scholarly journals Mental health nurses’ perceptions of attachment style as a construct in a medium secure hospital: a thematic analysis

2015 ◽  
Vol 10 (4) ◽  
pp. 218-233 ◽  
Author(s):  
Nikki Boniwell ◽  
Leanne Etheridge ◽  
Ruth Bagshaw ◽  
Joanne Sullivan ◽  
Andrew Watt

Purpose – Attachment Theory can be regarded as central to the concept of relational security. There is a paucity of research examining the coherence of this construct for ward-based staff. The paper aims to discuss these issues. Design/methodology/approach – Five female nurses from the acute admission and assessment ward of a UK medium secure unit acted as participants. Semi-structured interviews were conducted, and inductive thematic analysis was applied. Findings – Six themes; “staff-service user relationships”, “staff diversities”, “service user backgrounds”, “variability in service users’ presentations”, “service users with personality disorder are problematic” and “nurses do not use attachment” emerged from the data. The nurses used heuristic models of attachment-related behaviour and they lacked knowledge of constructs associated with Attachment Theory. Research limitations/implications – Acute admissions may not be representative of all treatment contexts. Traditional models of attachment style may have only limited relevance in forensic services. Practical implications – Limited knowledge and confidence in the nurses regarding how Attachment Theory might apply to service users is interesting because it may limit the extent to which care, treatment and risk management might be informed by an understanding of service user representations of therapeutic relationships. Training and educational interventions for nurses that enhance understanding of personality development and attachment styles are warranted. Originality/value – The importance of nurses for achieving relational security is emphasised and the adequacy of their training is questioned.

2020 ◽  
Vol 8 (3) ◽  
Author(s):  
Eleni Rizou ◽  
Vaitsa Giannouli

Therapeutic Relationship has been regarded as a profound element of the psychotherapeutic procedure and crucial for the outcome of therapy. Research evidence so far claims that both therapist’s and client’s personality can impact the Therapeutic Relationship. Based on the well-researched Attachment Theory there has been some research mostly focused on how clients’ attachment patterns can affect the Alliance. Limited research, though, on how therapists experience the Relationship in relation with their Attachment Styles do exist. The current study investigates trainee therapists’ experience of the Therapeutic Relationship in the light of their Attachment Style. A qualitative approach was used for this research to investigate in depth the experience of five trainee Integrative psychotherapists who were recruited to take part in semi-structured interviews. Interviews were transcribed and verbatim was divided into superordinate and subordinate themes and analyzed by Interpretative Phenomenological Analysis method. Four master themes were identified. Findings were then compared and discussed according to existing literature. All participants referred to the relevance of Attachment Theory in psychotherapy. They also agreed on the activation of their Attachment Styles during the therapeutic process. The securely attached therapist confirms previous studies on her capability to offer a secure base for her clients. On the other hand therapists with insecure Attachment Styles appeared sensitive in their collaboration mostly with insecure clients. Anxiously attached therapists proved to experience difficulty in the initial stages of the Therapeutic Relationship while the combination of avoidant therapist-avoidant client appeared to be the most demanding one, regarding the concept of trust and relationship ruptures. We suggest that the exploration of trainee therapists’ Attachment Styles as well as the study of the Attachment Theory should be added to all Counseling and Psychotherapy curricula regardless the therapeutic orientation because of its contribution to forming positive Therapeutic Relationships.


2018 ◽  
Vol 17 (2) ◽  
pp. 69-80 ◽  
Author(s):  
Michael Rowe ◽  
Adele Irving ◽  
Sarah Soppitt

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.


Author(s):  
Ina Grau ◽  
Jörg Doll

Abstract. Employing one correlational and two experimental studies, this paper examines the influence of attachment styles (secure, anxious, avoidant) on a person’s experience of equity in intimate relationships. While one experimental study employed a priming technique to stimulate the different attachment styles, the other involved vignettes describing fictitious characters with typical attachment styles. As the specific hypotheses about the single equity components have been developed on the basis of the attachment theory, the equity ratio itself and the four equity components (own outcome, own input, partner’s outcome, partner’s input) are analyzed as dependent variables. While partners with a secure attachment style tend to describe their relationship as equitable (i.e., they give and take extensively), partners who feel anxious about their relationship generally see themselves as being in an inequitable, disadvantaged position (i.e., they receive little from their partner). The hypothesis that avoidant partners would feel advantaged as they were less committed was only supported by the correlational study. Against expectations, the results of both experiments indicate that avoidant partners generally see themselves (or see avoidant vignettes) as being treated equitably, but that there is less emotional exchange than is the case with secure partners. Avoidant partners give and take less than secure ones.


2019 ◽  
Vol 23 (1) ◽  
pp. 23-29
Author(s):  
Laura Lea ◽  
Sue Holttum ◽  
Victoria Butters ◽  
Diana Byrne ◽  
Helen Cable ◽  
...  

PurposeThe 2014/2015 UK requirement for involvement of service users and carers in training mental health professionals has prompted the authors to review the work of involvement in clinical psychology training in the university programme. Have the voices of service users and carers been heard? The paper aims to discuss this issue.Design/methodology/approachThe authors update the paper of 2011 in which the authors described the challenges of inclusion and the specific approaches the authors take to involvement. The authors do this in the context of the recent change to UK standards for service user and carer involvement, and recent developments in relation to partnership working and co-production in mental healthcare. The authors describe the work carried out by the authors – members of a service user involvement group at a UK university – to ensure the voices of people affected by mental health difficulties are included in all aspects of training.FindingsCareful work and the need for dedicated time is required to enable inclusive, effective and comprehensive participation in a mental health training programme. It is apparent that there is a group of service users whose voice is less heard: those who are training to be mental health workers.Social implicationsFor some people, involvement has increased. Trainee mental health professionals’ own experience of distress may need more recognition and valuing.Originality/valueThe authors are in a unique position to review a service-user-led project, which has run for 12 years, whose aim has been to embed involvement in training. The authors can identify both achievements and challenges.


Author(s):  
Patricia McCormick ◽  
Bridget Coleman ◽  
Ian Bates

AbstractBackground Medication reviews are recognised as essential to tackling problematic polypharmacy. Domiciliary medication reviews (DMRs) have become more prevalent in recent years. They are proclaimed as being patient-centric but published literature mainly focuses on clinical outcomes. However, it is not known where the value of DMRs lies for patients who participate in them. Objective To determine the value of domiciliary medication reviews to service users. Setting Interviews took place with recipients of domiciliary medication reviews residing in the London boroughs of Islington and Haringey. Method Semi-structured interviews analysed using thematic analysis. Main outcome measure Themes and sub-themes identified from interview transcripts. Results Five themes were identified: advantages over traditional settings, attributes of the professional, adherence, levels of engagement and knowledge. Conclusion For many patients, the domiciliary setting is preferred to traditional healthcare settings. Patients appreciated the time spent with them during a DMR and felt listened to. Informal carers felt reassured that the individual medication needs of their relative had been reviewed by an expert.


2014 ◽  
Vol 25 (2) ◽  
pp. 142-149 ◽  
Author(s):  
S. Mathews ◽  
J. Onwumere ◽  
S. Bissoli ◽  
M. Ruggeri ◽  
E. Kuipers ◽  
...  

Background.Attachment theory proposes that psychological functioning and affect regulations are influenced by the attachment we form with others. Early relationships with parents or caregivers lay the foundations for attachment styles. These styles are proposed to influence how we relate to others during our life can be modified by the relationships and events we experience in our lifespan. A secure attachment style is associated with a capacity to manage distress, comfort with autonomy and the ability to form relationships with others, whereas insecure attachment can lead to dysfunctional relationships, emotional and behaviour avoidance. Attachment theory provides a useful framework to inform our understanding of relationship difficulties in people with psychosis. This paper aims to complement recent systematic reviews by providing an overview of attachment theory, its application to psychosis, including an understanding of measurement issues and the clinical implications offered.Method.A narrative review was completed of the measures of attachment and parental bonding in psychosis. Its clinical implications are also discussed. The paper also explores the link between insecure attachment styles and illness course, social functioning and symptomatology. The following questions are addressed: What are the key attachment measures that have been used within the attachment and psychosis literature? What are the results of studies that have measured attachment or parental bonding in psychosis and what clinical implications can we derive from it? What are some of the key questions for future research from these findings in relation to the onset of psychosis research field?Results.The most commonly used measures of attachment in psychosis research are reviewed. Self-report questionnaires and semi-structured interviews have mainly been used to examine attachment styles in adult samples and in recent years comprise a measure specifically developed for a psychosis group. The review suggests that insecure attachment styles are common in psychosis samples. Key relationships were observed between insecure, avoidant and anxious attachment styles and psychosis development, expression and long-term outcome.Conclusions.Attachment theory can provide a useful framework to facilitate our understanding of interpersonal difficulties in psychosis that may predate its onset and impact on observed variability in outcomes, including treatment engagement. Greater attention should be given to the assessment of attachment needs and to the development of interventions that seek to compensate for these difficulties. However, further investigations are required on specifying the exact mechanisms by which specific attachment styles impact on the development of psychosis and its course.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hila Axelrad ◽  
Alexandra Kalev ◽  
Noah Lewin-Epstein

PurposeHigher pensionable age in many countries that are part of Organization for Economic Co-operation and Development (OECD) and a shrinking pension income force older people to postpone their retirement. Yet, age-based discrimination in employers' decisions is a significant barrier to their employment. Hence, this paper aims to explore employers' attitudes regarding the employment of workers aged 60–70, striving for a better understanding of age discrimination.Design/methodology/approachThe authors used a thematic analysis of semi-structured interviews with 30 managers, experts and employees in retirement age in Israel.FindingsFindings reveal a spectrum of employers' attitudes toward the employment of older workers. The authors' analytical contribution is a conceptual typology based on employers' perceived ability to employ older workers and their stated attitudes toward the employment of older workers.Social implicationsThe insights that emerge from this research are fundamental for organizational actors' ability to expand the productive, unbiased employment of older workers.Originality/valueBy understanding employers' preferences and perspectives and the implications on employers' ability and/or willingness to employ older workers, this research will help policymakers formulate and implement policy innovations that address these biases.


2020 ◽  
Vol 25 (2) ◽  
pp. 185-196
Author(s):  
Lucy Fiddick ◽  
Emily Neale ◽  
Falguni Nathwani ◽  
Kristina Bennert ◽  
James Gregory

Purpose Evidence-based psychological therapies are available for severe and enduring mental health problems, but resources and access to these are limited within England. Practitioners in community mental health teams (CMHTs) can act as gatekeepers for access to psychological therapies for those in secondary care, but little is known about how they make referral decisions. This paper aims to understand how CMHT practitioners make decisions about who to refer or not, to secondary care psychological therapy services (PTS). Design/methodology/approach A total of 11 CMHT practitioners were interviewed to understand the decision making processes underpinning their referrals or otherwise, to a PTS within NHS England. The data were analysed qualitatively using thematic analysis. Findings Thematic analysis resulted in 11 sub-themes under three main themes of the self, the organisation and wider structure and the service user. Results indicated that some participants were referred automatically for psychological therapy if a service user asked or if there was external pressure to refer, while others’ decisions were informed by contextual information such as the service user’s ability to engage or change, risk status and limited organisational resources. Originality/value This study explores the decision making of multi-disciplinary professionals referring to PTS. The findings have important implications for understanding some of the factors that can influence patient access to psychological treatment in secondary care.


Author(s):  
Chia-Huei Wu

The aim of this chapter is to introduce attachment theory in terms of context-specific attachment styles, and the stability and changeability of attachment style. An attachment relationship exists not only between children and parents, but also in other relationship contexts. Context-specific attachment relationships, such as attachment at work, are more proximal to influence behavior in the specific contexts. This theoretical proposition helps illustrate how relationships in organizations are important to shape employee proactivity. Attachment theory also suggests the changeability of attachment style as individuals’ prototype of attachment style and internal working models of self, others, and the broader social environment can be changed when they encounter different experiences.


2014 ◽  
Vol 35 (6) ◽  
pp. 555-565 ◽  
Author(s):  
Aharon Tziner ◽  
Alla Ben-David ◽  
Lior Oren ◽  
Gil Sharoni

Purpose – The purpose of this paper is to investigate the associations between attachment styles, work centrality and job satisfaction with turnover intentions. Design/methodology/approach – A self-report questionnaire that included psychometrically sound measures of the key constructs was completed by a sample of 125 employees. A structural equation model was conducted to test the proposed relations and mediating hypotheses. Findings – Attachment styles were found to be linked directly to turnover intentions, and not mediated by job satisfaction and work centrality, as predicted. Avoidant and anxious employees showed higher levels of turnover intentions. A positive relationship was found between work centrality and job satisfaction; job satisfaction was negatively related with turnover intentions. Research limitations/implications – Although the study involved cross-sectional self-report data, it shed light on the associations between attachment theory and the costly organizational phenomena of voluntary turnover. Practical implications – Managers should pay particular attention to employees characterized by an insecure attachment style. Efforts should be made to improve work centrality and job satisfaction among employees. Originality/value – The study adds attachment styles as an additional tool available to managers in their efforts to manage turnover.


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