Hannah Rettie, Joya Georgewill, Sarah Stacey and Emma Griffith
The benefits of including a psychosocial group programme alongside a medical inpatient detoxification and stabilisation regime has been recognised within addiction research;…
Abstract
Purpose
The benefits of including a psychosocial group programme alongside a medical inpatient detoxification and stabilisation regime has been recognised within addiction research; however, a “gold standard” psychosocial intervention has not been established. This small-scale study aimed to evaluate the psychosocial group (“Straight Ahead”) currently running at a substance use inpatient unit based in the UK.
Design/methodology/approach
A mixed-methods questionnaire design aimed to capture service user perspectives of the group programme via a questionnaire and assess whether an individual’s recovery capital and emotion regulation scores improved during their stay.
Findings
Thirty-four service users participated in the evaluation. Results indicate the group significantly increased individuals’ recovery capital scores; however, it did not significantly improve emotion regulation. The three themes from the qualitative results focused on the importance of shared experiences, learning of new skills and the group as a positive experience. Service users provided suggestions for improvements, and these informed the provision of service-specific recommendations for the team and project commissioner.
Originality/value
The evaluation provides tentative support for the use of the Straight Ahead programme and provides an insight into what service users find helpful when attending a psychosocial group during an inpatient detoxification admission.
Details
Keywords
Sally McGuire, Alex Stephens and Emma Griffith
This paper aims to describe a service evaluation study of “Balance” – a National Health Service Tier 2 pilot weight management course delivered in a primary care mental health…
Abstract
Purpose
This paper aims to describe a service evaluation study of “Balance” – a National Health Service Tier 2 pilot weight management course delivered in a primary care mental health service. The 12 weekly sessions included dietetic, psychological and behavioural elements underpinned by cognitive behavioural theory and “third-wave” approaches, including acceptance and commitment therapy, compassion-focused therapy and mindfulness.
Design/methodology/approach
A mixed-methods design was used in this service evaluation study that included analysis of outcome measures (weight, eating choices, weight-related self-efficacy and mental health) and focus group data (n = 6) analysed using thematic analysis. Eleven clients with a body mass index of 25–40 kg/m2 enrolled, and nine clients completed the course. Outcome data were collected weekly with follow-up at three and six months.
Findings
Quantitative data analysis using non-parametric Wilcoxon signed-rank tests showed that the group mean weight decreased significantly (p = 0.030) by the end of Balance, but the group mean weight loss was not statistically significant at the three-month (p = 0.345) or six-month (p = 0.086) follow-up. The qualitative results showed that participants valued the course ethos of choice and also welcomed learning new tools and techniques. Balance was very well-received by participants who reported benefitting from improved well-being, group support and developing new weight management skills.
Research limitations/implications
Only one client attended all sessions of the group, and it is possible that missed sessions impacted effectiveness. Some of the weight change data collected at the six-month follow-up was self-reported (n = 4), which could reduce data reliability. Focus group participants were aware that Balance was a pilot with a risk that the group would not be continued. As the group wanted the pilot to be extended, the feedback may have been positively skewed. A small sample size limits interpretation of the results. A group weight management intervention, including dietetic, psychological and behavioural elements, underpinned by cognitive behavioural theory was well-received by service users and effective for some. Commissioners and service users may have different definitions of successful outcomes in weight management interventions.
Practical implications
Longer-term support and follow-up after Tier 2 weight management interventions may benefit service users and improve outcomes.
Originality/value
The paper contributes to a small but growing evidence base concerned with the design and delivery of weight management interventions. Areas of particular interest include: a gap analysis between the course content and National Institute for Health and Care Excellence clinical guidelines, participants’ views on the most impactful course features and recommendations for course development. The results also show a disconnect between evidence-based guidelines (mandatory weight monitoring), participants’ preferences and clinicians' experience. The difference between client and commissioner priorities is also discussed.
Details
Keywords
Paula Robinson, Emma Griffith and Chris Gillmore
Studies show that experiences of repeated or complex trauma are very common in patients with severe mental health problems. Unfortunately, many professionals do not routinely ask…
Abstract
Purpose
Studies show that experiences of repeated or complex trauma are very common in patients with severe mental health problems. Unfortunately, many professionals do not routinely ask about abuse, due to concerns about how to ask and respond. There is also a need for frontline staff to be trained in trauma-informed care. The purpose of this paper is to identify the needs of inpatient staff and developed a tailor-made training package.
Design/methodology/approach
A training programme was developed from focus-group discussion and delivered to the team. Questionnaires were administered pre-, post-training and at three-month follow-up, to assess changes in knowledge, confidence and worries in the assessment and treatment of complex trauma.
Findings
There was an increase in self-reported staff confidence (p=0.001) and knowledge (p=0.028) about working with complex trauma and their worries decreased (p=0.026) between pre- and post-training.
Practical implications
In order to sustain the benefits of training for longer, recommendations were made to the service for on-going training, supervision and evaluation.
Originality/value
Given the recent interest in complex trauma within the literature (Diagnostic and Statistical Manual of Mental Disorders – Fifth Version (DSM-V); International Statistical Classification of Diseases – 11th Version (ICD-11)), the piloting and development of complex trauma training packages is timely. To the author’s knowledge, this is the first published account of complex trauma training for inpatient staff. This paper offers clinical and research implications to services who may want to develop as trauma-informed services within the NHS.
Details
Keywords
Jac Neirin Airdrie, Alexandra Lievesley and Emma Griffith
There is no specific recommended treatment for the co-morbid presentation of post-traumatic stress disorder (PTSD) and substance use disorder in the United Kingdom (UK). Seeking…
Abstract
Purpose
There is no specific recommended treatment for the co-morbid presentation of post-traumatic stress disorder (PTSD) and substance use disorder in the United Kingdom (UK). Seeking Safety (SS), a group-based treatment that targets symptoms of both disorder, has emerging evidence in the USA but lacks evidence from UK-based samples. The purpose of this study was to explore UK service users’ experience of attending SS and evaluate its impact on mental health symptomology and substance misuse.
Design/methodology/approach
A mixed method approach was used to evaluate the acceptability of SS for a small sample (n = 7) of adult users of a substance misuse service in the UK. Thematic analysis was used to explore their experiences, derived from individual semi-structured interviews. The authors also calculated the number of participants who achieved reliable and/or clinically significant change in mental health symptomology and substance misuse from data routinely collected by the service.
Findings
Seven overarching themes emerged: strengthening the foundations of the self, the evocation and management of emotions, safety and validation provided relationally, readiness and commitment, content and delivery, Seeking Safety is Not an Island and ending. Most participants with data available both before and after the group made reliable (three out of four) and clinically significant (two out of three) change for depression and anxiety symptomology; however, this was less evident for PTSD symptomology with two out of three making reliable change and one out of three making clinically significant change.
Originality/value
To the best of the authors’ knowledge, this was the first study exploring the experiences of UK attendees of a SS group as an approach to treating comorbid PTSD and substance misuse.
Details
Keywords
Hermine L Graham, Emma Jean Griffith, Alex Copello and Max Birchwood
To provide a summary of the principles, theories and basic components of a recently developed brief integrated motivational intervention (BIMI) for working with individuals…
Abstract
Purpose
To provide a summary of the principles, theories and basic components of a recently developed brief integrated motivational intervention (BIMI) for working with individuals experience co-ccurring severe mental health and substance use problems in inpatient settings, including the outcomes of a feasiblity randomised controlled trial (RCT). There are greater financial costs and a negative impact on functioning associated with psychiatric admissions for people who experience co-occurring severe mental heath and substance misuse problems. In addition, their engagement in treatment is often problematic.
Design/methodology/approach
The BIMI described was evaluated via a feasibility RCT that assessed whether the opportunity to discuss use of substances whilst on an inpatient ward represented an opportunity to engage inpatients in thinking about their use and the impact it has on their mental health.
Findings
The BIMI is delivered in short burst sessions of 15-30 minutes over a two-week period adopting a simple 3-step approach that can be delivered by routine ward staff. It incorporates an assessment of substance use, mental health and motivation followed by personalised feedback, a focus on increasing awareness of the impact on mental health and development of goals and a change plan. The intervention has been shown to lead to higher levels of engagement in clients exploration of substance use and the impact on mental health. Findings suggest both staff and inpatients found the intervention feasible and acceptable.
Originality/value
Routine ward staff were trained to deliver a brief intervention to inpatients during an acute hospital admission.
Emma Foreman, Sara McMillan and Amanda Wheeler
The community-managed mental health sector needs to meet growing workforce demands. Yet, limited research has explored professional development opportunities and effective…
Abstract
Purpose
The community-managed mental health sector needs to meet growing workforce demands. Yet, limited research has explored professional development opportunities and effective recruitment and retention strategies to support sector growth. One strategy is the use of a scholarship program to increase skills and training, via a University qualification. The purpose of this paper is to explore the progress of 19 mental health scholarship students and the impact of the scholarship on career intentions.
Design/methodology/approach
A mixed-methods approach comprising scholarship applications, questionnaires and semi-structured interviews was used to explore the students’ university experiences between February 2013 and January 2015. Course convenors of the Mental Health Program were interviewed. Data were collected across three time-points over 24 months, with each collection informing the next research phase. Data analysis involved thematic analysis and descriptive statistics.
Findings
Deeper knowledge, recognition of experience, new career pathways and improved work practice were benefits. Managing time and study, and work-life balance were the greatest challenges. Completing students displayed a range of internal attributes and accessed external supports. At the time of the study, the scholarships maintained student motivation and intention to work in the sector.
Originality/value
This research provides a deeper understanding of the demographics of the sector’s workforce. Insight into the attributes of completing students was obtained. The benefits realized and the challenges faced by the scholarship recipients will inform ongoing workforce development programs for the community-managed mental health sector.
Details
Keywords
elke emerald and Lorelei Carpenter
The purpose of this paper is to gather research-stories, that is, the stories of the researcher themselves. The authors gather stories that situate researchers in their social…
Abstract
Purpose
The purpose of this paper is to gather research-stories, that is, the stories of the researcher themselves. The authors gather stories that situate researchers in their social, political, personal and professional contexts to learn about being a researcher in a University at this particular historical moment.
Design/methodology/approach
The authors’ stories began with the naive question – “What is it like to be a researcher in a University right now?”. The authors asked this question of Julie White’s (2012) “disposable academics” (p. 50); short-term and casualised staff with insecure teaching or research contracts. They asked White’s (2012, p. 48) “academic infantry” the mid-career researchers who have felt the labour intensification of recent times. They also asked senior academics, established professors with established research histories and the security (they hope) of a steady track record and a list of external grants.
Findings
The answers were not simple. They were stories of the pragmatics of managing the new academic scene; maintaining a research passion despite the pressures of new managerialism’s focus on certain forms of efficiency, external accountability and monitoring; resolving the apparent losses of autonomy, academic freedom, support, security and academic dignity. The authors heard emotional and vulnerable stories, stories of personal investment and emotionally and physically risky and dangerous encounters. The authors learnt something of the complex business of negotiating personal and professional subjectivities.
Originality/value
The authors heard emotional and vulnerable stories, stories of personal investment and emotionally and physically risky and dangerous encounters. They learnt something of the complex business of negotiating personal and professional subjectivities.
Details
Keywords
Victoria Stewart, Matthew Campbell, Sara S. McMillan and Amanda J. Wheeler
The purpose of this paper is to explore the experiences of students and teachers who had participated in a postgraduate work-based praxis course within a Master of mental health…
Abstract
Purpose
The purpose of this paper is to explore the experiences of students and teachers who had participated in a postgraduate work-based praxis course within a Master of mental health practice qualification.
Design/methodology/approach
This qualitative study used an interpretative phenomenological approach to understand the lived experience of students and course convenors participating in a work-based praxis course. Seven students and two convenors were recruited. Interview and reflective portfolio data were analysed thematically.
Findings
The main themes identified were the importance of planning, the value of partnerships, the significance of learning in the workplace and how the facilitation of work-based learning differs from coursework.
Originality/value
Work-based learning within postgraduate coursework qualifications can support higher-level learning, knowledge and skills has received limited attention in the literature. This study supported the value of providing postgraduate students with work-based learning opportunities, resulting in the application of new or advanced skills, within their existing work roles. This study is important, because it provides insights into the student experience of postgraduate work-based learning and the impact of this learning on professional practice.