The meaning of significant encounters in forensic care

Abstract

Background Research in forensic psychiatric care focusing on person‐oriented care is ambiguous about matters of quality. The encounters between a healthcare professional (HCP) and patient could influence how connections and relations emerge between the caregiver and the patient. Objectives To better understand caring aspects, this study explores significant encounters in forensic psychiatric care from the perspective of HCPs. Method This study is based on 34 written narratives from HCPs from two forensic psychiatric hospitals in Sweden. The narratives concern significant encounters with a patient. These narratives were analysed according to methodologies developed by phenomenological and reflective lifeworld research. Findings The essence of a significant encounter is a temporal extended phenomenon that both precedes as well as is a consequence of the actual encounter as it occurs. The encounter is unforeseeable and being open to an encounter also means to be vulnerable as it is not predetermined how someone will respond. The significant encounter is an act of sharing, and HCPs may come to understand more about their patients as well as about themselves. Moreover, these encounters seem to create repercussions and hope for the future care. Conclusions The everyday activities of forensic psychiatric care are not trivial activities. Rather, they are important aspects of health care as these everyday encounters can deepen the relationship between the HCPs and their patients and help both the HCPs and their patients develop a sense of hope for the future.

Meanings of carers’ lived experience of “regulating oneself” in forensic psychiatry

“…Our findings suggest that finding the source of suffering together with the patient could prove to be a challenge, as being present in suffering means encountering one’s shortcomings (Vincze et al, 2015 ) because understanding oneself is intertwined with understanding the life of another (Rydenlund et al, 2019 ). Being a carer and having a person-centred attitude requires reflecting upon whether one is prepared to listen to the patient’s story, challenging one´s preconceived notions and being accessible to the patient (Rytterström et al, 2020 ).…”

“…If the carer’s presence is accepted by the patient, a carer may be able to share the patient’s suffering, thereby creating a place where the patient could be in contact with their suffering, share it with another human being and find a way to move forward (Fredriksson, 1999 ). An encounter can unite the carer and patient by sharing experiences and creating a sense of belonging (Rytterström et al, 2020 ). Our findings suggest that sharing means developing trust and is the very foundation upon which a fruitful relationship within a forensic setting is established.…”

“…Giving meaning to the patients’ expressions in the encounter means making the patients’ experiences part of the carers’ life experience (Rytterström et al, 2020 ). By accepting the patients’ worlds as part of their own, carers are also faced with a responsibility to “be there for the other” (Rydenlund et al, 2019 ), a notion that is intertwined with the findings of this study that emphasizes the importance of being a safe companion to maintain stability in the community.…”

“…Encounters between carers and patients in a forensic setting are mostly spontaneous during daily activities and involve openings for dialogue and opportunities to provide support (Rytterström et al, 2020 ). However, these encounters could also mean dealing with physical and verbal outbursts from patients, being forced into conditions in which setting limits is considered a part of everyday work (Eivergård et al, 2020 ) and dealing with uncomfortable situations, sometimes alone (Rytterström et al, 2020 ). At the same time, establishing a fruitful relationship (Rydenlund et al, 2019 ) is perceived as emotional labour, meaning that it is necessary to deal with one’s emotions to care for another person (Edward et al, 2017 ).…”

Offender Recovery. Forensic Patient Perspectives on Long-Term Personal Recovery Processes

“…The elements and factors pointed out by the informants also correspond with the CHIME model maintaining: The elements in CHIME are crucial in recovery processes and have been experienced and described by a large number of service users [9]. The quality of the relation between patient and significant others, not least professionals, has also been identified as a crux in personal recovery processes [16,[39][40][41]. The professionals play an important role as carriers of hope and optimism over time, which enhances the patient's opportunities to create new narratives and identities.…”