Jade Robinson
About
My research project
Investigating therapeutic involvement in relationships between ward staff and service users in adult forensic mental health inpatient settings: evidence identification and initial scale development.Research question:
What constitutes a therapeutic relationship (TR) including over- and under- involvement, between nursing staff and forensic inpatients and how could this be measured?
The overall aim of this project is to understand what constitutes a TR between these individuals to develop an item bank which could, in future, be used to develop a scale to measure the quality of TRs. This will be achieved by conducting three separate but interrelated studies.
There are four overall objectives:
1: To understand how TRs between nursing staff and forensic patients have been conceptualised and measured across nursing settings by conducting a scoping review of published scales.
2: To understand the experiences and perspectives of service users and nursing staff nationally, in forensic settings, of TRs by conducting a review of relevant qualitative literature.
3: To understand how TRs, including over- and under-involvement, are conceptualised by nursing staff and service users in UK forensic settings by conducting a qualitative study using semi-structured interviews informed by the above reviews.
4: To use data from the above studies to develop an item bank that may be used to develop a new scale for use in adult forensic inpatient settings to measure the quality of TRs between nursing staff and service users.
Supervisors
Research question:
What constitutes a therapeutic relationship (TR) including over- and under- involvement, between nursing staff and forensic inpatients and how could this be measured?
The overall aim of this project is to understand what constitutes a TR between these individuals to develop an item bank which could, in future, be used to develop a scale to measure the quality of TRs. This will be achieved by conducting three separate but interrelated studies.
There are four overall objectives:
1: To understand how TRs between nursing staff and forensic patients have been conceptualised and measured across nursing settings by conducting a scoping review of published scales.
2: To understand the experiences and perspectives of service users and nursing staff nationally, in forensic settings, of TRs by conducting a review of relevant qualitative literature.
3: To understand how TRs, including over- and under-involvement, are conceptualised by nursing staff and service users in UK forensic settings by conducting a qualitative study using semi-structured interviews informed by the above reviews.
4: To use data from the above studies to develop an item bank that may be used to develop a new scale for use in adult forensic inpatient settings to measure the quality of TRs between nursing staff and service users.
University roles and responsibilities
- University Ethics Committee Volunteer
My qualifications
Publications
Introduction Nursing staff often struggle with balancing care and security in forensic settings, which can lead to over- or under-involvement. These are a cause for concern as this can directly impact therapeutic relationships. Aim To systematically review and synthesise qualitative evidence relating to nursing staff and patient perceptions of over- and under-involvement experienced. Method Of 465 studies identified, twelve were included in the review. A thematic synthesis of included studies exploring therapeutic relationships, including therapeutic over- and under-involvement, was conducted. Results Three analytical themes were developed from the data: (1) The importance of trust in therapeutic interactions; (2) Implications arising from power imbalances and staff's lack of confidence or experience; and (3) The importance of relational security. Discussion Therapeutic relationships are influenced by factors such as gender, experience, trust, communication style and empathy. Over-involvement occurs when patients become overly reliant on certain staff members, whereas under-involvement can lead to feelings of loneliness, lack of autonomy and distrust. Implications for Practice This systematic review highlights the need for individualised care, effective communication and well-defined boundaries to create a safe and effective therapeutic environment. Recommendations Further research is required to explore the experiences of over- and under-involvement based on staff characteristics, participant gender and security levels within forensic care.
Background: Therapeutic relationships are key to both service user recovery and the safety of staff and service users in adult mental health care. However, staff over-involvement (crossing professional boundaries including sexual and emotional exploitation) and under-involvement (staff disinterest, avoidance or neglect) is often a cause for concern within mental health care. Little is known about measuring and assessing over / under involvement. This scoping review provides a broad understanding of existing tools used to measure this in adult mental health care. Objective: To explore what measures are used, and the characteristics of the identified measures, to understand the therapeutic relationship between staff and adult service users in mental health care settings. Design: Scoping review Setting(s): Adult mental health settings Participants: Service users and staff Methods: This review is guided by Levac et al.’s six stage methodology of scoping review frameworks. The reporting of this review has been guided by the PRISMA-ScR. Results: Of 2,863 papers found, 23 were eligible for inclusion. The papers identified 14 scales. No tool specifically measured over- or under- involvement. Finally, data indicates that scales should be specific to their intended setting as the nature of therapeutic relationships may vary by setting. Conclusions: Definitions of therapeutic relationships and over- and under-involvement relevant to different settings is needed. There is a need to develop setting-specific scales to measure therapeutic involvement and definitions for over- and under- involvement. This would enhance care provided to service users and encourage staff members to challenge their own boundary setting practices. Registration: https://osf.io/93dxp/