scholarly journals What characterizes a good mental health professional in court-mandated treatment settings?: Findings from a qualitative study with older patients and mental health care professionals

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Helene Seaward ◽  
Tenzin Wangmo ◽  
Tobias Vogel ◽  
Marc Graf ◽  
Monika Egli-Alge ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Care Professionals ◽  
Service Providers ◽  
Interview Study ◽  
Therapist Characteristics ◽  
Good Mental Health ◽  
Qualitative Interview Study ◽  
Court Mandated ◽  
Treatment Settings

Abstract Background Therapist-related activities and characteristics such as empathy and genuineness are factors that significantly contribute to psychotherapy outcome. As they play a role in psychotherapy more generally, it can be expected that they are equally important in the treatment of court-mandated patients more specifically. At the same time, these treatment settings come with specific challenges—e.g. due to coercion and control—and it could thus be that some therapist-related characteristics might have a different empathy on the therapy. This interview study sought to investigate service providers’ and users’ perspectives on therapist-related characteristics in the context of detention. Methods We conducted a qualitative interview study with 41 older incarcerated persons mandated to treatment, and 63 mental health professionals (MHP). The data analysis followed thematic analysis. Results Patients and experts both emphasized the importance of treating patients with respect by taking a humanistic approach, that is, condemn the deeds but embrace the person and display genuine interest in supporting patients with any issue or concern that is of relevance to them. Furthermore, interviewees underscored that the coerciveness of the therapy context required to incorporate patients’ wishes into treatment planning, recognize and respond to the patients’ needs, and allow some choice within the given framework. Such inclusive attitude was deemed critical to engage and motivate patients to participate in treatment. In addition, it was emphasized that feedback and advice by the therapists need to be concrete, detailed and applied to each person’s current situation. Lastly, patients questioned MHP’s qualification when they did not progress in therapy. Discussion Our findings indicate that some therapist-related activities and characteristics are of particular importance in court-mandated settings. These include genuine interest in the patient, a respectful and positive attitude, as well as the capacity to target sensitive issues in a directive but non-confrontational manner. Further research needs to identify specific expressions and behaviors that are linked to the aforementioned characteristics in the forensic context. Our study therefore contributes to much-needed empirical research on clinician and patient perspectives on therapist characteristics and activities in the treatment of court-mandated patients.

scholarly journals Court-Mandated Patients’ Perspectives on the Psychotherapist’s Dual Loyalty Conflict – Between Ally and Enemy

2021 ◽  
Vol 11 ◽  
Author(s):  
Helene Merkt ◽  
Tenzin Wangmo ◽  
Félix Pageau ◽  
Michael Liebrenz ◽  
Corinne Devaud Cornaz ◽  
...  
Keyword(s):  
Therapeutic Alliance ◽  
Mental Health Professionals ◽  
Qualitative Interview ◽  
Interview Study ◽  
Dual Role ◽  
Therapist Characteristics ◽  
High Quality ◽  
Dual Loyalty ◽  
Qualitative Interview Study ◽  
Court Mandated

BackgroundMental health professionals working in correctional contexts engage a double role to care and control. This dual loyalty conflict has repeatedly been criticized to impede the development of a high-quality alliance. As therapeutic alliance is a robust predictor of outcome measures of psychotherapy, it is essential to investigate the effects of this ethical dilemma.MethodsThis qualitative interview study investigates patients’ perceptions of their therapists’ dual role conflict in court-mandated treatment settings. We interviewed 41 older incarcerated persons using a semi-structured interview guide, the interviews were subsequently analyzed following thematic analysis.ResultsWe first present the patients’ perceptions of their treating psychotherapist’s dual loyalty conflict, which was linked to their overall treatment experience. In a second step, we outline the study participants’ reasons for this judgment, which were most commonly linked to feelings of trust or betrayal. More specifically, they named certain therapist characteristics and activities that enabled them to develop a trustful therapeutic alliance, which we grouped into four topics: (1) respecting the patient’s pace and perceived coercion; (2) patient health needs to be first priority; (3) clarity in roles and responsibilities; and (4) the art of communication – between transparency and unchecked information sharing.DiscussionDeveloping a high quality alliance in mandatory offender treatment is central due to its relationship with recovery and desistance. Our findings show that some therapists’ characteristics and activities attenuate the negative impact of their double role on the development and maintenance of the alliance. To increase the effectiveness of court-mandated treatments, we need to support clinicians in dealing with their dual role to allow the formation of a high quality therapeutic alliance. Our qualitative interview study contributed to this much-needed empirical research on therapist’ characteristics promoting a trustful relationship in correctional settings.

scholarly journals Forensic mental health professionals’ perceptions of their dual loyalty conflict: findings from a qualitative study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Helene Merkt ◽  
Sophie Haesen ◽  
Ariel Eytan ◽  
Elmar Habermeyer ◽  
Marcelo F. Aebi ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Justice System ◽  
Mandated Treatment ◽  
Dual Loyalty ◽  
Qualitative Interview Study ◽  
Ethical Conflicts ◽  
Court Mandated ◽  
Treatment Settings

Abstract Background Mental health professionals (MHP) working in court-mandated treatment settings face ethical dilemmas due to their dual role in assuring their patient’s well-being while guaranteeing the security of the population. Clear practical guidelines to support these MHPs’ decision-making are lacking, amongst others, due to the ethical conflicts within this field. This qualitative interview study contributes to the much-needed empirical research on how MHPs resolve these ethical conflicts in daily clinical practice. Methods 31 MHPs working in court-mandated treatment settings were interviewed. The interviews were semi-structured and our in-depth analysis followed the thematic analysis approach. Results We first outline how mental health professionals perceive their dual loyalty conflict and how they describe their affiliations with the medical and the justice system. Our findings indicate that this positioning was influenced by situational factors, drawing the MHPs at times closer to the caring or controlling poles. Second, our results illustrate how participating MHPs solve their dual loyalty conflict. Participants considered central to motivate the patient, to see the benefits of treatment and its goals. Further, transparent communication with patients and representatives of the justice system was highlighted as key to develop a trustful relationship with the patient and to manage the influences from the different players involved. Conclusions Even though individual positioning and opinions towards dealing with the influences of the justice system varied, the results of our research show that, in spite of varying positions, the underlying practice is not very different across participating MHPs. Several techniques that allow developing a high-quality therapeutic alliance with the patient are key elements of general psychotherapy. Transparency appears as the crucial factor when communicating with the patient and with representatives of the justice system. More specifically, patients need to be informed since the beginning of therapy about the limits of medical confidentiality. It is also recommended to develop guidelines that define the level of detailed information that should be disclosed when communicating with the authorities of the justice system.

scholarly journals Experience of stigma among Chinese mental health patients in Hong Kong

2004 ◽  
Vol 28 (12) ◽  
pp. 451-454 ◽  
Author(s):  
K. F. Chung ◽  
M. C. Wong
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Hong Kong ◽  
Mental Health Professionals ◽  
Health Care Professionals ◽  
Mental Health Problems ◽  
Chinese People ◽  
The People ◽  
Mental Health Patients ◽  
Stigma Of Mental Illness

Aims and MethodThe study was intended to rectify the lack of data on how Chinese people experience the stigma of mental illness. A questionnaire on perceived stigmatisation, experiences of rejection and ways of coping with stigma was completed by 193 persons attending a psychiatric out-patient clinic in Hong Kong.ResultsMost of the participants were aware of the stigma associated with mental illness, but experiences of rejection were relatively less frequent. Eleven per cent of the respondents indicated that they were neglected by health care professionals and 8% had been avoided by family members. The most frequently reported coping method was maintaining secrecy about the illness.Clinical ImplicationsIn China, people with mental health problems experience stigma in various degrees. However, some of the people surveyed expressed feelings of relief that others were supportive and sympathetic towards their illness. Mental health professionals should maintain optimism in helping their patients to cope with the stigma.

scholarly journals Structuring Roles and Gender Identities Within Families Explaining Suicidal Behavior in South India

Crisis ◽  
2016 ◽  
Vol 37 (3) ◽  
pp. 205-211 ◽  
Author(s):  
Reena A. Lasrado ◽  
Khatidja Chantler ◽  
Rubina Jasani ◽  
Alys Young
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Suicidal Behavior ◽  
Health Professionals ◽  
South India ◽  
Attempted Suicide ◽  
Service Providers ◽  
Social Systems ◽  
Traditional Healers ◽  
Problem Situation

Abstract. Background: This paper examines the social structures, culture, gendered roles, and their implications for suicidal behavior in South India. Exploring the cultural process within the structures of family and society to understand suicide and attempted suicide from the perspectives of survivors, mental health professionals, and traditional healers has not been achieved in the existing suicide-related research studies conducted in India to date. Aims: This study aimed to explore the cultural implications of attempted suicide by examining the survivors' life stories, their perceptions, and service providers’ interpretations of problem situation. Method: A qualitative design was used drawing on constant comparison method and thematic analysis. The analysis was underpinned by the theoretical concepts of Bourdieu's work. In-depth interviews were conducted with 15 survivors of attempted suicide, eight mental health professionals, and eight traditional healers from Southern India. Results: The study found interactions among visible and invisible fields such as faith, power, control, culture, family, religion, and social systems to have strengthened the disparities in gender and role structures within families and societies and to have impacted survivors’ dispositions to situations. Conclusion: The role of culture in causing suicide and attempted suicide is explained by unraveling the negative impact of interacting cultural and structural mechanisms.

Professionals harnessing experiential knowledge in Dutch mental health settings

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Simona Karbouniaris ◽  
Alie Weerman ◽  
Bea Dunnewind ◽  
Jean Pierre Wilken ◽  
Tineke A. Abma
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Experiential Knowledge ◽  
Research Approach ◽  
Content Type ◽  
Action Research Approach ◽  
Mental Health Settings ◽  
Four Levels

Purpose This study aims to explore the perspectives of mental health professionals who are in a process of integrating their own experiential knowledge in their professional role. This study considers implications for identity, dilemmas and challenges within the broader organization, when bringing experiential knowledge to practice. Design/methodology/approach As part of a participatory action research approach, qualitative methods have been used, such as in-depth interviews, discussions and observations during training and project team. Findings The actual use of experiential knowledge by mental health care professionals in their work affected four levels: their personal–professional development; the relation with service users; the relation with colleagues; and their position in the organization. Research limitations/implications Because of its limited context, this study may lack generalisability and further research with regard to psychologists and psychiatrists, as well as perceptions from users, is desirable. Social implications According to this study, social change starts from a bottom-up movement and synchronously should be facilitated by top-down policy. A dialogue with academic mental health professionals seems crucial to integrate this source of knowledge. Active collaboration with peer workers and supervisors is desired as well. Originality/value Professionals with lived experiences play an important role in working recovery-oriented, demonstrating bravery and resilience. Having dealt with mental health distress, they risked stigma and rejections when introducing this as a type of knowledge in current mental health service culture. Next to trainings to facilitate the personal–professional process, investments in the entire organization are needed to transform governance, policy and ethics.

scholarly journals Mental health professionals’ perceptions on patients control of data sharing

2020 ◽  
Vol 26 (3) ◽  
pp. 2011-2029 ◽  
Author(s):  
Julia Ivanova ◽  
Adela Grando ◽  
Anita Murcko ◽  
Michael Saks ◽  
Mary Jo Whitfield ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Information ◽  
Data Sharing ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Health Data ◽  
Structured Interviews ◽  
Timely Access ◽  
The Impact

Integrated mental and physical care environments require data sharing, but little is known about health professionals’ perceptions of patient-controlled health data sharing. We describe mental health professionals’ views on patient-controlled data sharing using semi-structured interviews and a mixed-method analysis with thematic coding. Health information rights, specifically those of patients and health care professionals, emerged as a key theme. Behavioral health professionals identified patient motivations for non-sharing sensitive mental health records relating to substance use, emergency treatment, and serious mental illness (94%). We explore conflicts between professional need for timely access to health information and patient desire to withhold some data categories. Health professionals’ views on data sharing are integral to the redesign of health data sharing and informed consent. As well, they seek clarity about the impact of patient-controlled sharing on health professionals’ roles and scope of practice.

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