Formal observations and engagement: a discussion paper

Bowles, Nick; Dodds, P.; Hackney, Diane; Sunderland, Cath; Thomas, Phil

doi:10.1007/978-1-349-92322-9_45

Cited by 25 publications

(65 citation statements)

References 1 publication

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“…If the association is an artefact of workforce allocation policies, no action is necessary. If aggressive incidents are triggered by interactions per se, this runs counter to a long research tradition sampling staff (Altschul 1972;Cormack 1976) and patients (Rogers, Pilgrim, & Lacey 1993) that descries low interaction rates, and calls for greater engagement and interaction with patients (Bowles et al 2002;Cutcliffe & Barker 2002). However, some patients reportedly value nurses that display a 'benign non-intervention', using flexibility and tolerance to establish a therapeutic ambience (Rogers & Pilgrim 1994).…”

Section: Discussionmentioning

confidence: 95%

Identifying Key Factors Associated with Aggression on Acute Inpatient Psychiatric Wards

Bowers

Allan

Simpson

et al. 2009

Issues in Mental Health Nursing

130

152

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This is the accepted version of the paper.This version of the publication may differ from the final published version. to ascertain those factors most strongly associated with verbal aggression, aggression towards objects and physical aggression against others. High levels of aggression were associated with a high proportion of patients formally detained under mental health legislation, high patient turnover, alcohol use by patients, ward doors being locked, and higher staffing numbers (especially qualified nurses). The findings suggest that the imposition of restrictions on patients exacerbates the problem of violence, and that alcohol management strategies may be a productive intervention. Permanent repository linkInsufficient evidence is available to draw conclusions about the nature of the link between staffing numbers and violence.3

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Section: Discussionmentioning

confidence: 95%

Identifying Key Factors Associated with Aggression on Acute Inpatient Psychiatric Wards

Bowers

Allan

Simpson

et al. 2009

Issues in Mental Health Nursing

130

152

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“…Research in Europe, North America and Australia has addressed the practical problems of managing perceived risks in this sector (e.g. Halleck & Petrilla, 1988;Nijman, Merckelbach, Allertz, & a Campo, 1997;Bowles et al, 2002;Quirk, Lelliott, & Seale, 2004;Meehan et al, 2006;Stubner et al, 2006;Cardell, 2009;Fluttert, van Meijel, van Leeuwen, Bjørkly, Nijman, & Grypdonck 2011;Manna, 2010). Such concerns have led to 'the re-articulation of mental health work in the language of risk' (Quirk et al, 2004(Quirk et al, , p. 2574 and the emergence of a new emphasis on confinement within secure buildings, which is of special interest in this paper.…”

Section: Contextualising Our Research In the Interdisciplinary Literamentioning

confidence: 99%

“…This influential rhetoric emphasizing risk governance and increasingly technical methods of observation and control is also contested in the literature, partly due to tensions between this model of risk management and other aims of mental health care (Bowles, Dodds, Hackney, Sunderland, & Thomas, 2002;Morrison et al, 2002;Deacon, 2004;Cowman & Bowers, 2008;Cleary et al, 2009). An emphasis on technical procedures and rules to enhance security and safety for staff and service users and the general public, may make it difficult to provide recreational, psychotherapeutic, educational, spiritual, and occupational therapies (Leader, 2011, p. 296).…”

Section: Contextualising Our Research In the Interdisciplinary Literamentioning

confidence: 99%

“…Secker et al (2004, p. 172) argue that patients' violent behaviour may be partly due to social tensions arising from a 'lack of staff engagement with clients'. Bowles et al (2002) and Manna (2010) question the benefits of close observation strategies, arguing that that observation may be detrimental to psychiatric treatment, and advocating instead engagement as 'a process of emotional and psychological containment of distress' (Bowles et al, 2002, p. 255). In this paper we use a therapeutic landscape research approach to explore the awareness of these arguments among participants and their sense of the implications for practice as well as design of hospital buildings.…”

Section: Contextualising Our Research In the Interdisciplinary Literamentioning

confidence: 99%

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Compassionate containment? Balancing technical safety and therapy in the design of psychiatric wards

Curtis

Gesler

Wood

et al. 2013

Social Science & Medicine

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'Compassionate containment? Balancing technical safety and therapy in the design of psychiatric wards.', Social science medicine., 97 . pp. 201-209. Further information on publisher's website:http://dx.doi.org/10. 1016/j.socscimed.2013.06.015 Publisher's copyright statement: NOTICE: this is the author's version of a work that was accepted for publication in Social science medicine. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reected in this document. Changes may have been made to this work since it was submitted for publication. A denitive version was subsequently published in Social science medicine, 97, 2013, 10.1016/j.socscimed.2013.06.015 Additional information: Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. landscapes. There were also more subtle implications, partly relating to 'Panopticist' theories about how the institution uses technical safety to supervise its own mechanisms, through the observation of staff behaviour as well as patients and visitors. Furthermore, staff seemed to feel that in relying on technical safety measures they were, to a degree, divesting themselves of human responsibility for risks they are required to manage. However, their critical assessment showed their concerns about how this might conflict with a more therapeutic approach and they contemplated ways that they might be able to engage more effectively with patients without the imposition of technical safety measures. These findings advance our thinking about the construction of therapeutic landscapes in theory and in practice.4

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“…This is surprising as engaging with patients should be considered standard practice. Bowles et al (2002) noted: Engagement is not the prerequisite of highly trained staff and is not necessarily 'therapy'; it is simply what some staff would recognize as caring, the development of empathy or just 'being with' rather than 'looking on'.…”

Section: Introductionmentioning

confidence: 96%

Therapeutic engagement in acute psychiatric inpatient services

Pereira¹,

Woollaston

2007

JPI

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Therapeutic engagement involves healthcare professionals spending quality time with patients and aims to empower the patient to actively participate in their care. This project was commissioned by the National Institute for Mental Health in England (NIMHE) Acute Care Programme in order to gain a greater understanding of how this process is successfully achieved and maintained on psychiatric wards. The NIMHE acute care lead in each regional development centre was asked to nominate wards that they thought were accomplishing a high level of therapeutic engagement. From this selection, a steering group identified seven 'positive practice units' that were suitable for inclusion in the study.Representatives of the multidisciplinary teams (MDT) who worked on the positive practice units took part in focus groups, which discussed the practices employed on the units to engage patients. Thematic analysis was used to code the data and raise themes. The themes that emerged from this analysis were: Respecting and empowering patients; Staff being 'available'; Engagement-focused observation; Good MDT working; Therapeutic work; Services for discharged patients; Embracing change. The study concluded that the positive practice on the units was the result of having a dynamic ward culture which was grounded in having empathy for patients and supporting staff.

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Formal observations and engagement: a discussion paper

Cited by 25 publications

References 1 publication

Identifying Key Factors Associated with Aggression on Acute Inpatient Psychiatric Wards

Identifying Key Factors Associated with Aggression on Acute Inpatient Psychiatric Wards

Compassionate containment? Balancing technical safety and therapy in the design of psychiatric wards

Therapeutic engagement in acute psychiatric inpatient services

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