Adult mental health practitioner beliefs about psychosis, parenting, and the role of the practitioner: A Q methodological investigation

Abstract

Objectives. There is a lack of research into parenting interventions for families which include a parent experiencing psychosis or other serious mental illness (SMI). Preliminary findings highlight the potential benefits of adult mental health practitioners supporting parents experiencing SMI by using self-directed parenting interventions. This study explored beliefs relating to parenting and psychosis held by practitioners working in adult mental health settings, specifically examining their beliefs about the parenting needs of adults experiencing psychosis who have dependent children, as well as their role as adult mental health practitioners. Design. This study used Q methodology to explore the beliefs of mental health practitioners on psychosis and parenting. Methods. Twenty-one adult mental health practitioners ranked 58 items according to how much they agreed with the belief statement presented. Participants also provided additional written information and interviews to contextualize the Q methodology data. Results. Three factors emerged representing three groups of practitioners with similar beliefs around psychosis and parenting. Factors were labelled: 'Parenting interventions are worthwhile, and I'd deliver them', 'Parenting interventions are worthwhile, but I'm not confident to deliver them', and 'Parenting interventions might be worthwhile, but it's not my responsibility'. Conclusion. Using parenting interventions as part of their clinical work was acceptable to most practitioners; however, some lacked confidence in their ability to work in a family-focused way. Efforts now need to focus on enhancing practitioners' skill, knowledge, and confidence in family-focused approaches to provide increased and improved support to families which include a parent experiencing psychosis or other SMI. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Mental health professionals’ experiences of working with parents with psychosis and their families: a qualitative study

“…This contrast in viewpoints with regard to working holistically is consistent with other qualitative studies conducted with mental health professionals working with parents with a mental health diagnosis, which also found differing viewpoints within their sample of professionals [ 16 , 23 , 36 ]. Specifically, two studies found that mental health professionals differed in terms of whether they focused on the welfare of the child or the parent [ 16 , 20 ], one study highlighted the reluctance of some mental health professionals to engage in family-focused practice [ 36 ], and another study showed disparity in terms of whether mental health professionals perceived themselves to be responsible for the delivery of parenting interventions [ 23 ].…”

“…These professionals feel that they are inadequately trained with regard to working with a service user who is also a parent [ 21 , 22 ]. There can also be a lack of agreement about how much responsibility they have for the children vis-a-vis other agencies who also have a role in supporting the family [ 19 , 23 ], with collaboration with these agencies often being seen as ineffective by those working in mental health services [ 13 , 21 ].…”

The ParentingWell Learning Collaborative Feasibility Study: Training Adult Mental Health Service Practitioners in a Family-Focused Practice Approach

“…The mental health services workforce (e.g., psychologists, social workers, psychiatric nurses, counselors, case workers, peer specialists) is ill-prepared to work effectively with adults who are parents (Adderley et al, 2020 ). There are many obstacles to family-focused, parent-informed practice, professional development, and practice improvements.…”

“…Change at the systems level is likely required to ensure integrated supports for families (Isobel et al, 2019 ). Adderley and colleagues suggest that future efforts focus on practitioners’ skills, knowledge and confidence in working in family-focused ways (Adderley et al, 2020 ). In doing so, organizational and community context must be considered, at the least.…”

“…While training staff is an essential step in the process, staff training is the least well-articulated and less frequently mentioned step; training modifications are much less commonly reported (Card et al, 2011 ; Escoffery et al, 2018 , 2019 ). What is missing in prior research and implementation work is a theoretically-sound learning opportunity for practitioners, who could be encouraged to adopt and use stakeholder-informed, empirically-based resources in the context of their home agencies (Adderley et al, 2020 ). Our larger mission is to lay a foundation of well-articulated program theory, not only for the ParentingWell practice approach itself, but to provide an explicit, empirically-sound strategy for adapting, implementing and sustaining an evidence-based approach to practitioner training to support the implementation and rigorous testing of the ParentingWell practice approach (Davies et al, 2010 ; Hoffman et al, 2014 ; Movsisyan et al, 2019 ).…”