From reflection to action: a case study of an art psychotherapy group which drew on occupational therapy perspectives

2020 ◽  
Vol 25 (3) ◽  
pp. 197-213
Author(s):  
Ali Coles ◽  
Tom Elliott

Purpose This paper aims to describe service user experiences of an art psychotherapy group which drew on occupational therapy perspectives to help adults with severe and enduring mental health difficulties move forward in their recovery. Design/methodology/approach A case study approach incorporating outcome data was used. The data gathered comprised attendance, facilitators’ clinical notes, photographs of participant artworks, the Psychological Outcome Profiles questionnaire (PSYCHLOPS: www.psychlops.org), a post-therapy feedback form, discussion at post-therapy individual review sessions and participants’ achievements post-group. Findings All but one participant scored the group as “very helpful” or “helpful” and all felt that the group had helped them with the personal aims they had identified. The PSYCHLOPS questionnaire yielded a large average effect size, indicating positive change in terms of problems, functioning and well-being. Participants identified several ways in which the group was helpful, and their artwork and reflections indicate how they used the art making in the group to pursue their recovery goals. The service user experiences and outcomes suggest that this group was effective in facilitating recovery for these adults with severe and enduring mental health difficulties. Originality/value This group was innovative in integrating approaches from the different professional specialisms and the findings encourage further investigation into this way of working.

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jack Purrington ◽  
Arthur Nye ◽  
Nigel Beail

Purpose The novel coronavirus and associated mitigation efforts have caused significant increases in stress for adults with intellectual disabilities. Such increases in life stress predict an increased risk of relapse following psychological therapy. This contributes to the high global disease burden of common mental health difficulties. Therefore, this paper aims to explore service user experiences of maintaining gains following therapy within the context of the Covid-19 pandemic. Design/methodology/approach A mixed-methods evaluation was completed in a psychology service based in the North of England which specialises in supporting adults with intellectual disabilities. Descriptive statistics and effect size calculations were used to examine therapeutic outcomes pre-therapy, post-therapy, and at follow-up. These findings informed a framework analysis of eight semi-structured interviews. Findings Overall, outcome results improved post-therapy and regressed at follow-up. The framework analysis revealed facilitators to maintenance include a recollection of specific aspects of therapy and the regular utilisation of strategies and resources. Conversely, barriers to maintenance include a recollection focussed on personal outcome, a reliance on social support and an inability to remember therapy. Originality/value This is the only study to the authors’ knowledge examining service user experiences of maintaining gains following therapy within the context of Covid-19. It is hoped that these findings will inform further research and be useful for services in preparing service users for discharge as the Covid-19 pandemic continues and moves towards the post-pandemic phase.


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.


2016 ◽  
Vol 18 (4) ◽  
pp. 254-264 ◽  
Author(s):  
Asad Ul Lah ◽  
Jacqui Saradjian

Purpose Schema therapy has gone through various adaptations, including the identification of various schema modes. The purpose of this paper is to suggest that there may be a further dissociative mode, the “frozen child” mode, which is active for some patients, particularly those that have experienced extreme childhood trauma. Design/methodology/approach The paper is participant observer case study which is based on the personal reflections of a forensic patient who completed a treatment programme which includes schema therapy. Findings The proposed mode, “frozen child”, is supported by theoretical indicators in the literature. It is proposed that patients develop this mode as a protective strategy and that unless recognised and worked with, can prevent successful completion of therapy. Research limitations/implications Based on a single case study, this concept is presented as a hypothesis that requires validation as the use of the case study makes generalisation difficult. Practical implications It is suggested that if validated, this may be one of the blocks therapists have previously encountered that has led to the view that people with severe personality disorder are “untreatable”. Suggestions are made as to how patients with this mode, if validated, can be treated with recommendations as to the most appropriate processes to potentiate such therapy. Originality/value The suggestion of this potential “new schema mode” is based on service user initiative, arising from a collaborative enterprise between service user and clinician, as recommended in recent government policies.


2014 ◽  
Vol 13 (3) ◽  
pp. 142-145 ◽  
Author(s):  
Elliot Benjamin

Purpose – The purpose of this paper is to describe the therapeutic benefits of a community-based creative artists support group. The author is also the participant/facilitator of the group, which has been ongoing for the past eight months. The relevant experiences of three participants in the group have been chosen, to briefly illustrate the diverse kinds of social and therapeutic value that people with creative artistic inclinations may benefit from. Design/methodology/approach – The philosophy of the author's facilitation of this creative artist support group is based upon the humanistic psychology foundations of Carl Rogers and Abraham Maslow, as well as the author's previous work on the relationship of the creative artist to mental disturbance and mental health. Findings – The pragmatic illustrations of therapeutic benefit from participation in this creative artist support group are directly related to the humanistic supportive atmosphere that is described in this paper as a cornerstone of the Artistic Theory of Psychology. Originality/value – This paper is highly original in the context of the author's description of his Artistic Theory of Psychology, which utilizes the foundation for the “successful creative artist” as being successful in both one's chosen artistic realm as well as making a satisfactory adjustment to day-to-day life. It should also be noted that this paper has been written in the context of a “brief case study” as discussed in August 2013 with the Journal of Public Mental Health editor.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Louise Kermode

PurposePerson-centred care is a fundamental component of any service. This case study aims to explore the delivery of person-centred care in the voluntary sector, discussing how integrating support can be achieved to benefit individuals. It identifies challenges, best practice and learning that can be applied across sectors and promotes further enquiry.Design/methodology/approachThis case study is the result of a service audit at a mental health charity. The findings are a blend of reflections, observations and examples from service delivery, synthesised with national policy to provide evidence of best practice and processes that enable person-centred care.FindingsA focus on need not diagnosis, creating accessible and inclusive services, employing dual trained practitioners, having a varied skill mix along with holistic self-assessment tools are all enablers for integrated person-centred support. Multi-agency assessment frameworks, collaboration across services, cross-agency supervision and a shared vision for integration and person-centred care support services to coordinate more effectively. Barriers to integrated person-centred support include complex physical and mental health needs and harmful risk and safeguarding. The diversity of the voluntary sector, a lack of resources along with complex and competitive funding also hinder integration.Originality/valueThis case study provides a valuable insight into the voluntary sector and shares its findings to enhance best practice. It aims to promote interest and invites further research into health and social care delivery by the voluntary sector. As this delivery continues to increase, it is vital to examine the interface between the voluntary and statutory sector. Through better understanding and further research across all sectors, the author can identify how they can achieve person-centred outcomes and deliver the national policies.


2017 ◽  
Vol 45 (2) ◽  
pp. 100-111 ◽  
Author(s):  
Laura Moloney ◽  
Daniela Rohde

Purpose Physical activity is associated with both physical and mental health benefits for people with psychosis. However, mental health services have been criticised for failing to adequately promote physical activities. Occupational Therapy, with its focus on meaningful everyday occupations, is well placed to incorporate physical activity interventions. The purpose of this study was to explore the experiences of men with psychosis participating in an Irish community-based football programme. Design/methodology/approach Six men with psychosis participated in qualitative interviews. The interviews were audio-recorded and transcribed verbatim. Interview data were analysed thematically. Findings Participants identified many benefits of engaging in the programme. Football became a valued part of weekly routines and fostered re-engagement with previously valued roles. Participants identified improvements in social confidence and motor and process skills, as well as a positive impact on their mental and physical health. Originality/value This study highlights the value and meaning of participation in football for men with psychosis, as well as demonstrating the longer-term feasibility of football as a therapeutic medium in Occupational Therapy mental health service provision. Findings could help to promote the routine use of sports interventions to mental health services.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Lee Edson P. Yarcia ◽  
Jan Michael Alexandre C. Bernadas

Purpose This paper aims to examine key obligations of states to persons deprived of liberty (PDLs) under the right to health framework in the context of COVID-19. As a case study, it also describes the state of health in places of detention in the Philippines during the pandemic, with an end view of providing granular recommendations for prison policy reforms. Design/methodology/approach Relevant rules under international human rights law related to places of detention were thematically analyzed to articulate the scope of the right to health of PDLs. To describe the state of places of detention in the Philippines, this paper relied on archival research of news from selected local mainstream and specialized media. Findings The right to health framework provides a foundation for the response to COVID-19 in places of detention. Key concerns include increase in the number of infections, vulnerabilities in physical and mental health, and the spread of infection among correctional staff. Long-standing structural constraints and limited health information compound the threat of COVID-19. The Philippines must comply with its human rights obligations to PDLs to effectively address COVID-19-related concerns. Practical implications Policy reforms in Philippine places of detention must include application of community standards on physical and mental health, implementation of emergency release and application of non-custodial measures for long-term prison decongestion. Originality/value This is one of the few papers to analyze human rights in health care in places of detention during a pandemic, as nuanced in the context of the Philippines.


2020 ◽  
Vol 24 (1) ◽  
pp. 6-12
Author(s):  
Sue Holttum

Purpose The purpose of this paper is to examine three recent papers on mental health services and how they support recovery following a diagnosis of a severe mental health condition. Design/methodology/approach A search was carried out for recent papers on mental health and recovery. The author selected three papers that seemed to advance understanding of not only whether, but also how recovery of a meaningful life may be best supported in mental health services. Findings One paper suggested how staff were able to support service users’ personal goals and focus on recovery in acute inpatient settings, and what got in the way. The author suggests practical ways to address the barriers. A second paper reported the testing of a new model for supporting staff in primary and secondary care to work together so that service users with a diagnosis of bipolar or schizophrenia were better supported to work towards valued goals. A third paper reviewed 40 studies of how people can experience positive change after a first diagnosis of psychosis, and how change happened. Originality/value By studying the issues in detail, all three papers show how improved support for recovery and inclusion can be implemented against the backdrop of many years of service shortcomings.


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.


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