The Journal of Mental Health Training Education and Practice

Tore Bonsaksen; Kjell Emil Granå; Cecilia Celo; Brian Ellingham; Ingunn Myraunet

2013 The Journal of Mental Health Training Education and Practice

doi: 10.1108/JMHTEP-08-2012-0028

Purpose – The purpose of this paper is to describe an addition to the practice placement design for occupational therapy students in Oslo, and to report on the learning experiences related to this modified practice placement design among the participants. Design/methodology/approach – Occupational therapy students and practice educators were interviewed in focus groups after having participated in an exploration of the utility of the Assessment of Communication and Interaction Skills during mental health placement. Thematic analysis was applied to the data material. Findings – Four themes emerged relating to the students’ learning experiences during practice placement. They were theory‐practice integration; the role of supervision; self‐awareness of communication; and socialization to the therapist role. Practical implications – The practice placement design addition presented in this paper was well received by students and practice educators. It contributed to students’ focussed experience and to their active participation within a community of practice. The program appears to be one way of organizing placement with a potential for making a substantial contribution to occupational therapy students’ learning. Originality/value – The study adds to the existing literature in providing an example of a successful addition to the practice placement design, and in the detailed account of the learning experiences among the participants.

Nicola Murphy; Andrew Vidgen; Clare Sandford; Steve Onyett

2013 The Journal of Mental Health Training Education and Practice

doi: 10.1108/JMHTEP-11-2012-0037

Purpose – There has been a rapid development and implementation of crisis resolution home treatment teams (CRHTT) in the UK over the past decade. The available research studies of this service provision to date have largely focused on issues related to the “outputs” of CRHTT, for example cost efficacy and the impact on admission rates. There is limited research on the experiences of clinical psychologists within CRHTT. This is despite the fact that it would seem that research exploring the experiences of mental health professionals in CRHTT is important, as working in a new area of service provision may present specific challenges. An understanding of the nature of these challenges is considered important in order to support clinical psychologists in these settings, and to sustain and improve service delivery. Design/methodology/approach –This study presents a qualitative exploration of clinical psychologists’ experiences of working in a CRHTT. In total, 11 clinical psychologists were interviewed about their perceptions of working within CRHTT, their relationships with other professionals and their experiences of working with service users in “crisis”. The grounded theory approach was employed to analyse participants’ accounts. Findings –Two themes were identified: psychological and clinical work and teamwork. The emergent themes are compared to the wider literature on clinical psychologists’ experiences of working in teams, and working with service users in “crisis”. Originality/value – This research demonstrates the value of a clinical psychology perspective in acute mental health settings. It also highlights the value of a clinical psychological perspective in multi‐disciplinary team working. It draws attention to the need for clinical psychologists working in CRHTT settings to be able to more clearly articulate their roles in these services. It points to the importance of clinical psychologists considering the interventions they provide to service users with complex presentations. Also, it highlights their need to consider the psychological interventions they provide in CRHTT settings more generally, as this area of work does not closely align with NICE guidelines.

Philip O’Hare; Gavin Davidson; Jim Campbell; Michael Maas‐Lowit

2013 The Journal of Mental Health Training Education and Practice

doi: 10.1108/JMHTEP-12-2012-0044

Purpose – Over the last 12 years there have been substantial developments in UK law and policy relevant to mental health social work practice. The previous legal frameworks across the jurisdictions were very similar but the new laws have developed in different ways and provide greater opportunities for comparison. Across all the jurisdictions policy developments, especially in the areas of recovery and risk assessment, have influenced the way that mental health social workers practice. Design/methodology/approach – This exploratory study used case study vignettes with 28 respondents to examine how these major legal and policy developments impact on social work practice. Findings – There were variations in how levels of risk are defined and often a lack of clarity about how this informs decisions. There was a consensus that recovery is important but difficulties in understanding how this might apply in crises. Predictably, differences in legal and policy contexts meant that there were a variety of perspectives on how mental health social workers applied the laws in their jurisdictions. Research limitations/implications – The limited focus on research informed practice and the lack of transparency in decision making across areas of risk assessment and intervention, use of recovery approaches and the use of mental health laws suggest the need for a more evidence‐based approach to training, education and practice. Originality/value – There is very limited previous research on practitioner experiences of the complexities involved in implementing mental health law. This paper provides some insights into the issues involved and for the need for more detailed examination of the decision‐making processes involved.

Catherine Hungerford; Patricia Kench

2013 The Journal of Mental Health Training Education and Practice

doi: 10.1108/JMHTEP-04-2012-0005

Purpose – Recovery approaches to healthcare are now an important feature of the mental health policies and plans of many western countries. However, there are continuing challenges to the operationalisation of these approaches. The purpose of this paper is to consider how to overcome these challenges, using insights gained from health managers and practitioners who have been involved in the process of implementation. Design/methodology/approach – The analysis is undertaken through a descriptive single‐case embedded study of the implementation of Recovery into a public mental health service in Australia. The unit of analysis that features in this paper is the perceptions of the implementation of Recovery‐oriented services, of health managers and practitioners. Findings – The analysis suggests that although health service managers followed many of the recommendations that can be found in the research literature to support achievement of Recovery‐oriented services, there was a need to go further. For example, practitioners in the case study context were educated about the principles of Recovery and provided with new processes of clinical documentation to support their work, however these practitioners felt they were ill‐equipped to address complex issues of practice, including the management of clinical risk and professional accountability issues. This raises questions about the content of the education and training provided, and also about the ongoing support provided to practitioners who work within a Recovery‐oriented framework. Originality/value – The descriptive single‐case embedded study of the implementation of Recovery is the first of its kind in Australia. Findings of the study provide insight for other health service organisations committed to effectively implementing Recovery‐oriented services.

Christopher Wagstaff; John Rose; Jerry Tew; Tarsem Singh‐Cooner; Jayne Greening

2013 The Journal of Mental Health Training Education and Practice

doi: 10.1108/JMHTEP-03-2012-0002

Purpose – The purpose of this paper is to present the results of a qualitative evaluation of a learning initiative between different mental health professional groups, the Collaborative Learning Initiative (CLI). These qualitative results are after the first year of a two year evaluation of the CLI in which social work, clinical psychology and nursing students together with post‐registration medics undertook a sequence of joint learning in relation to mental health theory and practice. Design/methodology/approach – In total, 81 post‐course evaluations were qualitatively analysed using a process of thematic analysis based on the guidelines outlined by Braun and Clarke (2006). Each academic involved with the CLI thematically analysed the post‐course evaluations from their discipline. Following the generation of key themes each set of evaluations was separately analysed by an academic from a different professional discipline associated with the initiative. Findings – The evaluation of this initiative demonstrates that the model of interdisciplinary teaching whereby service user and carers facilitating small group working is an effective model for delivering interprofessional mental health education. The paper highlights the convergent and divergent themes between the different groups involved in the initiative. Most of the social work, medics, nursing and all clinical psychology participants evaluated the programme positively, however some of the themes were not positive and these are also discussed within the paper. Originality/value – Based on this qualitative evaluation, the evaluation of the service user and carer small group facilitators and observations by the CLI organizers, changes will be made to the second year of the evaluation cycle and these changes are highlighted in the paper. The uniqueness and value of this initiative lies in both having service users and carers involved in the design, delivery, evaluation and dissemination of the CLI and also in the strength of having four professional disciplines involved. Limitations of the study are highlighted.