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

Abstract

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.

Citation

Boniwell, N., Etheridge, L., Bagshaw, R., Sullivan, J. and Watt, A. (2015), "Mental health nurses’ perceptions of attachment style as a construct in a medium secure hospital: a thematic analysis", The Journal of Mental Health Training, Education and Practice, Vol. 10 No. 4, pp. 218-233. https://doi.org/10.1108/JMHTEP-01-2015-0002