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Article
Publication date: 11 July 2019

Lindsay Jones and Phyllis Annesley

An innovative training approach was developed to enable staff working with complex cases, including personality disorder, to reflect on and work with the interpersonal…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Originality/value

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.

Details

The Journal of Mental Health Training, Education and Practice, vol. 14 no. 4
Type: Research Article
ISSN: 1755-6228

Keywords

Article
Publication date: 21 February 2020

Phyllis Annesley, Zoe Hamilton, Roisin Galway, Samantha Akiens, Rachel Hicks and Martin Clarke

Neuropsychologically informed rehabilitation (NIR) is one approach to supporting people with intellectual disabilities, cognitive impairment and challenging behaviour…

Abstract

Purpose

Neuropsychologically informed rehabilitation (NIR) is one approach to supporting people with intellectual disabilities, cognitive impairment and challenging behaviour. This study aims to evaluate a five-day training course in NIR for staff working with adult male offenders with intellectual disabilities in a high secure hospital. The impacts on both the staff who undertook the training and the patients with challenging behaviour were explored.

Design/methodology/approach

Participants were psychology, nursing and day services staff and male patients. The staff completed a post-training questionnaire and three measures at pre-NIR training, post-NIR training and one-year follow-up. Patients completed four questionnaire measures within the same periods.

Findings

NIR training was positively evaluated by staff. Staff members’ perceived efficacy in working with challenging behaviour significantly increased post-training which was maintained at follow-up. Thematic analysis showed that the training staff members built their confidence, knowledge and skills. Because of these being high to start with, the study could not evidence statistically significant changes in these. Thematic analysis yielded two main themes, namely, benefits and quality of training, each with their own subthemes. The impacts of the training on patients were difficult to assess related to various factors.

Research limitations/implications

The knowledge and confidence measures used were limited in scope with an experienced staff group and required development.

Practical implications

NIR training could assist staff in other secure and community settings in working with people with intellectual disabilities and challenging behaviours.

Originality/value

This study positively contributes to an area that requires more research.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 11 no. 2
Type: Research Article
ISSN: 2050-8824

Keywords

Article
Publication date: 28 February 2019

Phyllis Annesley, Adedayo Alabi and Laura Longdon

The purpose of this paper is to describe the Eye movement desensitisation and reprocessing (EMDR) treatment of an adult female patient detained within a high secure…

Abstract

Purpose

The purpose of this paper is to describe the Eye movement desensitisation and reprocessing (EMDR) treatment of an adult female patient detained within a high secure hospital with complex mental health difficulties, including complex trauma, factitious disorder, self-injury and a history of offending. The EMDR treatment addressed the patient’s urges to engage in severe and sometimes life-threatening self-injury, a primary motive of which was to access physical healthcare interventions within a general hospital. The paper describes the wide-ranging benefits of the treatment and incorporates feedback from the patient and clinicians within her multi-disciplinary team (MDT).

Design/methodology/approach

Four triggers for self-injury were processed during the therapy using the DeTUR Protocol (Popky, 2005, 2009) and the Constant Installation of Present Orientation and Safety (CIPOS, Knipe, 2009a) method. In total, 18 one hour therapy sessions were delivered plus three follow-up sessions to continue to offer support and complete the post-treatment evaluation.

Findings

The level of urge for each trigger was reduced to 0 which the patient defined as “no urge to self-injure”. Benefits went well beyond self-injury with reported positive impacts on mood, thinking, sleep, concentration, memory and experience of flashbacks.

Practical implications

This case report demonstrates that the EMDR DeTUR Protocol together with the CIPOS method can be extremely valuable in the treatment of patients who self-injure.

Originality/value

The case report offers an important contribution to an area that requires much further research.

Details

Journal of Criminological Research, Policy and Practice, vol. 5 no. 1
Type: Research Article
ISSN: 2056-3841

Keywords

Article
Publication date: 13 February 2017

Phyllis Annesley, Leonie Davison, Chris Colley, Liz Gilley and Louise Thomson

The purpose of this paper is to discuss the implementation and evaluation of interventions for women firesetters in high secure mental healthcare at the UK’s National…

Abstract

Purpose

The purpose of this paper is to discuss the implementation and evaluation of interventions for women firesetters in high secure mental healthcare at the UK’s National Women’s Service.

Design/methodology/approach

Two types of Arson treatment programmes for women, one delivered to individuals, the other within a group context, were developed, delivered and evaluated. The evaluation incorporated qualitative and quantitative data, including psychometric measures. Qualitative data were analysed using thematic analysis.

Findings

The evaluation evidenced very high engagement with and attendance at treatment programmes, and several post-treatment gains. Participants’ ratings of programmes and qualitative feedback were similarly very positive. The study demonstrated that engaging women firesetters in their treatment is paramount and can be facilitated by consistent boundaries around therapy provision balanced with sensitivity, empathy and flexibility; providing interactive and varied teaching methods; ongoing service user involvement and recognising participants’ achievements; employing a mixed cognitive analytic therapy and cognitive behavioural therapy therapeutic approach; having input from fire service staff; and maintaining organisational support for firesetting interventions.

Practical implications

In all, 12 key recommendations are made for clinicians considering offering treatment programmes for women firesetters.

Originality/value

Amid few published papers on treating women firesetters this paper guides forensic clinicians in establishing and delivering interventions for women firesetters.

Details

Journal of Forensic Practice, vol. 19 no. 1
Type: Research Article
ISSN: 2050-8794

Keywords

Article
Publication date: 11 May 2012

Phyllis Annesley and Kerry Sheldon

This paper aims to describe issues clinicians encounter when delivering cognitive analytic therapy (CAT) within a high secure hospital (HSH).

Abstract

Purpose

This paper aims to describe issues clinicians encounter when delivering cognitive analytic therapy (CAT) within a high secure hospital (HSH).

Design/methodology/approach

Focus groups were conducted with six staff using a semi‐structured interview. Thematic analysis was used to analyse the data.

Findings

Five main themes emerged from the data. These were: concerns around therapy and the therapeutic relationship; issues with CAT stages and structure; issues around CAT tools; issues connected with the HSH setting; and concerns about integrating CAT and teamwork. Clinicians addressed these issues by helping others understand therapeutic relationships and adapting CAT tools and structure.

Research implications

It is recommended that HSH managers ensure that therapists are fully supported and subsidiary therapy staff members are appropriately trained. Additionally, the Association for Cognitive Analytic Therapy (ACAT) and CAT training organizations need to demonstrate sensitivity to the HSH context and fully prepare trainees for forensic work.

Originality/value

This paper describes how clinicians effectively address challenges when delivering CAT and makes recommendations for future delivery.

Details

The British Journal of Forensic Practice, vol. 14 no. 2
Type: Research Article
ISSN: 1463-6646

Keywords

Article
Publication date: 10 May 2013

Kate Robertson, Sue Elcock, Chris Milburn, Phyllis Annesley, Jane Jones and Birgit A. Völlm

Patients in the National High Secure Healthcare Service for Women have a high prevalence of trauma and self injury. This highlights the need for specialised training of…

275

Abstract

Purpose

Patients in the National High Secure Healthcare Service for Women have a high prevalence of trauma and self injury. This highlights the need for specialised training of staff dealing with such women. The aim of this study was to evaluate the trauma and self injury (TASI) training programme on staff knowledge and skills.

Design/methodology/approach

A total of 135 nurses and nursing assistants participated in the TASI two‐day training course. Questionnaires allowing for quantitative and qualitative data collection were completed before and after the training. Training and confidence levels in dealing with women who self‐harm prior to the training were identified and the impact of the programme was assessed.

Findings

The majority of staff had not received any previous training on trauma and self injury. There was an increased level of confidence in working with trauma and self injury following training and staff reported an increased ability to ask for support. Self‐perceived competence improved to a greater extent in those who had not received previous training compared to those who had.

Research limitations/implications

The authors' data is limited to self‐report. Future research should use objective measures to evaluate the impact of staff training.

Practical implications

A relatively short training programme focusing on trauma and self injury appears to improve staff confidence, understanding and competence in working with women patients in a high secure setting. Similar training programmes might also be beneficial in different patient groups with complex backgrounds and behaviours.

Originality/value

This is the first report on a training programme focussing on women in high secure care who self‐harm and have experienced trauma.

Details

The Journal of Forensic Practice, vol. 15 no. 2
Type: Research Article
ISSN: 2050-8794

Keywords

Content available
Article
Publication date: 11 May 2012

Carol A. Ireland and Neil Gredecki

324

Abstract

Details

The British Journal of Forensic Practice, vol. 14 no. 2
Type: Research Article
ISSN: 1463-6646

Article
Publication date: 1 October 1932

THE library year ends in no spectacular way. If posterity has any cause to remember 1932 it will probably be as of a year when the doctrine of economy was raised to the…

Abstract

THE library year ends in no spectacular way. If posterity has any cause to remember 1932 it will probably be as of a year when the doctrine of economy was raised to the rank of a divine dogma by a world of debtors and creditors all crazed with fear over international debts. A year of hurried committees producing reports for the reduction of expenditures, beneficient or otherwise; especially, in this last month, a report which if implemented would cripple almost every local activity, and set back the clock of social effort at least thirty years. The intention of such reports is no doubt good; their effects are yet to be seen. So far, the increased parsimony in national and local affairs seems only to have intensified unemployment without bettering the general situation. A reaction against all this is beginning, not a moment too soon, and all who care for the finer things in our civilisation will be compelled to stand against the more unsocial recommendations of these reports.

Details

New Library World, vol. 35 no. 6
Type: Research Article
ISSN: 0307-4803

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