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Article
Publication date: 10 April 2017

Anisha Vyas, Cathy Spain and David Rawlinson

The purpose of this paper is to explore the impact working in a therapeutic community (TC) has on staff practice and personal development.

Abstract

Purpose

The purpose of this paper is to explore the impact working in a therapeutic community (TC) has on staff practice and personal development.

Design/methodology/approach

Eight female members of staff who work in the TC participated in semi-structured interviews. Interviews were recorded and transcribed. Thematic analysis was used.

Findings

The findings of this paper show three superordinate themes: confidence gained within TC; the staff impact of the intensity of TC; and staff value for specific TC principles.

Research limitations/implications

Limitations include researcher bias as both authors work in the TC and/or in the service. Reasonable adjustments were made in order to account for this.

Practical implications

Implications for future research include understanding and supporting the needs of staff and further exploration of the impact of staff working within TCs for people diagnosable with emotionally unstable personality disorders.

Originality/value

The research was carried out at one of the longest running TCs for people with emotional instability in the country. It offers a unique opportunity to garner the views of staff members with up to 27 years of experience. Findings may be of value to practitioners, administrators, policy makers and researchers interested in therapeutic communities.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 38 no. 1
Type: Research Article
ISSN: 0964-1866

Keywords

Article
Publication date: 7 April 2014

Peter Rex Massingham and Rada K Massingham

The paper examines ways that Knowledge Management (KM) can demonstrate practical value for organizations. It begins by reviewing the claims made about KM, i.e. the benefits KM can

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Abstract

Purpose

The paper examines ways that Knowledge Management (KM) can demonstrate practical value for organizations. It begins by reviewing the claims made about KM, i.e. the benefits KM can provide to organizations. These claims are compared with traditional firm performance metrics to derive a criterion to measure the value of KM. Seven practical outcomes of KM are then presented as methods to persuade managers to invest in KM. These practical outcomes are then evaluated against the value criterion. The paper is based on empirical evidence from a five year longitudinal study.

Design/methodology/approach

This paper is based on a longitudinal change project for a large Australian Research Council (ARC) Linkage Project grant in the period 2008-2013. The Project was a transformational change program which aimed to help make the partner organisation a learning organisation. The partner organisation was a large Australian Government Department, which faced the threat of knowledge loss caused by its ageing workforce. The sample was 118 respondents, mainly engineering and technical workers. A total of 150 respondents were invited to participate in the study which involved an annual survey and attendance at regular training workshops and related activities, with a participation rate of 79 per cent.

Findings

This paper provides a checklist from which to evaluate KM in terms of financial and non-financial measures and seven practical outcomes from which to identify the organisational problem which may be addressed by KM. Lead and lag indicators – what needs to be done and what will result – are also provided. Managers may use this framework to identify the value proposition in any KM investment.

Research limitations/implications

The research is based on a single case study in a public sector organization. While the longitudinal nature of the study and the rich data collected offsets this issue, it also presents good opportunities for researchers and practitioners to test the ideas presented in this paper in other industry contexts. The seven practical outcomes also vary in the maturity of the empirical evidence supporting KM ' s impact. Strategic alignment, value management, and psychological contract, in particular, are still under-developed and could be areas for specific further research testing the ideas presented here.

Practical implications

This paper argues that investment decisions regarding KM may benefit from focusing on significant and on-going organisational problems, which will connect KM with firm performance and demonstrate financial and non-financial impact. The seven practical outcomes were evaluated against measurement criteria and against KM ' s claims. Overall, common themes were time and cost, as well as capability growth and performance improvements. Financial impact was mainly found in cost savings. Non-financial impact was found across the seven practical outcomes. It provides management with a checklist to make investment decisions regarding KM.

Originality/value

The decision whether to invest in KM begins with methods used to evaluate any organisational project. Managers must determine first whether necessary funds are available; and then whether the project is worthwhile. The standard method for evaluating a project ' s worth is return on investment (ROI). However, calculating ROI for KM investment is problematic. Unless KM can be proven to directly improve performance in financial terms, managers may struggle to see its ROI. The paper begins by reviewing the claims made about KM, i.e. the benefits KM can provide to organizations. These claims are compared with traditional firm performance metrics to derive a criterion to measure the value of KM.

Details

Journal of Knowledge Management, vol. 18 no. 2
Type: Research Article
ISSN: 1367-3270

Keywords

Article
Publication date: 10 June 2020

David N. Eades

This paper aims to explore the impact of stressors and the strategies staff use to cope with these at a detention facility. It documents through case studies some of the triggers…

Abstract

Purpose

This paper aims to explore the impact of stressors and the strategies staff use to cope with these at a detention facility. It documents through case studies some of the triggers of trauma, possible coping mechanisms that might assist in navigating the associated stressors in a workplace and recommendations as to what might assist staff.

Design/methodology/approach

A naturalist approach was used in this research, using an ethnographic qualitative methodology. Grounded theory assisted in the analysis of the data to capture naturalistically the subjective experience of the participants of the study. Conversations occurred with staff who had worked in a detention facility using face to face semi-structured interviews. The structure was open-ended to allow the staff to discuss and share their experiences freely.

Findings

Stressors that impacted staff working in a detention facility resulted from areas such as heightened reactions from detainees because of the length of their detainment, detainee self-harm, dealing with the effects of an increase of substance abuse through detainees obtaining contraband and the associated violent reactions that can occur as a result. Adverse symptoms noted within the lives of staff included acute anxiety, sleeplessness, depression and tension within impersonal relationships, including family. What compounded the issue was staffs’ reluctance to talk about work stressors.

Research limitations/implications

The research used nine participants for case studies of staff who had formerly experienced various adverse impacts of stressors. This is not a comprehensive study, however, of the broader experiences of staff at an Australian detention facility. It does provide, however, a snapshot of the experiences of a small group who had significantly been impacted by the stressors of the workplace.

Practical implications

This paper provides fresh perspectives or initiatives that are needed to assist staff to navigate the changing environment of working in a detention facility. In particular, some support mechanisms and protective factors that could be put in place to curb the negative impact of stressors in the workplace and to mitigate against long term stress disorders developing in the personal lives of staff.

Social implications

Many staff are not getting the help they need to cope with the emotional distress they experience in their workplace. However, there are practical interventions to support staff in managing the stressors they face. These will be outlined in this article.

Originality/value

This study was carried out with the goal of giving staff a voice and to capture their former experiences in their vocational responsibilities in a venue that has had very limited research attention. This study has presented the challenges staff faced in a unique venue of working in a detention facility. It has documented some of the common stressors staff faced, the impact of such and some coping mechanisms used to handle them.

Details

The Journal of Adult Protection, vol. 22 no. 3
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 22 March 2013

Louise G. Braham, Jonathan F. Heasley and Sam Akiens

Night confinement (NC) has been proposed as an appropriate and safe way to make cost improvements in a high secure NHS hospital. Given potential controversy, evaluating the impact

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Abstract

Purpose

Night confinement (NC) has been proposed as an appropriate and safe way to make cost improvements in a high secure NHS hospital. Given potential controversy, evaluating the impact of this change is vital. This paper aims to focus on the issue.

Design/methodology/approach

The study used a mixed methods design to assess the impact of a three month night confinement pilot on four high secure admission wards. In total, 158 staff and 42 patients were approached to complete questionnaires and interview prior to and following the pilot. Questionnaires were analysed using T tests, ANOVA and Mann Whitney‐U to asses perceived changes in ward climate, working environment and quality of life. Thematic and saliency analysis was used to explore themes arising from semi structured interviews. Hospital data were collected to identify behavioural changes.

Findings

The study found that NC had no adverse effects and incidents of self harm, other incidents and seclusion hours dropped by a third during this period. This was contrary to staff expectations.

Research limitations/implications

Limitations include: a large number of researchers involved; average response rate and a disproportionate number of patients on Tilt restrictions on the pilot wards. Further evaluation is necessary if NC is to be adopted more widely.

Practical implications

This evaluation suggests that NC can contribute to providing an efficient and effective secure mental health service.

Originality/value

This study provides a unique opportunity to assess the impact of NC on patients and is of value to other secure units seeking effective cost improvements.

Details

Mental Health Review Journal, vol. 18 no. 1
Type: Research Article
ISSN: 1361-9322

Keywords

Article
Publication date: 8 February 2024

Yara Levtova, Irma Melunovic, Caroline Louise Mead and Jane L. Ireland

This preliminary investigation aims to examine the psychological impact of the COVID-19 pandemic on patients and staff within a high secure service.

Abstract

Purpose

This preliminary investigation aims to examine the psychological impact of the COVID-19 pandemic on patients and staff within a high secure service.

Design/methodology/approach

To discern the connection between COVID-19-related distress and multiple factors, the study involved 31 patients and 34 staff who completed assessments evaluating coping strategies, resilience, emotional reactivity, ward atmosphere and work-related aspects.

Findings

Results demonstrated that around a third of staff (31.2%) experienced COVID-19-related distress levels that met the clinical cut-off for possible post-traumatic stress disorder. Emotional reactivity, staff shortages, secondary traumatic stress and coping strategies were all positively correlated with COVID-19-related-distress. Resilience was negatively associated with distress, thus acting as a potential mitigating factor. In comparison, the prevalence of distress among patients was low (3.2%).

Practical implications

The authors postulate that increased staff burdens during the pandemic may have led to long-term distress, while their efforts to maintain minimal service disruption potentially shielded patients from psychological impacts, possibly lead to staff “problem-focused coping burnout”. This highlights the need for in-depth research on the enduring impacts of pandemics, focusing on mechanisms that intensify or alleviate distress. Future studies should focus on identifying effective coping strategies for crisis situations, such as staff shortages, and strategies for post-crisis staff support.

Originality/value

The authors postulate that the added burdens on staff during the pandemic might have contributed to their distress. Nonetheless, staff might have inadvertently safeguarded patients from the pandemic’s psychological ramifications by providing a “service of little disruption”, potentially leading to “problem-focused coping burnout”. These findings underscore the imperative for further research capturing the enduring impacts of pandemics, particularly scrutinising factors that illuminate the mechanisms through which distress is either intensified or alleviated across different groups. An avenue worth exploring is identifying effective coping styles for pandemics.

Details

The Journal of Forensic Practice, vol. 26 no. 1
Type: Research Article
ISSN: 2050-8794

Keywords

Article
Publication date: 9 February 2015

Simon Chu, Kimberley McNeill, Karen M. Wright, Anthony Hague and Tracy Wilkins

From 2012, all high-secure forensic mental health services in England began operating a policy of confining patients to their locked bedrooms overnight to increase service…

Abstract

Purpose

From 2012, all high-secure forensic mental health services in England began operating a policy of confining patients to their locked bedrooms overnight to increase service efficiency and reduce costs. The purpose of this paper is to assess the views of staff and patients concerning the policy and examine the specific impact of the policy on patients.

Design/methodology/approach

Measures of patients’ sleep hygiene, patients’ behaviour, ward atmosphere, engagement with therapy and adverse incidents were taken both before and after the night confinement (NC) policy was implemented. Both patients and staff also expressed their views of the impact of the NC policy.

Findings

Results provide converging evidence that the impact of the NC policy on patients is negligible. There were no consistent negative effects of confining patients overnight. Rather, patients and staff were broadly positive about the impact that the practice had on patients.

Practical implications

Confining patients to locked bedrooms overnight does not exert any consistent influence, positive or negative, on patients’ sleep hygiene, behaviour or engagement with therapy, and patients expressed a broadly positive view of the practice of NC. Thus, a NC policy may have a contribution to make to the provision an effective high-secure mental health service.

Originality/value

The study provides convincing evidence that secure inpatient mental health services that are considering the adoption of a NC policy may do so without fear of a negative impact on patients.

Details

Journal of Forensic Practice, vol. 17 no. 1
Type: Research Article
ISSN: 2050-8794

Keywords

Article
Publication date: 9 September 2013

Nicola Bethel and Nigel Beail

There continues to be a small group of people who have intellectual disabilities who need some form of restraint in their support plan due to their self-injurious behaviour. The…

Abstract

Purpose

There continues to be a small group of people who have intellectual disabilities who need some form of restraint in their support plan due to their self-injurious behaviour. The mechanical restraint restricts their freedom of movement to help prevent injury. Despite the growing literature on the use of such devices, there is very limited literature looking at the impact the use of mechanical restraints has upon service users and support staff using them. The aim of this study was to ascertain the experiences of support staff who apply the restraints to the people they support.

Design/methodology/approach

Qualitative methodology was utilised. A semi-structured interview was conducted with nine support workers who: directly worked with a client with intellectual disabilities who engage in self-injurious behaviours; followed positive behavioural support plans developed with a multi-disciplinary team; applied restraints as a response to severe self-injurious behaviours to prevent harm; and they had to have been directly involved in the application and removal of the mechanical restraints in the last week. Content analysis utilising emergent coding was used to analyse the data.

Findings

All participants described using mechanical restraints as having a negative impact upon them. Participants said they manage the negative impact by reframing, inhibiting their emotions, following support plans closely and gaining support from other staff. Participants described concerns and unmet needs regarding whether they were applying the restraints correctly, the responsibility of teaching others to use restraints, not feeling prepared on starting their current job and that the impact/concerns of using restraints is not talked about. Recommendations for practice are made.

Originality/value

This is the first study to explore the views of care staff who are required to use mechanical restraint. It provides insight on the impact of this on them.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 7 no. 5
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 28 December 2021

Claire McDonald, Fiona Seaman-Thornton, Che Ling Michelle Mok, Hanne Jakobsen and Simon Riches

Negative attitudes towards “personality disorder” are common among mental health professionals. This study aims to design a psychoeducational training targeting attitudes to…

Abstract

Purpose

Negative attitudes towards “personality disorder” are common among mental health professionals. This study aims to design a psychoeducational training targeting attitudes to “personality disorder” for staff working in a London psychiatric hospital. Its impact on staff attitudes was evaluated.

Design/methodology/approach

Mental health clinicians were recruited from five acute psychiatric wards. Feasibility of implementing the training was measured. A free-association exercise explored baseline attitudes to “personality disorder” and visual analogue scales assessed staff attitudes pre- and post-training. Content analysis of staff feedback was carried out.

Findings

Psychoeducational training was found to be feasible, well-attended and highly valued by ward staff (N = 47). Baseline results revealed negative perceptions of “personality disorder”. Post-training, significant improvements in understanding, levels of compassion and attitudes to working with service users with a diagnosis of a “personality disorder” were observed. Staff feedback highlighted desire for further training and support.

Research limitations/implications

The sample size was relatively small and there was no control group, so findings should be interpreted with caution.

Practical implications

The findings highlight the need for support for staff working with service users with diagnoses of “personality disorder” on acute psychiatric wards. Providing regular training with interactive components may promote training as a resource for staff well-being. Planning to ensure service users’ and carers’ views are incorporated into the design of future training will be important.

Originality/value

This study is innovative in that it investigates the impact of a brief psychoeducational training on “personality disorder” designed for mental health staff on acute psychiatric wards.

Details

Mental Health Review Journal, vol. 27 no. 1
Type: Research Article
ISSN: 1361-9322

Keywords

Article
Publication date: 18 February 2019

Zofia Bajorek and David Guest

The purpose of this paper is to address a gap in the recent literature on employment of temporary workers by exploring the impact of temporary workers on the perceptions…

Abstract

Purpose

The purpose of this paper is to address a gap in the recent literature on employment of temporary workers by exploring the impact of temporary workers on the perceptions, attitudes and behaviour of permanent staff with particular reference to their implications for patient safety and service quality in hospital accident and emergency departments. The analysis is set in the context of the job demands-resources theory.

Design/methodology/approach

The research was undertaken using a case study approach with semi-structured interviews in two London hospitals. Participants included staff from the HR director level, clinical managers and permanent staff who all had an influence in the hiring and management of temporary staff in some way. Transcripts were analysed thematically using an adopted framework approach.

Findings

The results indicate that the effect of temporary staff on permanent staff depended on the quality of the “resource”. There was a “hierarchy of preference” for temporary staff based on their familiarity with the context. Those unfamiliar with the department served as a distraction to permanent staff due to the need to “manage” them in various ways. While this was rarely perceived to affect patient safety, it could have an impact on service quality by causing delays and interruptions. In line with previous research, the use of temporary staff also affected perceptions of fairness and the commitment of some permanent staff.

Practical implications

A model developing an approach for improved practice when managing temporary staff was developed to minimise the risks to patient safety and service quality, and improve permanent staff morale.

Social implications

The review highlights the difficulties that a limited amount of temporary staff integration can have on permanent staff and patient care, indicating that consideration must be placed on how temporary staff are inducted and clarifying expectations of roles for both temporary and permanent staff.

Originality/value

This paper studies the under-researched impact of temporary staff, and, distinctively, staff employed on a single shift, on the behaviour and attitudes of permanent staff. It highlights the need to consider carefully the qualitative nature of “resources” in the job demands-resources theory.

Details

Journal of Organizational Effectiveness: People and Performance, vol. 6 no. 1
Type: Research Article
ISSN: 2051-6614

Keywords

Article
Publication date: 8 July 2021

Thomas Nally, Jane L. Ireland, Kimberley McNeill, Philip Birch and Carol A. Ireland

The purpose of this paper is to explore non-violent pornography within secure hospital settings.

Abstract

Purpose

The purpose of this paper is to explore non-violent pornography within secure hospital settings.

Design/methodology/approach

It includes a systematic review (n = 40 papers), followed by a qualitative study comprising semi-structured interviews (n = 24, 6 patients and 18 staff) and staff focus groups (n = 22 staff).

Findings

The systematic review identified six themes, as follows: pornography is inconsistently defined, pornography exposure can increase general aggression, pornography exposure may increase the risk for sexual aggression, pornography exposure can increase aggression supportive beliefs, pornography exposure impacts negatively on those with a violent predisposition and pornography is educational for men not identifying as heterosexual. The semi-structured interviews and focus groups revealed four themes as follows: staff members hold diverse beliefs about pornographic material, pornography is difficult to obtain and use for patients who do not identify as heterosexual, pornography is used for specific functions, and frequent exposure to pornography can have negative effects for staff members.

Practical implications

Trying to obtain consensus on the impacts of pornography on forensic patients is not possible; material access decisions should be on a case-by-case basis. Policy decisions should be based on fully represented views, including the LGBTI community. The impacts on staff of their occupational exposure to such material should be recognised and support provided. Clinical decision-making in this area should consider not only if access should be allowed but also how it can be managed safely, if at all. This includes for all those who could be exposed to such material, inadvertently or otherwise.

Originality/value

It addresses the under-researched area of patient access to pornography, capturing a poorly considered sample, namely, high secure psychiatric.

Details

The Journal of Forensic Practice, vol. 23 no. 2
Type: Research Article
ISSN: 2050-8794

Keywords

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