The needs of staff who care for people with a diagnosis of personality disorder who are considered a risk to others

Kurtz, Arabella

doi:10.1080/14789940500098475

Cited by 32 publications

(26 citation statements)

References 45 publications

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“…A semi‐structured interview schedule was developed with the aim of exploring staff's experiences of work according to the areas emphasized by the relevant empirical and theoretical literature (Kurtz, 2005). Open questions, designed to get staff to articulate their own interests and concerns rather than those of the researchers, were combined with probes for concrete detail to avoid getting overly abstract and unfocussed material (Burman, 1994; Hollway & Jefferson, 2000; Pidgeon & Herwood, 1996).…”

Section: Methodsmentioning

confidence: 99%

“…Little has been published about the experiences of forensic mental health staff, although this area of work is regarded as particularly challenging because of a complex and demanding patient group and tensions in combining therapeutic and custodial responsibilities (Grubin & Duggan, 1998; Kurtz, 2005; Lavender, 2002). Government inquiries into malpractice at Broadmoor and Ashworth have highlighted systemic difficulties within these organizations, suggesting that mistakes can result from the general impact of work and work‐setting on groups of staff, rather than the failures of particular individuals (Blom‐Cooper, 1999; Fallon, Bluglass, Edwards, & Daniels, 1999).…”

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confidence: 99%

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An exploratory study of the needs of staff who care for offenders with a diagnosis of personality disorder

Kurtz

Turner

2007

Psychol Psychother

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People with a diagnosis of personality disorder who are considered a risk to others are a current concern for public services, government and society. Healthcare provision for this group has recently increased, making it important to begin to learn about the needs of staff working in such a challenging area. An exploratory interview study with staff working in a medium secure unit for offenders with a diagnosis of personality disorder (Unit Z) is presented. Interviews were line-coded and analysed according to the grounded theory method. A model was developed from higher order categories. This related key contextual factors to areas of concern for staff. The key contextual factors were: 'complexity of the task' and 'tension in the relationship with outside'. The areas of concern were: 'desire for more meaningful contact', 'contradictory attitude towards openness', 'feeling physically safe but emotionally vulnerable', 'ambivalence towards structure and control' and 'emphasis on staff relationships'. 'Risk of isolation' formed a core category and described Unit Z staff's pervading sense of distance from the outside world. These categories are described with supporting quotations and discussed in relation to the existing literature. Their implications for clinical practice and the development of services are considered.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

An exploratory study of the needs of staff who care for offenders with a diagnosis of personality disorder

Kurtz

Turner

2007

Psychol Psychother

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“…Hargreaves, 1997). Kurtz (2005) found that reflection was particularly useful for staff working with people with complex presentations, as is the case when supporting people experiencing homelessness. A philosophy of reflective practice underpins PIEs and this study strongly supports this as a practice and a philosophy to support processing emotional aspects of the work, whilst also advocating for the value of complex case discussions and formulations to support staff and inform client work.…”

Section: Service Developmentmentioning

confidence: 99%

Developing best practice in psychologically informed environments

Westaway

Nolte

Brown³

2017

HCS

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Paper type: Research paper PurposeThe purpose of this paper is to extend our understanding of the issues facing those who experience multiple moves around homelessness projects. It considers these issues and how they relate to best practice, informing the delivery of Psychologically Informed Environments. Design/methodology/approachA qualitative design was employed, with interviews undertaken with men currently residing in hostels for those with additional needs. These men had already experienced multiple moves within the hostel system. Interpretative phenomenological analysis was used to analyse the data. FindingsMain themes consider issues and challenges associated with hope and moving forward; help and the conditional or temporal nature of this; identity and stigma; and intimacy and relationships. Clinical implications of these findings are discussed. Research limitations or implicationsImplications include best practice for future planning with service users, the relational nature of hope, how best to manage endings and practical guidance for service developments in these settings. OriginalityThese findings further our understanding of the challenges faced by service users with complex needs and how best to address them. They build on PIE guidance, offering tangible advice for practice.

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“…Whilst this helps to ensure the viability of the service, the reduced opportunity for discussion of ‘really complex people’ (Psychiatrist 1 a ) and perceived inability to exercise control over daily decisions may cause disenfranchisement among some team members (particularly Nurses), if not burnout (Ministry of Justice, 2011). To improve staff motivation and well-being, and reinforce institutional purpose, training may be needed to clarify definitional concepts, such as psychopathy and personality disorder (Huband & Duggan, 2007), and to identify research on effective interventions for these groups (Kurtz, 2005). If this does not provide the collateral benefit of reducing professional disagreement on an individual's suitability for admission, the RC should be willing to ‘articulate clear organizational values to which practitioners can feel committed’ (Ministry of Justice, 2011, p. 63).…”

Section: Resultsmentioning

confidence: 99%

Admitting offenders with antisocial personality disorder to a medium secure unit: a qualitative examination of multidisciplinary team decision-making

McRae

2013

The Journal of Forensic Psychiatry & Psychology

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This paper reports on the results of a qualitative study funded by the Economic and Social Research Council (ESRC) looking at multidisciplinary team decisions to admit sentenced offenders with antisocial personality disorder to a medium secure unit. The aim of the study was to examine admission decision-making from a multidisciplinary perspective, and to explore the interprofessional dynamics and contextual pressures informing those decisions. The primary method of data collection was 12 semi-structured interviews with a convenience sample of various multidisciplinary staff involved in pre-admission assessment and post-assessment decision-making. Data was then coded according to the dialectic of competitive and cooperative goal seeking within groups. The findings suggest that, whilst both forms of goal seeking inform admission decisions, the presence of significant resource pressures will lead to decisional solidarity among the multidisciplinary team. When minor professional disagreements arise, they are resolved by the group leader, the Responsible Clinician, in order to maximise group productivity. It is argued that the discursive-limiting effect of resource pressures on group decision-making may weaken the morale of certain front line staff, if not undermine institutional purpose.

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The needs of staff who care for people with a diagnosis of personality disorder who are considered a risk to others

Cited by 32 publications

References 45 publications

An exploratory study of the needs of staff who care for offenders with a diagnosis of personality disorder

An exploratory study of the needs of staff who care for offenders with a diagnosis of personality disorder

Developing best practice in psychologically informed environments

Admitting offenders with antisocial personality disorder to a medium secure unit: a qualitative examination of multidisciplinary team decision-making

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