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“Part of being human”: evaluating the 4Ps model to support inpatient staff teams in reflecting on interpersonal dynamics

Lindsay Jones (Tees, Esk and Wear Valleys NHS Foundation Trust, York, UK)
Phyllis Annesley (Department of Clinical and Forensic Psychology, Rampton Hospital, Retford, UK)

The Journal of Mental Health Training, Education and Practice

ISSN: 1755-6228

Article publication date: 11 July 2019

Issue publication date: 15 July 2019




An innovative training approach was developed to enable staff working with complex cases, including personality disorder, to reflect on and work with the interpersonal dynamics of their interactions with service users. The aim of this approach is to support effective, compassionate and boundaried care. An overview of the model and development of the training is provided along with presentation and discussion of outcome data. Implications for future practice are also considered.


One-day workshops were provided within inpatient forensic women’s services. Nine workshops were delivered with 96 multidisciplinary staff having attended in total. Evaluation tools were developed to ascertain participants’ feedback regarding the training including its relevance and potential for impact on practice. Feedback was analysed using a mixture of quantitative and qualitative methods.


The evaluation demonstrated that the training was well received by a motivated group of participants and was felt to be relevant to their clinical practice.

Research limitations/implications

The evaluation is limited by the lack of a follow-up to assess the longer-term impacts of the training and whether the positive effects of the training were maintained.

Practical implications

The findings demonstrate that the training can be delivered within a short time frame, which makes the training efficient and cost effective.

Social implications

The training can develop practitioners’ skills in delivering compassionate and boundaried care in line with key NHS drivers for staff working with complex service users.


The 4Ps model enables staff with little or no psychotherapy training to deliver psychologically informed care which takes account of interpersonal dynamics and positively contributes to relational security, with an emphasis on reflecting on self and others.



Jones, L. and Annesley, P. (2019), "“Part of being human”: evaluating the 4Ps model to support inpatient staff teams in reflecting on interpersonal dynamics", The Journal of Mental Health Training, Education and Practice, Vol. 14 No. 4, pp. 232-241.



Emerald Publishing Limited

Copyright © 2019, Emerald Publishing Limited

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