scholarly journals Service user perspectives of an early intervention in psychosis service: a service evaluation

2018 ◽  
Vol 23 (3) ◽  
pp. 156-164
Author(s):  
Simon Watkins ◽  
Chris Sanderson ◽  
Victoria Richards
Keyword(s):  
Early Intervention ◽  
Thematic Analysis ◽  
Service Evaluation ◽  
Therapeutic Relationships ◽  
Service Development ◽  
Content Type ◽  
Individual Interviews ◽  
Open Questions ◽  
Early Intervention In Psychosis ◽  
Inductive Thematic Analysis

Purpose The purpose of this paper is to gather the perspectives of individuals accessing an early intervention in psychosis service (EIPS), in order to inform service development. Design/methodology/approach Individual interviews (n=9) and one focus group (n=7) were conducted. Discussions focused on open questions pertaining to service users’ (SU’s) experiences of accessing the EIPS. The results were analysed using inductive thematic analysis. Findings Inductive thematic analysis was used and three main themes were generated: consistency and communication, facilitating therapeutic relationships between EIPS staff and SU’s; pushing boundaries, relating to the importance of services taking a graded approach to developing therapeutic relationships and (re)engaging in activities; and normalising and validating experiences of psychosis. Participants emphasised the importance of relationships with EIPS staff and fellow SUs and highlighted how SUs can feel fearful and vulnerable when staff are not accessible or they view their care as inconsistent. Participants further emphasised the need for practitioners to balance an approach that de-stigmatises psychotic experiences whilst validating distress. Practical implications Consistency of support from EIPSs can be as important as flexibility. Clinicians should carefully consider the balance between validating and normalising distressing experiences associated with psychosis. Offering social activities with other SUs can facilitate therapeutic relationships and recovery but the results suggest that this should be facilitated in a graded way. Originality/value The paper addresses current need in the literature to understand the experiences of people using services in order to improve the quality of the services provided.

Creating a culture of employability in mental health

2014 ◽  
Vol 18 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Naomi Boycott ◽  
Justine Schneider ◽  
Michael Osborne
Keyword(s):  
Mental Health ◽  
Supported Employment ◽  
Implementation Process ◽  
Lessons Learned ◽  
Service Development ◽  
Content Type ◽  
The Individual ◽  
The Uk ◽  
Early Intervention In Psychosis ◽  
The Impact

Purpose – The purpose of this paper is to draw out the lessons learned from the implementation of the Individual Placement and Support (IPS) approach to supported employment in two contrasting adult mental health teams; one “standard” CMHT, and one early intervention in psychosis (EIP) team. Design/methodology/approach – These inferences are based on the evidence from a four-year study of IPS in one mental health care provider in the UK, which began by setting up a new service, and went on to run a RCT looking at the impact of psychological input as an adjunct to IPS alone. Findings – In attempting to introduce IPS to mental health teams in Nottingham the authors came across numerous barriers, including service reorganisation, funding cuts and the wider context of recession. Differences were observed between mental health teams in the willingness to embrace IPS. The authors argue that this variability is due to differences in caseload size, recovery priorities and client profiles. The authors have learnt that perseverance, strenuous efforts to engage clinical staff and the use of IPS fidelity reviews can make a positive difference to the implementation process. Practical implications – The experience suggests that setting up an IPS service is possible even in the most challenging of times, and that EIP services may be a particularly fertile ground for this approach. The authors also discuss potential barriers to implementing new services in mental health teams. Originality/value – This paper will be of value to service development and the science of implementation in mental health.

Development and Acquisition of Knowledge of Youth Parasport Coaches

2020 ◽  
Vol 37 (1) ◽  
pp. 72-89
Author(s):  
Pierre Lepage ◽  
Gordon A. Bloom ◽  
William R. Falcão
Keyword(s):  
Thematic Analysis ◽  
Social Factors ◽  
Physical Disability ◽  
Learning Experiences ◽  
Learning Opportunities ◽  
Future Generations ◽  
Trial And Error ◽  
Individual Interviews ◽  
Use Of Technology ◽  
Inductive Thematic Analysis

The purpose of this study was to understand the learning experiences and acquisition of knowledge of youth parasport coaches. Five able-bodied male participants (M = 39 years old), who coached youth with a physical disability for an average of 7.4 years, participated in individual interviews. An inductive thematic analysis identified patterns within and across the data, allowing for description and interpretation of the meaning and importance of the themes. The results showed that coaches learned mostly from informal experiences, particularly through mentoring, trial and error, or use of technology. In addition, these learning opportunities were influenced by personal, environmental, and social factors. These findings can help to guide current and future generations of coaches of youth participants with a physical disability by highlighting available resources and addressing several barriers and facilitators to their learning.

scholarly journals Audit of early intervention in psychosis service development in England in 2005

2007 ◽  
Vol 31 (1) ◽  
pp. 7-10 ◽  
Author(s):  
Vanessa Pinfold ◽  
Jo Smith ◽  
David Shiers
Keyword(s):  
Early Intervention ◽  
Self Report ◽  
Service Development ◽  
Clinical Implications ◽  
Intervention Fidelity ◽  
Audit Tool ◽  
Service Model ◽  
Early Intervention Services ◽  
Critical Phase ◽  
Early Intervention In Psychosis

Aims and MethodThis study provides an overview of the development of early intervention services for psychosis across England in February 2005. A bespoke self-report audit tool was completed by key informants across the eight regional development centres of the National Institute for Mental Health in England.ResultsOut of 117 teams identified, 86 have funding, of which 63 are operational with case-managed patients (as of February 2005). Only 3 teams meet all 10 audited early intervention fidelity requirements and there are variations in service model, delivery setting and resources across teams.Clinical ImplicationsCurrent inequity of access and the early, fragile nature of service development means that early intervention in England has reached a critical phase requiring consolidation.

Exploring the impact of peer support in early intervention in psychosis

2017 ◽  
Vol 21 (2) ◽  
pp. 102-109
Author(s):  
Hannah White ◽  
Laura Price ◽  
Tom Barker
Keyword(s):  
Early Intervention ◽  
Peer Support ◽  
Qualitative Methodology ◽  
Service Providers ◽  
Service Users ◽  
Content Type ◽  
Service Engagement ◽  
Mental Health Settings ◽  
Early Intervention In Psychosis ◽  
The Impact

Purpose Peer support (PS) has, over recent years, been implemented across a variety of NHS adult mental health settings. In November 2015, peer support workers (PSW) were introduced to an Early Intervention in Psychosis Service (EIS) in the Midlands. The purpose of this paper is to focus on organisational factors, asking how do PS impact on an early intervention in psychosis multi-disciplinary team (MDT). Design/methodology/approach Six EIS MDT members participated in an hour-long focus group. The data were analysed using thematic analysis, in line with a qualitative methodology (Braun and Clarke, 2006). Findings Two themes were generated, including “The values of PS” (consisting of three sub-themes: improving service engagement; personal qualities; and the peer relationship); and “The peer support role” (consisting of three sub-themes: living experience; boundaries; and alternative perspectives). Findings imply that PS in the current EIS related to: improved service engagement and greater understanding between service providers and users; which could be linked to better outcomes for service users (such as reduced duration of untreated psychosis (DUP)). Originality/value It has been suggested that PSWs facilitate an improved understanding between service providers and service users (Repper and Watson, 2012). However, research into organisational and team benefits of PS is lacking, with a need for more exploration (Repper, 2013). The current study begins to address the lack of literature regarding the organisational impact of PS, and even further regarding early intervention.

Assessing the complexity of adult ASD cases across three areas in Southern England: a service evaluation

2018 ◽  
Vol 4 (1) ◽  
pp. 2-9 ◽  
Author(s):  
Raja A.S. Mukherjee ◽  
Minahil Nawaz ◽  
Terry Joseph
Keyword(s):  
Autism Spectrum Disorder ◽  
Service Provision ◽  
Global Assessment ◽  
Design Methodology ◽  
Service Evaluation ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Service Development ◽  
Global Assessment Of Functioning ◽  
Content Type

Purpose Over the last few years increasing numbers of Autism Spectrum Disorder (ASD) services have been established across the country. The different services use varying models and the level of complexity seen in each is unclear. The paper aims to discuss this issue. Design/methodology/approach In order to facilitate the development of the next phase of service provision the three geographical areas covered by SABP ASD services were compared. Modified Global Assessment of Functioning (mGAF) scores were calculated for 75 patients from each area before being compared across various domains to identify the complexities in each area covered. Findings Overall high levels of complexity were seen, with 85 per cent presenting with a serious or major functional difficulty based on, mGAF scores. Originality/value This has planning implications both for commissioners and future service development as previously not identified at a time when services are continuing to expand.

Confronting behaviour in palliative care: a qualitative study of the lived experience of nursing staff

2021 ◽  
Vol 27 (5) ◽  
pp. 245-253
Author(s):  
Natalie Pejoski ◽  
Gemma Skaczkowski ◽  
Juli Moran ◽  
Hilary Hodgson ◽  
Carlene Wilson
Keyword(s):  
Palliative Care ◽  
Focus Group ◽  
Lived Experience ◽  
Thematic Analysis ◽  
Qualitative Data ◽  
Individual Interviews ◽  
Metropolitan Hospital ◽  
Challenging Environment ◽  
The Impact ◽  
Inductive Thematic Analysis

Background: Little research examines the extent and impact of aggressive or uncomfortable ‘confronting behaviour’ experienced by palliative care nurses, despite palliative wards being an emotionally labile environment. Methods: Qualitative data on nurses' experiences of confrontation were collected from 17 palliative care nurses at a major metropolitan hospital via a focus group and individual interviews. Data were analysed using inductive thematic analysis. Findings: Results indicated that family members were the main perpetrators and tolerance of confrontation varied dependent on the characteristics of the aggressor. Confrontation was described as arising in response to grief, and because of misunderstandings of palliative care goals. Nurses reported a perceived lack of appreciation for their work from some patients' families and feelings of discontent with the nature and amount of structured support available following a confrontation. Informal workplace support helped nurses to deal with these incidents and, despite bad experiences, nurses affirmed their commitment to working in this area. Conclusion: The findings demonstrate the demands placed on nurses working in palliative care, and the importance of compassion in moderating the impact of a challenging environment.

Appreciative enquiry peer review improving quality of services

2019 ◽  
Vol 32 (5) ◽  
pp. 857-866
Author(s):  
Frank R. Burbach ◽  
Sarah K. Amani
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Peer Review ◽  
Large Scale ◽  
Service Development ◽  
Service Improvement ◽  
Content Type ◽  
Early Intervention In Psychosis ◽  
Health Service Improvement

Purpose Mental health service improvement initiatives often involve the setting of targets and monitoring of performance. The purpose of this paper is to describe the application of appreciative enquiry (AE), a radically different but complementary approach to quality assurance and improvement, to specialist mental health services across a health region. Design/methodology/approach This case study describes a regional quality improvement (QI) project involving 12 early intervention in psychosis (EIP) services in South West England. In total, 40 people were trained in AE interviewing skills and in non-reciprocal peer review visits 59 interviews were conducted involving 103 interviewees including service users, carers, clinicians, managers and commissioners. Immediate verbal feedback was provided and main themes summarised in individual reports to host teams using the following headings: team values, strengths, dreams and development plans. A thematic analysis was conducted on team reports and a project report produced which summarised the stages and results of this regional initiative. Findings All participants rated the experience as positive; it enhanced staff motivation and led to service development and improvement. Research limitations/implications The experiences of these 12 EIP teams may not necessarily be generalisable to other services/regions but this positive approach to service improvement could be widely applied. Practical implications AE is applicable in large-scale QI initiatives. Originality/value To the authors knowledge this is the first time that AE has been applied to large-scale mental health service improvement and innovation.

Qualitative research with primary school-aged children: ethical and practical considerations of evaluating a safeguarding programme in schools

2019 ◽  
Vol 14 (3) ◽  
pp. 194-204
Author(s):  
Vicki Jackson-Hollis
Keyword(s):  
Primary School ◽  
School Setting ◽  
Service Evaluation ◽  
Careful Consideration ◽  
Research Literature ◽  
Primary School Children ◽  
Service Development ◽  
Content Type ◽  
School Aged Children ◽  
School Based

Purpose The purpose of this paper is to explore some of the ethical and practical challenges of working with primary school-aged children to conduct qualitative service evaluations regarding sensitive safeguarding topics. Design/methodology/approach The paper centres on the author’s learnings from conducting school-based, task-assisted focus groups with 5–11 year olds. The reflections are drawn from notes made during fieldwork, debrief discussions with evaluation colleagues and wider team debates. This was a consultative participatory evaluation and the findings are situated within the wider literature around rights-based approaches to research. Findings Using multi-method and creative approaches can facilitate young children to assent and dissent from service evaluation in a school setting. However, the challenges of helping children understand confidentiality are highlighted, as is the challenge for researchers in recognising and responding in situ to disclosures. Using suitable and creative activities, this evaluation demonstrates that primary school children can contribute meaningful data to assist with service development. However, the approach to collecting these data from the youngest children needs careful consideration. Practical implications Researchers may need to adopt full participatory methods to better help children understand the confidentiality bounds of research and to form views on the subject matter. More discussion is needed in the wider safeguarding research literature to show how researchers have navigated the challenges of handling disclosures. Originality/value This paper contributes to the literature by providing examples of how to overcome issues of children’s participation, consent and protection in service evaluation focussed on a sensitive topic.

scholarly journals Welcoming peer workers in NHS settings: facilitating readiness with an Early Intervention in Psychosis team

2019 ◽  
Vol 23 (1) ◽  
pp. 30-35
Author(s):  
Kyt Proctor ◽  
Rachael Wood ◽  
Katherine Newman-Taylor
Keyword(s):  
Mental Health ◽  
Early Intervention ◽  
Peer Support ◽  
Pilot Project ◽  
Lessons Learned ◽  
Content Type ◽  
Mental Health Settings ◽  
Business As Usual ◽  
Early Intervention In Psychosis ◽  
Practical Implications

Purpose A pilot project commissioned to assess feasibility and impact of peer support in an Early Intervention in Psychosis (EIP) service highlighted the importance of team readiness. The purpose of this paper is to reflect on the lessons learned in recognising and facilitating team readiness in an NHS setting. Design/methodology/approach The literature suggests that mental health teams need to be ready to implement peer support, if this is to be done successfully. The authors describe the process of preparing for peer support, obstacles that arose and ways that the team found to address these. Findings The team had actively sought to develop peer support for some time, and negotiated with Trust managers to agree these roles in principle. However, initially unspoken concerns about duty of care emerged as a key obstacle. An arguably paternalistic desire to protect potential peer worker colleagues from stress and distress could have resulted in unnecessary risk aversion and a narrowing of the role. Willingness and opportunity to reflect on the change in relationship from service user/professionals to colleagues enabled these concerns to be aired, and practical solutions agreed. Practical implications Team enthusiasm is not the same as team readiness. The team’s willingness to identify and reflect on implicit concerns facilitated an acceptance of the change in relationship with peer workers, which in turn enabled the development of standard operating procedures to ensure safe and effective peer support as “business as usual.” Originality/value This paper considers the process of welcoming peer workers in an EIP team and offers practical suggestions that may be of value to other teams seeking to implement peer support in similar adult mental health settings.

PIKIPDL

2012 ◽  
Vol 30 (3) ◽  
pp. 490-512 ◽  
Author(s):  
Shu‐Chen Kao ◽  
ChienHsing Wu
Keyword(s):  
Digital Libraries ◽  
Knowledge Integration ◽  
Information Service ◽  
Service Evaluation ◽  
Service Development ◽  
Prototype System ◽  
Knowledge Map ◽  
Content Type ◽  
Integration Platform ◽  
Subject Category

PurposeThe purpose of the paper is to conduct an exploratory study that proposes a personalized knowledge integration platform for digital libraries which can provide users with personalized information and knowledge services.Design/methodology/approachA prototype system (PIKIPDL) is designed and developed with two types of service, i.e. personalized information/knowledge service and personalized subject category service. Evaluation of the PIKIPDL by domain specialists and software experts is conducted. Comments are implications are addressed.FindingsThe main findings include the following: the proposed system can help suggest materials that readers are interested in for DL; the proposed system can help construct knowledge contents in a hierarchical structure; and a common recommendation concerning knowledge structure from the reviewers is that the proposed system should add a self‐organizing knowledge map function that would allow users to view knowledge subjects in a graphic manner.Practical implicationsThe results from the evaluation of reviewers revealed that the proposed PIKIPDL is acceptable to the integration of both personalized information service and personalized knowledge subject service. This implies that librarians and DL software agents should place emphasis on integrated service development to attract the attention of their users. Towards this goal, they could explain that personalized services (e.g. material recommendation, message recommendation, knowledge subject materials) with a mechanism of multi‐resource integration can help provide DL resources according to users' needs and wants, and in consequence to enhance DL service efficacy.Originality/valueThe research describes the importance of information/knowledge integration with respect to its support on the learning and study methods of users, and has developed a personalized knowledge integration platform as a mechanism that provides a personalized information service and a personalized knowledge subject category service. By employing Apriori algorithm and association rules as the data mining mechanism, personalized information recommendations are derived from circulation data, and a knowledge subject category is integrated from online sharing knowledge by participants.

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