Reflections on introducing a Leavers’ Preparation Group in an intellectual disability secure service

2018 ◽  
Vol 9 (2) ◽  
pp. 81-90 ◽  
Author(s):  
Gareth Hickman ◽  
Nicola Booth ◽  
Thuy Hoang
Keyword(s):  
Intellectual Disability ◽  
Service Provision ◽  
Group Intervention ◽  
Outcome Data ◽  
Service Users ◽  
Current Group ◽  
Content Type ◽  
User Attitudes ◽  
Personal Reflections ◽  
Learning Points

Purpose The purpose of this paper is to report on the introduction of a Leavers’ Preparation Group in an Intellectual Disability (ID) Secure Service. In the context of reductions in ID inpatient beds and reductions in restrictive practices, discharge and transfers out of hospital settings are increasing. The current group was established to provide support and preparation for service users as they approach discharge/transfer from hospital. The current paper provides example outcome data and reflects on the experience and learning points in delivering such interventions in secure contexts. Design/methodology/approach The Leavers’ Preparation Group is an eight-session preparatory, recovery focussed group intervention focussing on supporting service users as they approach discharge/transfer to lower levels of security. The intervention has a multi-disciplinary approach, focussing on psychosocial aspects of current and future risk reduction. Findings Overwhelmingly service users reported that they experienced the group as positive and beneficial. Personal reflections of the authors are offered on service user attitudes to discharge/transfer, the contextual impact of restrictive systems and the benefits of this type of group intervention. Originality/value This paper reports on clinical practice, which involves multi-disciplinary intervention, co-production with service users and relevant stakeholders, and provides a description of the group intervention. It also offers critical reflection on tensions in this area of service provision, such as control and choice, freedom and responsibility, limitations and restrictions and power imbalances.

An outcomes study of eTherapy for dual diagnosis using Breaking Free Online

2014 ◽  
Vol 7 (2) ◽  
pp. 52-62 ◽  
Author(s):  
Sarah Elison ◽  
Jonathan Ward ◽  
Glyn Davies ◽  
Nicky Lidbetter ◽  
Daniel Hulme ◽  
...  
Keyword(s):  
Mental Health ◽  
Dual Diagnosis ◽  
Substance Dependence ◽  
Clinical Effectiveness ◽  
Outcome Data ◽  
Post Treatment ◽  
Service Users ◽  
Original Cohort ◽  
Content Type ◽  
Self Help

Purpose – In recent years there has been a proliferation of computer-based psychotherapeutic interventions for common mental health difficulties. Building on this, a small number of such interventions have now been developed to address substance dependence, one of which is Breaking Free Online (BFO). A new “eTherapy” self-help service, which was set up by the UK mental health charity Self-Help Services, has provided access to BFO to service users presenting with comorbid mental health and substance misuse difficulties. The purpose of this paper is to evaluate a range of clinical outcomes in the first cohort of service users accessing this dual diagnosis service. Design/methodology/approach – A number of standardised psychometric assessments were conducted with service users at baseline and post-treatment at discharge from the service. Outcome data were available for 47 service users out of an original cohort of 74. Findings – Statistically significant improvements were found in terms of measures of social functioning, depression, anxiety, alcohol and drug use and social anxiety. Clinically relevant gains were also identified, with fewer service users reaching threshold scores for depression and anxiety at post-treatment compared to baseline. Effect sizes also indicated that the identified improvements across the psychometric measures were robust and significant. Research limitations/implications – These findings provide further support for the clinical effectiveness of BFO, and also provide evidence that an eTherapy self-help service may be appropriate for some individuals presenting with dual diagnosis. Further research is underway with larger and alternative clinical populations to examine the effectiveness of BFO and also this novel eTherapy self-help approach. Originality/value – This paper has provided initial data to support effectiveness of a novel eTherapy service for dual diagnosis.

scholarly journals Restrictive practices on refugees in Australia with intellectual disability and challenging behaviours: a family’s story

2016 ◽  
Vol 10 (4) ◽  
pp. 222-232 ◽  
Author(s):  
Julie King ◽  
Niki Edwards ◽  
Ignacio Correa-Velez ◽  
Rosalyn Darracott ◽  
Maureen Fordyce
Keyword(s):  
Intellectual Disability ◽  
Service Provision ◽  
Service System ◽  
Ethnographic Study ◽  
Refugee Status ◽  
Content Type ◽  
Loved One ◽  
Restrictive Practice ◽  
Complex Disability

Purpose The purpose of this paper is to explore the experiences of a refugee family navigating complex disability and restrictive practice service systems. Living with disability, or caring for someone with disability can compound the disadvantage and marginalisation already experienced by refugees. The nexus between disability and refugee status, particularly intellectual disability and restrictive practices, has received little scholarly attention and almost nothing is known of people’s experiences in this situation. Design/methodology/approach Thematic analysis of a case study is used to illustrate the experiences of a refugee family in this situation. The case study presented was part of a larger ethnographic study exploring the experiences of people of refugee background living with disability. Findings There were numerous barriers to accessing appropriate services. The family experienced high levels of stress simultaneously navigating the resettlement process and the disability service system. They were poorly informed and disempowered regarding the care of their loved one and the use of restrictive practices. Experiences in the country of origin, employment responsibilities, and unfamiliarity with the service system were key factors in this family’s difficulty in safeguarding the rights of their family member with disability. Originality/value This case study examines the complexity experienced when disability intersects with refugee background. Areas for additional research and significant gaps in service provision are identified. The case study clearly demonstrates the importance of understanding people’s pre- and post-settlement experiences to inform policy and service provision.

“Part of being human”: evaluating the 4Ps model to support inpatient staff teams in reflecting on interpersonal dynamics

2019 ◽  
Vol 14 (4) ◽  
pp. 232-241
Author(s):  
Lindsay Jones ◽  
Phyllis Annesley
Keyword(s):  
Psychotherapy Training ◽  
Cost Effective ◽  
Time Frame ◽  
Outcome Data ◽  
Service Users ◽  
Interpersonal Dynamics ◽  
Content Type ◽  
Positive Effects ◽  
Training Approach ◽  
Multidisciplinary Staff

Purpose An innovative training approach was developed to enable staff working with complex cases, including personality disorder, to reflect on and work with the interpersonal dynamics of their interactions with service users. The aim of this approach is to support effective, compassionate and boundaried care. An overview of the model and development of the training is provided along with presentation and discussion of outcome data. Implications for future practice are also considered. Design/methodology/approach One-day workshops were provided within inpatient forensic women’s services. Nine workshops were delivered with 96 multidisciplinary staff having attended in total. Evaluation tools were developed to ascertain participants’ feedback regarding the training including its relevance and potential for impact on practice. Feedback was analysed using a mixture of quantitative and qualitative methods. Findings The evaluation demonstrated that the training was well received by a motivated group of participants and was felt to be relevant to their clinical practice. Research limitations/implications The evaluation is limited by the lack of a follow-up to assess the longer-term impacts of the training and whether the positive effects of the training were maintained. Practical implications The findings demonstrate that the training can be delivered within a short time frame, which makes the training efficient and cost effective. Social implications The training can develop practitioners’ skills in delivering compassionate and boundaried care in line with key NHS drivers for staff working with complex service users. Originality/value The 4Ps model enables staff with little or no psychotherapy training to deliver psychologically informed care which takes account of interpersonal dynamics and positively contributes to relational security, with an emphasis on reflecting on self and others.

Managers’ views of the effects on their service of hosting a cognitive-behavioural anger management group

2015 ◽  
Vol 9 (1) ◽  
pp. 19-29 ◽  
Author(s):  
Nicola Rose ◽  
John Rose ◽  
Biza Stenfert Kroese ◽  
Aimee Stimpson ◽  
Pamela MacMahon ◽  
...  
Keyword(s):  
Group Intervention ◽  
Anger Management ◽  
Behavioural Therapy ◽  
Service Users ◽  
Unique Contribution ◽  
Content Type ◽  
Staff Members ◽  
Management Group ◽  
Cognitive Behavioural ◽  
Service Managers

Purpose – The purpose of this paper is to investigate how service managers perceive their service prior to, and following the delivery of a cognitive-behavioural therapy (CBT) anger management group for individuals with an intellectual disability. Design/methodology/approach – Telephone interviews were conducted with seven service managers, before and after a CBT group intervention. The interviews were recorded, transcribed and analysed using thematic analysis to identify common and/or contrasting themes. Findings – Before the intervention took place managers observed a lack of consistency in how their staff dealt with challenging incidents and the serious consequences these incidents had for service users as well as staff. They spoke about the importance of multi-disciplinary working and good quality staff selection, support and training. After the group intervention managers commented on a positive “spilling-out effect” whereby the whole organisation was influenced by the intervention, a greater willingness on the part of service users to talk about their problems, and an increased confidence in the staff members who had co-facilitated the group work. Research limitations/implications – The implications of the themes raised are discussed and recommendations for further research are suggested. Originality/value – This research provides a unique contribution of managers’ views and insight into how hosting a CBT group intervention impacted on their wider services.

scholarly journals The legitimacy of offender management programmes in a post-TR landscape

2018 ◽  
Vol 17 (2) ◽  
pp. 69-80 ◽  
Author(s):  
Michael Rowe ◽  
Adele Irving ◽  
Sarah Soppitt
Keyword(s):  
Service Provision ◽  
Service User ◽  
Design Methodology ◽  
Service Providers ◽  
Service Users ◽  
Structured Interviews ◽  
Content Type ◽  
User Perceptions ◽  
Key Dimensions

Purpose The purpose of this paper is to explore the under-considered perspectives of service users engaged in various community sentences based on a “strengths-based” approach to desistance. Further to recent changes in the sector, the paper considers service user views for programmes delivered by combinations of agencies from private, public and third sectors. Design/methodology/approach The paper is based on analysis of 64 semi-structured interviews with users of four programmes, accompanied with informal fieldwork observations by the researchers as they carried out the research at the premises of service providers. Findings The research finds that service user perceptions of the legitimacy of programmes are closely related to their understanding of three key dimensions: first, the “authenticity” of those delivering the service; second, the instrumental (in broad terms) gains they expect from engagement; and third, their understanding of the identity and ethos of the programme. Originality/value The paper adds important understanding based on service user perceptions in a period when service provision is being diversified. Further directions for other research are identified and it is recognised that a limitation of the current study is that it incorporates a sample drawn from one area.

scholarly journals Gaining super control: Psychoeducational group intervention for adolescents with mild intellectual disability and their parents

2021 ◽  
pp. 174462952199537
Author(s):  
Stine Ericson ◽  
Marianne Winge Hesla ◽  
Kristine Stadskleiv
Keyword(s):  
Intellectual Disability ◽  
Transition To Adulthood ◽  
Group Intervention ◽  
Positive Impact ◽  
Outcome Data ◽  
Mild Intellectual Disability ◽  
Psychoeducational Group ◽  
Social Challenges ◽  
Strengths And Difficulties ◽  
Adolescent Outcome

Adolescents with intellectual disability experience psychological and social challenges in their transition to adulthood. Knowledge about the diagnosis and insight into own strengths and difficulties can help them manage the limitations and barriers they face, but suitable interventions with this purpose are scarce. The present paper presents a psychoeducational group intervention, The Super Control Project, for adolescents (15–17 years old) with mild intellectual disability (n = 23) and their parents. In a pre-post design, adolescent outcome data was obtained through teacher and parent questionnaires, and interviews with the adolescents. Parents and adolescents also evaluated the interventions’ usefulness. Results indicated positive impact on participants’ understanding of the diagnosis, managing of everyday challenges, and social networking. The intervention seemed to fit the participants’ needs and abilities. The study encourages further implementation and rigorous evaluation.

scholarly journals “Be here now” – service users’ experiences of a mindfulness group intervention

2018 ◽  
Vol 12 (2) ◽  
pp. 77-87 ◽  
Author(s):  
Aiveen Dillon ◽  
Charlotte Wilson ◽  
Catherine Jackman
Keyword(s):  
Mental Health ◽  
Intellectual Disabilities ◽  
Group Intervention ◽  
Group Process ◽  
Service Users ◽  
Structured Interviews ◽  
Content Type ◽  
Mental Health Difficulties ◽  
Mindfulness Interventions ◽  
Individuals With Intellectual Disabilities

Purpose The purpose of this paper is to explore service users’ experiences of a mindfulness group intervention. Design/methodology/approach In total, 15 participants with a diagnosis of a mild or moderate intellectual disability and concurrent mental health difficulties were interviewed using semi-structured interviews about their experiences of attending the mindfulness group. Findings Thematic analysis was used to interpret the data. The three super ordinate themes that emerged were positive aspects of mindfulness, positive aspects of attending the group and negative aspects of attending the group. There were seven subthemes. The results highlighted that participants found the mindfulness group to be beneficial, partly due to specific aspects of the mindfulness intervention and partly due to the group process. The negative aspects of the group were harder to elicit, and were less specifically related to mindfulness. Originality/value Mindfulness-based interventions have emerged as a promising approach for individuals with intellectual disabilities with mental health difficulties. There is currently a lack of research exploring service users with intellectual disabilities about their experiences of mindfulness interventions.

Mental health service users’ lived experiences of recovery-oriented services: a scoping review

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rosalind Lau ◽  
Anastasia Hutchinson
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Decision Making ◽  
Mental Health Service ◽  
Health Service ◽  
Scoping Review ◽  
Service Provision ◽  
Lived Experiences ◽  
Service Users ◽  
Content Type

Purpose Over the past 15 years, mental health organisations have taken steps to move towards providing services that are more recovery-oriented. This review was undertaken to explore what is known about service users’ experience of services that have introduced a recovery-oriented approach to service provision. There is limited research evaluating consumers’ lived experiences of recovery-orientated care; a scoping review was chosen to provide an overview of the available research in this area (Munn et al., 2018). The purpose of this review was to summarize and synthesize current qualitative research exploring consumers’ experience of recovery orientated mental health care provision. Design/methodology/approach This scoping review was undertaken as outlined by Arksey and O'Malley (2005). The five steps consisted identifying the research question; searching for relevant studies; selecting the studies; charting the studies; and collating, summarising and reporting the findings. Findings Three key themes emerged from this review: translation of recovery policy to practice; ward environment; and recovery principles with five subthemes: engagement; not being listened to; shared decision-making; informational needs; and supportive and collaborative relationships. The themes and subthemes identified in each of the 18 studies are presented in Table 3. Research limitations/implications This review highlights the different degree to which service users have received recovery-oriented recovery care. In the majority of cases, most service users reported few opportunities for nursing engagement, poor communication, inadequate information provision, a lack of collaborative care and mostly negative experiences of the ward environment. Because of the limited studies on mental health service users’ lived experiences of a recovery-oriented service, more clinical studies are needed and in different cultural contexts. Practical implications On hindsight, the authors should have included service users in this review process as consumer inclusion is progressively emphasised in mental health educational and research activities. This review highlights that not all studies have involved service users or consumers in their research activity. Social implications Service users need relevant information in a timely manner to participate in decision-making regarding their treatment and care. This review found that either no information was provided to the service users or it was provided in a limited and fragmented manner. This review also found inpatients reported limited opportunities to have meaningful participation in decision-making about their care. These findings have important social implications, as greater consumer engagement in the design and delivery of mental health services will increase community trust in the care provided. This in turn has the potential to facilitate greater community engagement in preventative mental health care. Originality/value This is the first review to systematically synthesis consumers perspectives on the extent to which service providers are achieving the goal of implementing recovery-orientated practice into their service provision. Despite important policy changes, the findings of this review demonstrate that more work is needed to truly operationalise and translate these principles into practice.

How can mental health clinicians, working in intellectual disability services, meet the spiritual needs of their service users?

2015 ◽  
Vol 9 (1) ◽  
pp. 9-18 ◽  
Author(s):  
Benjamin Loynes ◽  
Jean O'Hara
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Literature Review ◽  
Intellectual Disabilities ◽  
General Health ◽  
Disability Services ◽  
Spiritual Needs ◽  
Service Users ◽  
Mental Health Clinicians ◽  
Content Type

Purpose – The purpose of this paper is to identify approaches that mental health clinicians, working in intellectual disability services, can adopt to ensure the spiritual needs of their service users are met. Design/methodology/approach – A narrative literature review examining original research, expert opinion pieces and book chapters was undertaken. To broaden the perspective of the paper, publications from different academic areas were reviewed including intellectual disabilities, mental health, neurodevelopmental disorders, general health and spirituality literature. Findings – The main principles of spiritual assessment tools from the general health literature can be applied to this group. However, the literature would suggest that certain approaches are of particular importance in intellectual disabilities mental health including advocating for service users to attend the religious services they wish to and working collaboratively with families and carers when addressing spiritual issues. Research limitations/implications – The question of how to meet the spiritual needs of people with autism and severe intellectual disability is a neglected research area. Research examining the spiritual needs of service users with intellectual disabilities, on mental health inpatient units, is also needed as well as a review of whether spiritual needs are being met in current person-centred care plans. Originality/value – No published literature review was identified that specifically addressed the question of how mental health clinicians should approach the spiritual needs of their service users.

Gathering meaningful service user feedback regarding a community forensic service

2015 ◽  
Vol 6 (2) ◽  
pp. 81-93 ◽  
Author(s):  
Karen Bamford ◽  
Carl Benton
Keyword(s):  
Risk Taking ◽  
Service Provision ◽  
Design Methodology ◽  
Service Evaluation ◽  
Third Party ◽  
Service Users ◽  
Engagement In Care ◽  
Content Type ◽  
Forensic Service ◽  
Practical Implications

Purpose – Engaging with people with a learning disability to develop and enhance service provision is central to the ethos of personalisation and citizenship. Despite this there appears to be a lack of research to gather users’ views on how they feel the services meet their unique needs and how these could be improved. A service evaluation was developed to understand service user’s experience of accessing a community forensic service (CFS). The paper aims to discuss these issues. Design/methodology/approach – The questionnaire was conducted by an independent third party experienced in facilitating complex communication, utilising a written format and Widget Rebus symbols. Questions were based on Trust Values, family and friends test and clinical forensic engagement. The samples were service users open to the CFS on 1 July 2014. Findings – Data were gathered from 28 individuals, there was an even spread of ages 17-65. In all, 93 per cent understood what help they needed from the service, there was acknowledgement of who they would go to if they wanted to complain, 100 per cent were happy with how information had been provided, most felt the service was respectful, fair, friendly and they were listened to. Practical implications – The findings suggest that more needs to be done around understanding and engagement in care planning. There are plans to gather information from direct carers and setting up focus groups to further understand some of the issues and ways forward. Originality/value – Asking for feedback from people who have offended, some of whom now experience increased restrictions, is fraught with concern and approached with trepidation. However, the responses received contradict the natural instincts. The results showed promising appreciation of the support received in the context of everyday lives and positive risk taking.

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