions, highlight the prevalence of mental health issues, and underscore the need for destigmatizing discussions around it. An impactful essay can ignite conversations, inspire action, and contribute to a more informed and empathetic society.

• What are some common topics covered in a mental health essay?

Answer: Common topics in a mental health essay might include the definition and importance of mental health, the connection between mental and physical well-being, various mental disorders and their symptoms, societal stigmas and misconceptions, the impact of modern life on mental health, and the significance of therapy and counseling. It may also delve into personal experiences, case studies, and the broader societal implications of neglecting mental health.

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87 Self-Reflection Questions for Introspection [+Exercises]

Do you sometimes take time to clarify your values in a moment of doubt or uncertainty?

If you answered “yes,” you are no stranger to self-reflection and introspection (terms that will be used more or less interchangeably in this article), an important psychological exercise that can help you grow, develop your mind, and extract value from your mistakes.

Read on if you’d like to learn the meaning of self-reflection and introspection, reasons why it’s important, and tools and techniques for practicing it yourself.

Before you continue, we thought you might like to download our three Self-Compassion Exercises for free . These detailed, science-based exercises will not only help you increase the compassion and kindness you show yourself but will also give you the tools to help your clients, students, or employees show more compassion to themselves.

This Article Contains:

What is introspection a definition, what is the importance of introspection, 70 self-reflective questions to ask yourself, 10 self-reflection exercises, activities, and techniques for adults and students, 4 self-reflection worksheets and tools, the 3 best books on self-reflection and introspection, a take-home message.

Introspection can be practiced both as an informal reflection process and a formal experimental approach, and the two have different definitions. Still, both processes can be undertaken by anyone with curiosity and determination (Cherry, 2016).

The informal reflection process can be defined as examining one’s own internal thoughts and feelings and reflecting on what they mean. The process can be focused on either one’s current mental experience or mental experiences from the very recent past.

The formal experimental technique is a more objective and standardized version of this, in which people train themselves to carefully analyze the contents of their own thoughts in a way that’s as unbiased as possible.

The original idea of introspection was developed by Wilhelm Wundt in the late 1800s (McLeod, 2008). Wundt focused on three areas of mental functioning: thoughts, images, and feelings. Wundt’s work eventually led to the current work on perceptual processes and the establishment of the field of cognitive psychology .

Researchers have shown that we think more than 50,000 thoughts per day, of which more than half are negative and more than 90% are just repeats from the day before (Wood, 2013).

If you don’t make the time and effort to refocus your mind on the positive through introspection, you won’t give yourself the opportunity to grow and develop.

Enhancing our ability to understand ourselves and our motivations and to learn more about our own values helps us take the power away from the distractions of our modern, fast-paced lives and instead refocus on fulfillment (Wood, 2013).

The importance of doing it right

Reflecting on ourselves and our environments is a healthy and adaptive practice, but it should be undertaken with some care—there is, in fact, a wrong way to do it.

When your focus on introspection has morphed from a dedication to an obsession, you have taken it too far. In fact, those who take self-reflection too far can end up feeling more stressed, depressed, and anxious than ever (Eurich, 2017).

In addition, it is all too easy for us to fool ourselves into thinking we have found some deep insight that may or may not be accurate. We are surprisingly good at coming up with rational explanations for the irrational behaviors we engage in (Dahl, 2017).

To help stay on the right path with your self-reflection, consider asking more “what” questions than “why” questions. “Why” questions can highlight our limitations and stir up negative emotions, while “what” questions help keep us curious and positive about the future (Eurich, 2017).

With this important point in mind, let’s move on to the questions, exercises, and worksheets that you can use to work on your own self-reflection.

Read through the following three lists to get some ideas for introspective questions. Answering them can take you from feeling like you don’t understand yourself to knowing yourself like the back of your hand.

These 10 questions are great ways to jumpstart self-reflection (Woronko, n.d.):

• Am I using my time wisely?
• Am I taking anything for granted?
• Am I employing a healthy perspective?
• Am I living true to myself?
• Am I waking up in the morning ready to take on the day?
• Am I thinking negative thoughts before I fall asleep?
• Am I putting enough effort into my relationships?
• Am I taking care of myself physically?
• Am I letting matters that are out of my control stress me out?
• Am I achieving the goals that I’ve set for myself?

The following 30 questions are questions you can ask yourself every day to get to know yourself better (William, n.d.):

• Who am I, really?
• What worries me most about the future?
• If this were the last day of my life, would I have the same plans for today?
• What am I really scared of?
• Am I holding on to something I need to let go of?
• If not now, then when?
• What matters most in my life?
• What am I doing about the things that matter most in my life?
• Why do I matter?
• Have I done anything lately that’s worth remembering?
• Have I made someone smile today?
• What have I given up on?
• When did I last push the boundaries of my comfort zone?
• If I had to instill one piece of advice in a newborn baby, what advice would I give?
• What small act of kindness was I once shown that I will never forget?
• How will I live, knowing I will die?
• What do I need to change about myself?
• Is it more important to love or be loved?
• How many of my friends would I trust with my life?
• Who has had the greatest impact on my life?
• Would I break the law to save a loved one?
• Would I steal to feed a starving child?
• What do I want most in life?
• What is life asking of me?
• Which is worse: failing or never trying?
• If I try to fail and succeed, what have I done?
• What’s the one thing I’d like others to remember about me at the end of my life?
• Does it really matter what others think about me?
• To what degree have I actually controlled the course of my life?
• When all is said and done, what will I have said more than I’ve done?

Finally, the following 30 prompts and questions are great ways to put your journal to use (Tartakovsky, 2014):

• My favorite way to spend the day is . . .
• If I could talk to my teenage self, the one thing I would say is . . .
• The two moments I’ll never forget in my life are . . . (Describe them in great detail, and what makes them so unforgettable.)
• Make a list of 30 things that make you smile.
• “Write about a moment experienced through your body. Making love, making breakfast, going to a party, having a fight, an experience you’ve had or you imagine for your character. Leave out thought and emotion, and let all information be conveyed through the body and senses.”
• The words I’d like to live by are . . .
• I couldn’t imagine living without . . .
• When I’m in pain—physical or emotional—the kindest thing I can do for myself is . . .
• Make a list of the people in your life who genuinely support you, and whom you can genuinely trust. Then, make time to hang out with them.
• What does unconditional love look like for you?
• What things would you do if you loved yourself unconditionally? How can you act on these things, even if you’re not yet able to love yourself unconditionally?
• I really wish others knew this about me . . .
• Name what is enough for you.
• If my body could talk, it would say . . .
• Name a compassionate way you’ve supported a friend recently. Then, write down how you can do the same for yourself.
• What do you love about life?
• What always brings tears to your eyes? (As Paulo Coelho has said, “Tears are words that need to be written.”)
• Write about a time when your work felt real, necessary and satisfying to you, whether the work was paid or unpaid, professional or domestic, physical or mental.
• Write about your first love—whether it’s a person, place or thing.
• Using 10 words, describe yourself.
• What’s surprised you the most about your life or life in general?
• What can you learn from your biggest mistakes?
• I feel most energized when . . .
• “Write a list of questions to which you urgently need answers.”
• Make a list of everything that inspires you—whether books, websites, quotes, people, paintings, stores, or stars in the sky.
• What’s one topic you need to learn more about to help you live a more fulfilling life? (Then, follow through and learn more about that topic.)
• I feel happiest in my skin when . . .
• Make a list of everything you’d like to say no to.
• Make a list of everything you’d like to say yes to.
• Write the words you need to hear.

For example, the five self-examination exercises listed below (Bates, 2012) are a good way to get started with self-reflection. They’re simple and easy to do, but they can familiarize you with the process for more in-depth reflection in the future.

Self-Examination Exercise 1

Consider whether or not you tend to analyze people or diagnose their problems for them without their encouragement or request.

Often when we hold information that has helped us to make sense of the world, we want to share it. This information, when unprompted and delivered to another person, sometimes doesn’t feel so good. They may feel like you are telling them that something about them is wrong, something that they might not necessarily agree with.

Remind yourself that this information needs to be asked for and not prescribed by you, no matter how valid it feels to pass it on (Bates, 2012).

Self-Examination Exercise 2

This is a good exercise if you tend to expend a lot of energy trying to understand what upsets you about another person’s actions. You may also spend a lot of energy thinking of ways to address that person about what upsets you.

Not only does this burn a lot of your energy, but it also can have an unintended effect on the person who has upset you. When you place a clear emphasis or focus on what is wrong when speaking with someone, it implies that you are dissatisfied and unhappy.

Usually, the issue you have is not something that is making you terribly unhappy, just an annoyance or irritation, so this doom and gloom is not the message you want to deliver. It’s just a single issue that needs attention, but it can seem much bigger and more pervasive to the person you are planning to discuss it with.

Try to remind yourself that this problem, no matter how valid an issue it is or how important it is to you, is not the whole of your feelings. When you deliver this information, remember that a person who loves you does not want to be the cause of your unhappiness—do not make them feel an unnecessary amount of pain as a result of the unhappiness they’ve caused you.

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Self-Examination Exercise 3

Do you frequently interrupt people or constantly think of your own stories to share while they are talking? If you’re like a lot of social people, the answer is probably yes.

In order to relate to others, we have to share a little bit of ourselves with them—your stories can help you establish common ground with others or make you closer with them. However, if you’re only focused on sharing your stories, it can distract you from the greater purpose of a conversation.

In our eagerness to relate, please, entertain, and share, we often remove ourselves from the present, reducing our ability to be sensitive and engaged listeners. Even if we spend our whole lives trying to be good listeners , sometimes we slip out of practice in empathizing or identifying with the person we’re talking to, or we lose an opportunity to comfort or entertain the other person.

Next time you have a conversation with a loved one and you find yourself thinking ahead of them, take a moment to pause and truly listen. Don’t think about how you can personally identify with what they are talking about, and don’t search your memory bank for a relevant story of your own—just listen.

It’s a rewarding experience to truly soak in what another person is saying, both for you and the other person (Bates, 2012).

Self-Examination Exercise 4

Sometimes when we work very hard to do good things, we get to a level of comfort with that fact, and we begin to talk about it to others. That can be a great thing in that it allows us to own our efforts and our actions and, with that, acknowledge our goodness to ourselves.

But for this exercise, consider how you might feel if you were to do things that are good, but only for your own knowledge. The next time you do something really wonderful, try keeping that wonderful thing to yourself and not sharing it with anyone.

Often when a person is good and loving, they don’t have to tell anyone; it’s a truth that shines from every angle of their person. As an experiment, keep some knowledge to yourself, as a gift to you (Bates, 2012).

Self-Examination Exercise 5

For this exercise, you need only to do one thing: Consider what you don’t know.

When we get to a place of comfort in our skin and in the world, we tend to lose the ability to see things from a different perspective. Things make sense to us in our own point of view, so what’s left to know?

Everything, it turns out.

By this, we mean to try and remind yourself of these facts: You cannot know or understand everything, and you are not the judge of what is right for another person.

You can neither read minds nor know what the future holds. You can only exist in one moment at a time, and you are changing every day.

Trust that sometimes others know themselves and their lives better than you ever could. Listen with the awareness that you might learn something new.

Be open to the fact that you might one day feel totally different about something that you believe to be fixed—and that includes your sticking points, the “unchangeables” you thought were forever set in stone. Let what you don’t know and can’t know be a comfort rather than something to fear, because it means that anything is possible (Bates, 2012).

Once you have found your footing with these self-examination exercises, the following introspective exercises are a great next step.

4 Self-reflection technique – OER Africa

Affirmations

Creating affirmations is a helpful way to clear your mind and put things in perspective. Affirmations can be defined as positive phrases or statements used to challenge  negative or unhelpful thoughts .

For this exercise, write a list of at least 50 affirmations. They should address what you want to embrace, improve, and achieve in your life.

Follow these instructions when composing and practicing your affirmations:

• Write the affirmations in the present tense and be sure to use the word “I” throughout the affirmations;
• Focus on the things that are occurring now that will lead to your future success. You may have negative thoughts pop up, but do your best to let go of the negative thoughts and replace them with positive thinking;
• Repeat your affirmations aloud to help reprogram your mind with more positive thoughts.

Following these steps can help you open yourself up to the positive in your life and take steps that will lead you to the future you want (Holothink, n.d.).

Subconscious Mind Exercise

In this exercise, you will dive into your subconscious. Don’t worry, it’s not as painful or scary as it sounds!

Your subconscious mind is where your self-image is stored. All of your attitudes, experiences, beliefs, and values are stored deep in your subconscious, driving your behavior and forming the core of who you are.

We don’t often take time to think about ourselves on this level. So in this exercise, take some time and put a concerted effort into thinking about your attitudes, experiences, beliefs, and values. It may take a few sessions of self-reflection to really uncover your core beliefs, but it’s worth the effort it takes to learn about yourself.

Reflecting on this core component of yourself will help you gain greater self-awareness . Much like meditation, it will help you achieve a new, higher level of consciousness, and it may just help you find valuable information and answers about yourself and your beliefs (Holothink, n.d.).

Visualization Exercise

This exercise offers you an opportunity to put your creativity to use.

Create a box, a vision board, or some other medium to store and display who you are and what your hopes and dreams are for the future. You can create or decorate your box or board however you’d like. Use whatever you feel represents yourself and what’s important to you.

Place pictures, words, drawings, poems, or small items of personal significance on your board or in your box. The more details you include, the better.

The end result is a visual representation of yourself and what you love. Come back to the box or board when you’re having a dilemma or trying to figure out the best course of action, and draw from this visual representation of yourself to help you make decisions (Holothink, n.d.).

For this exercise, feel free to put your imagination to good use—the sky’s the limit when it comes to visualization.

Questions About Yourself

This exercise is simple, but that doesn’t mean it’s easy. All you need to do is ask yourself some questions.

Ask yourself questions about yourself. Write down the questions, then write down your answers to the questions. Ask yourself about your past, present, and future, and compose answers to the questions that are positive, insightful, and motivating to you.

Don’t worry about coming up with the “right” answers—there aren’t any right answers, and your answers will likely change over time. And be as creative as you’d like with the questions and answers since no one else needs to answer or read them but you.

Be sure to structure your questions to include details about your hopes and dreams. The more detailed your questions and answers, the more opportunity you have to dig into some valuable self-reflection (Holothink, n.d.).

Write and Reflect

Journaling is great for many reasons, and it can be used in several applications for introspection.

For this exercise, get a journal , diary, or notebook with plenty of pages to write in.

Every day, write down three things in your journal:

• At least one positive thing that happened to or around you today;
• A question for yourself (you can use one of the questions from the previous exercise, a question from the lists we covered earlier, or something entirely new), but don’t answer it yet;
• A reflection on the question you wrote the previous day for yourself and an answer to it.

Following these steps, you will write only the first two components on the first day but will write three components every day thereafter (Holothink, n.d.).

Self-Awareness Worksheet

This worksheet is a treasure trove of exercises and ideas to help you think about yourself, including your talents, qualities, values, and perceptions.

The point of this worksheet is to help you know and understand:

• Your beliefs and principles;
• What you value and what is important to you;
• What motivates you;
• Your own emotions ;
• Your thinking patterns;
• Your tendencies to react to certain situations;
• What you want out of life.

There are several sections to this worksheet, each of which has its own set of questions and prompts:

– Talents

• What are your greatest talents or skills?
• Which of your talents or skills gives you the greatest sense of pride or satisfaction?

– Traits/Qualities

• What are your five greatest strengths?
• What do you feel are your two biggest weaknesses?
• What qualities or traits do you most admire in others?

– Values

• What are ten things that are really important to you?
• What are the three most important things to you?
• What are the values that you hold nearest to your heart?

– Perception

• How is the “public you” different from the “private you”?
• What do you want people to think and say about you?
• Is it more important to be liked by others or to be yourself? Why?

– Accomplishments

• What three things are you most proud of in your life to date?
• What do you hope to achieve in life?
• If you could accomplish only one thing before you died, what would it be?

– Reflection

• What is something that represents you (e.g., song, animal, flower, poem, symbol, jewelry, etc.)? Why?
• What three things would you like to change most about yourself?
• List three things that you are.

– Finish the Sentence

In the final section, you will be shown several prompts to complete:

• I do my best when . . .
• I struggle when . . .
• I am comfortable when . . .
• I feel stress when . . .
• I am courageous when . . .
• One of the most important things I learned was . . .
• I missed a great opportunity when . . .
• One of my favorite memories is . . .
• My toughest decisions involve . . .
• Being myself is hard because . . .
• I can be myself when . . .
• I wish I were more . . .
• I wish I could . . .
• I wish I would regularly . . .
• I wish I had . . .
• I wish I knew . . .
• I wish I felt . . .
• I wish I saw . . .
• I wish I thought . . .
• Life should be about . . .
• I am going to make my life about . . .

Once you finish this worksheet, you should have plenty of insight into who you really are and what is most important to you. Use your answers to inform your decisions about what goals you choose to strive toward, what you would like to do in the future, and what moves to make next.

You can view, download, or print this worksheet for yourself.

The average human has more than 50,000 thoughts per day; more than half of them are negative, and more than 90% are just a repetition from the day before (Wood, 2013).

This means refocusing your mind on positive thoughts through introspection is essential for personal ascendance and growth. Most people take the end of the year as an opportunity to reflect on the past and set goals for the following year. However, reflections and introspection are critical at any point in time and enable your clients to grow.

Wilhelm Wundt developed the concept of introspection in the late 1800s (McLeod, 2008). According to him, introspection is focused on thoughts, images, and feelings. Introspective questions are often used in the field of cognitive psychology.

Understanding your clients allows you to learn more about their values, internal thoughts, and feelings. Furthermore, it takes the focus away from fast-paced lives and allows your client to be in the present moment and refocus on fulfillment (Wood, 2013).

Besides asking your client reflective questions, another tip is to practice active listening. Being able to stay entirely in the present moment without interruption or projecting your own story onto someone is key to helping your clients flourish. When the urge to share your story arises, pause and take the time to listen.

Tool 1: Persona

Before moving on to the empathy map below, first create a “persona,” or a clear character representation of your actual self, your ideal self, and your “ought” self (Kos, n.d.).

In order to create this persona, you will need to thoroughly analyze who you are, who you want to become, and what the social expectations connected to your feelings and behaviors are like in different situations.

Answering questions like the following can help you define these three important selves:

• Why do I want to become [enter a characteristic important to you] ? Who in my life was or is like that?
• Who would I be proud if I were [enter a characteristic important to you] ? Why?
• How are my feelings in certain situations connected with my actual, ideal, and ought self?
• Am I pushing myself to be something I’m actually not?
• Am I being something I’m not just because others expect it of me?

Use your answers to these questions to help you get an idea of who you are, who you want to be, and who you feel you ought to be. Once this preparation has been completed, move on to creating an empathy map.

Tool 2: Empathy Map

An empathy map can help you engage in a valuable and informative process of self-reflection, using all of your senses to help you identify your needs and the disconnections between what you say and what you do (Kos, n.d.). Don’t worry—we all have a disconnect between what we say and what we do.

This exercise can help you figure out where you have these disconnects and how you can best address them to become the person you want to be.

To create your empathy map, simply draw four quadrants on a piece of paper. Each quadrant represents a different aspect of yourself:

Next, consider a situation that evokes a specific strong emotion in you, like having a fight with your spouse or significant other. In each quadrant, write down the relevant aspects of each perspective.

For example, for the fight scenario, you could write down something like the following:

• Seeing: What are some of the things you saw during the situation?
• Doing: What actions did you do and which behaviors did you notice in yourself? What is the behavioral pattern you can identify?
• Thinking: What were you thinking in that situation? What does this tell you about your beliefs?
• Feeling: What emotions were you feeling? Why? Which past situation do they most remind you of?

On the backside of your piece of paper, on another piece of paper, or next to your four quadrants, create a fifth section. Here, you will write down your insights and ideas based on your empathy map.

The following questions can help you with the self-reflection process while you’re working on your map:

• How is the situation connected to your fears and hopes? What are your fears? What are your hopes? Which of your needs are met or not met in that situation?
• What was the environment in which you encountered the situation? What do you remember from the environment? How did you find yourself in that environment and why? What was your sight focused on?
• What hurts you most in the situation or makes you feel good about the situation?
• What was the feedback you gathered from your environment or other people?
• What are all the positives about the situation? What can you learn about yourself, others, and the world by experiencing that kind of a situation?

Do your best to avoid falling prey to cognitive distortions or reinforcing negative feelings while answering these questions. Go deep, and identify why you feel like you do. Observe, but don’t judge (Kos, n.d.).

Tool 3: Life Satisfaction Chart

A life satisfaction chart is a great way to assess how well you are meeting your goals and furthering your hopes for the future. You can complete this chart periodically to track your progress toward your goals and see what needs to be revised, improved, reduced, or eliminated to help you strive toward them.

Draw a scale from 1 (not at all satisfied) to 10 (extremely satisfied) horizontally, and list the following ten areas of life vertically:

• Relationships;
• Competencies;
• Spirituality ;
• Technology.

Assess your satisfaction in each of the 10 areas using the scale you created.

Next, take a second look at all the areas where you are only somewhat satisfied (where you used a rating between 4 and 7). It can be hard to effectively reflect when you don’t have a clear idea of whether you are satisfied with a specific area or not.

Go back through these “somewhat satisfied” areas and rate your satisfaction again, but use only ratings between 1 and 3 or 8 and 10. Limiting your options to either “very satisfied” or “not very satisfied” will help you to make a more decisive judgment about your satisfaction in each area.

Highlight every section rated with a 1, 2, or 3 with red, and highlight every section rated with an 8, 9, or 10 with green. Finally, for all ten areas of life, ask yourself, Why did you rate each area how you did? What would make you change your rating?

Repeat this exercise as often as you’d like to help you keep track of your satisfaction with the way your life is going (Kos, n.d.).

17 Exercises To Foster Self-Acceptance and Compassion

Help your clients develop a kinder, more accepting relationship with themselves using these 17 Self-Compassion Exercises [PDF] that promote self-care and self-compassion.

Created by Experts. 100% Science-based.

There are many books out there on self-reflection, self-awareness , and introspection, but we recommend the books below as resources to help you start your journey.

1. Question Your Life: Naikan Self-Reflection and the Transformation of Our Stories – Gregg Krech

Like the physical bags we carry when we go on a journey, our hearts and our minds only have so much room—but instead of carrying luggage, they carry stories. Some stories inform our lives and help us understand ourselves, while others don’t serve a purpose and can weigh us down.

In this book, Krech will guide the reader through several powerful examples of people who had an important change of heart or mind as a result of quiet self-reflection, including a woman who hated her mother, a man estranged from his father, a pregnant woman hit by a train, a couple who was struggling with their marriage, and a rabbi who neglected his shoes.

Read this book to open yourself up to seeing the world differently, and finding a better path forward.

You can find it on Amazon .

2. Being Present: A Book of Daily Reflections – David Kundtz

Being present can be defined as:

• Paying full attention to what is going on right now;
• Staying in the moment;
• Observing what is, without criticism or judgment;
• Having a balanced concern for things exactly as they are;
• Accepting whatever experience one is having;
• Having an awake participation in ongoing life.

You can use this book as a reminder to be more present through every season of the year and every season of life. The book draws inspiration from poets, scientists, spiritual teachers, children, butterflies, and big cities, and teaches you to accept each day as one full of possibilities and potential surprises.

3. 52 Weeks of Self Reflection – Erika R. Dawkins

You can use this book to guide you through self-reflection. No matter your goal, this guidebook will help you clear your head, see the world from a new perspective, and build a greater understanding of yourself.

In this piece, we defined introspection, described the importance of self-reflection (especially healthy self-reflection), and provided many example exercises, activities, and worksheets for you to enhance your understanding of yourself.

Keep in mind that self-reflection is an intensely personal process. If you find other activities that work better for you, feel free to focus on those—but we’d love for you to come back here and share with us what works.

Do you have any other techniques for self-reflection that you like to use? How important do you think introspection is for the average person, or for yourself? Let us know in the comments.

We hope you enjoyed reading this article. Don’t forget to download our three Self Compassion Exercises for free .

• Bates, S. M. (2012, November 11). Check yo’ self: An exercise in self-reflection. Hello Giggles. Retrieved from https://hellogiggles.com/fashion/check-yo-self-an-exercise-in-self-reflection/
• Cherry, K. (2016, June 14). What is introspection? Wundt’s experimental technique. Very Well. Retrieved from https://www.verywell.com/what-is-introspection-2795252
• Dahl, M. (2017). Sometimes ‘introspection’ is you just making stuff up. Science of Us. Retrieved from http://nymag.com/scienceofus/2017/03/sometimes-introspection-is-you-just-making-stuff-up.html
• Eurich, T. (2017). The right way to be introspective (yes, there’s a wrong way). TED. Retrieved from https://ideas.ted.com/the-right-way-to-be-introspective-yes-theres-a-wrong-way/
• Holothink. (n.d.). The art of self-reflection – 5 exercises to find peace in your life. Holothink.org. Retrieved from https://holothink.org/the-art-of-self-reflection-%E2%80%93-5-exercises-to-find-peace-in-your-life/
• Kos, B. (n.d.). Tools to help you with self-reflection. Agile Lean Life. Retrieved from https://agileleanlife.com/tools-to-help-you-with-self-reflection/
• McLeod, S. (2008). Wilhelm Wundt. Simply Psychology. Retrieved from https://www.simplypsychology.org/wundt.html
• Tartakovsky, M. (2014). 30 journaling prompts for self-reflection and self-discovery. Psych Central. Retrieved from https://psychcentral.com/blog/archives/2014/09/27/30-journaling-prompts-for-self-reflection-and-self-discovery/
• William, D. K. (n.d.). 30 thought-provoking questions you should ask yourself every day. Lifehack. Retrieved from http://www.lifehack.org/articles/communication/30-thought-provoking-questions-you-should-ask-yourself-every-day.html
• Wood, K. (2013). The lost art of introspection: Why you must master yourself. Expert Enough. Retrieved from http://expertenough.com/2990/the-lost-art-of-introspection-why-you-must-master-yourself
• Woronko, M. (n.d.). The power of self-reflection: Ten questions you should ask yourself. Lifehack. Retrieved from http://www.lifehack.org/articles/communication/the-power-self-reflection-ten-questions-you-should-ask-yourself.html

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Fantastic article and each of the Reflective Question is like a light house taking us deep inside of our life experiences. Thank You with deep appreciation in preparing this.

Great article! Self-reflection is necessary for improvement!

A very informative article. I learned alot.

I would say ”Best” information I’ve ever read about Self-reflection

I am really impressed with your writing style. Keep it up. The way you explain a complex topic in an easy to understand way is really impressive. Thanks for your inspiring thoughts which guided me well during my journey and gave me the hope I was looking for in personal and professional life. Hats off for this content…

First of all, Thank you for writing this article. It was very useful for Self Motivation.. All the points are very important to our personal and professional career. This will be a useful book for everyone.

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Unlocking Self-Reflection: The Ultimate Mental Health Tool

The power of self-reflection.

Self-reflection is a powerful  mental health tool  that can have a profound impact on an individual’s well-being. By taking the time to introspect and examine one’s thoughts, emotions, and experiences, self-reflection offers a pathway to self-awareness, personal growth, and improved mental health.

Understanding the Importance of Self-Reflection

Self-reflection involves stepping back from the busyness of everyday life and engaging in deep introspection. It allows individuals to gain a deeper understanding of themselves, their values, beliefs, and motivations. By reflecting on past experiences and behaviors, individuals can identify patterns, triggers, and areas for personal development.

Self-reflection also provides an opportunity to explore emotions and thoughts, helping individuals to gain a better understanding of their mental and emotional well-being. This heightened self-awareness can lead to improved self-regulation, allowing individuals to manage stress, anxiety, and other mental health challenges more effectively.

How Self-Reflection Supports Mental Health

Self-reflection plays a vital role in supporting mental health by facilitating the following:

• Emotional Regulation : Engaging in self-reflection allows individuals to identify and understand their emotions, leading to better emotional regulation and management.
• Stress Reduction : Reflecting on stress triggers and identifying coping mechanisms can help individuals develop healthier responses to stressors, reducing overall stress levels.
• Enhanced Problem-Solving : Self-reflection enables individuals to analyze past experiences and identify areas for improvement, enhancing problem-solving skills and decision-making abilities.
• Increased Self-Esteem : Through self-reflection, individuals can recognize their strengths, achievements, and areas of growth, fostering a positive self-image and increased self-esteem.
• Improved Relationships : By reflecting on one’s own thoughts, emotions, and behaviors, individuals can gain insight into their interpersonal dynamics, enhancing empathy, communication, and fostering healthier relationships.
• Personal Growth : Self-reflection is a catalyst for personal growth and self-development. By gaining a deeper understanding of oneself, individuals can set realistic goals, make positive changes, and cultivate a sense of purpose and fulfillment.

Incorporating self-reflection into mental health practices can be immensely beneficial for therapists, coaches, and practitioners. By encouraging clients to engage in self-reflection, professionals can support their clients’ personal growth and empower them to take an active role in their mental well-being.

In the next section, we will explore various techniques for self-reflection, including journaling, meditation and mindfulness, and creative expression, that can be incorporated into mental health practices.

Self-Reflection as a Mental Health Tool

Self-reflection serves as a powerful  mental health tool  that can contribute to personal growth and overall well-being. By taking the time to delve into one’s thoughts, emotions, and experiences, individuals can gain valuable insights and develop a deeper understanding of themselves. In this section, we will explore what self-reflection entails and the benefits it brings when incorporated into mental health practices.

What is Self-Reflection?

Self-reflection is the process of  introspection  and examination of one’s own thoughts, emotions, and behaviors. It involves stepping back from daily routines and taking a moment to focus inwardly, creating an opportunity for self-awareness and self-discovery.

Through self-reflection, individuals can gain a clearer understanding of their values, beliefs, strengths, and areas for growth. It allows them to explore their past experiences, current circumstances, and future aspirations. This practice can be facilitated through various techniques, such as journaling, meditation, and creative expression.

Benefits of Incorporating Self-Reflection into Mental Health Practices

Incorporating self-reflection into mental health practices offers a range of benefits that support emotional well-being and personal development. Some of these benefits include:

• Increased self-awareness:  Self-reflection provides an opportunity to deepen self-awareness, enabling individuals to identify patterns, triggers, and underlying emotions. This awareness can lead to a better understanding of oneself and the ability to make conscious choices aligned with personal values and goals.
• Enhanced emotional intelligence:  By engaging in self-reflection, individuals can develop a greater understanding of their emotions and how they influence their thoughts and behaviors. This heightened emotional intelligence can improve relationships, communication, and decision-making skills.
• Stress reduction and self-care:  Self-reflection allows individuals to identify sources of stress, recognize their emotional needs, and implement self-care practices. It can help individuals develop effective coping strategies, manage stress, and prioritize their mental and emotional well-being.
• Personal growth and development:  Through self-reflection, individuals can identify areas for personal growth and set realistic goals. They can assess their progress and make adjustments along the way, leading to continuous self-improvement and personal development.
• Improved problem-solving:  Self-reflection enhances problem-solving skills by encouraging individuals to think critically and consider different perspectives. It fosters a mindset of curiosity and exploration, enabling individuals to approach challenges with a flexible and open mindset.

By incorporating self-reflection into mental health practices, individuals can tap into their inner resources, gain clarity, and develop a greater sense of self. This valuable tool can be utilized by therapists, coaches, and practitioners to support their clients’ journey toward improved mental well-being. To explore additional mental health tools and resources, visit our article on  mental health tools .

Techniques for Self-Reflection

Incorporating self-reflection into mental health practices can be a powerful tool for personal growth and well-being. There are several techniques that individuals can utilize to engage in self-reflection. These techniques include  journaling ,  meditation and mindfulness , and  creative expression .

Journaling is a widely recognized technique for self-reflection that involves writing down thoughts, emotions, and experiences. It provides an opportunity to explore and process one’s feelings, gain insights, and track personal growth over time. By putting thoughts into words, individuals can gain clarity and a deeper understanding of their own experiences.

To incorporate journaling into your self-reflection practice, set aside dedicated time each day or week to write freely and without judgment. You can choose to focus on specific topics or simply let your thoughts flow. Consider using prompts or questions to guide your writing, such as “What am I grateful for today?” or “What challenges did I face and how did I overcome them?”.

Meditation and Mindfulness

Meditation and mindfulness practices involve cultivating present-moment awareness and non-judgmental observation of thoughts, feelings, and sensations. These techniques can be effective for self-reflection by creating a space for self-exploration and inner observation. By taking time to quiet the mind and focus on the present moment, individuals can gain insights into their thoughts, emotions, and patterns of behavior.

To incorporate meditation and mindfulness into your self-reflection practice, find a quiet and comfortable space where you can sit or lie down. Close your eyes, take deep breaths, and bring your attention to the sensations of your breath or your body. Notice any thoughts or emotions that arise without judgment, allowing them to come and go.

Creative Expression

Creative expression, such as painting, drawing, writing poetry, or playing music, can be a powerful form of self-reflection. Engaging in creative activities allows individuals to express their thoughts and feelings in a non-verbal way, tapping into their subconscious mind and gaining insights that may not be accessible through traditional reflection methods.

To incorporate creative expression into your self-reflection practice, find a creative outlet that resonates with you. Experiment with different forms of expression and allow yourself to explore without judgment. Set aside regular time to engage in creative activities, allowing your thoughts and emotions to flow freely through your chosen medium.

By incorporating techniques such as journaling, meditation and mindfulness, and creative expression into your self-reflection practice, you can deepen your understanding of yourself, promote personal growth, and enhance your overall well-being. These techniques can be utilized by therapists, coaches, and practitioners to support their clients in their self-reflection journey. Remember to be consistent and commit to regular practice to experience the full benefits of self-reflection.

Integrating Self-Reflection into Mental Health Practices

Self-reflection is a powerful tool that can greatly enhance mental health practices. Whether you are a therapist, coach, or practitioner, integrating self-reflection into your work can have numerous benefits. In this section, we will explore how self-reflection can be integrated into  therapy ,  coaching , and  personal growth .

Self-Reflection in Therapy

In therapy, self-reflection plays a vital role in helping clients gain deeper insights into their thoughts, emotions, and behaviors. Therapists encourage clients to reflect on their experiences, patterns, and beliefs, fostering self-awareness and facilitating personal growth. Through guided self-reflection exercises, such as journaling or mindfulness practices, clients can explore their inner world, identify triggers, and develop coping strategies.

Therapists can also use self-reflection as a tool for their own professional development. Reflecting on their therapeutic approach, interactions with clients, and personal reactions to sessions allows therapists to continually improve their skills and enhance their effectiveness. By integrating self-reflection into therapy sessions, therapists create a safe and supportive environment for clients to explore their thoughts and feelings. For more tools and resources related to mental health, visit our  mental health resource tool .

Self-Reflection for Coaches and Practitioners

Coaches and practitioners can also benefit from incorporating self-reflection into their work. By engaging in self-reflection, coaches can gain a deeper understanding of their own biases, beliefs, and strengths. This self-awareness allows coaches to better support their clients, as they can recognize and manage their own reactions and emotions during coaching sessions.

Self-reflection also helps coaches and practitioners identify areas for professional growth and development. By examining their coaching techniques and interactions with clients, they can refine their skills and enhance the effectiveness of their coaching practice. Additionally, practicing self-reflection can serve as a model for clients, encouraging them to engage in their own self-reflection and personal growth journeys.

Self-Reflection for Personal Growth

In addition to professional settings, self-reflection is a valuable tool for personal growth. Engaging in self-reflection allows individuals to gain clarity about their goals, values, and aspirations. It provides an opportunity to examine one’s beliefs, strengths, and areas for improvement.

Through techniques such as journaling, meditation, and creative expression, individuals can deepen their self-awareness and develop a greater sense of self-compassion. Self-reflection also helps individuals identify patterns and behaviors that may be holding them back, allowing them to make meaningful changes and cultivate a more fulfilling life.

By integrating self-reflection into their mental health practices, therapists, coaches, and individuals can unlock the transformative power of self-reflection. Whether it’s in therapy sessions, coaching sessions, or personal growth journeys, self-reflection provides a valuable opportunity for exploration, growth, and healing.

Tips for Effective Self-Reflection

To make the most out of self-reflection as a  mental health tool , it’s important to follow some key tips. These tips will help create a safe and supportive environment for self-reflection, set realistic goals, and maintain consistency and commitment in the practice.

Creating a Safe and Supportive Environment

Creating a safe and supportive environment is crucial for effective self-reflection. Here are some tips to create such an environment:

• Find a quiet and comfortable space where you can focus without distractions.
• Ensure your environment is free from interruptions or disruptions.
• Create a calming ambiance by incorporating elements like soft lighting, soothing music, or aromatherapy.
• Consider using a mental health app or a mental health website that offers tools and resources to support your self-reflection journey. These platforms can provide structure and guidance in your reflection process. Check out the  Quenza mental health platform  for a comprehensive toolkit.

Setting Realistic Goals

Setting realistic goals for self-reflection helps to provide direction and focus. Here are some tips to set realistic goals:

• Start small: Begin with shorter periods of reflection and gradually increase the duration as you become more comfortable.
• Be specific: Identify the specific areas or aspects of your life that you want to reflect on, such as relationships, emotions, or personal growth.
• Break it down: Divide your goals into manageable steps or questions to guide your reflection.
• Use a journal or a mental health tool for self-reflection: Writing down your thoughts and reflections in a journal or using a mental health tool can help you track your progress and revisit your reflections over time. Consider using a mental health tool for journaling, such as the  Quenza mental health tool for journaling .

Consistency and Commitment

Consistency and commitment are key to making self-reflection a lasting habit. Here are some tips to maintain consistency and commitment:

• Set aside dedicated time for self-reflection in your schedule.
• Make it a regular practice, whether it’s daily, weekly, or monthly, depending on your needs and availability.
• Hold yourself accountable by setting reminders or using a mental health tracking tool to monitor your progress.
• Seek support from a therapist, coach, or practitioner who can help guide and support your self-reflection journey. They can provide valuable insights and help you navigate any challenges that arise.

By creating a safe and supportive environment, setting realistic goals, and maintaining consistency and commitment, you can effectively harness the power of self-reflection as a mental health tool. Remember, self-reflection is a personal journey, and it’s important to tailor your practice to suit your individual needs and preferences.

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The Questions That Empowered My Mental Health Journey

If you’re living with mental illness or are neurodivergent, you’re likely familiar with feelings of overwhelm and frustration due to the challenges associated with your condition. Combined with misconceptions about mental health and its treatments, it can often feel like the odds are against us.

However, even on the toughest days, it’s crucial to remember that there’s still hope. Through helpful coping skills that come along with understanding our sphere or locus of control as defined by the APA: the extent to which we believe we can influence our lives and the factors that impact our lives, circumstances, and situations.

Understanding our sphere of control is a great tool and first step for learning how to define and process our challenges, diagnoses, and other mental health-related obstacles in a way that fosters empathy, accountability, resilience, and compassion for ourselves.

It’s also a great tool for helping us realize in a world full of stigma, we still have a choice in how we relate to all aspects of our well-being. Here are a few other ways understanding one’s sphere of control and influence can come in handy in our mental health journey.

If you’re ever feeling overwhelmed, defensive, or frustrated by unsolicited advice, societal stigma, social media pressures, or negative portrayals of mental health, you’re not alone.

In my journey as someone with ADHD and anxiety , I’ve learned the importance of prioritizing my mental health and well-being. It often meant I had to distance myself from individuals who perpetuated stigma or dismissed the validity of seeking treatment. It’s draining to constantly feel the need to justify one’s diagnosis. While it was difficult to confront these attitudes, doing so allowed me to create a supportive network of understanding individuals who uplifted rather than undermined my recovery.

• What is ADHD

I recall the first few years of my mental health journey when I assumed that one day, my ADHD and anxiety, along with the intense thoughts and feelings accompanying those diagnoses, would disappear. Then one day, another mental health professional reminded me that having challenging thoughts, emotions, situations, or memories doesn’t mean we’re not making progress.

So, how does our sphere of control how we relate to these challenges? It does so by empowering us to shift where we focus our attention. For example, shifting our attention from rumination to action also empowers us to validate those aspects of our journeys through solutions and healthy self-talk, helping us build self-acceptance, self-awareness, and self-compassion to hold space for ourselves.

A person’s sphere of control is one of the many tools in their mental health journey. It’s perfectly normal if you’re still figuring out your sphere of control — that’s part of the journey!

As a former peer support specialist and outreach worker diagnosed with ADHD and anxiety, here are a few questions I’ve found helpful in my journey and in supporting others:

• What information and resources do I need to better understand my obstacles, diagnosis, and treatment? • How can I base my progress on what I consider progress instead of comparing myself to others? • How can I play a more active role in my treatment so my support workers better understand what is going on with my well-being? • How can I learn to be more compassionate with myself on my journey? • What barriers are stopping me from seeking help?

If these questions don’t work for you, remember that everyone’s journey is unique. Here’s an alternative list of self-reflection questions (from Positive Psychology) to inspire and empower you on your path.

Hi there. I'm Sandy, a mental health advocate based in Calgary, Alberta. I am a former peer support specialist and outreach worker with a human services background, and I've dedicated myself to this cause. My journey has led me to write extensively on mental health-related topics for reputable publications like Thought Catalog, ADDitude Magazine, TotallyADD, and LinkedIn. I started writing because, living with ADHD and Social Anxiety, I understand firsthand the challenges many face. I'm celebrating my one year of being relapse-free this year; I'm passionate about offering support and resources to those who need it. Currently, I'm immersed in completing my training as an ADHD and Neurodiversity coach, aiming to provide specialized support for individuals navigating these experiences. Feel free to reach out if you're seeking support, resources, or just someone to chat with. Together, let's navigate the complexities of mental health with empathy and understanding."

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Self-Reflection and Mindfulness: A Powerful Combination for Students’ Mental Health

College life can turn out to be pretty stressful at times. Even though you enjoy your time in college, you meet new people and you go on adventures, you still have to face all the academic challenges that lie ahead. Learning how to manage your time, how to collaborate, and communicate can be one way you can do this. And it will help you tremendously. But you also need to take care of your mental health, as this will relieve stress and help you manage your academics successfully. 

Mindfulness and self-reflection are gaining more and more momentum and they help you make sense of your inner world, find your peace, and the strength you need to go on with your college life. But how can you use this combination to take care of your mental health? Here are some tips and tips that will help you, where the benefits of mindfulness are highlighted too. Being mindful is something we all should do as this contributes to better mental health. Learn how here. 

Reduced Stress and Anxiety 

One of the benefits of mindfulness meditation is reduced stress and anxiety. When you are a student in college, you have many tasks to handle. You need to attend classes, take notes, and prepare for the exams. Additionally, you have to complete your written tasks, which sometimes can put a toll on yourself and your mental health. Some college moments are more crowded than others. There are moments when you need to put in a lot of effort and time to make it work. Whether you have to write a self-reflection essay or just a research paper, you will have to research and find essay samples to inspire you. To streamline self-reflection essay examples by Eduzaurus will help you a lot with the progress of your paper. But you also need to take care of your mental health, as these tasks can make you stressed and anxious. 

One of the mindfulness benefits is that it helps you become more self-aware. This way, you can identify the triggers of your stress and start working on them. At the same time, you learn how to manage your emotions successfully. Sometimes, emotions might be so intense that they prevent you from being productive, focusing on your writing, and completing your tasks. Through mindfulness meditation and self-reflection, you learn to observe your emotions without letting yourself be overwhelmed by them. Which, in turn, helps you reduce the stress and anxiety you are already feeling. And this helps you improve your stress resilience too. Which will have a positive effect on your mental health. 

Improved Focus and Concentration 

Among the benefits of mindfulness meditation is improved focus and concentration . You may ask yourself why is mindfulness important. Besides helping you get more in tune with your own emotions and feelings, how can it help you in your academic life? Well, it helps you focus and concentrate on your tasks, which means less lost time and less stress. 

It helps you train your brain to stay present, without falling for the distractions around you . As the world we live in is full of distractions, you might experience them while you try to focus. But through mindfulness and self-reflection, you learn to identify the things that distract you and keep them away. You learn to minimize their impact on you, so you will be more productive and focused on your tasks. 

Improved Physical Health 

One of the things that happen in the life of most college students is that they neglect their physical health. Many students are pulling all-nighters to learn everything for the exam the next day. They neglect to do physical exercises, take breaks, or even get enough sleep . Not having healthy eating habits and a sleeping schedule can indeed put a toll on your body. And when your body is not feeling well, your mind is not feeling well either. 

So, you reduce stress by practicing mindfulness and self-reflection. But you also improve your sleep quality which will help you focus on your tasks and be efficient. You become more aware of your habits that do not contribute to your physical health, so you can act on changing them. Which will help you improve your physical health tremendously. 

Conclusion 

Self-reflection and mindfulness are powerful combinations that help students take care of their mental health. College time is full of amazing moments but of challenges too. And getting more in tune with your emotions, your inner world, and habits will help you know how to act on changing them. You improve your physical health too, not only your mental health. You improve your focus and concentration but also relieve stress and anxiety. 

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21-Day Plan of Inner-Reflection For Your Mental Health

Try this 21-day mental health plan from therapists for mindfulness and self-reflection.

Sometimes the biggest form of self-care is knowing the right questions to ask yourself. It's a complicated feat — and one you might not want to start on your own — but eight different therapists took the guesswork out for you.

Each day for 21 days, a therapist will pose a question you can contemplate, and you'll also be tasked with an actionable way to answer that question. This practice is supposed to help your mental health and, in doing so, perhaps your physical wellbeing . You'll find a chart of these inquiries below and, ahead, check out a full list of action items for each day of this three-week plan.

Though this is not equivalent to therapy by any means, these therapist-informed inquiries are meant to guide you toward everyday mindfulness. They are important questions that will hopefully promote more self-discovery about your hopes, intentions, and values as well as get you thinking about how you treat your body and mind. Take the challenge to invest in yourself and look within — you may be better for it in the end.

Day 1: How Can I Help Someone Else Today?

Helping others has been shown to improve people's mental health , Katelyn Baker , PsyD, told POPSUGAR, adding "good deeds make you feel good!"

Action item: Try doing one thing for someone else today: go grocery shopping for a neighbor who can't, send a virtual gift card, complete someone else's chore, or deliver an encouraging message to a friend you know is struggling. Anything for someone else counts!

Day 2: What Are 3 Things I Have to Accomplish Today?

"Workloads can be overwhelming," Dr. Baker said. "Research shows that setting small, attainable goals can help with procrastination , self-worth, and motivation ."

Action item: Make a list of three things you absolutely need to accomplish today, big or small. Set a few realistic goals, not a laundry list of "to-do"s that may not get done. These goals could be running a single errand, tackling two specific work tasks, or doing chores around your living space.

Day 3: What Was a Success of My Day?

This is something you'll ask yourself at the end of the day. Licensed professional counselor Lindsay Fleming knows that "success" can be a daunting word. "We need to redefine what success is and what it looks like," she told POPSUGAR.

Action item: Think outside of achievement to answer this question. For example, Fleming said, success might be making your bed or, perhaps, not getting mad at yourself if you woke up late.

Day 4: What Am I Grateful For?

Fleming said, "We can become so caught up in all the wants of life that we forget to focus on what we have." She added that practicing gratitude can help us lead more fulfilling and happy lives.

Action item: Write at least three things you are grateful for, whether that's jotting it down when you wake up, in the afternoon, or before you head off to bed. They can be anything: appreciating the roof over your head, counting your close friends, or remembering that you were able to make it through the day.

Day 5: What Are 3 Self-Affirmations?

Focusing on self-affirmations helps us believe in ourselves and move away from negative self-talk , Fleming noted.

Action item: Write down three self-affirmations. They can start with "I am," "I can," and "I will."

Day 6: What Are My Unmet Needs?

Licensed professional clinical counselor Shani Tran told POPSUGAR that it's important to look within ourselves and identify unmet needs we might have.

Action item: Identify at least one need, and then seek to meet it on your own. An example is rest. Find time in your day to take a break.

Day 7: What Sensations Am I Noticing in My Body?

"For people who struggle to identify how they are feeling, paying attention to physical sensations is an easier way to ground yourself in the moment and name hard emotions," registered psychotherapist Meghan Watson told POPSUGAR. Tran agreed with this as well, stating that emotions can manifest physically.

Action item: Get into a comfortable position, and scan your body from head to toe for discomfort and tension. Try to describe what and where you are feeling discomfort, and practice extending compassion to that area. Repeat as often as necessary.

Day 8: What Boundaries Are Most Important For Me to Uphold Today?

Boundaries prevent burnout, Watson explained. They prevent us from doing too much in too little time and help us manage being overwhelmed. "Boundaries are important for us to create the necessary space to show up unapologetically as ourselves as well as stay accountable to our needs," she said.

Action item: Write down one to three boundaries as it relates to your time, energy, and resources. Reflect briefly on your upcoming day or week, and consider how you want to enforce these boundaries as you navigate your work, school, or home life.

Day 9: How Can I Be More Open?

Sana Powell , MA, LPC, told POPSUGAR that taking time to reflect on how we can be more open-minded is essential because "past experiences, bias, and self-limiting beliefs can limit our growth." She added, "Directly asking ourselves what we can be more accepting of can help us identify ways we can more fully receive what life offers us, whether it's a new perspective, opportunity, or relationship."

Action item: Do one thing outside of your comfort zone today. Here are some examples from Powell: show vulnerability to someone you care for, try something new without worrying about whether you're "good" at it, or practice saying "yes" to an opportunity that may foster your growth.

Day 10: What Is My Intention For Today?

Watson said that setting up your day with an intention can create a sense of purpose and is a way to keep your core values in mind during your daily routine.

Action item: Take a deep breath, close your eyes, and consider where you want to focus your energy and purpose for the day. Try not to get caught up in naming a to-do list. Instead, focus more on how you want to move through your day. Once you've named an intention, say it out loud or write it down somewhere you can see it as a reminder for when things feel out of balance.

Day 11: In What Ways Are My Stresses Related to Discrimination and Systemic Injustice?

Melody Li , LMFT, founder of Inclusive Therapists , told POPSUGAR that systemic oppression hurts the mental health of people who have been marginalized . This includes those who identify as BIPOC, the LGBTQ+ community , people with disabilities, and those who are considered neurodiverse .

"People with marginalized identities may begin to question or minimize their own experiences," Li said. "To take care of our mental health starts with identifying the sources of trauma: personal, relational, systemic, intergenerational, historical. This reflection empowers us to tend to ourselves and our communities more holistically and authentically."

Action item: Find a caring community with similar experiences. Share your story, and hold space for others. "Collective care is a powerful way to tend to the pains caused by systemic oppression," Li said. It helps to find validation elsewhere. And, if you don't find an answer to this question because you come from a place of privilege , do research on how to be a better ally . Read the stories of others . Learn and listen.

Day 12: What Parts of Myself Have I Been Neglecting?

"Self-care encompasses different domains of ourselves such as the psychological, emotional, spiritual, physical, social, and academic or professional realms of life," Powell said. "Many of us tend to focus on certain areas of our lives while neglecting others, resulting in an imbalance of self-care that places stress on our mental health."

Action item: Make a balanced self-care plan for yourself. Jot down ideas for how you can care for yourself in each of the following areas of your life: psychological, emotional, spiritual, physical, social, and professional. You might find overlap in your ideas, or you may notice that brainstorming ideas for self-care is easier for some areas and harder for others. Plan to nurture parts of yourself that you tend to overlook.

Day 13: What Self-Limiting Beliefs Are Holding Me Back?

This is the opposite of identifying self-affirmations. "The negative messages we consciously and subconsciously tell ourselves can deteriorate our self-confidence and lead to self-doubt," Powell said. "Checking in with ourselves about what self-limiting beliefs we hold and where they might have originated from can help us maintain our mental health and achieve our potential."

Action item: Tap into your inner-critic to identify doubts you have about yourself. Ask yourself if your inner-critic resembles the voice of someone in your life or a person from your past. Then, write down your reflections. This, Powell said, may help provide insight on your negative self-talk and how it might hold you back.

Day 14: How Can I Invest in a Relationship That Matters to Me Today?

Therese Mascardo , PsyD, told POPSUGAR that healthy relationships are an important building block of sustained mental health, though it can be difficult during our daily lives to prioritize those relationships. "Asking this question daily can help us make sure that we are prioritizing what will support our wellbeing in the long run," she said.

Action item: Write down the name of one person who matters to you. Next to their name, write down one thing you can do to invest in that relationship. For example, "Sarah: send over a text to see how her mom is doing."

Day 15: How Do I Want to Feel at the End of Today?

Dr. Mascardo said that focusing on how we want to feel can help us follow through with goals for the day.

Action item: Complete the following sentences on paper:

• "At the end of today, I want to feel . . . "
• "Two things I can do to help me feel that way are . . ."

Day 16: What Can I Let Go Of?

Powell said that it can be easy to hold on to things we're comfortable with even though they may affect our health in a negative way. "Asking ourselves what we can let go of challenges us to consider the beliefs and behaviors that we no longer need," she explained. "Maintaining our mental health is a process that requires decluttering what we've outgrown and making space for new ways of being."

Action item: Focus on how you spend your time. Identify things you spend time on solely out of habit even if they don't align with what your goals and values are. Chose something else you'd like to make time for instead.

Day 17: What Growth Have I Experienced?

Powell said that looking backwards in order to see how far you've come is important. "While it can be easy to ignore your growth and solely focus on what you have not accomplished, take time to reflect on your journey, what you've learned, and how you've evolved," she noted. "Acknowledging and affirming your growth can help build your self-esteem and sustain your motivation to achieve your goals."

Action item: Free-write a reflection of different parts of your life. This can be your mental health, physical health, social life, or anything else. See how you've evolved over time.

Day 18: Am I Fawning?

Tasha Bailey , MBACP, a trauma and creative counselor , told POPSUGAR that the fawn response is a reaction to stress or trauma , and it's "pretending that everything is fine or people-pleasing in order to be liked and to avoid further stress."

Action item: Today, when you enter spaces or conversations, decide whether you feel safe enough to not wear that mask. Ask yourself what stands in your way of taking that mask off. Or, more generally, you can reflect on what people you tend to have your guard up with.

Day 19: What's 1 Small Step That Can Help Me Move Toward My Goal?

Dr. Mascardo said that we tend to focus on large, intimidating goals that cause us to feel discouraged, and this can "sabotage any hint of progress." Breaking these goals down into small steps makes them easier to grasp.

Action item: "Take a big goal, and identify one laughably small step to move you forward," Dr. Mascardo suggested.

Day 20: Am I Honoring My Body?

"In society, we are often told what bodies are acceptable or unacceptable ," Bailey said. She noted that it leads to body-shaming "whether it be because of body shape, skin color, or disability. All bodies are beautiful and deserve to be appreciated."

Action item: Bailey suggested purchasing, renting, or borrowing books like The Body Is Not an Apology and Fattily Ever After . Diversify your social media feed so that you are seeing more bodies that look like yours rather than society's expectations of what beauty is.

Bonus action item: Dr. Mascardo suggested identifying one thing you can do to support your body. It can be:

• Moving your body in a way that feels good
• Feeding your body energizing food
• Speaking kind words to your body
• Taking a few minutes to stretch
• Not putting off going to the bathroom when you need to
• Drinking water throughout the day

Day 21: What's the Most Beautiful Thing I Saw Today?

Dr. Mascardo said, "Appreciating beauty is immensely valuable for our well-being," and that asking this question can help us connect with gratitude. It also can make us more mindful of beauty on a regular basis.

Action item: At the end of your day, write down something that you felt was beautiful. It can be a person, situation, feeling, object, or whatever else you want to identify. Beauty should be boundless.

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Can Self-Reflection Help My Mental Health?

Are you feeling busy, distracted and exhausted? Even after the emotionally overwhelming year we’ve all just experienced, we haven’t slowed down and taken time for ourselves. Further, our society doesn’t value the practice of introspection, the observation of one’s own mental and emotional processes. Introspection, or self-reflection, is the willingness to recognize and determine your “old programming” that no longer serves you so that you can build new “programming.” How this can be done? With a calm mind to start.

How do I calm my mind? Having a calm mind will allow you to concentrate and feel more relaxed. This practice will vary person to person, but here are some suggestions:

• Take a few deep breaths; practice breath work
• Stretch your body
• Go for a walk; move your body
• Journal, meditate, pray

How do I practice self-reflection? When your mind is calm, allow yourself to draw inward and think deeply on the issue, emotion or memory at hand. To help, ask yourself:

• What does this make me think?
• How does it make me feel?
• How does it hold me back?

It’s important not to judge yourself. Be honest with yourself so that you’re not tempted to imagine how you should feel. Don’t be afraid to dig deeper! You’re trying to access the root of the issue and you will most likely come across resistance. This is your ego/mind trying to protect you from uncomfortable and harmful emotions.

Additionally, you can ask yourself questions in order to get to know yourself better whether or not you’re currently working through an issue. Start with these:

• What am I really scared of?
• Am I holding on to something that I can let go of?
• When did I last push passed my comfort zone?
• What do I want most in life?
• When was the last time I made someone smile?

Why should I practice self-reflection? With self-reflection comes self-awareness. You’ll begin to see your thoughts, behaviors, emotions and reactions in real time as you experience them. You can determine which ones bother you, don’t serve you or harm you and learn to let them go. By slowing down, calming your mind, and asking yourself substantial questions to draw on old issues, you can then learn to shift your behaviors, thoughts and reactions to ones that better represent you, your values and beliefs.

The more you reflect, the easier you’ll be able to hold yourself accountable. This not only benefits you directly, but it also benefits those you surround yourself with. You may even inspire them to be more introspective!

What are benefits to introspection? A self-aware person can expect myriad of benefits, but here are some that may be true for you:

• Self-control
• Less stress and anxiety
• Higher self-esteem and pride
• Increased emotional intelligence
• Easier time coping with challenges
• Appropriate reactions to situations
• Realize their potential and become more aligned

Remember, slowing down, calming your mind and regular self-reflection may come with resistance­­­­ from your mind, your family, even your job. Stay strong­­–this time is essential for your mental health. It’s okay to start small and always be gracious and patient with yourself. You’re in the process of changing how you think, feel, and behave. You’re changing your life!

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Learn more tips on living well and understanding mental illness. Help to end the stigma, and hear inspiring stories of recovery. Sign up here!

Posted on January 28, 2021 by Author Hanna Gilley in Categories Journey , Tips for Healthy Living , Understanding Mental Illness Tagged calm mind , introspection , Mental Health , relaxation , resilience , self care , self-awareness , self-reflection , shift your behavior

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Home — Essay Samples — Nursing & Health — Mental Health — The Importance of Mental Health Awareness

The Importance of Mental Health Awareness

• Categories: Mental Health Social Isolation Stress Management

About this sample

Words: 1622 |

Updated: 4 November, 2023

Words: 1622 | Pages: 4 | 9 min read

Table of contents

Introduction, mental health awareness, video version, emotional well-being, psychological well‐being, social well-being.

• Health Effects of Social Isolation and Loneliness. (n.d.). Retrieved from https://www.aginglifecarejournal.org/health-effects-of-social-isolation-and-loneliness/.
• Top of Form Mental Health Myths and Facts https://www.mentalhealth.gov/basics/mental-health-myths-facts
• Mental Health Care Services by Family Physicians Position Paper. American Academy of Family Physicians Web site. http://www.aafp.org/online/en/home/policy/policies/m/mentalhealthcareservices.htm. Accessed February 11, 2013. [Google Scholar]
• Newman, T. (2017, August 24). Mental health: Definition , common disorders, and early signs. Retrieved from https://www.medicalnewstoday.com/articles/154543.php.
• Bottom of Form Rodriguez, B. D., Hurley, K., Upham, B., Kilroy, D. S., Dark, N., & Abreu, E (n.d.).Happiness and Emotional Well-Being. Retrieved from https://www.everydayhealth.com/emotional-health/understanding/index.aspx.
• World Health Organization. The Global Burden of Disease, 2004 Update. Part 4, Burden of Disease, DALYs. http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf . Accessed January 10, 2013. [Google Scholar]

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Exploring the therapeutic relationship through the reflective practice of nurses in acute mental health units: A qualitative study

Diana tolosa‐merlos.

1 Institut de Neuropsiquiatria i Addiccions, Hospital del Mar, Barcelona Spain

Antonio R. Moreno‐Poyato

2 Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L'Hospitalet de Llobregat Spain

3 IMIM (Hospital del Mar Medical Research Institute), Barcelona Spain

Francesca González‐Palau

4 Hospital Santa Maria, Salut/Gestió de Serveis Sanitaris, Lleida Spain

Alonso Pérez‐Toribio

5 Unitat de Salut Mental de l'Hospitalet, Gerència Territorial Metropolitana Sud, Institut Català de la Salut, L'Hospitalet de Llobregat Spain

Georgina Casanova‐Garrigós

6 Department and Faculty of Nursing, Universitat Rovira i Virgili, Tortosa Spain

Pilar Delgado‐Hito

7 Department of Fundamental Care and Medical‐Surgical Nursing, Nursing School, Universitat de Barcelona, L'Hospitalet de Llobregat Spain

8 GRIN‐IDIBELL (Nursing Research Group‐ Bellvitge Biomedical Research Institute), L'Hospitalet de Llobregat Spain

Associated Data

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Aims and objectives

To explore the therapeutic relationship through the reflective practice of nurses in acute mental health units.

In mental health units, the therapeutic relationship is especially relevant for increasing the effectiveness of nursing interventions. Reflective practice is considered an essential aspect for improving nursing care.

Action and observation stages of a participatory action research project.

Data were collected through reflective diaries designed for the guided description and reflection of practice interactions related to the therapeutic relationship and content analysis was applied. A total of 152 nurses from 18 acute mental health units participated. The COREQ guidelines were used.

The results were classified into three categories as follows: (i) Nursing attitude as a core of the therapeutic relationship. For the nurses, the attitudinal component was key in the therapeutic relationship. (ii) Nursing practices that are essential to the therapeutic relationship. Nurses identified practices such as creating a conducive environment, using an appropriate verbal approach, offering help and working together with the patient as essential for establishing a therapeutic relationship in practice. (iii) Contextual factors affecting the therapeutic relationship. The nurses considered the patient's condition, the care dynamics of the unit and its regulations, as well as the structure and environment of the unit, as contextual factors involved the establishment of an adequate therapeutic relationship in daily clinical practice.

Conclusions

This study has provided knowledge of the importance and role of the nurses' attitude in the context of the nurse–patient therapeutic relationship based on the reflections of nurses in mental health units regarding their own practice.

Relevance to clinical practice

These findings help nurses to increase awareness and develop improvement strategies based on their own knowledge and day‐to‐day difficulties. Moreover, managers can evaluate strategies that promote motivation and facilitate the involvement of nurses to improve the therapeutic relationship with patients.

What does this paper contribute to the wider global clinical community?

• An in‐depth analysis of nurses' reflections regarding the aspects that underlie the therapeutic relationship in their clinical practice enables the nurses themselves to become aware and to develop strategies for improvement based on their own knowledge.
• Understanding and confirming how the attitudinal component is a key element for nurses in the practice of the therapeutic relationship allows managers to evaluate strategies that promote motivation and facilitate the involvement of nurses to improve their practice with patients.
• The results point to the need for further studies aimed at identifying and implementing strategies that facilitate mental health nurses to incorporate and improve attitudinal skills related to establishing the nurse–patient therapeutic relationship in clinical practice.

1. INTRODUCTION

The nursing discipline is defined as a significant, therapeutic and interpersonal process that acts in conjunction with other human processes that make health possible for individuals (Peplau, 1988 ). The relationship established between nurse and patient is therapeutic, regardless of the setting in which care is provided (Stevenson & Taylor, 2020 ). However, in the mental health unit setting, the therapeutic relationship is especially relevant to increase the effectiveness of any nursing intervention (McAndrew et al., 2014 ). Reflective practice is considered an essential aspect of improving nursing care and generating knowledge (Vaughan, 2017 ). This paper aims to deepen the knowledge of the therapeutic relationship based on the reflections of nurses regarding their practice, in the context of current challenges within the mental health acute care setting.

1.1. Background

Based on Peplau's model of interpersonal relationships by ( 1988 ), which is the most widely held theory in the mental health nursing community, many authors have based their models on person‐centred mental health nursing (Barker & Buchanan‐Barker, 2010 ; O'Brien, 2001 ; Scanlon, 2006 ). All of them identify the therapeutic relationship as the foundation of nursing practice and the pillar upon which mental health nursing has been built (McAllister et al., 2019 ; Moreno‐Poyato et al., 2016 ). The proper establishment of the nurse–patient therapeutic relationship is especially relevant to increase the effectiveness of any nursing intervention in acute psychiatric units (McAndrew et al., 2014 ).

The therapeutic relationship could be defined as a human exchange (Peplau, 1988 ) that is based on effective communication that favours the possibility for a person to help another person to improve their health condition, with the objective that, through such communication, the person will be able to develop interpersonal and problem‐solving skills (Forchuk et al., 1998 ). To this end, concepts such as understanding, interest, availability, individuality, authenticity, warmth, respect and self‐knowledge are basic pillars for the nurse (Moreno‐Poyato et al., 2016 ). The literature points out that mental health nurses seem to be knowledgeable of the importance of the therapeutic relationship in inpatient units; however, the reality of clinical practice leads us to believe that theoretical knowledge is not enough to create a good bond with patients (Moreno‐Poyato et al., 2016 ). In addition, the literature points out that for nurses, the implementation of the therapeutic relationship in the current context of mental health units has suffered a strong impact related to neoliberal policies, with increased management and a risk‐centred approach (Kingston & Greenwood, 2020 ). Thus, today's environments are chaotic, and nurses are committed to therapeutic work, yet they struggle to balance it with the new demands of management (Kingston & Greenwood, 2020 ). In addition, barriers such as lack of time, communication problems (Harris & Panozzo, 2019a ), the physical structures of the units, the ratios or the cultures of care are external factors that limit the therapeutic relationship (Tolosa‐Merlos et al., 2021 ). If nurses are unable to become aware of how they respond to time pressure, frustration or unclear care policies, there is a risk that these barriers will become entrenched, new ones will be created and the patient will perceive their actions as lacking care, presence or involvement (Harris & Panozzo, 2019b ). Thus, although nurses recognise the importance of self‐awareness and knowing how to recognise how their actions can impact the therapeutic relationship and the care provided to patients, they are also aware of the need for self‐awareness (Thomson et al., 2019 ), institutions and, in general, care policies should encourage nurses to be aware of interpersonal influences, as well as the desirability of providing a safe and supportive clinical environment for these relationships (Stevenson & Taylor, 2020 ).

From the patients' point of view, in the complex environment of inpatient units, their interactions with staff are central components to their satisfaction regarding their experience with admission (Molin et al., 2021 ). When staff spend time, engage in daily activities, and recognise patients as individuals, patients seem to find it easier to be physically and emotionally closer to each other and to themselves (Eldal et al., 2019 ; Moreno‐Poyato et al., 2021 ). However, this therapeutic commitment is not always met in practice, and interventions to improve participation are few and far between and ineffective (McAllister et al., 2021 ).

Thanks to the therapeutic relationship, nurses are in a key position to lead the development of customised interventions (Molin et al., 2021 ). However, there is a significant gap in the literature regarding improving the quality of the therapeutic relationship in acute mental health units (Hartley et al., 2020 ). The nursing profession is characterised by its ability to reflect on practice to improve care and provide more person‐centred care, which is why there is a need to increase the use of evidence‐based practice (Vaughan, 2017 ). In fact, reflective practice allows practitioners to learn from their experiences (Bulman & Schutz, 2013 ; Schön, 1987 ). When nurses are given time to reflect through guided reflection questions they are able to gain valuable insight into practice (Bolg et al., 2020 ); therefore, reflective practice helps nurses integrate their emotional response and practical experience into a better understanding of the care they provide, incorporating knowledge and applying theory (Vaughan, 2017 ). Thus, although the nurse–patient therapeutic relationship has been extensively studied, no studies to date provide knowledge on the establishment of the therapeutic relationship and its implications based on the reflection on the nurses' own practice. Consequently, knowing the meaning of the therapeutic relationship together with the elements that facilitate and hinder its implementation in the complex practice of current acute mental health units can be a starting point for both nurses and managers to become aware of the needs and for the design of strategies for improvement, suited to the reality of clinical practice.

In this regard, the aim of this study was to explore the phenomenon of the therapeutic relationship through the reflective practice of nurses in acute mental health units.

2.1. Design

This study is part of a multicentre mixed methods study involving 18 acute mental health units in Catalonia (Spain) (MiRTCIME.CAT). The principal aim of the project is to improve the nurse–patient therapeutic relationship through the implementation of evidence. The project was carried out following a sequential and transformational design. Quantitative methods were used based on a single‐group quasi‐experimental design with baseline and follow‐up measurements in phases I and III of the project. In the second phase, qualitative methodology was used. In its qualitative component, participatory action research (PAR) was proposed, framed within the constructivist paradigm and following the model by Kemmis and Mctaggart ( 2008 ). A two‐cycle process consisting of four stages each was designed to carry out the PAR. Specifically, this work corresponds to the action and observation stages of the first cycle. These stages are basic in the PAR process of change and make it possible to generate relevant knowledge regarding habitual practice (Cusack et al., 2018 ). In fact, it allows nurses to understand their practices as the product of particular circumstances and thus to identify the crucial aspects on which it may be possible to transform the practices they are carrying out (Kemmis & Mctaggart, 2008 ). The study is reported in line with the Consolidated criteria for reporting qualitative research guidelines (COREQ: Tong et al., 2007 ) (File S1 ).

2.2. Participants

All the acute mental health units that were part of the Catalan Mental Health Network ( n  = 21) were informed of the study. The principal investigator presented the research project and its objectives to the management of each centre through informative sessions. Finally, 18 units agreed to participate. A nurse from each unit joined the research team and this researcher was in charge of coordinating the study at their centre and recruiting the nurses from each unit. All nurses employed in the participating units ( n  = 235) were invited to participate in the study. The inclusion criteria for the participating nurses were belonging to the permanent or interim staff and being assigned to the acute unit at the time the intervention began. The following nurses were excluded from the study: nurses who were training to obtain ‘the official qualification of mental health nurse’, staff nurses who were scheduled to be on leave or maternity leave during the intervention. Thus, a convenience sample of 195 nurses agreed to participate in PAR, of which, ultimately 152 nurses completed the action and observation stages of the first part of this study.

2.3. Data collection

During a previous meeting among the entire research team, a guide was agreed upon so that the nurses could self‐observe their clinical practice in relation to the establishment of the therapeutic relationship. The research team sent the self‐observation guide by email to each nurse, along with a reflective diary in which the nurses were asked to record the self‐observation data (File S2 ). The diary was to include the description and reflection of three types of common interactions in their usual clinical practice: (a) a standard situation of welcoming a patient for admission, (b) an interaction in which there was a pre‐agitational state that required verbal de‐escalation and (c) an interaction whereby the patient is approached individually, promoted by the nurse and in the absence of any demand on behalf of the patient. The structure of the diary, together with the instructions for completion, pursued two purposes. First, to enable nurses to reflect on their starting assumptions, to understand their practice, to understand themselves and their patients, and, finally, to understand their profession (Price, 2017 ). Second, to monitor the process of change planned for the PAR, according to the proposals of Kemmis and Mctaggart ( 2008 ). In this sense, for each interaction, the nurses had to record the description of the situation, the type of verbal and nonverbal language they had used, their reflected intervention, their emotions during the interaction and, finally, a reflection on the influence of the environment on the interaction. Once the nurses had completed the diary, they sent it to the research team by e‐mail. The data were collected between April and June 2018.

2.4. Ethical considerations

This study was approved by the Research Ethics Committees of all the participating hospitals. The nurses participated on a voluntary basis, and all participants signed an informed consent form. Nurses did not receive any compensation or incentive for participating in the study. To maintain the confidentiality and anonymity of the data obtained, each nurse received an alphanumeric code that was incorporated into their diary. The diaries were sent to a generic e‐mail of the project that was only accessible to the principal investigator of the project, subsequently, the data were stored on a computer used exclusively for this study.

2.5. Data analysis

The content analysis method was used to analyse the data (Crowe et al., 2015 ). The diaries reached the first author and were coded to preserve the anonymity and confidentiality of the participants. Under their responsibility, the entire coding and categorisation process was carried out in a consensual manner by a collaborative team that formed the backbone of the process of developing a rigorous coding system (Merriam, 2016 ). In the first stage of analysis, the text was fragmented into descriptive codes assigned exclusively according to their semantic content. In a second stage, these initial codes were grouped into more analytical subcategories, which classified the codes according to the meaning of the linguistic units and their combinations. This led to a third hierarchical stage in which, considering the semantic analysis of the previous subcategories, the codes were ranked inductively. The first and second steps were taken iteratively until a more specific understanding of the subcategories was achieved. These steps were carried out primarily by the first author and discussed and reflected upon continuously and critically within the research team. Throughout the process, the QRS NVivo 12 program was used as computer support.

2.6. Rigour

Reflexivity was continuous throughout the process. Most of the researchers were experts in mental health, with training in qualitative methodology and experience in previous similar studies. As this was a multicentre study and a very large research team, neutrality was ensured as team members adopted an open attitude towards sharing, reasoning and discussing the findings as they emerged. In addition, the team became aware of its initial onto‐epistemological positioning, which was reflected in the design of the self‐observation guide for this stage of the process. As the research progressed, team members repeatedly contrasted the experiences identified in the participants' diaries with their own opinions. They asked follow‐up questions for the generation of new knowledge without guiding the participants' responses, so that this initial positioning could not influence the subsequent analysis. Similarly, the credibility and confirmability of the data should be emphasised, given the triangulation of the researchers in the analysis process and the constant auditing of the results by the participants in subsequent groups. In relation to the transferability of the results, in the case of this study, where participation is so high and from so many centres, it ensures that the results are valid for all units.

3. FINDINGS

The diaries of 152 nurses working at 18 centres were collected and analysed. The nurses ranged in age from 22 to 62 years, with a mean age of 33.6 years (SD = 9.4). Over 70% of the nurses were female. Their experience in mental health was a mean of 7.6 years (SD = 7.5). Almost a quarter of them had the official title of mental health nurse specialist and over 25% of the nurses had a doctoral or master's degree. All facility shifts were equally represented in the sample, although 40% of the nurses had rotating shifts or served on an as‐needed basis (Table ​ (Table1 1 ).

Participants' sociodemographic and professional characteristics ( n  = 152)

Data are shown as absolute number (percentage).

Abbreviation: MH, mental health.

The nurses, by describing and reflecting on their interactions with patients, expressed what the therapeutic relationship was for them and how it was carried out in their usual clinical practice. In this sense, three main categories were identified that responded to how they gave meaning to what the therapeutic relationship represented in practice and what limitations they identified in it (Figure ​ (Figure1 1 ).

Nurses' reflections on the practice of the therapeutic relationship in acute mental health units

3.1. Nursing attitude as a core of the therapeutic relationship

After reflecting on their practice, the nurses stated that attitude was a key element in establishing a quality therapeutic relationship with patients in the units. In this regard, they identified different attitudinal components. In the first place, the nurses considered the attitude of openness to the relationship. This meant being open and available, offering time, letting the patient talk and being attentive to the person's needs.

Patients are confused when they are first admitted and need the staff to listen to them and spend time with them. I always try to use an empathetic approach and be honest from the very beginning. I think it is very important for the patient to know that they can count on me, I try to convey that I am available if they need me. (01DR101)

However, they also identified that, in order to maintain this attitude, they had to be aware of barriers such as the presence of prejudice, the unavailability of other team members, the belief that the therapeutic relationship is useless, or lying to the patient.

The first contact already gives me the feeling that there may be a personality background, a victimizing attitude, excessively correct at times, totally inadequate at others, in spite of which I stay on track and treat him with the utmost respect. (10DR101). Certain users only perform certain actions to push you to the limit. (13DR103)

Secondly, they referred to the communicative attitude as another basic element in the therapeutic relationship. In this case, the nurses considered that special attention should be paid to both their verbal and nonverbal language when interacting with patients. In this sense, they pointed out the need to establish a dialogue with the patient by means of clear and concrete messages, with an appropriate tone and without shouting, as well as showing interest in the conversation, listening attentively, without showing tiredness or boredom, and adapting their distance and physical contact to each situation.

I try to be aware of my gestures, I avoid being invasive, respecting the safety distance with the patient at all times. Regarding verbal language, I use neutral terms, a friendly and calm tone of voice. (04DR115). In a polite but firm manner, I explain to the patient his situation and the alternatives I can offer him instead of smoking. The language is clear and concise, responding directly to what he asks. Saying NO if necessary, as sometimes vague answers upset the patient even more. (04DR104)

In addition, they considered it extremely important that, as caregivers, they should adapt to the other person, that is individualise the care they provide in the context of the therapeutic relationship. This implies considering the patient's psychopathological and emotional state at any given moment, as well as the patient's age, language or culture. This often meant postponing interviews, adapting language, using sign language to communicate, agreeing on a special type of diet, or even relaxing the rules and letting the patient make a call outside the usual hours.

I try to be flexible and adapt things as much as I can to the patient and his or her characteristics. (03DR109). Sometimes the stigma in mental health appears from the self‐stigma and the treatment that the mental health professional gives to patients. Personality is lost by prioritizing the disorder, people talk about the schizophrenic, the depressive, the BPD… obviating the fact that there is a person behind it all, with a context and a manner of understanding and living their life. (05DR104)

Finally, the nurses emphasised the role of their own emotional experience of caregiving. This meant having self‐confidence, feeling they were able to help the patient and do their job well, feeling satisfied with their work and remaining calm, at ease, and relaxed with the patient during their interventions. Nurses also identified emotions that, conversely, had a negative effect on the therapeutic relationship, such as feeling fear, insecurity, tension, patient rejection, grief, helplessness and frustration when the interventions had not been resolved as expected.

To feel fulfilled in my daily work (18DR101). Calm and confident, well supported by the team. Satisfied to have successfully completed an admission. (16DR112). Then I felt helpless, as I could not find a way to reverse the situation. (12DR111)

3.2. Essential nursing actions for the therapeutic relationship

This category refers to the nurses' reflections on their actions in the context of the therapeutic relationship with patients. In their diaries, the nurses were describing and reflecting on different interventions and activities that were carried out in their usual practice and they detected certain actions that were common to all of them.

First, the nurses pointed out the importance of generating an appropriate environment to build a bond and facilitate the relationship with the patients. A calm, intimate, comfortable, unhurried environment without external stimuli or interruptions.

The room is quiet with the door closed and without any interaction from the environment…A pleasant and silent environment favors the therapeutic relationship between the professional and the patient. (04DR110)

In relation to the establishment of a good therapeutic bond, the nurses agreed that the welcome provided on admission was a fundamental intervention. This was viewed as one of the situations in which the therapeutic relationship took on a greater relevance, since this first contact was considered the key to the success of the subsequent relationship with the patient.

Without welcoming the patient when he or she enters the unit, a better quality of the patient/professional relationship cannot be achieved. (01DR113)

Secondly, the nurses felt that the verbal approach was also a relevant aspect of their practice in the context of the therapeutic relationship. For them, it was an essential step in order to be able to carry out any intervention, such as when welcoming a patient when they are admitted to the unit, the use of verbal de‐escalation techniques to ease the tension with very demanding and uncooperative patients or, on the contrary, to approach isolated patients who hardly interact with the environment, although the use of words is not always as effective as they would like it to be.

Verbal containment is one of the most relevant parts of our work. In a pre‐agitation situation, we may be able to transition a patient from pre‐agitation to calmness or from pre‐agitation to psychomotor agitation. (09DR108)

In this sense, the nurses described that the act of offering the patient their assistance was at the heart of the therapeutic relationship. They stated that this action was carried out in the context of being present, listening or through agreement with the patient by proposing alternatives to the demands and needs that they cannot meet.

As he speaks I give him my support with non‐verbal language. I take his hand and he hugs me. I offer my help. We agree that he will make an effort to eat some solid food at dinner and that I will give him a supplement (he has it prescribed if he needs it). (01DR101)

The nurses also acknowledged that interventions such as mechanical restraint were sometimes the only measure to reduce stimuli or were implemented because of patient aggressiveness, risk of escape or even medical indication. However, the nurses reflected that, although this intervention was performed relatively often, it could be seen as a failure and a deterioration in the therapeutic relationship.

(…) avoid as much as possible the adoption of measures that restrict the mobility of the people under our care, since we are aware that this produces a significant deterioration of the therapeutic relationship, adding to the patient's mistrust and suspicion (…) (07DR105)

Finally, the nurses pointed to therapeutic work as another fundamental aspect of the therapeutic relationship. This meant working with the patient on positive reinforcement and other aspects such as pharmacological adherence, identification of symptoms or awareness of the disease, explaining the objectives of admission and the importance of asking for help, respecting the patient's decisions and involving the person in their care and recovery.

The attitude is one of interest, I keep an eye on her so that she doesn't get distracted and can talk calmly. I ask her what she thinks we can do for her to explore her expectations with the admission. (07DR101)

3.3. Contextual factors affecting the therapeutic relationship

The nurses identified contextual factors that facilitated or, on the contrary, acted as barriers to the therapeutic relationship. Indeed, they described that the type of admission could already condition the therapeutic bond, with voluntary admission being a facilitator. The same is true of other factors such as knowing the patient from previous admissions, and whether the patient remembers having a good experience in those previous admissions. However, the nurses also considered elements that are intrinsic to the patient, such as language, culture or bad experiences of previous admissions, as factors limiting the establishment of the therapeutic relationship.

He is open to help and agrees to the admission (03DR110). I must admit that the fact that I know the user from previous admissions has helped the situation to unfold smoothly. (14DR106)

Similarly, the nurses identified barriers that hindered or prevented the establishment and maintenance of a good therapeutic relationship, related to both the environment and the physical structures of the units. In this sense, the structural barriers were related to the lack of adequate spaces to carry out interventions with patients with the intimacy that the nurses considered necessary. Other environmental factors were noted, such as environmental noise and tension, the unpredictability of some patients, the presence of the family or the multiple interruptions were elements that added to the difficulty of the therapeutic relationship.

That afternoon the environment allowed me to dedicate some time to the patient, since there were no emergencies, other admissions, or complicated situations in the unit that required nursing intervention, apart from the "scheduled" or "usual" activities such as the control of vital signs, medication, etc. (03DR105)

Finally, the nurses also expressed how the regulations and care dynamics of the units also conditioned the therapeutic relationship in daily clinical practice. Thus, unit regulations were recurrently brought up by the nurses as a major barrier, due to the numerous limitations and prohibitions.

I explain the rules of the unit: no cell phones, no smoking, no entering other rooms, no belts, no glass objects, etc. and the established schedules… (10DR104)

Nonetheless, the greatest source of difficulties was the care dynamics at the unit, ranging from lack of time, high workload, administrative tasks, staff rotations or the night shift.

Even so, there are barriers that hinder the therapeutic relationship. Sometimes, our language is influenced by the tension in the unit, the lack of time, excessive administrative tasks, etc.… (01DR101)

4. DISCUSSION

This study aimed to explore the phenomenon of the therapeutic relationship from the reflective practice of nurses in acute mental health units. The nurses highlighted that attitude was the core aspect of the therapeutic relationship after reflecting on their practice. Similarly, they also reflected on the actions that were customary in the habitual interventions carried out in the context of the therapeutic relationship, identifying the most common barriers encountered in practice. Finally, the nurses reflected on those aspects of the context of care that conditioned the therapeutic relationship in the clinical practice of acute mental health units.

These findings offer knowledge about relational competence, a competency of professional nursing that is highly relevant in mental health (D'Antonio et al., 2014 ). This competence is directly linked to participation in practice and incorporates not only knowledge and skills, but also attitudes and professionalism that involve applying evidence and learning to practice (Casey et al., 2017 ; Moreno‐Poyato, Casanova‐Garrigos, et al., 2021 ). Specifically, the attitudinal component highlighted in the results and its importance in the context of the nurse–patient therapeutic relationship has been described from a theoretical perspective by authors such as Peplau or Orlando (Forchuk, 1991 ), Travelbee ( 1971 ) and Watson (Turkel et al., 2018 ). Similarly, the empirical literature has collected multiple studies that study the importance of nurses' attitudes towards more general aspects of mental health, such as stigma (Young & Calloway, 2021 ), recovery (Gyamfi et al., 2020 ), coercion (Doedens et al., 2020 ; Laukkanen et al., 2019 ) or severe mental disorder (Economou et al., 2019 ). However, there is hardly any empirical evidence that explicitly shows the relevance and identifies the specific attitudinal skills of nurses in the context of the practice of the therapeutic relationship. Thus, it is likely that the fact that the nurses were able to reflect on their practice made them more aware of the importance of attitude in the context of the therapeutic relationship (Harris & Panozzo, 2019a ), as they were able to respond to the real challenge of establishing an adequate therapeutic relationship in their day‐to‐day work in the acute mental health units (Choperena et al., 2019 ). Moreover, the attitudinal capacity identified by the nurses encompassed aspects already empirically recognised in the context of the therapeutic relationship, such as availability, communication and individualisation (Delaney & Johnson, 2014 ; Harris & Panozzo, 2019b ; McAllister et al., 2019 ; Moreno‐Poyato et al., 2016 ). However, the nurses also highlighted other aspects that have been less empirically studied, such as the importance of self‐confidence and self‐assurance, both in a positive way in order to be able to establish an appropriate therapeutic relationship, (Roche et al., 2011 ; Van Sant and Patterson, 2013 ) as well as negatively, in the form of limitation (O'Connor & Glover, 2017 ; Van Sant and Patterson, ). These results confirm the relevance of Peplau and Orlando's theoretical approaches and the use of the nurse's awareness as a fundamental part of the nursing relationship (Forchuk, 1991 ; Thomson et al., 2019 ).

The results indicate that by reflecting on their practice, the nurses were able to identify those skills (practices) that are essential for the development of the therapeutic relationship and which were transversal to any intervention. The nurses emphasised the importance of generating an adequate environment for the relationship, considering the environment not only as an element of context typical of many acute care units, but also as an element that is essential for the development of the therapeutic relationship (Kingston & Greenwood, 2020 ), also considering that it was their responsibility to be able to build the space where the relationship could take place (McAllister et al., 2021 ; Raphael et al., 2021 ). As in other studies, nurses also identified skills such as verbal engagement, offering help or working with the patient as basic practices for the development of effective interventions in the context of the relationship with their patients (Harris & Panozzo, 2019a ; McAllister et al., 2019 ; Molin et al., 2018 ). Furthermore, in relation to specific interventions, reflection on practice allowed nurses to identify and become aware of nursing admission assessment and mechanical restraint as two common interventions in mental health units that were particularly influential in the therapeutic relationship with the patients. In this sense, for the nurses, welcoming the patient on admission was considered an essential intervention determining a large part of the success in building the therapeutic relationship with the patients (Forchuk et al., 1998 ; Peplau, 1997 ). However, the use of mechanical restraint compromised the therapeutic relationship and the patient's trust (Kinner et al., 2017 ), although they understood that, even if this measure was undesirable, at times it was necessary (Doedens et al., 2020 ).

In addition, the nurses reflected on the contextual factors that directly affected the therapeutic relationship with the patients. In this sense, the nurses paid attention to patient aspects such as voluntariness or involuntariness regarding admission (Moreno‐Poyato, El Abidi, et al., 2021 ) or being previously acquainted with each other from previous admissions and the experience of the relationship (Van Sant and Patterson, 2013 ). The nurses also emphasised the role of the environmental and structural conditions of the units (Staniszewska et al., 2019 ), as well as the regulations and the dynamics of care that were automatically generated in the intense day‐to‐day routine of the units (Adler, 2020 ; Kingston & Greenwood, 2020 ).

4.1. Strengths and limitations

This study has several strengths and limitations. First, it should be noted that this project faced major challenges from a methodological point of view as well as during its execution. Initially, a research group had to be formed with representation of the institutions to assess the feasibility of the project. Next, a balanced team of researchers, consisting of methodologists and clinicians had to be assembled to ensure that the different stages of the research project could be completed. The team had to be formed in several initial working sessions and, subsequently, there was a process of constant mentoring by the principal investigator to the rest of the team. In addition, a considerable volume of data had to be managed. For management and storage, a secure on‐line space was created, guarded and accessed only by the principal investigator of the project. All data were collected electronically to facilitate the circuit. In relation to the analysis, a team was set up under the responsibility of a researcher. This team had to work in a collaborative and consensual manner. Regarding more specific limitations, it should be mentioned that the nurses' reflections in the diaries could be subject to the Hawthorne effect and their responses may have been biased by social desirability. In this sense, the research team insisted on the importance of honesty in the nurses' responses and on the team's handling of the confidentiality of the data. Secondly, another limitation inherent to the use of diaries is related to memory bias and the stress associated with reflective practice. In relation to this, the team recommended specific instructions, both verbally and through the guide provided to the nurses, to prevent this from occurring. Furthermore, the representativeness of the participating nurses and the number of diaries obtained should be highlighted as strengths of the study. These facts enable the findings of this study to be transferred to similar contexts.

5. CONCLUSIONS

The present study contributes to the understanding of the phenomenon of the therapeutic nurse–patient relationship by reflecting on the actual practice of nurses in acute mental health units. The attitudinal component is at the heart of the therapeutic relationship, and, in this sense, it is fundamental for nurses to believe in themselves and their attitude to communicate, adapt and open up to the relationship with the patient. In addition, there are actions that are essential for nurses to establish a TR in practice such as creating a conducive environment, using an appropriate verbal approach, offering help and working together with the patient. Finally, nurses should consider the patient's conditions, the dynamics of care and regulations of the unit, as well as the structure and environment of the unit, as contextual factors to be able to establish an adequate TR with patients in daily clinical practice.

6. RELEVANCE TO CLINICAL PRACTICE

These findings have important implications. The study findings demonstrate that participatory methods stimulate nurses' reflection, motivation and critical thinking. By learning from the reflection of the nurses themselves about the aspects that underlie the therapeutic relationship in their clinical practice, this enables the nurses themselves to become aware and to develop strategies for improvement based on their own knowledge. Moreover, the individual reflection involved in these first stages of a participatory process provides the nurses with an intrinsic knowledge of how they approach the therapeutic relationship and shows that the attitudinal component is basic for them. In this sense, understanding and confirming how the attitudinal component is a key element for nurses in the practice of the therapeutic relationship allows managers to evaluate strategies that promote motivation and facilitate the involvement of nurses in improving their practice with patients. Moreover, these results point to the need to conduct mixed or qualitative studies aimed at exploring the aspects that facilitate the motivation, empowerment and attitudinal training of nurses in greater depth, rather than studies that only seek improvements in the theoretical knowledge of the therapeutic relationship.

CONFLICT OF INTEREST

No conflict of interest has been declared by the authors.

AUTHOR CONTRIBUTIONS

Study design: ARMP and PDH; Data collection: APT, FGP and GCG; Data analysis team: DTM; Final report draft: DTM, ARMP and PDH; Supervision the process of data collection and analysis and provide support and feedback during all study phases: ARMP; Contribution of the manuscript, and read and approved the final manuscript: All authors.

Supporting information

Acknowledgements.

We would like to acknowledge all the participants of MiRTCIME.CAT project.

Tolosa‐Merlos, D. , Moreno‐Poyato, A. R. , González‐Palau, F. , Pérez‐Toribio, A. , Casanova‐Garrigós, G. , & Delgado‐Hito, P. ; MiRTCIME.CAT Working Group (2023). Exploring the therapeutic relationship through the reflective practice of nurses in acute mental health units: A qualitative study . Journal of Clinical Nursing , 32 , 253–263. 10.1111/jocn.16223 [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]

College of Nurses of Barcelona (PR‐218/2017)

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