Pub Date : 2022-08-18DOI: 10.1108/mhrj-02-2022-0012
Christy L Connell, Emma Jones, M. Haslam, Jayne Firestone, Gill Pope, C. Thompson
Purpose This paper aims to explain how and why the philosophical changes to the pre-registration nursing standards by the UK’s Nursing and Midwifery Council (NMC) have resulted in a paradigm shift for mental health nursing. Design/methodology/approach This paper critically examines the changes to nursing education standards and offers an analysis of the problems associated with the shift towards a generic nursing syllabus. Findings The said shift prioritises physical health intervention, skills, procedures and tasks over the uniqueness of mental health nursing. Practical implications This paper argues that mental health nursing skills and qualities such as connection, genuine advocacy and therapeutic-use-of-self have been undervalued and under-represented by the new education standards. Originality/value This paper calls on the profession and service users to join the discourse and inform future mental health nursing identity. Ultimately, this paper calls on the NMC to reconsider the underpinning principles of the education standards and allot due consideration to the specific needs of the mental health nursing profession.
{"title":"Mental health nursing identity: a critical analysis of the UK’s Nursing and Midwifery Council’s pre-registration syllabus change and subsequent move towards genericism","authors":"Christy L Connell, Emma Jones, M. Haslam, Jayne Firestone, Gill Pope, C. Thompson","doi":"10.1108/mhrj-02-2022-0012","DOIUrl":"https://doi.org/10.1108/mhrj-02-2022-0012","url":null,"abstract":"\u0000Purpose\u0000This paper aims to explain how and why the philosophical changes to the pre-registration nursing standards by the UK’s Nursing and Midwifery Council (NMC) have resulted in a paradigm shift for mental health nursing.\u0000\u0000\u0000Design/methodology/approach\u0000This paper critically examines the changes to nursing education standards and offers an analysis of the problems associated with the shift towards a generic nursing syllabus.\u0000\u0000\u0000Findings\u0000The said shift prioritises physical health intervention, skills, procedures and tasks over the uniqueness of mental health nursing.\u0000\u0000\u0000Practical implications\u0000This paper argues that mental health nursing skills and qualities such as connection, genuine advocacy and therapeutic-use-of-self have been undervalued and under-represented by the new education standards.\u0000\u0000\u0000Originality/value\u0000This paper calls on the profession and service users to join the discourse and inform future mental health nursing identity. Ultimately, this paper calls on the NMC to reconsider the underpinning principles of the education standards and allot due consideration to the specific needs of the mental health nursing profession.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45643446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-27DOI: 10.1108/mhrj-04-2022-0023
P. Larsson, Russell Lloyd, Emily Taberham, Maggie Rosairo
Purpose The purpose of this paper is to explore waiting times in improving access to psychological therapies (IAPT) services before and throughout the COVID-19 pandemic. The paper aims to help develop a better understanding of waiting times in IAPT so that interventions can be developed to address them. Design/methodology/approach IAPT national data reports was analysed to determine access and in-treatment waiting times before, during and after the COVID-19 pandemic. Time-series data was used to examine referral patterns, waiting list size and waiting times between the period of November 2018 and January 2022. The data covers all regions in England where an IAPT service has been commissioned. Findings There was a dramatic drop in referrals to IAPT services when lockdown started. Waiting list size for all IAPT services in the country reduced, as did incomplete and completed waits. The reduction in waiting times was short-lived, and longer waits are returning. Practical implications This paper aims to contribute to the literature on IAPT waiting times both in relation to, and outside of, COVID-19. It is hoped that the conclusions will generate discussion about addressing long waits to treatment for psychological therapy and encourage further research. Originality/value To the best of the authors’ knowledge, there is no published research examining the performance of IAPT waiting times to second appointment. The paper also contributes to an understanding of how IAPT waiting times are measured and explores challenges with the system itself. Finally, it offers an overview on the impact of the COVID-19 pandemic on waiting time performance nationally.
{"title":"An observational study on IAPT waiting times before, during and after the COVID-19 pandemic using descriptive time-series data","authors":"P. Larsson, Russell Lloyd, Emily Taberham, Maggie Rosairo","doi":"10.1108/mhrj-04-2022-0023","DOIUrl":"https://doi.org/10.1108/mhrj-04-2022-0023","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to explore waiting times in improving access to psychological therapies (IAPT) services before and throughout the COVID-19 pandemic. The paper aims to help develop a better understanding of waiting times in IAPT so that interventions can be developed to address them.\u0000\u0000\u0000Design/methodology/approach\u0000IAPT national data reports was analysed to determine access and in-treatment waiting times before, during and after the COVID-19 pandemic. Time-series data was used to examine referral patterns, waiting list size and waiting times between the period of November 2018 and January 2022. The data covers all regions in England where an IAPT service has been commissioned.\u0000\u0000\u0000Findings\u0000There was a dramatic drop in referrals to IAPT services when lockdown started. Waiting list size for all IAPT services in the country reduced, as did incomplete and completed waits. The reduction in waiting times was short-lived, and longer waits are returning.\u0000\u0000\u0000Practical implications\u0000This paper aims to contribute to the literature on IAPT waiting times both in relation to, and outside of, COVID-19. It is hoped that the conclusions will generate discussion about addressing long waits to treatment for psychological therapy and encourage further research.\u0000\u0000\u0000Originality/value\u0000To the best of the authors’ knowledge, there is no published research examining the performance of IAPT waiting times to second appointment. The paper also contributes to an understanding of how IAPT waiting times are measured and explores challenges with the system itself. Finally, it offers an overview on the impact of the COVID-19 pandemic on waiting time performance nationally.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44656660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-07-13DOI: 10.1108/mhrj-06-2021-0049
Lorna Phillips, Panoraia Andriopoulou
Purpose Despite government and national health service demands for equality within mental health (MH) services, racial inequalities remain. South Asian (SA) women underutilise MH services, yet research regarding their experiences and the cultural sensitivity (CS) of services is sparse. The purpose of this study was to explore the experiences of SA women who have used MH services and the cultural sensitivity of the latter. Design/methodology/approach Thematic analysis was used for data analysis of semi-structured interviews carried out with 16 SA women. Findings Analysis yielded an overarching theme of “degree of understanding” and three main themes: “shared background and understanding” “humanity” and “cultural factors” and their subsequent subthemes. Results demonstrated mixed experiences, illustrating varied levels of CS and the impacts of this upon experiences. Cultural understanding underpins CS: participants’ experiences demonstrated the benefit of significant understanding and the detriment of limited understanding. Research limitations/implications All participants were well educated, English-speaking and from psychology, health or research backgrounds. SA culture is nuanced; thus, the demographic of “South Asian” could be too broad. However, because current understanding is limited, this research provides fundamental empirical knowledge. Practical implications Clear recommendations were co-produced with participants, highlighting strong impacts for service development and best practice. Social implications The research provides valuable insight into SA women’s experiences of MH services and wider understanding of CS. This raises cultural awareness in a field lacking understanding. Findings and recommendations can, therefore, provide foundational knowledge for broader societal issues experienced by people from this demographic and challenge preconceptions. Originality/value This research offers unique recommendations for more culturally sensitive practice, co-produced with participants.
{"title":"An exploratory study of South Asian women’s experiences of mental health services in England: a thematic analysis of cultural sensitivity","authors":"Lorna Phillips, Panoraia Andriopoulou","doi":"10.1108/mhrj-06-2021-0049","DOIUrl":"https://doi.org/10.1108/mhrj-06-2021-0049","url":null,"abstract":"\u0000Purpose\u0000Despite government and national health service demands for equality within mental health (MH) services, racial inequalities remain. South Asian (SA) women underutilise MH services, yet research regarding their experiences and the cultural sensitivity (CS) of services is sparse. The purpose of this study was to explore the experiences of SA women who have used MH services and the cultural sensitivity of the latter.\u0000\u0000\u0000Design/methodology/approach\u0000Thematic analysis was used for data analysis of semi-structured interviews carried out with 16 SA women.\u0000\u0000\u0000Findings\u0000Analysis yielded an overarching theme of “degree of understanding” and three main themes: “shared background and understanding” “humanity” and “cultural factors” and their subsequent subthemes. Results demonstrated mixed experiences, illustrating varied levels of CS and the impacts of this upon experiences. Cultural understanding underpins CS: participants’ experiences demonstrated the benefit of significant understanding and the detriment of limited understanding.\u0000\u0000\u0000Research limitations/implications\u0000All participants were well educated, English-speaking and from psychology, health or research backgrounds. SA culture is nuanced; thus, the demographic of “South Asian” could be too broad. However, because current understanding is limited, this research provides fundamental empirical knowledge.\u0000\u0000\u0000Practical implications\u0000Clear recommendations were co-produced with participants, highlighting strong impacts for service development and best practice.\u0000\u0000\u0000Social implications\u0000The research provides valuable insight into SA women’s experiences of MH services and wider understanding of CS. This raises cultural awareness in a field lacking understanding. Findings and recommendations can, therefore, provide foundational knowledge for broader societal issues experienced by people from this demographic and challenge preconceptions.\u0000\u0000\u0000Originality/value\u0000This research offers unique recommendations for more culturally sensitive practice, co-produced with participants.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49158802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-17DOI: 10.1108/mhrj-05-2021-0038
Kevin O’ Shanahan, James O’ Flynn, Declan McCarthy, L. MacGabhann
Purpose This paper aims to describe a novel community development and how the synergies arising from the interaction of diverse perspectives (including arts and health, person centredness, co-production and shared leadership) have led to a transformative initiative for individuals and a local community in the Republic of Ireland. Design/methodology/approach This is a descriptive case study. It includes the personal narrative of an expert by experience who is one of the co-authors. Links to short digital films are also included along with references to internal evaluation documents and published literature. Reflections from the nurses who contributed to the initiative and a university academic are also incorporated. Findings A space in the community built around the principles of relational practice has evolved into an alchemical space, enabling creativity, recovery and well-being. The benefits arising out of this network of social relationships have contributed to personal recovery, integration with the local community and generated social capital. This has enhanced mental health and well-being locally. Practical implications Statutory Irish health policy is reflective of developments in health care internationally, with an emphasis on greater delivery of care in the community. This views citizens as active partners in the maintenance of their health and well-being. This case study illustrates how this has unfolded in practice in a rural mental health community context. Originality/value This paper adds to the evidence base that demonstrates the potential benefits of participation in the arts to individual recovery journeys. In addition, it shows that when arts and health perspectives coalesce with the wider domain of relational practice, the synergies arising contribute positively to the health and well-being of local communities.
{"title":"Creating alchemy within an Irish mental health service","authors":"Kevin O’ Shanahan, James O’ Flynn, Declan McCarthy, L. MacGabhann","doi":"10.1108/mhrj-05-2021-0038","DOIUrl":"https://doi.org/10.1108/mhrj-05-2021-0038","url":null,"abstract":"\u0000Purpose\u0000This paper aims to describe a novel community development and how the synergies arising from the interaction of diverse perspectives (including arts and health, person centredness, co-production and shared leadership) have led to a transformative initiative for individuals and a local community in the Republic of Ireland.\u0000\u0000\u0000Design/methodology/approach\u0000This is a descriptive case study. It includes the personal narrative of an expert by experience who is one of the co-authors. Links to short digital films are also included along with references to internal evaluation documents and published literature. Reflections from the nurses who contributed to the initiative and a university academic are also incorporated.\u0000\u0000\u0000Findings\u0000A space in the community built around the principles of relational practice has evolved into an alchemical space, enabling creativity, recovery and well-being. The benefits arising out of this network of social relationships have contributed to personal recovery, integration with the local community and generated social capital. This has enhanced mental health and well-being locally.\u0000\u0000\u0000Practical implications\u0000Statutory Irish health policy is reflective of developments in health care internationally, with an emphasis on greater delivery of care in the community. This views citizens as active partners in the maintenance of their health and well-being. This case study illustrates how this has unfolded in practice in a rural mental health community context.\u0000\u0000\u0000Originality/value\u0000This paper adds to the evidence base that demonstrates the potential benefits of participation in the arts to individual recovery journeys. In addition, it shows that when arts and health perspectives coalesce with the wider domain of relational practice, the synergies arising contribute positively to the health and well-being of local communities.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44940935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-09DOI: 10.1108/mhrj-11-2021-0087
Gigi Lam, E. Y. Chung
Purpose The purpose of this paper is to review the development of mental health service policy in Hong Kong. After the return of Hong Kong’s sovereignty to China, mental health services in Hong Kong transformed from an institution-based care model supplemented by community care to a staging model covering primary prevention, early identification, treatment and integration. However, the staging model is subject to cultural barriers, including collectivist values and medical dominance. Therefore, the development of a community-based inclusive development model that follows a rights-based strategy and addresses the regression of the staging model (due to cultural barriers) should be considered. Design/methodology/approach It is a comprehensive literature review which covered the journal articles, policy review papers and service reports. The foundation of this review was laid upon the development of traditional Chinese culture and values. As brought by the influence of the Western world, the mental health service policy was cling towards a medically oriented system. Following the worldwide change in the definition of disability, the ideology of the mental health service system has been developing into a community-based and person-centred model which emphasised on equal participation and human rights. This review serves to evaluate and discuss how a community-based inclusive development can be further developed in Hong Kong. Findings A formal support system for providing personal assistance to people with mental health issues through supported decision-making and certified peer specialists forms the principal foundation of a community-based inclusive development model. A review and reconsideration of laws governing guardianship, compulsory treatment and detention should be conducted to enable the local implementation of supported decision-making. Originality/value The paper addressed and integrated the theoretical, historical and practical issues in developing a community-based inclusive mental health service policy in Hong Kong.
{"title":"Mental health services in Hong Kong: development of community-based inclusive development practice faced with the cultural barriers","authors":"Gigi Lam, E. Y. Chung","doi":"10.1108/mhrj-11-2021-0087","DOIUrl":"https://doi.org/10.1108/mhrj-11-2021-0087","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to review the development of mental health service policy in Hong Kong. After the return of Hong Kong’s sovereignty to China, mental health services in Hong Kong transformed from an institution-based care model supplemented by community care to a staging model covering primary prevention, early identification, treatment and integration. However, the staging model is subject to cultural barriers, including collectivist values and medical dominance. Therefore, the development of a community-based inclusive development model that follows a rights-based strategy and addresses the regression of the staging model (due to cultural barriers) should be considered.\u0000\u0000\u0000Design/methodology/approach\u0000It is a comprehensive literature review which covered the journal articles, policy review papers and service reports. The foundation of this review was laid upon the development of traditional Chinese culture and values. As brought by the influence of the Western world, the mental health service policy was cling towards a medically oriented system. Following the worldwide change in the definition of disability, the ideology of the mental health service system has been developing into a community-based and person-centred model which emphasised on equal participation and human rights. This review serves to evaluate and discuss how a community-based inclusive development can be further developed in Hong Kong.\u0000\u0000\u0000Findings\u0000A formal support system for providing personal assistance to people with mental health issues through supported decision-making and certified peer specialists forms the principal foundation of a community-based inclusive development model. A review and reconsideration of laws governing guardianship, compulsory treatment and detention should be conducted to enable the local implementation of supported decision-making.\u0000\u0000\u0000Originality/value\u0000The paper addressed and integrated the theoretical, historical and practical issues in developing a community-based inclusive mental health service policy in Hong Kong.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41598951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-20DOI: 10.1108/mhrj-11-2021-0084
Cecilia M. Votta, P. Deldin
Purpose The purpose of this paper is to test a mental wellness intervention, Mood Lifters (ML), that addresses significant barriers to mental health care. ML includes adults over 18 struggling with mental wellness or any life difficulties, except those with active suicidality, mania and psychosis, and addresses barriers to care using peer leaders in a manualized group format with a gamified point system. Design/methodology/approach Participants were recruited using online postings. Those eligible (76% female, 80% white) were randomly assigned to professional-led groups (N = 30), peer-led groups (N = 33) or a waitlist (N = 22; i.e. attended assigned condition if available). Participants completed pre- and postgroup measures (including the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 and Perceived Stress Scale), attended 15 weekly meetings and tracked “points” or at-home skills practice. Multiple imputation was used to account for attrition. Linear regressions were analyzed to determine the program’s impact on anxiety and depressive symptoms and perceived stress. Further analyses included comparisons between peer- and professional-led groups. Findings Participants in ML experienced significant reductions in anxiety symptoms. Completing more homework across the program led to significant reductions in anxiety and perceived stress. Finally, there were no significant differences in attendance, homework completed or outcomes between peer- and professional-led groups. Practical implications Overall, participation in the ML program led to reduced anxiety symptoms, and for those who completed more homework, reduced perceived stress. More accessible programs can make a significant impact on symptoms and are critical to address the overburdened care system. Additionally, there were no differences between leader types indicating that peers may be an effective way to address accessibility concerns. Originality/value ML is unique for three reasons: it takes a biopsychosocial/Research Domain Criteria approach to mental wellness (i.e. incorporates many areas relevant to mental health, does not focus on a specific diagnosis), overcomes major barriers to mental health care and uses a peer-delivery model. These attributes, taken together with the results of this study, present a care alternative for those with less access.
{"title":"Mood Lifters: evaluation of a novel peer-led mental wellness program","authors":"Cecilia M. Votta, P. Deldin","doi":"10.1108/mhrj-11-2021-0084","DOIUrl":"https://doi.org/10.1108/mhrj-11-2021-0084","url":null,"abstract":"\u0000Purpose\u0000The purpose of this paper is to test a mental wellness intervention, Mood Lifters (ML), that addresses significant barriers to mental health care. ML includes adults over 18 struggling with mental wellness or any life difficulties, except those with active suicidality, mania and psychosis, and addresses barriers to care using peer leaders in a manualized group format with a gamified point system.\u0000\u0000\u0000Design/methodology/approach\u0000Participants were recruited using online postings. Those eligible (76% female, 80% white) were randomly assigned to professional-led groups (N = 30), peer-led groups (N = 33) or a waitlist (N = 22; i.e. attended assigned condition if available). Participants completed pre- and postgroup measures (including the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 and Perceived Stress Scale), attended 15 weekly meetings and tracked “points” or at-home skills practice. Multiple imputation was used to account for attrition. Linear regressions were analyzed to determine the program’s impact on anxiety and depressive symptoms and perceived stress. Further analyses included comparisons between peer- and professional-led groups.\u0000\u0000\u0000Findings\u0000Participants in ML experienced significant reductions in anxiety symptoms. Completing more homework across the program led to significant reductions in anxiety and perceived stress. Finally, there were no significant differences in attendance, homework completed or outcomes between peer- and professional-led groups.\u0000\u0000\u0000Practical implications\u0000Overall, participation in the ML program led to reduced anxiety symptoms, and for those who completed more homework, reduced perceived stress. More accessible programs can make a significant impact on symptoms and are critical to address the overburdened care system. Additionally, there were no differences between leader types indicating that peers may be an effective way to address accessibility concerns.\u0000\u0000\u0000Originality/value\u0000ML is unique for three reasons: it takes a biopsychosocial/Research Domain Criteria approach to mental wellness (i.e. incorporates many areas relevant to mental health, does not focus on a specific diagnosis), overcomes major barriers to mental health care and uses a peer-delivery model. These attributes, taken together with the results of this study, present a care alternative for those with less access.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62088520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-05-03DOI: 10.1108/mhrj-12-2020-0094
Nicola Walker, Sally J Hall
Purpose Here, this study aims to report a case study of the initial design and programme theory of an interdisciplinary work-focused relational group cognitive behaviour therapy (CBT) treatment programme for moderate-severe depression using realist methods. Design/methodology/approach This case study shows how the authors designed the intervention using component analysis of existing literature and focus groups of frontline practitioners and former service users and mind-mapping analysis to establish its operational logic and evaluated the theory underpinning the intervention using realist synthesis and evaluation to establish its conceptual logic. Findings An iterative hybrid approach of literature review, component analysis, focus group discussion and realist methods established the initial design and programme theory for the new intervention. The intervention focused on three areas of therapy, three inter-dependent outcomes, in a group format, with opportunities created for peer interaction. The main theoretical principles most likely to promote efficacy were to accelerate and optimise activation of one or more of six hypothesised mechanisms: realise, reflect, regulate, resolve, relate and retain/resume in the context of skilfully facilitated group psychotherapy. Social implications This study outlines a methodological approach based on the layered ontology of critical realist philosophy, applied to a successful example, which will be useful during the early stages of the design and development of new group-based psychotherapeutic interventions. Originality/value By adopting the critical realist approach, the authors identified underlying mechanisms of change in relational group CBT. The theoretically integrated approach involving service users and practitioners from different professional backgrounds was unique and meant that the treatment programme was multi-modal rather than informed by a single therapeutic or theoretical approach.
{"title":"The initial design and programme theory for a new work-focused psychotherapeutic intervention to treat moderate-severe recurrent depression and enhance job retention","authors":"Nicola Walker, Sally J Hall","doi":"10.1108/mhrj-12-2020-0094","DOIUrl":"https://doi.org/10.1108/mhrj-12-2020-0094","url":null,"abstract":"\u0000Purpose\u0000Here, this study aims to report a case study of the initial design and programme theory of an interdisciplinary work-focused relational group cognitive behaviour therapy (CBT) treatment programme for moderate-severe depression using realist methods.\u0000\u0000\u0000Design/methodology/approach\u0000This case study shows how the authors designed the intervention using component analysis of existing literature and focus groups of frontline practitioners and former service users and mind-mapping analysis to establish its operational logic and evaluated the theory underpinning the intervention using realist synthesis and evaluation to establish its conceptual logic.\u0000\u0000\u0000Findings\u0000An iterative hybrid approach of literature review, component analysis, focus group discussion and realist methods established the initial design and programme theory for the new intervention. The intervention focused on three areas of therapy, three inter-dependent outcomes, in a group format, with opportunities created for peer interaction. The main theoretical principles most likely to promote efficacy were to accelerate and optimise activation of one or more of six hypothesised mechanisms: realise, reflect, regulate, resolve, relate and retain/resume in the context of skilfully facilitated group psychotherapy.\u0000\u0000\u0000Social implications\u0000This study outlines a methodological approach based on the layered ontology of critical realist philosophy, applied to a successful example, which will be useful during the early stages of the design and development of new group-based psychotherapeutic interventions.\u0000\u0000\u0000Originality/value\u0000By adopting the critical realist approach, the authors identified underlying mechanisms of change in relational group CBT. The theoretically integrated approach involving service users and practitioners from different professional backgrounds was unique and meant that the treatment programme was multi-modal rather than informed by a single therapeutic or theoretical approach.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"62089812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-25DOI: 10.1108/mhrj-02-2021-0016
Andrew Ware, A. Preston, S. Draycott
Purpose People with a borderline personality disorder (BPD) diagnosis can require support from mental health services for managing risk behaviour. Current routine inpatient and community treatment can be unhelpful for this group. Positive risk taking has been developed to help community teams manage risk with people with a BPD. This study aims to explore experiences of risk management in an NHS Trust where positive risk taking is being implemented with people with a BPD. Design/methodology/approach Interpretative phenomenological analysis is the methodology of transcripts from semi-structured interviews. Nine adults with a diagnosis of BPD and current or previous experiences of risk management approaches were sampled from one NHS Trust. Findings Limited resources and interpersonal barriers had a negative impact on experiences of Positive risk taking. Participants experienced one-off risk assessments and short-term interventions such as medication which they described as “meaningless”. Traumatic experiences could make it difficult to establish therapeutic relationships and elicit unhelpful responses from professionals. Participants could only feel “taken seriously” when in crisis which contributed towards an increase in risky behaviour. Positive risk taking was contingent upon collaborative and consistent professional relationships which created a “safety net”, enabling open communication and responsibility taking which challenged recovery-relapse patterns of service use. Research limitations/implications Positive risk taking approaches to risk management may benefit people with a BPD. Findings complement those from other studies emphasising the importance of compassion and empathy when working with personality disorder. Training and increased resources are required to implement effective risk management with this group. Originality/value Findings expand upon the sparse existing research in the area of risk management using the Positive risk taking approach with people with a BPD diagnosis, and provide idiographic understanding which is clinically meaningful. Participants’ experiences suggest Positive risk taking may provide a framework for improving quality of life and decreasing service use for people diagnosed with BPD engaging in risk management with Community Mental Health Teams, which facilitates recovery and other benefits.
{"title":"“It doesn’t get taken seriously until it gets bad”: experiences of risk management from people diagnosed with a borderline personality disorder","authors":"Andrew Ware, A. Preston, S. Draycott","doi":"10.1108/mhrj-02-2021-0016","DOIUrl":"https://doi.org/10.1108/mhrj-02-2021-0016","url":null,"abstract":"\u0000Purpose\u0000People with a borderline personality disorder (BPD) diagnosis can require support from mental health services for managing risk behaviour. Current routine inpatient and community treatment can be unhelpful for this group. Positive risk taking has been developed to help community teams manage risk with people with a BPD. This study aims to explore experiences of risk management in an NHS Trust where positive risk taking is being implemented with people with a BPD.\u0000\u0000\u0000Design/methodology/approach\u0000Interpretative phenomenological analysis is the methodology of transcripts from semi-structured interviews. Nine adults with a diagnosis of BPD and current or previous experiences of risk management approaches were sampled from one NHS Trust.\u0000\u0000\u0000Findings\u0000Limited resources and interpersonal barriers had a negative impact on experiences of Positive risk taking. Participants experienced one-off risk assessments and short-term interventions such as medication which they described as “meaningless”. Traumatic experiences could make it difficult to establish therapeutic relationships and elicit unhelpful responses from professionals. Participants could only feel “taken seriously” when in crisis which contributed towards an increase in risky behaviour. Positive risk taking was contingent upon collaborative and consistent professional relationships which created a “safety net”, enabling open communication and responsibility taking which challenged recovery-relapse patterns of service use.\u0000\u0000\u0000Research limitations/implications\u0000Positive risk taking approaches to risk management may benefit people with a BPD. Findings complement those from other studies emphasising the importance of compassion and empathy when working with personality disorder. Training and increased resources are required to implement effective risk management with this group.\u0000\u0000\u0000Originality/value\u0000Findings expand upon the sparse existing research in the area of risk management using the Positive risk taking approach with people with a BPD diagnosis, and provide idiographic understanding which is clinically meaningful. Participants’ experiences suggest Positive risk taking may provide a framework for improving quality of life and decreasing service use for people diagnosed with BPD engaging in risk management with Community Mental Health Teams, which facilitates recovery and other benefits.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41677682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-22DOI: 10.1108/mhrj-12-2021-0091
Tomasz Prusiński
Purpose The results of empirical research on the patient–psychotherapist relationship have led to the fundamental conclusion that the therapeutic alliance is one of the key factors ensuring the positive outcomes of psychotherapy. The main aim of the present study is to determine what variables pertaining to the context of psychotherapy (type of treatment applied in accordance with the psychotherapist’s modality/orientation, type of disorder diagnosed in the patient) differentiated the alliance. Design/methodology/approach Participants for the main study were recruited from public and private psychotherapy offices across Poland. The working alliance was assessed based on 262 psychotherapist–patient dyads. The sample consisted of 428 participants. To assess the quality of therapeutic alliance, the author used the full version of the Working Alliance Inventory as adapted into Polish. Findings The results of analyses led to several basic conclusions. The study revealed a differentiating effect of type of psychotherapy on the quality of therapeutic alliance. Alliance quality was not differentiated by the type of disorder diagnosed in patients and treated in the psychotherapeutic process. Originality/value The results of analyses presented in this empirical study allowed for exploring the quality of the therapeutic alliance with contextual variables related to the psychotherapeutic process taken into account.
{"title":"The active factor of alliance in psychotherapy: differentiation of therapeutic alliance quality according to the psychotherapist’s theoretical orientation and type of disorder","authors":"Tomasz Prusiński","doi":"10.1108/mhrj-12-2021-0091","DOIUrl":"https://doi.org/10.1108/mhrj-12-2021-0091","url":null,"abstract":"\u0000Purpose\u0000The results of empirical research on the patient–psychotherapist relationship have led to the fundamental conclusion that the therapeutic alliance is one of the key factors ensuring the positive outcomes of psychotherapy. The main aim of the present study is to determine what variables pertaining to the context of psychotherapy (type of treatment applied in accordance with the psychotherapist’s modality/orientation, type of disorder diagnosed in the patient) differentiated the alliance.\u0000\u0000\u0000Design/methodology/approach\u0000Participants for the main study were recruited from public and private psychotherapy offices across Poland. The working alliance was assessed based on 262 psychotherapist–patient dyads. The sample consisted of 428 participants. To assess the quality of therapeutic alliance, the author used the full version of the Working Alliance Inventory as adapted into Polish.\u0000\u0000\u0000Findings\u0000The results of analyses led to several basic conclusions. The study revealed a differentiating effect of type of psychotherapy on the quality of therapeutic alliance. Alliance quality was not differentiated by the type of disorder diagnosed in patients and treated in the psychotherapeutic process.\u0000\u0000\u0000Originality/value\u0000The results of analyses presented in this empirical study allowed for exploring the quality of the therapeutic alliance with contextual variables related to the psychotherapeutic process taken into account.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48797283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-07DOI: 10.1108/mhrj-06-2021-0050
H. M. Asif, Hafiz Abdul Sattar Hashmi, R. Zahid, K. Ahmad, Halima Nazar
Purpose The purpose of this study was to evaluate the psychosocial impact during the current epidemic situation of COVID-19 in Pakistan. Design/methodology/approach A total of 1,149 respondents were recruited in the study. Mental health status and psychological impact of COVID-19 outbreak were measured by impact of events scale–revised (IES-R) instrument and depression, anxiety and stress scales (DASS-21), respectively. Findings Results of IES-R revealed moderate or severe psychological impact in 13.05% respondents (score > 33). DAAS score revealed that severe and extremely severe depression (score: 21–42), anxiety (score: 15–42) and stress (score: 27–42) were reported in 6.35%, 6.87% and 2.78% respondents, respectively. Higher levels of stress, anxiety and depression were recorded in female gender, student, medical professionals, farmer and daily wages employed, exhibiting significant (p < 0.05) association with psychological impact of the COVID-19 outbreak. Majority of respondents received increased support, shared feeling and family care. Originality/value Mild to moderate psychological impact on mental health status was recorded in this study, which enables further planning and opportunities for health authorities to design psychological interventions for the improvement of negative psychological impact of COVID-19 epidemic in vulnerable groups.
{"title":"COVID-19 pandemic impact on mental health and quality of life among general population in Pakistan","authors":"H. M. Asif, Hafiz Abdul Sattar Hashmi, R. Zahid, K. Ahmad, Halima Nazar","doi":"10.1108/mhrj-06-2021-0050","DOIUrl":"https://doi.org/10.1108/mhrj-06-2021-0050","url":null,"abstract":"\u0000Purpose\u0000The purpose of this study was to evaluate the psychosocial impact during the current epidemic situation of COVID-19 in Pakistan.\u0000\u0000\u0000Design/methodology/approach\u0000A total of 1,149 respondents were recruited in the study. Mental health status and psychological impact of COVID-19 outbreak were measured by impact of events scale–revised (IES-R) instrument and depression, anxiety and stress scales (DASS-21), respectively.\u0000\u0000\u0000Findings\u0000Results of IES-R revealed moderate or severe psychological impact in 13.05% respondents (score > 33). DAAS score revealed that severe and extremely severe depression (score: 21–42), anxiety (score: 15–42) and stress (score: 27–42) were reported in 6.35%, 6.87% and 2.78% respondents, respectively. Higher levels of stress, anxiety and depression were recorded in female gender, student, medical professionals, farmer and daily wages employed, exhibiting significant (p < 0.05) association with psychological impact of the COVID-19 outbreak. Majority of respondents received increased support, shared feeling and family care.\u0000\u0000\u0000Originality/value\u0000Mild to moderate psychological impact on mental health status was recorded in this study, which enables further planning and opportunities for health authorities to design psychological interventions for the improvement of negative psychological impact of COVID-19 epidemic in vulnerable groups.\u0000","PeriodicalId":45687,"journal":{"name":"Mental Health Review Journal","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43448204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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