Search results

This article focuses on group work with children using a board game format. Combining the principles of group work and board games helps to engage and motivate children and adolescents to address and work through their difficulties. Lifegames are a series of six therapeutic board games developed for group work with children and adolescents who encounter adversity in their life as a consequence of bereavement, family break up, poor relationships, bullying, chronic illness or obesity. The games facilitate the understanding and disclosure of the complex feelings experienced by children and young people when they are confronted with traumatic life events. The games encourage and assist the participants to obtain and maintain behavioural change. Lifegames are a means to assist professionals in their group work with children and adolescents.

This paper aims to discuss a service user perspective of factors that influence engagement in therapeutic group‐work within a high secure hospital environment.

An opportunistic sample of 11 male service users were interviewed, using a semi‐structured protocol. This was underpinned by social and psychological factors highlighted within the literature, and concepts drawn from the Health Belief Model (HBM). In accordance with service‐user led initiatives, interview questions were open‐ended, designed to invite and encourage exploration of themes through general discussion. Research findings were analysed through an interpretative phenomenological analysis (IPA) approach to identify emergent themes of apparent influence. Themes were identified, and were categorised into emergent themes and related sub themes. Emergent themes were then considered in relation to the theories and concepts that underpinned and connected them.

It was found that the most substantial theme was culture of the environment, closely linked to the concepts of choice, which stem from and are greatly influenced by culture. Participants highlighted additional influential areas, namely relationships, trust, motivation, group‐work content and expected outcomes.

Given the complexities of need presented by service users within high secure settings, professionals recognise a range of approaches and treatment modalities incorporating individual therapy, occupational and vocational engagement and therapeutic group‐work. It is specifically service users' views of engagement in such group‐work that is considered within this paper.

The purpose of this paper is to highlight theoretical and clinical similarities between therapeutic communities (TCs) and group analysis (GA).

Literature review shows comparison of TC and group-analytic concepts with illustrative case material.

Findings reveal many similarities between TCs and GA, but also significant divergences, particularly in practice.

This paper provides theoretical basis for TC practice, and highlights the need for greater theorising of TC practice.

This paper highlights the importance of group-based treatment approaches in mental health.

This is the first paper to review the relevant literature and compare theory and practice in TCs and GA, highlighting their common roots in the Northfields Experiments in the Second World War.

The purpose of this paper is to review issues of relevance to practitioners using group cognitive behavioural therapy (CBT) with women in secure settings.

The extant literature on CBT as applied to women in secure settings is reviewed to highlight best practice. Aspects of best practice are illustrated with examples from a women's medium secure service.

Obstacles include the characteristics of the patient group, treatment non compliance and an environment that accepts the primacy of security over treatment. Environmental and need factors amenable to intervention are highlighted in addition to CBT specific considerations that include the timing and intensiveness of treatment, content and delivery of therapy, treatment readiness and use of the group process. The use of a manualised CBT group treatment aid attempts to ensure treatment integrity is associated, and which is associated with treatment outcome. A focus on the social and environmental factors that attribute to the therapeutic milieu is vital to treatment generalisation, as is harnessing the therapeutic potential of the built environment. Finally, treatment evaluation imposes a structure that can facilitate progress in treatment.

There is comparatively little work on CBT group treatments for women in secure settings. Attempts to synthesise best practice initiatives in this area are helpful in guiding treatment developments.

The purpose of this paper is to illustrate how psychoanalytic thinking can help therapeutic communities think about how the defence of psychic retreat can develop and take hold in the face of organisational transition and overwhelming loss.

This paper draws upon the paradigm of psychoanalysis and is a case study orientated by a participant/observer stance.

This paper posits that unless loss is worked through then perverse clinical cultures can develop including bullying and denial of reality.

This paper illustrates the unique selling point of therapeutic communities incorporating justice into the treatment frame. It also identifies that unless loss is emotionally worked through then it can become the ground soil in which perverse cultures can develop.

This paper aims to present results achieved by the first, and to date only, Democratic Therapeutic Communities (DTC) quality improvement program developed in Italy, in the past 10 years, named “Visiting DTC Project.” Process of bottom-up identification, definition and evaluation of good practices of TCs for adult users with long term severe mental disorders will be described. In addition, a five-phase clinical care pathway will be presented for the same user category, developed by the “Visiting DTC Project” to comply with Italian National Health Service accreditation standards for TCs.

“Visiting DTC Project” involved 40 Italian TCs, since 2012 until 2020, in an action research on good practices developed throw a democratic and bottom-up methodology. Project’s methodology is the “Democratic Peer-to-peer Accreditation,” a kind of professional scientific quality accreditation and continuous improvement process for community mental health services. Scientific model for the definition of service standards and principles of treatment is the British “Democratic Therapeutic Community,” which the “Visiting DTC Project” is organizationally inspired by.

In the eighth annual cycle of the program for TC with adult users of mental health services a significantly effective good practice procedure (GPP), with good practical efficacy, was finally identified (for the first time after eight years), but still no best practice. GPP with the title “Multi-family Community Meeting” is the Good Practice of the year 2020. No Best Practice has yet been identified. An integrated clinical care pathway for Adult DTCs Users in five phases is also presented. This care pathway organizes advanced standards of Community Group Quality in a map, to support the description and planning of the five phases of the user’s clinical work in DTC treatment.

Cooperation with local community services, organizations and networks, as well as a therapeutic environment based on informal coexistence and cooperation between TC members, are thus, together with care of family relationships, the main characteristics of the Italian experience of implementing and developing the Italian DTC treatment model. These characteristics make it clear how fragile Italian DTCs are at this moment. They are still in an early stage of development. All the most applied and effective best practice procedures are dependent on a wide and dense network of relationships, formal and informal, which cross the therapeutic environment and interconnect TC members with all other stakeholders.

This paper describes two different services within the UK, both of which aim to better address the needs of offenders with personality disorder. Both services have been developed in the light of recent policy and practice guidance, which recognises the need to develop new ways of working with this hard‐to‐reach population.The importance of developing boundaries and optimistic therapeutic relationships in order to foster motivation and engagement is emphasised. It is within these that assessment and interventions to address risk, mental health and social integration issues can be undertaken. In addition, the need for different agencies to work together in partnership to better address these needs is also emphasised.Resettle is a stand‐alone service in the pilot stage whilst the probation link‐work role is a resource within an established community personality disorder service.

The purpose of this paper is to inspire services to create Psychologically Informed Environments (PIEs) to support people experiencing homelessness, complex trauma and multiple exclusion.

It outlines key elements of PIEs and how these have been implemented at the Waterloo Project; a 19 bed hostel and integrated health and social care partnership in Lambeth. It considers the importance of meeting individuals emotional and psychological needs to support them out of homelessness.

The service review found a reliable reduction in residents’ mental distress and improved health and wellbeing. Repeat homelessness, anti-social and self-harming behaviour decreased whilst engagement with services, self-care and esteem increased. There are early indications of cost benefits to health and social care services. Staff reported professional development and an increase in their sense of personal accomplishment.

The paper aims to share learning, good practice and the outcomes of a psychologically informed approach to working with individuals who have not had their needs met by existing services. It illustrates the actual and potential social and economic impact and value on both individuals and public services.

The purpose of this paper is to assess unit manager perspectives on the introduction of a group-based trauma-specific programme delivered across Scotland’s secure estate. As this was the first time such an estate-wide initiative had occurred, it was important to identify the benefits/challenges at a strategic level.

An exploratory qualitative case study was utilised involving semi-structured interviews with five senior unit managers in three secure units to discover their perceptions of the benefits and challenges of implementing Teaching Recovery Techniques (TRT). A quasi-qualitative analysis was used to quantify and give meaning to manager responses. Inter-rater reliability of analysis was assessed.

Unit managers perceived gains in trauma-informed knowledge for themselves, and knowledge and skills gains for programme workers, care staff and adolescents. Challenges involved: managing a shift in paradigm to include a trauma-specific programme; the limiting context of competitive tendering; short duration placements; and the need for psychoeducation for staff, parents and agencies.

Large sample sizes are likely to identify further issues for unit managers. Manager perceptions need directly compared with staff and adolescent perceptions and included in randomised control trials of trauma-specific programmes.

Managers perceived that TRT needed to be delivered within trauma-informed organisations and identified the need for manager training in traumatisation, trauma recovery and organisational implications to guide strategic planning. Managers emphasised the need for psychoeducation for families, staff and agencies.

The current study is the first in Scotland to explore unit manager experience of introducing a trauma-specific programme across the secure estate.