Search results

Lengthy and complex routes to specialist care may negatively affect clinical profiles of trauma survivors accessing mental health services. The purpose of this study was to describe the characteristics and referral pathways of a cohort of clients accepted by a specialist trauma service in England; and investigate the associations between referral pathways and clients’ clinical profiles, namely, pre-treatment levels of post-traumatic stress, depression, anxiety, stress and post-traumatic growth.

Data on 117 consecutive, accepted referrals were extracted from clients’ clinical records. Information on demographics, trauma histories, clinical presentations and referral pathways was synthesised through summary statistics. Correlational analyses were conducted to test associations with pre-treatment scores.

Clients accessing the service were highly complex and mostly experienced prolonged, interpersonal trauma. Pathways to the service varied, but 50% of the sample had at least four “steps” in their referral histories and seven previous clinical contacts. The average time between trauma and specialist referral was 16.34 years. The number of referral steps positively, significatively and moderately correlated with anxiety and stress at pre-treatment.

Limitations include issues around collecting past referral information, the small sample size for clients with available pre-treatment data and the lack of post-treatment scores.

This evaluation provides an informative overview of the characteristics and referral pathways of clients accessing a specialist trauma service. It also offers preliminary insights on the relationship between clients’ routes into the service and their clinical profiles. Practice, commissioning and research implications are discussed.

The purpose of this paper is to explore service users’ experiences of the process of ending from national health service (NHS) community personality disorder services.

Semi-structured interviews were conducted with eight participants recruited from four NHS community personality disorder services.

Three main themes emerged; “Service users” experiences in the context of “Reflective versus Reactive practice”, “Endings held in mind” and “What next”?

Further recommendations are provided for practitioners supporting individuals managing endings alongside a “readiness to end” model which may be used in clinical practice.

The purpose of this paper is to systematically identify, appraise and synthesise qualitative literature exploring the experience, both positive and negative, of clinical supervision from the supervisor’s perspective.

A systematic search of three databases, grey literature, reference lists and citations was conducted. Six articles met the inclusion criteria and their quality was critically appraised by using a modified version of the Critical Appraisal Skills Programme tool. Data extracted from the articles were synthesised using meta-ethnography.

Four key themes were identified: experiencing difficulties in clinical supervision, responsibility, similarities to therapy and capabilities as a supervisor. These demonstrated that the role of a supervisor has the potential to be both beneficial and harmful to personal and professional development.

The quality of the studies was variable. Further research is required to explore how supervisors manage difficult experiences to ensure personal development and growth.

Clinical implications include the need for employers to consider the additional pressure associated with providing clinical supervision and to ensure that appropriate support is available. Results complement previous research on the bi-directionality of parallel process in clinical supervision.

This review presents an original synthesis of the supervisor’s experience of delivering clinical supervision to qualified therapists. This is achieved by utilising a systematic methodology and appraising the quality of the studies included. The review highlights how the effects of clinical supervision are not limited to the supervisee, but also experienced by the supervisor. The competing demands and responsibilities associated with clinical supervision impact upon the supervisor’s experience, both positively and negatively. When beneficial, delivering clinical supervision can lead to personal and professional growth in addition to the acquisition of new skills.

The purpose of this paper is to explore staff and service users’ perceptions of therapeutic principles within a unique male high secure learning disability therapeutic community (LDTC).

A qualitative approach was adopted using deductive content analysis and inductive thematic analysis. In total, 12 participants took part in a semi-structured interview to explore their perceptions of Haigh’s (2013) quintessence principles and any further additional therapeutic features in the environment not captured by the theory.

All five quintessence principles were identified in the LDTC environment. Some limits to the principle of “agency” were highlighted, with specific reference to difficulties implementing a flattened hierarchy in a forensic setting. Additional therapeutic features were identified including; security and risk, responsivity, and more physical freedom which appear to aid implementation of the quintessence principles.

The study was performed within a single case study design. Therefore, results remain specific to this LDTC. However, the finding of these principles in such a unique setting may indicate Haigh’s (2013) quintessence principles are evident in other TC environments.

This is the first research paper that has attempted to test whether Haigh’s (2013) quintessence principles are evident within a given therapeutic community. The research provides empirical evidence for the quintessence principles in a novel TC setting and suggests recommendations for future research.

Germany has become the most important destination country for young refugees in Europe (Destatis, 2021). Vocational education and training can make an important contribution to overcome educational barriers and gain participation in society (Will & Hohmut, 2020). Since 2015, rural regions have faced new challenges in establishing effective support systems for young apprentices with forced migration experience (Ohliger et al., 2017). The participatory LaeneAs research project seeks to identify educational barriers and to promote successful educational pathways for young refugees in vocational training. In four distinct rural areas in Germany, stakeholders in formal, non-formal, and informal learning environments and young refugees will be brought together in real-world laboratories. The authors aim to open space for a co-constructive knowledge production process between scientific and political stakeholders, educational practitioners, and refugee youth. Real-world laboratories are a socio-spatial methodology that combines research and a sustainable capacity building process. The lifeworld expertise will be used for a contextual condition analysis of structural, societal, and individual barriers to education as well as for practice transfer. Building on the discussion of the current state of research and the identification of significant gaps in the practice and research landscape, this essay will focus on the critical discussion of the methodological implementation of the study.

We discuss workforce management, related to those aged 50+ , in the United Kingdom and the Republic of Korea. With international competitiveness becoming increasingly crucial, retaining the ‘right’ mix of employees to achieve strategic organisational goals is likely to determine organisational success. However, we argue that workforce management is not only influenced by organisational-level strategy but also by national institutional and sectoral policies. Decisions on whether and how to retain older workers are therefore (co-)determined by institutional incentives and barriers to doing so.

We find that British and Korean governments have legislated in favour of extended working lives and, hence, the retention of ageing workforces. In the United Kingdom, pension eligibility ages are being increased and in Korea mandatory retirement age has been raised to age 60. While changes to the UK pension systems leave individuals with the (financial) risks associated with extended working lives, the Korean government tries to protect individuals from financial hardship by enabling them to remain longer in their primary career. However, whether and how government regulation plays out depends on how organisations react to it. The Korean discussion, in fact, shows that there might be leeway: organisations might continue to externalise their employees early framed as honourable, or voluntary, early retirement, which might not be in the interest of the individual but very much in the interest of the organisation. It therefore appears as if the retention of ageing staff is not (yet) considered to be of strategic importance by many organisations in these countries.

The purpose of this paper is to review quantitative research since 1999 evaluating the effectiveness of democratic therapeutic community (DTC) treatment for individuals with personality disorders (PD) with reference to interpersonal and offending risk outcomes.

A systematic search resulted in the review of ten studies. All of the studies investigated DTCs treating PD in community, inpatient residential and forensic settings. Only peer-reviewed, English-language articles employing a quantitative design were included.

The majority of studies were conducted poorly and of low methodological quality, with limitations located in the representativeness of participants, limited use of control and comparison groups, follow up periods and controls for confounders. Heterogeneity remained in use of measures and limited consideration was given to the validity of interpersonal measures used. While improved interpersonal outcomes post DTC treatment were noted in forensic and residential settings, results were mixed in day and mini TC settings. Inconsistent findings in offending risk outcomes were also indicated. A study with increased methodological rigour indicated residential treatment had limited effects on interpersonal outcomes, when compared to combination treatment (residential TC and step-down treatment).

The study provided an evaluation of the limitations of DTC research across a range of settings and highlighted a combination of residential TC and step-down treatment may achieve superior outcomes to residential TC treatment alone in a community inpatient population. Recommendations are made for future research to contribute to the treatment of PD.

This study aims to identify the benefits and costs of participation in small group consumption communities (SGCCs), and understand how benefits and costs experienced in these communities differ from those experienced in large group consumption communities (LGCCs).

Thematic analysis of data collected through multi-method approach comprising depth-interviews, participant observation of community events and online community forums was used to identify benefits and costs of SGCC participation.

Eight benefits and three costs of SGCC participation were identified. While some benefits and costs were found to be similar to those identified in LGCCs earlier, their experience and manifestation was found to differ significantly in SGCCs.

Data were collected from SGCCs located in India (collectivist culture). Hence, findings may not be reflective of individualist cultures.

Understanding that benefits and costs of community participation are experienced differently in SGCCs and LGCCs may be useful input for managers wanting to seed/nurture consumption communities. By increasing benefits and reducing costs, managers can transform communities into vibrant social systems, and thereby improve members’ engagement and involvement.

Of the eight benefits identified in the study, two benefits – Escape and Meaningful Engagement are identified for the first time. The study also explores costs of SGCC participation (an area hitherto under explored) in detail. In addition, the study illustrates how some of the benefits despite being seemingly similar in SGCCs and LGCCs are inherently different.

Measures introduced to mitigate the spread of coronavirus-19 (COVID-19) may have contributed to an increase in waiting times for face-to-face psychological treatments. As adults with intellectual disabilities (ID) are more likely to encounter barriers when accessing remote therapies, it is important they receive appropriate support while waiting. To understand what care is needed, this service evaluation [aimed to] explored the experiences of service users with ID who have waited for treatment during the pandemic.

Seven individuals who had been waiting for psychological therapy during the COVID-19 pandemic, which included those waiting longer than the national health service target of 18 weeks, were interviewed. Data were analysed using framework analysis.

The following four key themes were identified: waiting has been “painful”, related to how service users continued to experience difficulties whilst they waited; tolerating the wait, highlighted that individuals understood the reasons for waiting; use of coping strategies where service users identified both internal and external strategies they had used to cope; and support and contact from the learning disability team, related to how individuals experienced the support they received from the service.

To the best of the authors’ knowledge, this service evaluation is the first to explore the experiences of service users with ID waiting for psychological therapy during the Covid-19 pandemic. Results guide suggestions on improving support whilst they are waiting to help prevent further decline.