Accessible summary What is known on the subject? Coercive interventions (CI) in emergency psychiatry face increasing criticism, as they can be an emotional, even traumatic event for all persons involved. They are thus considered the last resort. The use of coercive interventions differs widely with regard to type and frequency of measures across different countries and institutions. Individual staff characteristics, such as attitudes towards coercion, may play a vital role in the management of aggression. Little is known about the influence of emotions of staff members on CI, but they are likely to play an important role. What the paper adds to existing knowledge? Most staff members surveyed had a rather critical view of coercion and considered it a “necessary evil.” Staff members with the most work experience had a more critical view of coercion in comparison with less experienced staff. Nurses rated coercion more positively than did psychiatrists or psychologists. Emotions play an important role in decision‐making processes. The current study systematically asked for accompanying emotions during the application of CI and looked for individual differences. A majority of the participants experienced compassion; about half felt helplessness, grief or anxiety. Almost 20% stated that they felt a sense of power. Older staff members more often felt anger or guilt; women felt less power than men did. Nurses felt more desperation than other occupational groups. Staff members consider reflective interventions, such as team supervisions or post‐seclusion/restraint debriefings with the patient, as important. Nevertheless, only half reported that these interventions are carried out routinely. Staff members believe that certain risk factors (including stress, low staffing, a fully occupied ward and the presence of particular staff members) enhance the probability of CI. What are the implications for practice? To reduce the use of coercive interventions, we recommend that psychiatric teams include highly experienced staff members as work experience has a positive effect on the attitudes towards coercive interventions. Structured post‐seclusion/restraint debriefings and team supervisions are considered helpful by staff members and are relatively easy to implement on acute wards. Enhancing staff members’ ability to reflect on their own attitudes, emotions and actions is likely to reduce coercive interventions. Abstract IntroductionLittle is known about staff attitudes towards coercive interventions (CI) and emotions accompanying these measures. AimThe current study assessed attitudes, views on reflective interventions and accompanying emotions of different occupational groups towards CI, as well as factors, that increase the probability of CI. MethodStaff members (N = 138) of a large psychiatric hospital in Germany were assessed using the Staff Attitude to Coercion Scale (SACS) and newly developed items assessing staff members’ emotions and views on coercion. ResultsExperienced staff members were most critical of co...

A growing body of research suggests that the functionality of coping strategies may in part depend on the context in which they are executed. Thus far, functionality has mostly been defined through the associations of coping strategies with psychopathology, particularly depression. Whether associations of coping strategies with proxies for happiness such as subjective well-being (SWB) are simply inverse remains to be shown. A total of n = 836 individuals from the U. S. general population participated in an online survey that included a revised version of the Maladaptive and Adaptive Coping Styles Questionnaire (MAX-R) that incorporates context-specific items, the Scale of Positive and Negative Affect (SPANE), the Temporal Satisfaction with Life Scale (TSWLS), the Patient Health Questionnaire (PHQ-9), and the Web Screening Questionnaire (WSQ). The MAX-R was submitted to an exploratory factor analysis. The factor analysis of the MAX-R yielded four subscales: adaptive, maladaptive, avoidance, and expressive suppression coping. Similar strategies in different contexts at times loaded on the same (e.g., maladaptive) or different (e.g., adaptive and avoidance) dimensions. Hierarchical multiple linear regression revealed significant associations of adaptive coping with SPANE (ß = 0.21), TSWLS (ß = 0.03), and PHQ-9 (ß = 0.07), all ps < .001, of maladaptive coping with SPANE (ß =  − 0.19), TSWLS (ß =  − 0.10), and PHQ-9 (ß = 0.02), all ps < .01, of avoidance with PHQ-9 (ß =  0.01, p < .001), and of expressive suppression with SPANE (ß =  − 0.06) and TSWLS (ß =  − 0.16), ps < .005. Final models explained 64.6% of variance in SPANE, 41.8% of variance in TSWLS, and 55% of variance in PHQ-9 score. In some instances, the functionality of coping strategies appears to be impacted by contextual factors. When investigating the overall benefit of use versus nonuse of coping strategies, their association with psychopathology measures and with subjective well-being should both be considered.

Psychological group interventions for the acute inpatient care setting are scarce. Whereas Metacognitive Training for patients with Psychosis (MCT) provides a widely accessible, easy‐to‐implement intervention for patients with mild to moderate symptoms, it is less adequate for the acute care setting with respect to length and density of information. We present the adaptation process and the resulting adaptation of MCT, MCT‐Acute, for the acute inpatient care setting. We report the case of a first patient, NK, who participated in MCT‐Acute during her mandated stay on the locked acute ward due to an exacerbation of schizophrenia. NK participated in MCT‐Acute 12 times, evaluated the training overall as positive and reported that she used exercises she had learned during training to improve her mood. She also described changing her behaviour in everyday life to think more slowly and make less hasty decisions, which is a central topic discussed in MCT and MCT‐Acute. Conducting an adapted version of MCT in the acute care setting is feasible, and the present case report suggests that MCT‐Acute may be a useful complement to a multidisciplinary treatment plan to stabilize patients with severe mental illness in acute inpatient care.

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