Harris, Katy (2010) Service users' experiences of an early intervention in psychosis service: an interpretative phenomenological analysis. DClinPsy thesis, University of Nottingham. Access from the University of Nottingham repository:

An exploration was undertaken into outreach workers' experiences of positive risk-taking (PRT), including dimensions of risk staff face, and factors influencing their risk approaches. Two groups of staff working in local community outreach teams in adult mental health and learning disability services in a midlands city in England were interviewed about their work supporting service-users. Interview transcripts were explored using a qualitative methodology, Interpretative Phenomenological Analysis. Themes were generated through connections between the different participants' accounts. Participant reports highlighted the centrality of their relationships with the service-user and sometimes with support staff. Staff negotiate a balance of control over risk taking with the service user, mindful that misjudging this balance could ultimately result in service responses shaped by rare, adverse incidents rather than by the everyday risks faced by most service users. The study highlighted different understandings of PRT at different levels within organisations and a need for better informed, coherent organisational approaches to its practice. Interpersonal trust relies upon such organisational coherence; without it some staff may see themselves as gambling when undertaking PRT, whereas others may retreat into conservative interventions. Such conservative practices were perceived as potentially dangerous, promoting coercion and disrupting therapeutic relationships, and so increasing risks over a longer time period. Research is needed into the use of systems failure analysis and risk assessment tools to highlight how PRT can generate successful outcomes.

Purpose – There has been extensive growth in the employment of mental health peer support workers (PSWs) over the last decade. However, limited research exists when exploring how PSWs make sense of the transition of entering and enacting the role. The purpose of this paper is to explore the lived experience of NHS employed PSWs’ transition from their own experiences of mental health problems to provide a service to support individuals with their mental health problems. Design/methodology/approach – The study used purposive sampling to recruit seven participants who were individually interviewed using a semi-structured interview schedule. Interviews were transcribed verbatim and analysed using interpretative phenomenological analysis (IPA). Findings – Three superordinate themes were identified: fluctuating identities, PSW role and organisational culture. These were interpreted as interdependent with interrelating subordinate themes. Research limitations/implications – Participants considered the complex, idiosyncratic and changeable nature of the transitions and the impact on their individual, interpersonal and collective identities. Emotional and practical support appeared to assist the transition whilst competing roles and blurred boundaries constrained the enactment of the new role. Implications for practice and research are provided. Originality/value – Reports on original research and adds to the sparse UK literature in this area.