Search results

The purpose of this paper is to focus on the development of Keep Safe, a manualised group intervention for adolescents with intellectual disabilities (ID) who display harmful sexual behaviour (HSB) as the initial phase of a feasibility study. National reports have highlighted the need for the development of specialist programmes, as adolescents with ID make up a significant proportion of young people referred to specialist HSB services and there is a lack of evidence or practice-based interventions for them. Aims included taking account of adolescents’ and families’ needs, motivations and practical commitments, integrating best- practice and being accessible and appropriate across different types of services.

Keep Safe development progressed from the practitioner/researcher collaborative young sex offender treatment services collaborative-ID through a project team, Keep Safe development group, comprising a range of practitioners with a variety of clinical expertise across services and an Advisory Group of people with ID. An expert-consensus methodology based on the Delphi method was used. The iterative process for the manual draws on the slim practice-based evidence from UK, New Zealand, North America and Australia.

Keep Safe comprises six modules distributed through 36 term-time young people’s sessions, alongside 16 concurrent parental/ carer sessions (some joint). The main focus of Keep Safe is to enhance well-being and reduce harm. Four initial sites volunteered as feasibility leads, and two more were added as recruitment was more difficult than foreseen.

National reports have highlighted the need for the development of specialist programmes, as adolescents with ID make up a significant proportion of young people referred to specialist HSB services and there is a lack of evidence or practice-based interventions for them. This study is innovative and valuable given the recognition that research and practice is significantly lacking in this area.

This paper seeks to present a theoretical framework with the aim of contributing to improved understanding of how reflection can provide a mechanism to integrate research‐based knowledge with the pre‐existing practice‐based knowledge.

The paper begins with an explanation of important concepts: research‐based and practice‐based knowledge, four levels of action and two modes of learning. Two mini cases concerning managers in the public sector in Sweden then provide an illustration of how research‐based knowledge can be utilized to challenge practice‐based knowledge. The concluding discussion addresses some of the challenges involved in achieving reflection in the workplace that utilizes research‐based knowledge.

The reflection programmes had several characteristics that facilitated their implementation: they achieved a balance between the workplace demands on the participating managers and time required for the reflection; the participants were specifically recruited, had full management support and were highly motivated to be part of the reflection groups; the facilitators played key roles in structuring the managers' discussions and linking their experiences to relevant research‐based knowledge.

Methodological limitations of the cases constrain the conclusions to be drawn from these studies. However, it should be emphasized that the case studies were intended primarily as illustrations of how workplace reflection can be used to integrate research‐based and practice‐based knowledge. Obviously, there is a risk of social desirability bias because the interviewer was also involved in developing and implementing the reflection programmes. She also participated as a supervisor in mini case 2.

The literature on reflection has largely focused on reflection in the context of education, training and preparing for work or a profession. The role of workplace reflection and learning for practitioners and managers in work has received far less attention. The emergence of the evidence‐based practice (EBP) agenda has further highlighted the importance of workplace learning and reflection, as practitioners are increasingly expected to critically appraise research studies and integrate new findings into their practice. A more EBP requires reflecting practitioners who are able to synthesize research‐based knowledge with their own practice‐based knowledge acquired through experience. However, the process of integrating research‐based and practice‐based knowledge has not been the focus of much study.

The purpose of this paper is to explore the discourses which exist around the alleviation of mental distress, from the different perspective of mental health professionals and service users. It then looks at the use of “practice-based evidence” as a means of bringing together these two diverging discourses.

Literature on the discourses which exist around the cause and treatment of mental distress, from the perspective of professionals and service users, is first explored. Differences between these two discourses are identified, as are theoretical and practical limitations of current professional diagnostic and treatment paradigms. Finally the use of practice-based evidence as a means of bridging the gap between these two discourses is outlined.

This paper highlights marked differences between the discourse which exists for professionals, and that for service users, around alleviating mental distress. The use of practice-based evidence is explored, not only as a means of bringing these two varying discourses together, but also as a tool which could help to improve treatment outcome in a way which is more inclusive of service users and fits with both empiricism and a broader recovery ethos.

This paper applies a “practice-based evidence” approach to bringing together the divergent perspectives regarding mental health of service providers and users. In doing so it provides a practical and pragmatic approach to true collaborative working.

The paper investigates the pivotal role of storytelling as a pedagogical tool in tertiary education, specifically in the context of the practice-based doctoral framework in design disciplines. In such a doctoral model, storytelling assumes different meanings and nuances that open to a study in relation to the self-reflective process at the core of the learning paradigm.

The research methodology integrates a qualitative and participatory approach with visual and design-based methods through which the authors interact with primary sources (the body of work of PhD candidates) and relevant research literature.

Drawing on the expanding field of creative practice research, the research work evidences the emergence of storytelling as a research method and learning tool applied at different levels of the candidates' Doctor of Philosophy (PhD) journey and provides methodological insights into the practice-based doctoral training paradigm.

The paper demonstrates the role of storytelling as a learning tool and evidences the multiple levels that storytelling assumes over the course of a practice-based doctoral journey, integrating processual, operational and contextual dimensions.

The purpose of the paper is to examine the discourses of risk, prevention and early intervention, with particular reference, to the treatment of girls in the contemporary Youth Justice System.

The paper has two broad objectives: first, the paper reviews the literature on early intervention and youth crime prevention policy. Second, the paper focuses on youth justice practice in relation to girls who are engaged in youth justice processes or “at risk” of criminal involvement.

The paper argues that: girls are drawn into the system for welfare rather than crime‐related matters; and youth justice policy and practice seems to negate girls' gender‐specific needs. Moreover, the paper highlights research evidence and practice‐based experience, and contends that youth justice policy and practice must be re‐developed in favour of incorporating gender‐specific, child and young person centred practices.

The results presented in this article will be particularly pertinent to policy makers, educators and practitioners in the sphere of youth justice, especially since the contemporary youth justice system, in its rigorous, actuarial pursuance of risk management, fails to distinguish between “genders” within its formulaic assessment documentation.

Across K–12 settings, instructional coaching continues to flourish as an approach to teacher professional development intended to address long-standing inequities in student achievement. Yet, coaching models differ in how to conceptualize change or transformation as a result of coaching efforts.

This case study problematizes the concept of change within one practice-based coaching program, by positing the possibilities of striving for transformational change directed at addressing educational inequities.

Qualitative methods reveal how coaching belief statements guide the burgeoning identities of beginning coaches to align to (and at times extend beyond) coaching for change through the lens of teacher practice.

Implications describe ways that coaching programs might utilize reflection and analysis activities to foster more equity-oriented coaching identities, regardless of coaching model.

Designing and facilitating authentic learning opportunities for coaches to reflect, rehearse, connect, and apply knowledge to practice as they develop their own understanding of what it means to coach for change is crucial.

The purpose of this paper is to summarise practice-based evidence from an analysis of outcomes from a county-wide pilot study of a specialised primary care clinic employing an original approach for patients with medically unexplained symptoms (MUS). Conditions with persistent bodily symptoms for which tests and scans come back negative are termed MUS. Patients are generic, high health-utilising and for most there is no effective current treatment pathway. The solution is a proven service based on proof of concept, cost-effectiveness and market research studies together with practice-based evidence from early adopters. The research was transferred from a university into a real-world primary care clinical service which has been delivering in two clinical commissioning groups in a large county in England.

Clinical data calculated as reliable change from the various clinics were aggregated as practice-based evidence pre- and post-intervention via standardised measurements on anxiety, depression, symptom distress, functioning/activity, and wellbeing. It is not a research paper.

At post-course the following percentages of people report reliable improvement when compared to pre-course: reductions in symptom distress 63 per cent (39/62), anxiety 42 per cent (13/31) and depression 35 per cent (11/31); increases in activity levels 58 per cent (18/31) and wellbeing 55 per cent (17/31) and 70 per cent felt that they had enough help to go forward resulting in the self-management of their symptoms which decreases the need to visit the GP or hospital.

Without a full clinical trial the outcomes must be interpreted with caution. There may be a possible Hawthorne or observer effect.

Despite the small numbers who received this intervention, preliminary observations suggest it might offer a feasible alternative for many patients with MUS who reject, or try and find unsatisfying, cognitive behaviour therapy.

Many patients suffering MUS feel isolated and that they are the only one for whom their doctor cannot find an organic cause for their condition. The facilitated group has a beneficial effect on this problem, for example they feel a sense of belonging and sharing of their story.

The BodyMind Approach is an original intervention mirroring the new wave of research in neuroscience and philosophy which prides embodiment perspectives over solely cognitive ones preferred in the “talking” therapies. There is a sea change in thinking about processes and models for supporting people with mental ill-health where the need to include the lived body experience is paramount to transformation.

Assertive outreach is based on extensive international research and has been promoted in the UK in 1999 as a key area of the National Service Framework for Mental Health. Its primary aim is to provide a specialist service for people disengaged from traditional approaches of mental health services, but very little attention has been paid to how such services can be developed. Practice Based Evidence, a practice development consultancy, has engaged seven assertive outreach teams to focus on development first, and follow‐up evaluation of the impact of reflective practice on team functioning. This has prompted a number of strengths‐based recommendations for changing the way we think about developing services before we engage in research and evaluation.

The purpose of this paper is to consider evidence for the effectiveness of the psychologically informed environments (PIEs) approach to working with homeless people in the five years since the national guidance was published.

The author reviewed the intended outcomes of the original guidance and then looked at a range of data from evaluations of current PIE services in UK and Ireland.

The findings were that the PIE approach is effective in meeting the outcomes suggested by the original guidance; in reducing social exclusion and improving the mental health of homeless people; and in improving staff morale and interactions.

This is a practice-based evidence. There needs to be more practice-based evidence gathered, and it would be useful if there were some standardised measures, as long as these did not limit the richness of the data which suggests that PIEs have a wide, not narrow, impact.

The implications are that homelessness services should use the PIE approach, and that they should be supported by clinically trained psychotherapists or psychologists; and that wider mental health services should look at the PIE approach in terms of working effectively with socially excluded people with complex needs/mental health problems.

PIEs are an effective way of working with socially excluded people with mental health problems/complex needs, enabling the reduction of social exclusion among this very excluded client group.

This is the first review of evidence, much of it so far unpublished, for the effectiveness of PIEs, despite the fact that this approach has been increasingly adopted by both providers and commissioners in the homelessness sector.

Data gathered from routine clinical settings is complementary to evidence garnered from controlled efficacy trials. The purpose of this paper is to present individual-level analysis of changes in a group of patients discharged from psychological therapy within an outpatient pain service. The service had recently shifted from a traditional cognitive-behavioural approach to one underpinned by Acceptance and Commitment Therapy.

Reliable and clinically significant change methodology was applied to CORE-10 outcomes for 27 patients discharged during 2013-2014. Outcomes were compared to 2012-2013. A patient satisfaction questionnaire was administered and functional outcomes were collated.

Outcomes were not adversely affected by the shift in service focus as clients demonstrating reliable improvement increased from 2012-2013; 81 per cent reliably improved, 44 per cent made a clinically significant improvement. Increases in returning to work/unpaid activities at post-treatment were noted. The service met a number of NICE quality standards concerning the “relational” aspects of care.

Clinical effectiveness is evaluated through one outcome measure thereby limiting conclusions. The longer term effectiveness of the service remains unclear. Narrow demographic information limits an assessment of any systematic biases in findings. Little is known about treatment drop-outs.

A number of recommendations concerning data collection and future service evaluations are made.

Returning to paid or unpaid activities has a high public health impact.

This paper contributes towards the evidence base for using psychological therapies with clients experiencing chronic pain and related distress. Importantly, the paper complements evidence for general efficacy (from large-scale controlled studies) through an evaluation of real-world effectiveness (i.e. practice-based evidence).