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Developing an emotional coping skills workbook for inpatient psychiatric settings: a focus group investigation

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Title: Developing an emotional coping skills workbook for inpatient psychiatric settings: a focus group investigation
Authors: Sharp, M
Gulati, A
Barker, C
Barnicot, K
Item Type: Journal Article
Abstract: Background Evidence suggests an unmet need for provision of psychological interventions in inpatient psychiatric settings. However, inpatient wards can present a challenging environment in which to implement interventions. The authors developed the Emotional Coping Skills workbook, a psychosocial intervention designed to overcome these challenges and provide inpatients with an opportunity for psychologically-informed therapeutic engagement. The workbook includes information and exercises to empower inpatients to understand their emotions and learn to cope with their distress. Methods A qualitative study using thematic analysis was undertaken in two UK inpatient psychiatric hospitals to explore staff’s views about whether and how the workbook could be implemented, and on barriers to its use. Thirty-five nursing and occupational therapy staff members participated in four focus groups, and a further two psychologists in semi-structured interviews. Results Staff identified key barriers to successful implementation of the workbook. These were firstly, the difficulty in finding time and space for therapeutic work in the stressful ward environment. Secondly, staff identified a culture of emotional neglect whereby neither staff nor inpatients felt able to talk about emotions, and patients’ physical needs and medication were prioritised. Thirdly, staff discussed how psychotic symptoms and emotional distress could limit patients’ ability to engage with the workbook material. Staff suggested ways in which the feasibility of using the workbook could be enhanced. Firstly, they discussed the importance of encouraging staff to value psychological approaches and to view the workbook as a resource to help them manage their existing tasks. Secondly, they emphasised the value of staff drawing on their expertise to deliver the workbook flexibly in different formats and settings, depending on each patient’s particular presentation. Thirdly, they advocated empowering staff to decide the timing of intervention delivery in the context of each inpatient’s fluctuations in distress and progress towards recovery. Conclusions The study has highlighted key principles for flexible and well-integrated intervention delivery; these principles will be helpful for enhancing the feasibility of any nurse-delivered psychological intervention in inpatient settings.
Issue Date: 22-Jun-2018
Date of Acceptance: 12-Jun-2018
URI: http://hdl.handle.net/10044/1/61308
DOI: https://dx.doi.org/10.1186/s12888-018-1790-z
ISSN: 1471-244X
Publisher: BioMed Central
Journal / Book Title: BMC Psychiatry
Volume: 18
Copyright Statement: © The Author(s). 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords: Science & Technology
Life Sciences & Biomedicine
Psychiatry
Focus groups
Inpatients
Mental health
Psychiatric hospitals
Psychosocial intervention
Qualitative research
Thematic analysis
RANDOMIZED CONTROLLED-TRIAL
QUALITATIVE RESEARCH
HEALTH
THERAPY
INTERVENTIONS
EFFICACY
DISORDER
NURSES
CARE
Focus groups
Inpatients
Mental health
Psychiatric hospitals
Psychosocial intervention
Qualitative research
Thematic analysis
1103 Clinical Sciences
Psychiatry
Publication Status: Published
Article Number: ARTN 208
Appears in Collections:Department of Medicine
Faculty of Medicine



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