Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-07T12:03:58.985Z Has data issue: false hasContentIssue false

A Pilot Study Investigating the Use of Psychological Formulations to Modify Psychiatric Staff Perceptions of Service Users with Psychosis

Published online by Cambridge University Press:  15 December 2008

Katherine Berry*
Affiliation:
University of Manchester, UK
Christine Barrowclough
Affiliation:
University of Manchester, UK
Alison Wearden
Affiliation:
University of Manchester, UK
*
Reprint requests to Katherine Berry, School of Psychological Sciences, University of Manchester, 2nd Floor Zochonis Building, Brunswick Street, Manchester M13 9PL, UK. E-mail: [email protected]

Abstract

Background: Psychiatric staff play a key role in the lives of people with psychosis and the quality of staff and service user relationships is associated with relapse and recovery. One factor that might determine the capacity of staff to form positive therapeutic relationships is their appraisals of service users' mental health problems. Method: A pilot intervention was implemented with psychiatric staff that involved helping them develop psychological formulations for individual service users. Staff perceptions of service users' mental health problems were measured before and after the intervention using Likert scales. Data at the two time points were collated for 30 staff. Results: There was a significant increase in staff perceptions of the degree of control service users and themselves had over problems, an increase in the degree of effort they felt service users were making in coping, reductions in blame, and more optimism about treatment. Staff also reported an increase in understanding of service users' problems, more positive feelings towards service users, and an increase in confidence in their work. Conclusions: Results from this pilot are promising, but findings warrant replication in controlled studies. It is also important to establish whether changes in staff perceptions influence the actual nature of staff-service user relationships.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barrowclough, C., Haddock, G., Lowens, I., Conner, A., Pidliswyi, J. and Tracey, N. (2001). Staff expressed emotion and causal attributions for client problems on a low security unit: an exploratory study. Schizophrenia Bulletin, 27, 517526.CrossRefGoogle ScholarPubMed
Barrowclough, C. and Hooley, J. M. (2003). Attributions and expressed emotion: a review. Clinical Psychology Review, 23, 849880.CrossRefGoogle ScholarPubMed
Barrowclough, C. and Tarrier, N. (1992). Families of Schizophrenic Patients: cognitive behavioural intervention. London: Chapman and Hall.Google Scholar
Beck, A. T. (1976). Cognitive Therapy for the Emotional Disorders. New York: International Universities Press.Google Scholar
Bowlby, J. (1982). Attachment and Loss: vol. 1. Attachment (2nd Edition). New York: Basic Books.Google Scholar
British Psychological Society (2002). Clinical Psychology in Services for People with Severe and Enduring Mental Illness. Briefing Paper Number 18. Leicester: British Psychological Society, Division of Clinical Psychology.Google Scholar
Broadbent, E., Petrie, K. J., Main, J. and Weinman, J. (2006). The brief illness perception questionnaire. Journal of Psychosomatic Research, 60, 631637.CrossRefGoogle ScholarPubMed
Davenport, S. (2002). Acute wards: problems and solutions. Psychiatric Bulletin, 26, 385388.CrossRefGoogle Scholar
Field, A. (2000). Discovering Statistics using SPSS for Windows. London: Sage Publications.Google Scholar
Finnema, E. J., Louwerens, J. W., Slooff, C. J. and Van Den Bosch, R. J. (1996). Expressed emotion on long-stay wards. Journal of Advanced Nursing, 24, 473478.CrossRefGoogle ScholarPubMed
Kinderman, P. (2005). A psychological model of mental disorder. Harvard Review of Psychiatry, 13, 206217.CrossRefGoogle ScholarPubMed
Kinderman, P. and Lobban, F. (2000). Evolving formulations: sharing complex information with clients. Behavioural and Cognitive Psychotherapy, 28, 307310.CrossRefGoogle Scholar
Lobban, F., Barrowclough, C. and Jones, S. (2005). Assessing cognitive representation of mental health problems II: the illness perception questionnaire for schizophrenia: relatives’ version. British Journal of Clinical Psychology, 44, 163179.CrossRefGoogle ScholarPubMed
Maguire, N. (2006). Cognitive behavioural therapy and homelessness: a case series pilot study. Behavioural and Cognitive Psychotherapy, 34, 107111.CrossRefGoogle Scholar
Moore, E., Ball, R. A. and Kuipers, L. (1992). Expressed emotion in staff working with the long-term adult mentally ill. British Journal of Psychiatry, 161, 802808.CrossRefGoogle ScholarPubMed
Moore, E. and Kuipers, L. (1992). Behavioural correlates of expressed emotion in staff-patient interactions. Social Psychiatry and Psychiatric Epidemiology, 27, 298303.CrossRefGoogle ScholarPubMed
Moss-Morris, R., Weinman, J., Petrie, K. J., Horne, R., Cameron, L. D. and Buick, D. (2002). The Revised Illness Perception Questionnaire (IPQ-R). Psychological Health, 17, 116.CrossRefGoogle Scholar
Oliver, N. and Kuipers, E. (1996). Stress and its relationship to expressed emotion in community mental health workers. International Journal of Social Psychiatry, 42, 150159.CrossRefGoogle ScholarPubMed
Penn, D. L., Mueser, K. T., Tarrier, N., Gloege, A., Cather, C., Serrano, D. and Otto, M. W. (2004). Supportive therapy for schizophrenia: possible mechanisms and implications for adjunctive psychosocial treatments. Schizophrenia Bulletin, 30, 101112.CrossRefGoogle ScholarPubMed
Perkins, R. (2001). What constitutes success? The relative priority of service users' and clinicians’ views of mental health services. British Journal of Clinical Psychology, 179, 910.Google ScholarPubMed
Perneger, T. V. (1998). What's wrong with bonferroni adjustments. British Medical Journal, 316, 12361238.CrossRefGoogle ScholarPubMed
Randolph, E. T. (1998). Social networks and schizophrenia. In Mueser, K. T. and Tarrier, N. (Eds.), Handbook of Social Functioning in Schizophrenia (pp. 238246). Needham Heights, MA: Allyn Bacon.Google Scholar
Ryle, A. and Kerr, I. B. (2002). Introducing Cognitive Analytic Therapy: principles and practice. Chichester: John Wiley and Sons.CrossRefGoogle Scholar
Summers, A. (2006). Psychological formulations in psychiatric care: staff views on their impact. Psychiatric Bulletin, 30, 341343.CrossRefGoogle Scholar
Van Audenhove, C. and Van Humbeeck, G. (2003). Expressed emotion in professional relationships. Current Opinion in Psychiatry, 16, 431435.CrossRefGoogle Scholar
Wearden, A. J., Tarrier, N., Barrowclough, C., Zastowny, T. R. and Rahill, A. A. (2000). A review of expressed emotion research in health care. Clinical Psychology Review, 20, 633666.CrossRefGoogle ScholarPubMed
Weiner, B. (1985). An Attributional Theory of Motivation and Emotion. New York: Springer-Verlag.Google ScholarPubMed
Willetts, L. E. and Leff, J. (1997). Expressed emotion and schizophrenia: the efficacy of a staff training programme. Journal of Advanced Nursing, 26, 11251133.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.