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A key aspect of psychologically informed planned environments (PIPEs), are the attachment theory-informed relationships between residents and staff (Bainbridge, 2017). The key-work provision of one-to-one support from officers to residents is one of the main ways through which relationships are formed. The purpose of this paper is to explore prison officers’ experiences of the key-work role within a PIPE in a women’s Prison in England.

Semi-structured interviews explored ten prison officers’ experiences. Interviews were analysed using thematic analysis.

Five main themes were identified; “Professional support”, “Negotiating Professional Boundaries”, “A Successful Relationship”, “Rupture and Repair” and “Growth for Everyone”. These themes reflected the framework around keywork; what support officers need to cope with the emotional demands of the role, and how to manage challenging situations and build meaningful key-work relationships.

Limitations include the lack of focus on diversity, the impact of the COVID-19 pandemic on officer experience and applicability to other PIPE services. Future research could address some of these limitations.

Practical implications highlight the need for consistent supervision, greater consideration of officers’ transition to the role and trauma-informed training.

The research provides an unprecedented account of prison officers’ experiences of the key-work role, adding to the limited literature within PIPEs in the women’s estate. The supportive nature of the key-work relationship was perceived by officers to contribute towards people’s sentence progression and officers’ personal and professional development.

In educational settings, intersectional factors such as neurodiversity, structural inequalities and social isolation have resulted in additional complexity in meeting young people’s mental health needs. The specific phenomenon of voice-hearing can be linked to these complexities and stigma has been shown to further marginalise young people following disclosure. Educational staff report a lack of confidence and specialist training in this area. This chapter outlines the current understanding around the experience of voice-hearing and identifies examples of good practice by considering the lived experiences of individuals that have made a disclosure of this nature in school. Barriers to disclosure and what was helpful about the experience are discussed. Developing a trauma-informed ethos and compassion-focussed principles are highlighted as whole-setting approaches to support and benefit both young people with these presentations and education staff. Recommendations of relevant organisations and training initiatives in schools are provided with guidance on developing and implementing best practices.

The therapeutic community (TC) is an environmental intervention where principles of working together democratically can enhance self-agency. While availability of inpatient TCs within the UK National Health Service (NHS) has declined, shorter or alternative interventions using core TC approaches have shown promise in enacting change. The purpose of this paper is to report and reflect on the development and running of a pilot nano-TC.

Foundations Group was a 2-h TC group intervention set up and run within the NHS for 18 months in 2021–2022, and taking place on City Farm premises. The group was convened as part of the complex emotional needs service in a mental health NHS Trust in the South West of England. Over the study period, the group comprised 11 members, one peer member and three staff members.

The authors reflected on the TC stance of working democratically with a fluid hierarchy, taking a non-expert approach, and using support and challenge to enhance self-agency and belongingness. The authors have detailed the structure of the group session including use of community meetings, psychoeducation, creative sessions and reviews. Members took on roles within the group including chairing sessions.

This group was a novel service within the NHS Trust where it was conducted and may represent a standalone therapeutic group. The authors hope it will show that core TC principles can be applied in shorter interventions than have previously been used.

The primary objective of this study is to investigate the cognitive aspects of spatial experiences of paediatric inpatients who receive long-term treatment in a healthcare setting in relation to the syntactic parameters of healthcare environment. It is aimed to investigate how the change in the child’s cognition caused by the environmental stress experienced by the child during his/her stay in the hospital is related to the physical parameters of the treatment space.

The methodology of the study is based on a correlational analysis to identify the cognitive and syntactic factors of the healthcare environment that contribute to changes in the perceptual processes of a sample group of thirty children. The study examined the relationships between the graph and isovist variables, and the cognitive parameters of paediatric inpatients. The two datasets were subjected to regression analyses in order to identify any significant findings, which allowed for a discussion of how the patients’ changing perceptual processes are influenced by the syntactic measures of the healthcare setting.

The study showed that a syntactically intelligible floor plan contributes significantly to reducing environmental stress among paediatric inpatients. The presence of shared spaces within the healthcare environment, where social interaction with peers is possible, emerges as a crucial factor influencing children’s spatial perception. Additionally, the visibility characteristics of shared spaces may also play a key role in enhancing children’s perceptions of safety.

The limitations of the study include the fact that the study was conducted in an oncology and haematology inpatient unit with challenging conditions in terms of the mobility potentials of the children, which might have affected their perceptual processes. A further limitation is that the sample size comprised only 30 children, and the spatial configuration of the healthcare environment was linear and not particularly complex.

By identifying the impact of spatial design on children’s well-being, the study informs the creation and improvement of healthcare environments. Enhanced understanding of factors like intelligible floor plans, shared spaces and isovist values can lead to more child-friendly facilities, potentially alleviating stress for young patients. Consequently, this research may contribute to improved healthcare outcomes, increased comfort for paediatric inpatients, and a more supportive environment for their families, fostering a holistic approach to paediatric care and positively influencing the overall quality of life for children undergoing long-term treatment.

This study contributes to the theoretical discourse on how the constrained physical conditions of a paediatric healthcare environment may influence the perceptual processes of paediatric inpatients. The results of this evidence-based study have the potential to inform the evaluation of design guidelines for healthcare settings, with the ultimate aim of enhancing therapeutic environments.

This discursive paper considers the use of restrictive practices in mental health inpatient settings and how these are often prioritised over relational approaches, especially where the diagnostic label of personality disorder intersects with risk.

Key concepts from Orwell’s 1984 are studied for their pertinence to mental health inpatient settings, supporting our argument that restrictive practices arise from dichotomous thinking and externalised fears.

Drawing upon Orwellian themes of power, social control and digital surveillance from 1984, the authors highlight the role of fear in perpetuating restrictive practices under a guise of benevolent care in mental health inpatient settings, especially for those who are diagnosed with a personality disorder. A lack of preparedness to work with complexity in such environments, coupled with a deficit in self-reflexivity and critical thinking, can exacerbate challenges.

To transcend damaging dichotomies and reduce restrictive practices in inpatient settings, the authors make the argument for the adequate preparation and education of the mental health nurse and authentic, collaborative, user-involved care.

The authors use Orwell’s novel to support a critical discourse around those damaging dichotomies and inherent contradictions that contribute to restrictive practice in contemporary mental health settings and to question whose interests’ these restrictive practices serve.

Around the world, prison complexes have always been fundamentally taxing environments. The strained atmosphere within these prisons often contributes to the deterioration of mental health, mostly those who may already be psychologically vulnerable. This paper aims to understand whether there exists a relationship between the built environment of prisons, particularly the central prisons of India and its effects on the mental health of inmates.

By means of literature reviews, the study parameters were found to be connectivity to nature, lighting, acoustics, colour, air quality and thermal comfort. The data collected through interviews and email correspondences with identified experts were analysed thematically using a deductive approach to derive a set of practical recommendations, which could be implemented in Indian prisons.

The built environment of prisons impacts the prison population by further contributing to depressive symptoms. The effects of the built space persist regardless of social factors. A well-designed environment is healthy for its occupants and would yield positive changes. However, it is not the sole contributor to depression; social interactions, prison management, societal acceptance and meaningful activities are equally relevant factors. The sole focus of this paper is the relationship between the built environment and the mental health of inmates.

There is a paucity of research into the intersection between prison architecture and the mental health of inmates in the Indian subcontinent. This paper that addresses the gap may have significant consequences on how criminal reform is perceived, and also encourage further research in this field.

Self-disgust appears to be a prominent feature in anorexia nervosa (AN), which might help explain why AN is often such a persistent disorder. Little is known about how this emotion can impact on recovering from this disorder. This study aims to develop our understanding of how people experience the emotion of self-disgust after physical recovery from AN.

Twelve female participants who reported previously having had a clinical diagnosis of AN but had physically recovered according to their EDE-Q scores took part in a semi-structured interview to explore their experiences of recovery and the role self-disgust played within this. Interpretative phenomenological analysis was used to explore the data.

Three themes were identified within the data to explain the experiences of self-disgust in those with AN: continued self-disgust following physical “Recovery”, multiple manifestations of self-disgust in recovery and increasing self-disgust in recovery as a driver for relapse.

Self-disgust was something each participant appeared to experience often, despite being physically recovered from AN. Disgust-based reactions to the self are enduring and highly resistant to change even whilst other aspects of the disorder become less potent. Self-disgust is multi-faceted and may trigger relapse as the signs of improvement and behaviours inherent in recovering were generally viewed as disgusting to the individuals.

Self-disgust is an emotion that continues to affect people with AN despite physical recovery. The recovery process itself is not linear and self-disgust is enduring and may cause those affected to relapse. Considering this emotion within therapeutic intervention may encourage those with AN to accept their recovered self.

The past two decades have witnessed exponential growth in the use of mindfulness-based programmes within professional workplace cultures. From digital media giants such as Google, Apple and Facebook, to Fortune 500 companies, hospitals, universities, and government departments, many contemporary workplaces now offer mindfulness-based programmes as a remedy for workplace challenges such as low productivity, employee stress and staff attrition. Using Google’s Search Inside Yourself Leadership Institute as a case study, this chapter adopts Lauren Berlant’s concept of ‘cruel optimism’ as a critical framework for re-evaluating the affective and relational experiences of mindfulness within the contemporary neoliberal workplace. Specifically, it considers the ways in which corporate mindfulness initiatives commonly use the rubric of ‘employee wellbeing’ and ‘self-care’ to pathologise employee experiences of boredom, dissatisfaction and stress while downplaying the social, political and economic factors that contribute to workplace dissatisfaction and employee burnout.

This paper aims to explore using the children’s accelerated trauma technique (CATT) in an adult intellectual disability population, with the aim of reducing symptoms of post-traumatic stress disorder (PTSD).

A service evaluation was completed to investigate differences between pre- and post-CATT trauma scores.

Scores on a measure of PTSD decreased significantly following CATT.

The findings support continued use of CATT in adults with intellectual disabilities, and they highlight the need to evaluate effectiveness in a larger sample.

This paper evaluates the novel application of a trauma treatment – developed for use with children – in an adult intellectual disability population and adds to the existing evidence base.

Clinically, it is often observed that autistic people may have a heightened need for rules and may find rule violations very distressing. It is clinically plausible that autistic individuals may be prone to hyper-morality and greater reactivity and adverse experiences arising from moral threats and violations. Such adverse experiences may, in some instances, lead to moral distress (MD) or in more extreme cases moral injury. Thus, this study aims to examine how MD can operate in the context of autism.

The authors explore clinical hypotheses on how MD can intersect with different features of autism by drawing on clinical and research knowledge of autism spectrum disorder and how it contextualises experiences of morality.

Based on a review of the literature and theory, the authors hypothesise that autistic individuals may be more prone to MD where they have a lower threshold for MD. As a result of this lower threshold, they may have more frequent exposure to MD, experience more immediate and intense subjective reactions to moral transgressions, for more protracted periods. Also, they may find it more difficult to over-ride and neutralise moral outrage. As a result, they may be more susceptible to mental health sequelae and impaired social and occupational functioning. Practical recommendations are made for clinicians supporting people with autism with a propensity for MD or moral injury, to improve their quality of life.

Practical recommendations are made for clinicians supporting people with autism with a propensity for MD or moral injury, to improve their quality of life.

Understanding MD in an autistic context is important for detecting and treating the adverse impacts of MD on autistic individuals. Importantly, erroneous preconceptions about moral reasoning in autism need to be mitigated to fully understand the moral experiences and harness the many strengths of people with autism.