Dissertations / Theses on the topic 'Preventive mental health services'
To see the other types of publications on this topic, follow the link: Preventive mental health services.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 dissertations / theses for your research on the topic 'Preventive mental health services.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse dissertations / theses on a wide variety of disciplines and organise your bibliography correctly.
1
Murphy, K. "Recovery-orientation in mental health services." Thesis, Canterbury Christ Church University, 2012. http://create.canterbury.ac.uk/11184/.
Full textAbstract:
Policy initiatives are calling for mental health services to change their ways of working to prioritising the promotion of service users’ personal recovery. This requires a major re-negotiation of working practices and the relationship between service users and staff/services and their respective social positions. Preliminary research has shown that change has been problematic. The present study aimed to explore the construction of recovery and the positioning of service users and staff during the adoption of recovery-oriented practices in a community support and recovery team. Transcripts of two rounds of focus groups with service users (n=9) and staff (n=5) held six months apart, service user care plans and Recovery Star notes were analysed using a Foucauldian Discourse Analysis. The study found that recovery was constructed as clinical/medical and personal recovery, at different times and in tension with each other. These constructions positioned service users as dependent, passive and hopeless or empowered and hopeful, and staff as helpless or facilitative. It was also apparent that a discourse of personal recovery was not available to service users. Staff oscillated between the constructions of recovery as medical and personal resulting in different subject positions and opportunities for action. The study concluded that adopting a recovery-orientation in services should lead to service users being positioned as more influential in decisions about their treatment and modes of support from the service, and services less likely to dictate their treatment. However, this can only happen if the recovery-orientation constitutes a widely shared discourse with all its assumptions and associated practices. The problematic aspects of the medical discourse and how it can position people socially and how those positions impact on the potential for personal recovery needs to be highlighted.
2
Jones, Siobhan. "Adolescent engagement in mental health services." Thesis, Canterbury Christ Church University, 2016. http://create.canterbury.ac.uk/14807/.
Full textAbstract:
Despite older adolescence being a risk period for the development of mental health concerns, mental health service engagement is low amongst 16-18 year olds. As therapeutic attendance is linked to clinical outcome, it is important to understand engagement in this population. There is a paucity of research looking specifically at the older adolescent engagement phenomenon. Previous qualitative research into adolescent experiences has provided rich and detailed results. Ten 16-18 years olds, engaged in Child and Adolescent Mental Health Services, were recruited from two London-based services. Each young person was interviewed in order to understand their personal experience of engaging in mental health services. Interviews were transcribed and underwent Interpretative Phenomenological Analysis. Analysis produced twelve subthemes subsumed within five superordinate themes: engagement begins at help seeking, strength of inner resolve, evolution of the self, in the clinic room, and, existing within service walls: physical and policy-based boundaries. Themes are discussed in detail. Conclusions are drawn in relation to previous theory and research. When considering 16-18 year understandings of the engagement phenomena, key elements include: clinician and service developmental appropriateness, negotiation of developmental tasks in relation to engagement, experience of the physical building environment, and awareness of service policy limitations. Suggestions for clinical practice in relation to engagement facilitators and threat are made, and recommendations for future research proposed.
3
Richter, Sundberg Linda. "Mind the Gap : exploring evidence-based policymaking for improved preventive and mental health services in the Swedish health system." Doctoral thesis, Umeå universitet, Epidemiologi och global hälsa, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-118179.
Full textAbstract:
Background: The challenges in the utilization of scientific findings in the fields of prevention and mental health are well documented. Scholars have found significant gaps between the knowledge available and the knowledge applied in healthcare. Studies have suggested that about half of the patients receive the recommended care for their medical condition. In order to address this gap, health systems at global, national, regional and local levels have made diverse efforts to facilitate the uptake of research for example through evidence-based health policy processes. In Sweden, government agencies and health policy actors such as the National Board of Health and Welfare support and control the health care system through evidence-based policies amongst other steering tools. The overall aim of this thesis is to explore evidence-based policy processes, and to further understand barriers to implementation of policies in the fields of preventive and mental health services. Methods: A multiple case study approach was used, and data were collected from several sources. Qualitative content analysis methodology was used. Case 1 comprises the development and early implementation of national guidelines for methods of preventing disease managed by the National Board of Health and Welfare during 2007–2014. Case 2 covers the effort to improve health care for the older population that was undertaken through an agreement between the Swedish government and the Swedish Association of Local Authorities and Regions during 2009–2014. Case 3 involves an effort to implement an adapted version of a systematic review from the Swedish agency for health technology assessment and assessment of social services on treatment of depression in primary health care. Data was collected between 2007 and 2010. In Paper 1, the policies from Case 1 and 2 were studied using a longitudinal, comparative case study approach. Data were collected through interviews, documents and observations. A conceptual model was developed based on prior frameworks. The model was used to organize and analyse the data. In Paper 2, the guideline development process (Case 1) was studied through interviews and the collection of documents. A prior framework on guideline quality was used in order to organize the data. Paper 3 investigated decision-making processes during guideline development using a longitudinal approach. Qualitative data were collected from questionnaires, documents and observations and analysed using conventional and summative content analysis. In Paper 4, the barriers to implementation were investigated through interviews and the collection of documents. Data were analysed using qualitative content analysis with a conceptual model to structure the analysis. Results: The sources and procedures for policy formulation differed in Case 1 and 2, as did the approaches to promote the implementation of the policies. The policy processes were cyclical, and phases overlapped to a large degree. The policy actors intended to promote implementation, both during and after the policy formulation process. The thesis shows variation in how the key policy actors defined and used research evidence in the policy processes. In addition, other types of knowledge (e.g. politics, context, experience) served as alternative or multiple sources to inform the health policies. The composition of sources that informed the policies changed over time in Cases 1 and B. During the policy formulation and implementation process, efforts to integrate research evidence with clinical experiences and values were associated with tension and recurrent dilemmas. On the local level (i.e. primary health care centres), barriers to implementation were found related to the innovation and among health professionals, patients, in social networks as well as in the organizational, economic and political contexts. Conclusion: The concept of evidence holds a key position in terms of goals and means for knowledge based policymaking in the Swedish health system. Broad definitions of evidence – including research and non-research evidence - were requested and to various extents utilized by the policy actors in the studied cases. An explicit terminology and systematic, transparent methodology to define, identify, and assess also non-research evidence in policy processes would potentially strengthen the clarity and validity of these processes and also enhance policy implementation. Particular determinants to implementation, such as the interventions characteristic, are to a considerable degree established early in the policy process, during agenda setting and policy formulation. This early phase offers unique opportunities to assess and build capacity, initiate and facilitate implementation. Early analysis and considerations of target populations and contexts and other implementation determinants related to the specific policy scope (e.g. disease preventive guidelines) could enhance the forth-coming implementation of the policy.
4
Woodbridge-Dodd, Kim. "A discursive study of how mental health social workers constructed their professional selves within the context of National Health Service mental health services." Thesis, University of Northampton, 2017. http://nectar.northampton.ac.uk/9721/.
Full textAbstract:
Since the 1990s there have been continued drives in England to integrate National Health Services and Local Authorities’ social care within a single mental health service, with the aim of bringing about improvements in health and social care (Local Government Association et al., 2016). This is underpinned by the belief that through bringing the different professional health (such as psychiatrists and mental health nurses) and social care disciplines together, people in need will have a single point of access to a range of skills and knowledge, that no one system could deliver alone (Cooper, 2017). However, the very unique professional approaches that have been stated as the reason to place social workers in NHS Mental Health Services have been the ones that mental health social workers have struggled to hold onto in this setting (Allen et al., 2016). This is a thesis of how mental health social workers constructed a professional self within the context of the NHS mental health services. I used a Foucauldian approach and the notion that professional identity is a socially constructed sense of self, produced from discourses, subject positions and a process of subjectification. Twelve social workers were interviewed; seven mental health social workers and five social workers who held positions as managers or educationalists. I asked social workers questions about their professional identity, their answers provided a rich source of ‘talk’ that I could analyse using Parker’s steps to discourse analysis. The findings discuss the nature of social work as a profession, generic and specialist social work, and suggests a typology of subject positions drawn from the mental health social workers’ discourses. These findings provide a useful resource to support critical social work practice, both as an example of how Foucauldian theory and concepts can be a rich toolbox for understanding practice in complex settings, and through the use of the typology of subject positions as a source to prompt self-reflection for mental health social workers’ practice.
5
Moth, Richard Robert. "'The Business End' : perspectives on mental distress in the context of neoliberal restructuring of community mental health services." Thesis, University of Birmingham, 2014. http://etheses.bham.ac.uk//id/eprint/5274/.
Full textAbstract:
Contemporary neoliberal reconfigurations of statutory mental health services involve significant organisational changes. Based on findings from twelve months fieldwork within a community mental health team, the thesis examines the effects of this new service landscape on the way conceptualisations of mental distress are utilised and articulated. The thesis combines critical realist epistemology and reflexive ethnographic method to produce a contextually situated understanding of the field capturing the dynamic relationships between concepts, agents and the context of action. This draws on and extends Rhodes’ ‘pentimento’ (1993) as a conceptual framework for understanding mental health practice. It argues the mental health team is a ‘differentially sedimented structural institution’ in which practitioners and service users navigate a field of contradictions defined by four strata: the custodial system of the asylum; the biomedical treatment system of the hospital; community care within the Keynesian welfare state; and neoliberal welfare reconfigurations. These are conceptualised as ideological positions that coexist within practitioners as alternative modes of thinking and operate in a relationship of mutual tension. Practice should be understood as a process shaped by mechanisms at different levels of scale from micro to macro, and involving movement between these overlapping and co-existing strata of historically sedimented meaning.
6
Walton, Kellana C. "Public Mental Health Spending, Services and Policy in Hamilton County, Ohio." University of Cincinnati / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1342104465.
Full text
7
Brown, Malgorzata. "Therapeutic relationships in acute inpatient mental health settings." Thesis, Canterbury Christ Church University, 2013. http://create.canterbury.ac.uk/12508/.
Full textAbstract:
This work considers the nature of therapeutic relationships between nursing staff and patients on acute mental health inpatient wards. Section A is a literature review, exploring the psychological theories behind the care delivered by nurses through the medium of therapeutic relationships in inpatient settings and providing a meta-synthesis of studies investigating the nature of therapeutic relationships between nursing staff and patients from the perspectives of nurses. Section B presents a phenomenological study in which nursing staff completed in-depth interviews providing descriptions of their therapeutic relationships with patients. The results suggest a great variance in the nursing staff ability to get to know and understand patients and their needs from a psychological perspective. The knowledge gained about patients through the medium of relationships did not seem to be shared by the staff team and did not seem to be integrated into a coherent treatment plan.
8
Saidi, Marya. "No place like HOME : specialist Housing services for people with mental health problems, Outcomes, Movements and Experiences." Thesis, London School of Economics and Political Science (University of London), 2013. http://etheses.lse.ac.uk/914/.
Full textAbstract:
Background: No exact and reliable data exists on the characteristics and needs of people with mental health problems in England living in specialist housing services (SHSs). Aims: To describe the cohort of service users’ with mental illness aged 18 to 65 living in various types of SHSs (care homes, supported housing, and Shared Lives schemes) as well as their housing satisfaction, taking into account their social inclusion, and social networks. Pathways into SHSs were accounted for: delayed discharge, referrals and move-on accommodation where applicable. Method: Semi-structured interviews were conducted - using interview schedules designed for the purpose of this study - with 86 service users and 40 managers of SHSs within 7 areas of England. Analysis: Based on a mixed-methods approach: each interview was coded and string variables were turned into quantifiable ones; anonymised quotes from service users and managers were included in the body of the text. Main analysis is quantitative, with a secondary qualitative study, using framework analysis. Results: Differing support levels influenced service users’ experiences and pathways into SHSs, as well as the outlooks of managers. Analyses revealed several aspects mediating housing satisfaction. Many service users were not very well integrated in the community although managers held different views. Some service users were very much reliant on staff and had small social networks. Discrimination was still persistent and recent policy initiatives, in terms of funding, housing, benefits and employment held a negative impact. Preferences of service users were for the most part not taken into account. Conclusions: Further research is needed with regard to BME groups as well as other SHSs settings like Shared Lives schemes. Data should be more systematically collected and in more detail and barriers to employment should be tackled. Better advocacy and information for service users should be established.
9
Bressington, D. "Medication management training for mental health professionals : a programme of research." Thesis, Canterbury Christ Church University, 2014. http://create.canterbury.ac.uk/12800/.
Full textAbstract:
Aim This research programme aimed to investigate issues relating to the management of patient non-adherence with antipsychotic medication. The findings from the patient-related studies and the systematic literature review informed the development of a medication management staff training programme; which was evaluated in terms of the effects on mental health professionals’ understanding and clinical practice in Hong Kong. Background Medication management interventions which are designed to maximise the potential benefits of antipsychotic medication for severe mental illness have shown promise in improving symptoms, reducing relapse rates and addressing non-adherence. Subsequent medication management studies which involve training mental health professionals in similar psychosocial interventions have also demonstrated that improvements in mental health professionals’ knowledge, attitudes and skills can result in improved patient outcomes; however, the studies have not been replicated outside western general psychiatry settings and therefore the effects of training mental health professionals in other clinical contexts have not been established. Methods This research programme consists of a series of five studies that utilised a variety of methodological approaches. Three cross-sectional surveys were used to identify and explore clinical problems central to medication management in order to refine the staff training programme; the first investigates the extent of, and associations with, antipsychotic medication non-adherence in prisons. Qualitative interview data from the prison study provides additional context to the requirements for medication management training interventions by exploring prisoners’ experiences of taking antipsychotic medication. The second survey ascertains and explores the problem of non-adherence with antipsychotics in an Asian population, and the third provides an estimate of potential treatment-related physical health problems. A systematic literature review investigates studies which measure the effects of medication management training on clinicians’ knowledge, attitudes and skills. Finally concept mapping and clinicians’ narratives are used in a longitudinal case series 2 study in order to establish the transferability of medication management training to an Asian setting and evaluate the effects of training on clinicians’ understanding and clinical practice. Results Patients’ positive attitudes towards antipsychotic medication, particularly awareness of the need for treatment predicted higher levels of adherence, and concerns about the adverse effects of these medications are closely related to the environmental context of treatment. Concerns associated with antipsychotic side effects appear to be less prominent when patients are not working or in prison but they may influence adherence when demands on functioning change. The modified medication management training was effective in improving clinicians’ understanding and was felt to be transferrable to an Asian setting, but patients’ and families’ traditional cultural beliefs about mental illness and concerns about the effects of western medication on physical health were found to be particular challenges when implementing adherence interventions. Patients with severe mental illness in Hong Kong are twice as likely compared to the general population to have developed metabolic syndrome, consequently medication management interventions could require greater focus on the identification and management of physical health problems; which may help to address patient and family concerns about long-term treatment. The staff training programme requires psychopharmacology teaching, provision of clinical supervision and side effects management content in order to improve clinicians’ confidence when implementing medication management interventions. Conclusions Concerns about the adverse effects of treatment that influence adherence are environmentally bound. As influences on medication adherence are different in different settings, staff training programmes should place more emphasis on the local context in order to improve efficacy and the feasibility of implementation. The results suggest that in Hong Kong medication management interventions should have an increased focus on families and that treatment satisfaction could be a suitable target for interventions. The findings also present a question about whether previous medication management studies have given due consideration to predicting and managing concerns about the impact of side effects on functioning over the longer term and the potential effects of medication on patients’ physical well-being. The outcomes of this programme also demonstrate that future medication management training studies need to use robust study designs in order to more certainly attribute clinicians’ improvements to the training intervention and could consider measuring treatment satisfaction as a primary patient outcome measure.
10
Eziefula, Ukachi E. "Refugee women in the UK : factors affecting engagement with mental health services." Thesis, Canterbury Christ Church University, 2011. http://create.canterbury.ac.uk/10340/.
Full textAbstract:
Section A. This paper opens with a broad overview of theoretical and empirical literature on refugee mental health. It highlights a relative weakness in the understandings of post-migration mental health, particularly in the context of female refugees. The paper then focuses on three areas of refugee women's mental health, critically evaluating theoretical and empirical literature: 1) risk factors and prevalence of mental health difficulties 2) coping strategies, 3) mental health service utilisation. Gaps in the extant literature are highlighted and suggestions are made for future research. Section B. This paper describes a qualitative study which aimed to explore refugee women's experiences of distress and their encounters with mental health services in the UK. Refugee women do not utilise UK mental health services as frequently as might be expected owing to their vulnerability to mental health problems. The study investigated the mental health experiences of refugee women who have encountered mental health services in the UK in order to contribute to understandings about factors affecting service utilisation. A grounded theory qualitative methodology was employed. Ten refugee women were recruited from a local non-governmental organisation and participated in semi-structured interviews about their experiences of distress, coping strategies and encounters with UK mental health services. A two-staged model emerged from the data. The first model depicted women’s experiences of distress predominantly in the context of post-migration experiences and how they coped, drawing notably from spiritual and social resources. The second stage of the model indicated how mental health service encounters were varied and a process of engagement involved evaluation and re-evaluation at particular stages. The study concluded that understanding refugee women’s utilisation of mental health services demands a multi-factorial, dynamic appraisal. Section C. This paper offers a critical appraisal of the study reported in Section B. The paper reflects on the research skills and abilities developed by the principal researcher and considers areas for development in terms of future clinical and research work in this field.
11
Banker, Karen Lee. "Morale and the mental health worker: Burnout in the Department of Behavioral Health." CSUSB ScholarWorks, 2001. https://scholarworks.lib.csusb.edu/etd-project/1885.
Full text
12
Butler, Lucy. "Caregiver wellbeing in psychosis services." Thesis, Canterbury Christ Church University, 2016. http://create.canterbury.ac.uk/15029/.
Full textAbstract:
The study aimed to examine the relationship between wellbeing, burden, distress and third-wave factors, including self-compassion and psychological flexibility, in caregivers of people with psychosis. The study secondly aimed to trial a new brief group intervention, combining Acceptance and Commitment Therapy (ACT) and Compassion-focused Therapy (CFT) for this population. Twenty-nine participants were assessed at baseline on primary measures of wellbeing, distress, psychological flexibility and self-compassion. Secondary factors including burden and mindfulness were also collected. Correlation analyses were used. Fourteen participants completed the group in intervention and follow-up measures, and pre-post investigations were employed. Lower levels of psychological flexibility and self-compassion were related to lower levels of wellbeing and higher levels of burden and distress. There was a potential mediating effect of psychological flexibility on the relationship between self-compassion and wellbeing. The group intervention was acceptable to caregivers, and there were significant positive changes in self-compassion, distress, burden and mindfulness. The study adds to the existing data regarding wellbeing and burden in caregivers of people with psychosis. This study provides new insights into the factors of self-compassion and psychological flexibility within this population. The ACT with Compassion intervention is a promising, brief intervention which would benefit from further application and evaluation.
13
O'Connell, Christine. "Integrating physical and psychological wellbeing in child health." Thesis, Canterbury Christ Church University, 2016. http://create.canterbury.ac.uk/15004/.
Full textAbstract:
Research shows that the integration of physical and mental healthcare in paediatric settings is beneficial in terms of clinical and cost effectiveness (Kahana, Drotar, & Frazier, 2008; Douglas & Benson 2008, Griffin & Christie, 2008). Due to the high rates of mental health problems within this population, several studies have shown that referral to paediatric psychology should be increased (e.g. Wagner & Smith, 2007). However, there are few studies investigating factors influencing healthcare professionals’ referral behaviour. The current study used theory of planned behaviour (Ajzen, 1988; 1991) to develop a questionnaire which explores factors influencing the referral of children and families to paediatric psychology. Psychometric properties of the questionnaire were examined. Findings indicate that the questionnaire holds good reliability and validity and that the main constructs of theory of planned behaviour are useful in predicting intention to refer to paediatric psychology. Specific beliefs about referral were also shown to influence intention to refer. Findings that individual referrer factors such as attitudes and beliefs can impact healthcare professionals’ referral behaviour indicates that multidisciplinary interventions and inter-professional education relating to the psychological aspects of illness are required. Recommendations for future research are discussed.
14
Gieniusz, Barbara. "Being a pioneer : mental health service users' experiences of peer brokerage." Thesis, Canterbury Christ Church University, 2014. http://create.canterbury.ac.uk/12866/.
Full textAbstract:
In recent years in the UK, services introduced personalisation, allowing mental health service users to be in charge of the budgets given to them by social care. Peer brokerage is based on advice regarding the best use of personal budgets. The aim of this study was to understand the experiences of mental health service users being trained and working as peer brokers, and any role of those experiences in their recovery and identity. Six peer brokers were interviewed and the data were analysed using Interpretative Phenomenological Analysis (IPA). Five main themes were identified in the interviews: changing and growing; rewarding and challenging aspects of the role; client-centred approach to peer brokerage; importance of peer-relationships; and the pioneering nature of the role. Participants emphasised that this is a new idea in mental health services requiring commitment and determination in facing obstacles. The study concluded that similarly to previous research on the experiences of peer workers, participants spoke of challenging and rewarding aspects, including learning and benefits from helping others. New themes highlighted by this study show the importance of support from other peers and a humanistic approach to helping others. More UK-based studies are needed to understand peer workers’ experiences and their partnership with services.
15
Crowley, Sarah. "Recognising and responding to suicide risk in a community mental health setting." Thesis, Canterbury Christ Church University, 2015. http://create.canterbury.ac.uk/13930/.
Full textAbstract:
Despite the number of best practice guidelines for working with those at risk of suicide, there remains a paucity of research pertaining to the realities of clinical practice. The aim of this study was to develop a grounded theory of how clinicians respond to those at risk of suicide in UK community mental health settings. Semi-structured interviews were conducted with eleven members of staff including social workers, nurses, psychologists, psychiatrists and occupational therapists. A theory grounded in the resulting data was developed. Results: Anxiety, uncertainty and practitioners’ perceived responsibility for preventing suicide influenced their attributions in relation to a client’s distress. Findings indicated that clinicians most often attributed low responsibility to clients for both the cause and the solution. Therefore, clinicians sought solutions to suicidal presentations within services, rather than attending to contextual or environmental ‘triggers’ to offer a resolution, potentially increasing dependency on services. Feeling supported and an environment of psychological safety enhanced professionals’ capacity to tolerate the uncertainty inherent in this work which allowed professionals to ‘hand the responsibility back’. This highlights the importance of services creating an environment of psychological safety in order for clinicians to tolerate the uncertainty of working with those who present with suicide risk.
16
Craig, Pauline M. "An exploration of primary care policy and practice for reducing inequalities in mental health." Thesis, Connect to e-thesis, 2008. http://theses.gla.ac.uk/287/.
Full textAbstract:
Thesis (Ph.D.) - University of Glasgow, 2007.Ph.D. thesis submitted to the Faculty of Medicine, Public Health and Community-Based Sciences, 2007. Includes bibliographical references. Print version also available.
17
Richards, Jenna. "How do people construct their identity when they are both a 'mental health professional' and a 'mental health service user'?" Thesis, Canterbury Christ Church University, 2013. http://create.canterbury.ac.uk/12347/.
Full textAbstract:
Literature suggests that there are a growing number of ‘mental health professionals’ speaking out about their own experiences of using mental health services. Research suggests that these professionals face dilemmas when constructing their identity because they are drawing on two identities that are viewed as fundamentally different, i.e. ‘mental health professionals’ as powerful and ‘mental health service users’ as powerless. This study aimed to explore how ‘mental health professionals’ who are/have been ‘mental health service users’ construct their identity using a social constructionist epistemology, which views identity as fluid and continuously renegotiated in social contexts (Davies & Harré, 1990; Potter & Wetherell, 1987). Ten participants who self-identified as ‘mental health professionals’ who are/have been ‘mental health service users’ volunteered to take part. Interviews were transcribed and analysed using discourse analysis. Participants constructed their identity in a variety of ways, including as separate identities, i.e. a ‘professional identity’ and a ‘patient/mental health service user identity’ constructions, switching between the two in different contexts, therefore developing an ‘un-integrated identity’. Participants also developed an ‘integrated identity’ construction in some professional contexts. These results are discussed and implications for clinical practice and future research are explored.
18
Boland-Shepherd, Susan. "The Role of School Nurses in the Early Identification, Referral and Provision of Services for Students with Early Signs of Mental, Emotional or Behavioral Disorders: A Dissertation." eScholarship@UMMS, 2012. https://escholarship.umassmed.edu/gsn_diss/25.
Full textAbstract:
The purpose of this qualitative study was to explore school nurses’ (SN) perceptions of factors influencing their ability to identify, refer, and provide mental health services to students with early signs of mental, emotional, and behavioral (MEB) needs. The National Research Council and Institute of Medicine have urged a preventive public health approach to decrease adverse outcomes of unidentified and untreated MEB needs among children (O’Connell, 2009). Historically and theoretically based in public health, SN have daily contact with students and are in an optimal location for early identification, referral and provision of services, yet little empirical research describing their role is available.
Five focus groups with 29 SN were conducted and four themes emerged through analysis of data: Frequent flyers : student visits to SN offices, the observations that alert SN to potential MEB needs; Digging to get the whole picture : the process SN frequently used to collect information necessary to confirm MEB needs; Road to referral : the resources used and barriers encountered within the referral process; and, Safety zone : the important role SN play in the provision of services to students with early signs of MEB needs. Within the provision of services was a collective subtheme across all five focus groups: What we need to better help our kids. In this category SN identified their educational limitations and learning needs, as well as potential strategies to improve provision of services for students with MEB needs.
The findings of this study provide a lens into the complex and little explored are of early identification, referral and intervention processes used by SN to care for students with MEB needs. Understanding the role of the SN is a critical first step towards improving outcomes.
19
Ellis, Kate. "An exploration of the relationships between inpatients and clinical psychologists in forensic mental health services." Thesis, Canterbury Christ Church University, 2013. http://create.canterbury.ac.uk/12509/.
Full textAbstract:
Recent studies with offenders have identified a growing distrust in psychologists and that this may be due to the changing role of clinical psychologists working within these settings. In addition to the traditional role of alleviating psychological distress, psychologists in these settings also have the additional role of providing expert risk assessment. Clinical psychologists working in forensic mental health settings (FMHS) are also tasked with this ‘dual role’. To date, there is no research exploring the impact of this dual role in FMHS. Semi-structured interviews were carried out with eight inpatients in two medium secure units. A grounded theory analysis produced a model of how trust was built and relationships developed. Despite the ‘dual role’ held in these settings, with an approach that is transparent, open, collaborative, and patient-centred; service users are able to build trusting relationships. Furthermore, they report making positive therapeutic gains. Where ‘coercive’ experiences were described, this appeared to be a representation of more distant times, with recent experiences being described as more satisfactory. Clinical psychologists also seem to be placed in a position of ‘mediator’ amongst the wider care team. Further research is required to explore these findings and whether they apply in other secure settings.
20
Nineham, C. "Involving service users and carers in mental health education : mental health students' perspectives of the impact of direct involvement on their learning and practice." Thesis, Canterbury Christ Church University, 2012. http://create.canterbury.ac.uk/11017/.
Full textAbstract:
Service user involvement (SUI) in healthcare and education is an established element of government policy. Emerging research demonstrates that SUI in education can positively impact on mental health students' learning. However, limited empirical attention has been paid to the impact on practice in this area. Moreover, no research has investigated whether impact on practice is sustained. Section B describes a qualitative study exploring qualified clinical psychologists' (CPs) experiences of a placement-based service user and carer involvement (SUCI) scheme during their training. The study focused on understanding their perception of the scheme's impact on their learning and practice and whether the impact on practice was sustained. Seven CPs were interviewed, predominantly 32-33 months post-scheme. Interpretative Phenomenological Analysis was used to analyse the data. Four super-ordinate themes were identified: “Contextual and relational factors underpinning learning”; “Learning: Personal and professional development”; “The enduring impact on practice”; and “Personal reflections and meaning-making”. The findings are discussed in relation to existing literature and relevant theory, including adult learning theories and social positioning theory. The findings suggest that SUCI in placement-based learning during training can support CPs' personal and professional development and a partnership approach to practice. Two participants' experiences highlight factors raising questions regarding for whom and when SUCI may be beneficial to learning. Methodological limitations, implications for SUCI in clinical psychology training and directions for future research are presented.
21
Hall, Deanna L. "Community music and interpersonal functioning amongst people with complex mental health needs." Thesis, Canterbury Christ Church University, 2013. http://create.canterbury.ac.uk/12266/.
Full textAbstract:
Section A is a critical review of empirical literature pertinent to the impact of community music projects (CMPs) on the interpersonal functioning of those with complex mental health needs living in the community. Section B presents a qualitative study exploring the interpersonal experiences of ten outpatients with complex mental health needs participating in a CMP. Background: Although participation in CMPs has been associated with improved interpersonal function amongst clinical and non-clinical populations their effects on outpatients with complex mental health needs are not clearly understood. Aims: The current study aimed to explore how outpatients with complex mental health needs experience, perceive, understand and respond to interpersonal interactions whilst participating in a CMP. Method: Participants included 10 outpatients with complex mental health needs, who had attended a CMP for at least 6 months. They completed a semi-structured interview concerning interpersonal experiences and the project’s impact (if any) on such experiences. Interpretative Phenomenological Analysis was utilised (Smith, Flowers, & Larkin, 2009). Results: Interpersonal experiences of participants were conceptualised as master themes involving hope for social interaction, non-musical interpersonal experience, musical interpersonal experience, wider community experience, belonging, esteem and positive identity. Conclusion: Interpersonal learning, bridging capital and the development of self-concept components may be experienced in relation to CMP participation. The importance of social context assessment to client formulations and interventions and the need for further longitudinal, qualitative research in this area is implicated.
22
Donaghay-Spire, Eloise G. "An exploration of psychological interventions in the acute inpatient mental health setting." Thesis, Canterbury Christ Church University, 2014. http://create.canterbury.ac.uk/12867/.
Full textAbstract:
Literature suggests that individuals experiencing acute mental health difficulties can benefit from psychological input, with calls to increase psychological provision in inpatient mental health settings in the United Kingdom (UK). Despite this, there is limited research to support this demand, which may in part be due to inherent difficulties in conducting research in this setting. Using an interview design and narrative analysis, this paper explored staff members’ and service-users’ experiences of inpatient psychological interventions in National Health Service (NHS) inpatient mental health settings. Evidence was found to support the use of direct, indirect and strategic interventions for individuals, groups, families and staff teams. Formulation and the therapeutic relationship were conceptualised as common features of such input. Connections between inpatient psychology and change within the stories suggested that interventions can help people make sense of a crisis, improve relationships and contribute to meaningful recovery. Barriers were also presented, suggesting that psychological input in this setting might not be right for everybody. This paper demonstrates that psychological input in the acute inpatient mental health setting is perceived as meaningful and can lead to changes. There is also a sense that this provision can be challenging, highlighting the need for further research.
23
Miller, David Teekell. "The establishment of a suicide prevention ministry team." Theological Research Exchange Network (TREN), 1989. http://www.tren.com.
Full text
24
Biggin, Isobelle J. R. "An investigation of elite athletes' and coaches' perceptions of mental ill-health in elite athletes." Thesis, Canterbury Christ Church University, 2015. http://create.canterbury.ac.uk/13826/.
Full textAbstract:
Research suggests elite athletes have an equal, possibly higher, probability of developing mental ill-health as the general population. However understanding of these issues amongst athletes and coaches remains largely unknown. The perceptions of 20 elite athletes and 16 elite coaches of mental ill-health amongst elite athletes were explored. Two concurrent, three round Delphi methods, using descriptive statistics and thematic analysis, were used to compare groups’ responses. Athletes and coaches expressed different opinions and experiences of mental ill-health amongst elite athletes. However, both felt the pressure athletes place upon themselves is a significant contributing factor and that obsessive compulsive disorder (OCD) and anxiety may be particularly prevalent. Whilst associated stigma was thought to be a barrier to support seeking, both groups felt sport and clinical psychologists would provide the most appropriate support, with coaches playing an important role. Implications for coaches, clinical and sport psychologists are explored and suggestions for future research are presented.
25
Joy-Johnson, Louise. "How do clients experience the alliance when working with the Mental Health Recovery Star in rehabilitation settings?" Thesis, Canterbury Christ Church University, 2016. http://create.canterbury.ac.uk/14995/.
Full textAbstract:
The Mental Health Recovery Star (MHRS) is a therapeutic tool and outcome measure, used widely in the UK and internationally for clients and keyworkers in mental health services to jointly assess and work towards client-centred recovery goals. As such it has been recognised as potentially offering a means of building a positive working alliance between clients and workers. The alliance is increasingly being highlighted as a key common factor across therapeutic models that may underpin positive clinical outcomes. This study employed Grounded Theory Methods to explore the alliance within the context of using the MHRS in rehabilitation mental health services. Semi-structured interviews were carried out with ten clients and four workers across three services. The findings are presented in a theoretical model that explains the core category that emerged from this study – “being engaged in working together towards improved wellbeing”. Working with the MHRS was seen to inform three particular alliance processes: collaborative working; negotiating new or shared perspectives; and motivation towards improved wellbeing. The findings also highlighted challenges that can hinder these processes when using the MHRS, calling for improvements in practices of negotiation and better support for workers. Further clinical implications alongside avenues for future research are discussed.
26
Narto, Linda. "Psykisk ohälsa bland ungdomar i mellan- och högstadiet – Ur skolsköterskans perspektiv. : En intervjustudie." Thesis, Högskolan Dalarna, Omvårdnad, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:du-29570.
Full textAbstract:
Syfte: Syftet med studien var att undersöka skolsköterskans erfarenheter av att arbeta med psykisk ohälsa bland ungdomar i mellan- och högstadiet. Metod: Urvalet av grundskolor valdes ut från samma kommun i mellersta Sverige och totalt deltog fyra kvinnliga skolsköterskor från fyra olika grundskolor. Datainsamlingen gjordes genom semistrukturerade frågor med kvalitativ ansats. Intervjuerna transkriberades ordagrant och blev analyserade med hjälp av en kvalitativ innehållsanalys. Resultat: Ur analysen framkom fyra huvudkategorier: Identifiering av psykisk ohälsa, begränsningar i arbetet mot psykisk ohälsa, prevention mot psykisk ohälsa samt förbättringsområden för identifiering av psykisk ohälsa . Resultatet visade att det var lättast att identifiera elever med psykisk ohälsa genom planerade hälsobesök där samtalet till viss del styrdes av en hälsoenkät. Genom elevhälsoteamet fick skolsköterskorna möjlighet att samverka och fånga upp elever som verkade vara i behov av hjälp. Tidsbrist upplevdes vara en stor påverkande faktor i arbetet. Skolsköterskorna uttryckte ett intresse av utökad kunskap i motiverande samtal (MI) samt att starta samtalsgrupper. Slutsats: Hälsoenkäten som användes inom elevhälsan och samverkan i elevhälsoteamet var de lättaste sätten att identifiera psykisk ohälsa bland ungdomar i mellan och högstadiet. Organisatoriska faktorer som ledning och tid var avgörande för arbetet mot psykisk ohälsa.Aim: The aim of the study was to study the school nurses experience of working with mental health illness among youth in the middle and later years of primary school. Method: The selection of primary schools was chosen from the same society in central Sweden and total four female school nurses were participating from four different primary schools. The data collection was done with qualitative approach using semistructured interviews. The interviews were transcribed literally and were analysed using a qualitative content analysis. Results: The analysis resulted in four main categories: Identification of mental health illness, limitations in the preventive work against mental health illness, prevention against mental health illness and improvement areas for identifying mental health illness . The result showed that all informants felt that it was easiest to capture students with mental health illness through the planned health visits, where the conversation was reasonably guided by a health questionnaire. Through the student health team the informants were given the opportunity to interact and capture the students who tended to be in need of help. Lack of time was perceived as a major influencing factor in the work. The school nurses expressed an interest in increased knowledge in motivational interviewing (MI) as well as starting conversation groups. Conclusion: The health questionnaire used in student health and collaboration in the student health team were the easiest ways to identify mental health illness among youth in the middle and later years of primary school. Organizational factors such as management and time were crucial for the work against mental health illness.
27
Wilding, Michael G. "Experiences of living with type 1 diabetes : psychological distress and clinical implications." Thesis, Canterbury Christ Church University, 2015. http://create.canterbury.ac.uk/13755/.
Full textAbstract:
Living with diabetes can present a number of challenges for individuals concerned. Managing diabetes day to day involves a complex medication and behavioural regime which interrelates with various important psychosocial factors. Previous research suggests that people living with diabetes are as much as two-three times more likely to experience mental health difficulties compared with the general population. However evidence is emerging that many of these difficulties may in fact be a direct result of feeling distressed about living with a complicated and stressful chronic health condition, and not necessarily resultant from co-morbid psychiatric illness. These experiences are known by the term diabetes related distress. To date psychosocial factors related to living with diabetes have mainly been explored quantitatively. However, qualitative approaches have increased in popularity in diabetes research in recent years and can add valuable and rich information to existing data from quantitative research. Extant qualitative research in diabetes has mainly focused on people living with type 2 diabetes or children with type 1 diabetes, leaving adults living with type 1 diabetes as a relatively under researched group. This study aimed to answer the following research questions:Primary: What are the lived experiences of adults with type 1 diabetes? And secondary:What aspects of living with type 1 diabetes are experienced as distressing? ; and What are the potential implications for health services? Eight adults living with type 1 diabetes were interviewed about their experiences. Interviews were transcribed and analysed using interpretative phenomenological analysis. Six major themes emerged from participants' interviews. These were: Experiences of diagnosis, Physical impact of type 1 diabetes, Psychological impact of type 1 diabetes, Social impact of type 1 diabetes, Influence of healthcare teams and Ways of coping. Example subthemes are; Feeling frustrated and restricted by treatment regimes, psychological and emotional distress, constant awareness and worry, impact on development and sense of self, stigma and lack of understanding from others, support from diabetes team and experiences of a simplistic view of diabetes. Participants reported a wide variety of experiences related to the biological, psychological and social components of type 1 diabetes. Some of these were experienced as highly distressing whilst others were more easily managed. This was often dependent on individual differences and was not necessarily static over time. Further awareness of this in practice and a focus on diabetes and its treatment within the context of people’s unique psychosocial circumstances is highly important in supporting people to reduce diabetes related distress, which can improve glycaemic control, health related quality of life and wellbeing.
28
Loft, Niki Oliver. "Exploring compulsory admission experiences of adults with psychosis using grounded theory." Thesis, Canterbury Christ Church University, 2011. http://create.canterbury.ac.uk/10433/.
Full textAbstract:
Section A reviews the literature related to compulsory admissions under the Mental Health Act (MHA) 1983/2007 of adults presenting with psychosis. It outlines the legal framework and examines empirical data relating to admissions under the MHA 1983/2007. A brief overview of psychosis, its aetiology and key psychosocial models are provided. Consideration of mental health within the legislative framework is offered and the experience of being compulsorily admitted is explored. Finally, further qualitative research is recommended. Section B: The study’s primary objective was to explore the experience and impact of compulsory admissions (under the MHA 1983/2007) on the psychological functioning of adults with psychosis. The study also aimed to develop a preliminary theoretical model. Design: The qualitative ‘Grounded Theory’ method (Glaser & Strauss, 1967) was chosen since it worked inductively from the data and enabled the development of a model. Method: Seventeen participants (eight service-users with psychosis, nine psychiatrists) involved in compulsory admissions were interviewed. Analysis and interviews were undertaken concurrently so initial findings could influence subsequent data collection. Results: Five higher-order categories and 47 categories were identified. These contributed to the development of the ‘A disturbing journey: To and from detention’ model of compulsory admissions. Conclusion: This small-scale qualitative study achieved its objectives, providing a preliminary model and understanding of the compulsory admission experience for adults with psychosis. Key service and clinical implications are discussed. Despite its limitations, the findings indicated scope for further investigation. Section C: addresses four key questions about the study. The first relates to skills the researcher learnt through conducting the study. The second relates to improvements that could be made if conducting the study again. The third relates to clinical implications, and the fourth to further research.
29
Glossop, H. "Young people's beliefs about help-seeking for first episode psychosis." Thesis, Canterbury Christ Church University, 2012. http://create.canterbury.ac.uk/11213/.
Full textAbstract:
The importance of early intervention for positive outcomes following a first episode of psychosis (FEP) is recognised, however, there are still delays in young people seeking help. The aim of this qualitative study was to explore beliefs about help-seeking in young people who have recently experienced a FEP. Twelve participants were interviewed and transcripts were analysed using grounded theory. Five categories of beliefs were identified which contributed to the development of a preliminary model of beliefs about a need for help-seeking. Young people’s beliefs about their experiences as normal or abnormal, and about the process and outcome of help-seeking, influenced beliefs about needing help. Existing beliefs about mental health problems, and beliefs about the impact of experiences on the self were important to the meaning young people ascribed to beliefs about help-seeking. Social networks were important in the development of these beliefs. The study identified beliefs which promoted and inhibited young people’s help-seeking beliefs for FEP. Self-stigma was present prior to help-seeking. Implications for clinical interventions include education to promote help-seeking for distress and not abnormality, and to dispel myths about the help-seeking process and outcome. Further research is needed to determine which beliefs are most important to young people’s help-seeking for FEP.
30
Payne, Tom. "An investigation into the experience of hearing voices network groups." Thesis, Canterbury Christ Church University, 2015. http://create.canterbury.ac.uk/13858/.
Full textAbstract:
Voice hearing has a diverse history but is currently understood as symptomatic of a disease within psychiatric frameworks. Alternatives to 'treatment' include peer-support 'Hearing Voices Network groups' (HVNGs) which have grown in popularity and exist alongside treatment-based hearing voices groups. Few studies have investigated processes underlying change in HVNGs. Established research into therapeutic factors and personal recovery may provide frameworks elucidating change processes. This study aimed to investigate how HVNG attendees experienced change within the group and how this change influenced their lives. A qualitative design was employed using interpretative phenomenological analysis (IPA) to elucidate group processes through immersion in the perspectives of group attendees. Semi-structured interviews were conducted with eight individuals who were purposively sampled from two HVNGs. Interviews lasted from 34 to 54 minutes, were recorded on a Dictaphone and later transcribed verbatim. Four superordinate themes emerged: 'healing', connecting with humanity; group as an emotional container; making sense of the voices and me; and freedom to be myself and grow. The study concluded that relationships, safety, exploration of voices and group ownership are key components of HVNG and fit into frameworks of therapeutic factors and recovery processes. Development of HVNGs should take these processes into account. Future studies should further elucidate processes.
31
Sullivan, Luke. "Men, masculinity and male gender role socialisation : implications for men's mental health and psychological help seeking behaviour." Thesis, Canterbury Christ Church University, 2011. http://create.canterbury.ac.uk/10199/.
Full textAbstract:
The work comprises of three sections, Section A: Literature review This section reviews men's underutilisation of professional health care services and brings together the extant literature on men's help seeking for psychological difficulties. This is discussed specifically in relation to theories of male gender role socialisation and male development. Section B: Empirical Paper. Introduction: Men’s reluctance to access health care services has been under researched even though it has been identified as a potentially important predictor of poorer health outcomes among men. Male gender role socialisation and male development may be important in accounting for men’s underutilisation of mental health service in the UK. Method: A cross-sectional online survey was used to administer standardised self-report measures that were subject to regression analysis. Five hundred and eighty-one men from the UK general population completed the survey and 434 participants formed the final regression model sample. Results: Men who score higher on measures of traditional masculine ideology, normative alexithymia and fear of intimacy reported more negative attitudes towards seeking professional psychological help. Normative alexithymia accounted for the variance in help seeking previously observed by fear of intimacy during regression modelling. Sexuality and ethnicity also significantly accounted for a proportion of unique variance in men’s help seeking attitudes. People who had received previous support from a mental health professional showed more positive attitudes towards seeking psychological help. Conclusions: Men’s attitudes towards seeking psychological help were closely related to traditional masculine ideology and normative alexithymia. A degree of content or construct overlap may exist between normative alexithymia and fear of intimacy in men. Limitations of this study and implications for future research are discussed. Section C: Critical Review. This section provides critical appraisal and reflection on the study and research process. Personal learning is discussed alongside clinical implications and ideas for further research.
32
Parsloe, T. "Clinical psychologists' beliefs about the purpose of their profession in relation to the wider mental health system : a case study of views on new powers of compulsion." Thesis, Canterbury Christ Church University, 2012. http://create.canterbury.ac.uk/10940/.
Full textAbstract:
Despite the profession’s putative reflexivity, little theoretical or empirical literature addresses British clinical psychologists’ beliefs about the nature of their profession and its relationship with the wider mental health system. This study examined attitudes towards one new development – the adoption of compulsory powers – in order to discover the implicit beliefs that clinical psychologists draw upon in practice. Written comments from 292 clinical psychologists responding to an earlier questionnaire survey were analysed using Grounded Theory, together with data from a focus group. Two contrasting constellations of belief emerged. Some clinical psychologists appeared to believe in the profession’s ability to transform services from the inside by opportunistically accreting power. Others appeared to believe in a need to defend the profession against assimilation, by maintaining separate spaces for more collaborative relationships. These overarching beliefs were associated with different beliefs about specific issues, namely professional identity, its compatibility or otherwise with coercion, where power is located and what drives organisational change. These findings suggest a need for greater professional self-examination. They are considered with reference to organisational, sociological and psychological literature. Limitations and areas for further research are discussed.
33
Lane, Carla. "Youth offending teams : a grounded theory of the barriers and facilitators to young people's help seeking from mental health services." Thesis, Canterbury Christ Church University, 2015. http://create.canterbury.ac.uk/13902/.
Full textAbstract:
Young people within the youth justice system experience three times higher rates of mental health problems than the general youth population yet are one of the least likely groups to seek help. Very little theory or research is available within this population to explain these high rates of unmet need. This study aimed to develop a theory about the barriers and facilitators that Youth Offending Team workers experience when supporting young people to access mental health services. Eleven semi-structured interviews were conducted with participants; eight youth offending team workers, two young people and a mental health worker. Interviews were audio-recorded and transcribed verbatim before being analysed using “grounded theory”. This method was chosen to allow the in depth exploration of participants experiences and the development of theory within an under researched area. The results showed that Youth Offending Team workers appeared to play a crucial role in supporting a young person’s help seeking from mental health services. A preliminary model was developed which demonstrated the complex relationships between six identified factors which influenced this role. The study concluded that Youth Offending Team workers would benefit from more support, training and recognition of the key role they play in supporting young people to become ready for a referral to mental health services. Mental health services could be well placed to provide this. Clinical implications are discussed. Further research is needed to develop our understanding of what influenced the help seeking of this vulnerable population.
34
Spencer, Matt. "An ecological exploration of personal recovery in the context of severe mental illness." Thesis, Canterbury Christ Church University, 2013. http://create.canterbury.ac.uk/12477/.
Full textAbstract:
This study had two objectives: to develop an ecological understanding of personal recovery in the context of severe mental illness (SMI) with a UK-based sample, and to develop a model of the discovery of hope and meaning in recovery, and relevant helping and hindering factors. A grounded theory methodology was employed as a framework for collecting and analysing qualitative data. The study provides an emergent ecological model of growth in the context of personal recovery incorporating seven theoretical categories including; prevailing contexts, the importance of relationships, purposeful goals, values-commitment, emerging self-efficacy, wellness experience, and tangible and intangible hope. The emergent model provides a novel understanding of the individual, ecological and interactional factors facilitating the discovery of hope and meaning in life. It is anticipated that such findings will benefit the provision of statutory and peer-run mental health services, and support further research into growth in the context of SMI.
35
Cole, Samantha. "Management of clients who self-harm in UK secure forensic units." Thesis, Canterbury Christ Church University, 2016. http://create.canterbury.ac.uk/15030/.
Full textAbstract:
Little evidence exists in the literature for how to manage clients who self-harm within low, medium and high secure forensic wards, despite the identified high rates of self-harm within these services. This study sought to investigate the management practices used with clients who self-harm in low, medium and high secure forensic wards, how helpful staff consider these practices and what understanding staff have of the reasons for which clients self-harm. A Delphi survey methodology was employed across three rounds using a multidisciplinary cohort of forensic ward staff, across low, medium and high wards. Physical management strategies were reported as most frequently employed to manage self-harm. Relational approaches to managing self-harm showed the highest rate of consensus for their helpfulness in practice. Consensus was reached across numerous domains explaining reasons for self-harm, including as a ‘communication of distressing feelings’. Statements indicating a negative view of self-harm such as ‘to manipulate staff and gain attention’ received consensus of disagreement. Psychological models and approaches used by clinical and forensic psychologists in the cohort were identified, and helpful elements of these models were identified, including ‘positive focus of approach’ and ‘emphasis on relational working’.
36
Scott, C. R. "An exploration of refugees, post traumatic stress disorder and quality of life." Thesis, Canterbury Christ Church University, 2012. http://create.canterbury.ac.uk/11320/.
Full textAbstract:
Section A presents a literature review which aims to consolidate the theoretical and empirical psychological research regarding refugees’ post-migration, to clarify and further understand their psychological experiences and needs. The literature search yielded papers which are divided into four sections: refugees and post traumatic stress disorder (PTSD); refugees, complicated grief and cultural bereavement; refugees, resettlement and acculturation; and refugees and Quality of Life (QoL). The review highlights key findings and areas requiring further exploration. Section B reports an exploratory narrative study which aims to explore the role of QoL in the narratives of refugees with a diagnosis of PTSD. Episodic semi-structured interviews were conducted with seven refugees (5 males, 2 females), and analysed using narrative thematic, structural and performance analysis. The results illustrated containing and consistent support was important in progressing the transition from suffering during asylum-seeking to a refugee with hope, and improved QoL and psychological health. The results are applied to theory and research, and limitations of the study are discussed.
37
Isbister, Chloe. "Young people, self-harm and help-seeking." Thesis, Canterbury Christ Church University, 2013. http://create.canterbury.ac.uk/12505/.
Full textAbstract:
Given the high rates of completed suicide and poor help-seeking among young men, this research explored how young men, who had successfully sought help from a Child and Adolescent Mental Health Service (CAMHS), experienced help-seeking. This study focused on the factors that facilitated initial access and on-going engagement in services. Eight young men between the ages of 16-18, who had entered CAMHS following self-harm or suicidal ideation, and who were engaged in on-going therapy, were recruited. Each young man was interviewed to elicit his personal experiences of help-seeking and help-receiving. Interviews were transcribed and subjected to Interpretative Phenomenological Analysis. Five dominant themes, that overarched participant’s individual experiences, emerged from the data: Role of external adult in recognising, normalising and initiating help seeking; Influence of another;Challenging and renegotiating perception of need for help and meaning behind this need; Change in perspective; Maintaining an independent self; Mechanisms of engagement and Shared experience. Help-seeking was described as a journey of two stages; 1) initial access and 2) on-going engagement, during which the presence and timing of external influences (parents, teachers) and internal influences (personal beliefs and attitudes) were crucial. A model of help-seeking is presented. This study is the first of its kind to consider factors that facilitate the help-seeking journey of young men aged 16-18 following self-harm. It highlights the need for provision of information to parents and teachers about how to identify need and ways to facilitate access to services. Information and guidelines on how to adapt services to meet the complex developmental needs of young men, is highlighted for service developers, commissioners and clinicians.
38
Radford, Rebecca. "Care coordinators' responses to clients' trauma : the role of coping and perceived organisational support." Thesis, Canterbury Christ Church University, 2013. http://create.canterbury.ac.uk/12507/.
Full textAbstract:
Research suggests that working with trauma survivors can result in a range of negative effects including ‘vicarious trauma’, ‘secondary trauma’, ‘compassion fatigue’ and ‘burnout’ amongst other things. Although the impact of being exposed to traumatic stories has been investigated in a range of professionals no studies to date have explored the impact of this on UK mental health workers known as care coordinators. The aim of this study was to explore a sample of care coordinators responses to client’s traumatic stories and the role of coping and perceived organisational support. Twelve UK care coordinators (community psychiatric nurses, occupational therapists and social workers) from two NHS mental health recovery teams completed interviews about their experiences of hearing clients’ traumatic experiences. Grounded theory was employed to analyse the interviews. The care coordinators heard traumatic stories in their role and were ‘active participants’ in these disclosures. They also experienced short and long-term levels of distress which included a range of negative emotions, a mixture of positive and negative responses and a broadening of their perspectives on themselves, their clients and the world. Care coordinators also developed a range of individual coping strategies, experienced individual and organisational barriers to seeking support and experienced limited organisational support for hearing traumatic stories. This is the first UK study to investigate care coordinators’ responses to clients’ traumatic experiences. Therefore further exploratory studies are required in addition to studies with larger sample sizes and measures of trauma related symptoms.
39
Law, Naomi. "Individual and organisational challenges for personalised care on an inpatient ward : the staff team perspective." Thesis, Canterbury Christ Church University, 2014. http://create.canterbury.ac.uk/12793/.
Full textAbstract:
Criticism of NHS acute psychiatric care has been high within patient experience research, compounded by critical press coverage of inpatient wards. Government policy requires staff to deliver compassionate, personalised care, but there is little research considering staff’s perspectives and experiences of the work. This study aimed to construct a grounded theory of acute psychiatric staff’s experiences, with particular attention to what might facilitate or block compassionate patient care. Semi-structured interviews were conducted with ten ward staff (three men, seven women) across a range of disciplines. Data were analysed using constructivist grounded theory. The model constructed captures the dynamic interactions between eleven categories: Being in a chaotic environment, Feeling limited, Struggling to improve without support, Building patient relationships, Enjoying the work, Staying vigilant, Taking an emotional toll, Putting up a barrier, Supporting each other, Seeing tensions and differences, and Acting as one team. The study concluded that staff described feeling motivated to engage with patients but restricted by practical and emotional demands. While support was provided by colleagues and formal structures, staff could not always make full use of them. Suggestions for future research and clinical practice include changes to practical demands on staff, as well as attitudes towards reflective practice.
40
Gunputh, Vanessa. "An exploration of help-seeking among South Asians living in the UK." Thesis, Canterbury Christ Church University, 2015. http://create.canterbury.ac.uk/13904/.
Full textAbstract:
Culture can often influence how psychological distress is experienced and where help is sought. South Asians are the largest ethnic minority group in the United Kingdom (UK). This paper aimed to explore how second-generation South Asian adolescents make sense of their experiences of psychological distress and the meanings attributed to help-seeking. Semi-structured interviews were carried out with nine second-generation adolescents aged 13-19 years. Interpretative Phenomenological Analysis was employed. Five superordinate themes emerged from the analysis: feeling distressed, negative impact of family and cultural ideals on the self, connectedness to others, perception of help-seeking outside the family and intergenerational differences in help-seeking. The results indicated that help is sought from families when participants perceive they are able to relate to the source of distress. However, when there is a lack of understanding of distress, participants sought this from external sources of help. Professional help-seeking appeared influenced by the interplay between not meeting family ideals, intergenerational differences in understanding of distress and the stigma of seeking help. Clinical and research implications are discussed.
41
Johnson, Bridget Ann. "Mental health promotion in Western Cape schools :an exploration of factors relating to risk, resilience and health promotion." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
Full textAbstract:
Recent South African research has confirmed that there is reason to be concerned about the mental health status and well-being of our youth. School-going youth are engaging in a wide array of risk behaviours that seriously threaten their well-being and hamper their chances of experiencing success in the future. The aim of this research was to explore factors relating to risk, resilience and health promoting schools in order to enhance the well-being of youth in South Africa.
42
Smith, Lesley-Ann. "'Mad, bad and dangerous to know' : exploring the everyday spaces of older, mental health service users." Thesis, University of Northampton, 2012. http://nectar.northampton.ac.uk/5423/.
Full textAbstract:
The area of mental health distress is one that crosses many disciplines including; psychiatry, critical psychiatry, psychology, critical psychology, history, politics, economics, philosophy, sociology, culture and human geographies (Thrift, 2006). Consequently, there are a complex set of issues to consider when discussing the experiences of being a mental health service user. Notwithstanding this diversity, such representations of mental health have a tendency to position service users as a fairly homogenous and static group of bodies – in other words, they are the stable ‘other’ (Conradson, 2005; Parr, 2000). As a way of exploring the complexity, this thesis sets out to explore the multiplex constituents and heterogeneous ways in which daily service user life is played out within everyday mental health spatial contexts. These spaces incorporate the psychiatric institution, the mental health day centre and the home. Using interviews, ethnography, poetry and visual ethnographies, service users’ experiences are analysed by exploring the relational aspects of the discursive and the non-discursive, such as receiving a diagnostic label and subsequent treatments and the ways in which these practices permeate the embodied and spatial experiences of every day service user life. This corpus of research data suggests that rather than the experiences of mental health distress operating as a stratified set of factors awaiting analysis, there were divergent accounts incorporating positivity, negativity and ambivalence in the ways which service users made meanings of their daily lives (Brown & Tucker, 2010). Consequently, this thesis is framed around the ontological realms of creativity, potentiality and of becoming within and through space (Deleuze & Guattari, 2004; Massumi, 2002). Finally, some implications of the current political changes and how these may impact upon daily service user life are discussed to highlight that mental health service users’ are always on the move.
43
Levy, Michelle A. "Can the theory of planned behaviour (TPB) predict trainee clinicians' use of CBT self-help materials in step 2 mental health services?" Thesis, Canterbury Christ Church University, 2011. http://create.canterbury.ac.uk/10434/.
Full textAbstract:
Section A reviews and synthesizes the extant literature on adherence to clinical guidelines, with specific reference to the use of CBT self-help interventions as a mainstay within the IAPT programme. The review also evaluates the utility of one psychological framework, namely the theory of planned behaviour (TPB), in assessing the cognitive factors that may be most associated with compliance in this context. The review ends by suggesting an avenue for future research. Section B In spite of evidence for their efficacy and effectiveness as well as the recommendations of NICE, CBT self-help materials are not used routinely or used as an intervention in their own right in mental health services. Aims: This cross-sectional study set out to assess whether the main constructs of the TPB, namely, attitudes, subjective norms (SN) and perceived behavioural control (PBC), as well as past use, self-help training and demographic characteristics, could predict IAPT psychological well-being practitioners’ (PWPs) intention to use CBT self-help materials in their clinical practice. Method: A convenience sample of PWPs (n=94) completed a web-based, mixed closed and open-response questionnaire, which was developed from an earlier elicitation study with a sub-sample of their colleagues. The data generated were analyzed by linear, multiple regression, mediation, and qualitative analyses. Results: The TPB’s main constructs predicted PWPs’ intention to use self-help materials in their clinical work, with attitude being most significant. Past use of self-help materials emerged as both a direct predictor of intention, as well as indirectly related to intention, independent of the mediating effects of the main constructs. The overall extended TPB model explained a respectable 70% of the variance in intention. However, neither self-help training nor demographic factors were associated with PWPs’ intention. Conclusion: It is recommended that future research could extend the methodology to prospective, longitudinal investigations of PWPs’ actual use of self-help materials. It is hoped that this would further elucidate the cognitive factors that are involved in PWPs’ decision-making when they are actually using the materials. Section C sets out and answers four specific questions that guide a reflective critical appraisal of the processes involved in the execution of this research project.
44
Malwah, Monique N. "An exploration into the social identity of members of service user groups that train mental health professionals." Thesis, Canterbury Christ Church University, 2013. http://create.canterbury.ac.uk/12511/.
Full textAbstract:
The aim of this grounded theory study was to explore the social identity of members of service user groups that train mental health professionals (SUG-TR). Additionally, the study aimed to construct an explanatory model of how participating in such groups contributes towards the achievement and maintenance of positive social identity. Semi-structured interviews were conducted with eight members of SUG-TR. Grounded theory was used to build a preliminary model, which contained 5 main categories: ‘Impact of mental illness/ impact of receiving a psychiatric diagnosis’; ‘The experience of stigma’; ‘Participating in SUG-TR’; ‘Contributing to positive identity’; and ‘Challenges to participating’. The constructed theory suggests that participation in such groups can contribute towards the achievement and maintenance of a positive social identity and that participants adopted specific strategies to achieve positive distinctiveness (i.e. an individual striving for positive self-concept) in the SUG-TR meetings and training environments. The constructed theory extends current research and suggests that SUG-TRs provide unique opportunities for the development of socially valued roles. The limitations and clinical implications of the research are explored and suggestions for further research are presented.
45
Webster, Hayley Monique, and n/a. "An Ecological Approach to the Prevention of Anxiety Disorders during Childhood." Griffith University. School of Applied Psychology, 2003. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20030807.105928.
Full textAbstract:
Research shows that anxiety disorders are common and problematic in children. Treatment studies demonstrate that cognitive-behavioural interventions for children can successfully minimise these problems. Further, when implemented as early intervention or prevention programs, these interventions can prevent the onset of anxiety problems in 7 to 14 year olds and reduce existing levels of anxiety. This type of preventive approach has enormous potential for improving community mental health in a low cost model of service delivery. Yet, to develop this as a viable service model, these programs need to be evaluated under 'real world' conditions as opposed to specialist university clinical teams. In this research, the long-term effectiveness of an ecological model of the prevention of anxiety disorders for children was conducted. In the first study, teachers (N = 17) were trained intensively in the principles of anxiety and the FRIENDS anxiety prevention program (Barrett, Lowry-Webster & Holmes, 1999). Measures were taken of the PROXIMAL effects of training on the knowledge and self-efficacy of participating teachers at two points in time. Compared to teachers in a control group (N= 17) and a group comprised of psychologists regarded as experts in the FRIENDS anxiety program (N= 22), trained teachers demonstrated significant increases in the levels of knowledge and self-efficacy at time two. These increases approached levels exhibited by experts in terms of knowledge, and were not significantly different from experts in their levels of self-efficacy to implement the FRIENDS program following training. This study also explored the quality or fidelity of program implementation by these trained teachers (INTERMEDIATE EFFECTS). Results demonstrated that trained teachers implemented the program with high levels of integrity in accordance with the FRIENDS intervention manual. The second study sought to investigate the outcomes for participating children in terms of actually preventing and reducing existing levels of anxiety. Also of interest was the impact this intervention had on levels of depression. Participants were 594 children aged 10-13 years from 7 schools in Brisbane Australia. Children, and parents reported on children's social, emotional and behavioural characteristics at three-assessment points over 12 months. Results were examined universally (for all children) and for children who scored above the clinical cut-off for anxiety at pre-test. Results revealed that children in the FRIENDS intervention group reported fewer anxiety symptoms regardless of their risk status at posttest. In terms of reported levels of depression, only the high anxiety group who completed the FRIENDS intervention evidenced significant improvements at posttest. The results indicated that intervention gains were maintained over a period of 12 months, as measured by self-reports and diagnostic interviews. Moreover, evidence of a prevention effect was also demonstrated, with a significantly greater percentage of children in the control group progressed to "at risk" or "remained at risk" compared to children in the intervention group. Additionally, 85% of children in the intervention group who were scoring above the clinical cut-off for anxiety and depression were diagnosis free in the intervention condition at 12-month follow-up, compared to only 31.2% of children in the control group. Implications of these findings are examined, alongside limitations of the study and directions for future research.
46
Schreur, Fides K. "Service user and carer involvement in mental health education : a grounded theory investigation into its impact on (trainee) clinical psychologists' learning." Thesis, Canterbury Christ Church University, 2013. http://create.canterbury.ac.uk/12458/.
Full textAbstract:
Service user and carer involvement has become a priority in the education of mental health professionals. While preliminary evidence suggests that service user and carer involvement is perceived positively by mental health students, there is a paucity of research investigating impacts relating to changes in learners’ knowledge, skills, attitudes or behaviour. The present qualitative study sought to investigate what, and how, (trainee) clinical psychologists learn as a result of service user and carer involvement in their training. Overall, 12 (trainee) clinical psychologists were interviewed and grounded theory methodology was used to analyse the data. Findings indicated that (trainee) clinical psychologists learned from service user and carer involvement in a variety of ways and a preliminary model was proposed, encompassing four main categories: 'mechanisms of learning', 'relational and contextual factors facilitating learning', 'relational and contextual factors hindering learning' and 'impact'. The findings are discussed in relation to extant empirical research, taking into account theoretical considerations. Recommendations for educators in clinical psychology training programmes are provided alongside suggestions for a future research agenda. A methodological critique of the study is offered.
47
Kemp, Natalie. "Fathers' experiences of a mother and baby unit : a qualitative study." Thesis, Canterbury Christ Church University, 2011. http://create.canterbury.ac.uk/10277/.
Full textAbstract:
Section A presents a literature review of the issues and challenges facing fathers in the postnatal period, in the context of an historical marginalisation of fathers in the study of child development. The review leads to a specific focus on the limited research evidencing the increased risk fathers face to their mental health, when coping with a partner's admission to a Mother and Baby Unit (MBU). Section B Fathers' experience of the joint admission of a partner and child to an MBU has been the subject of limited research, despite initial findings suggesting fathers are at increased risk of postnatal paternal mental health difficulties. This qualitative study aimed to explore the lived experience of fathers in this context, to inform the validity of future research in the area. Interpretative phenomenological analysis was carried out following semi-structured interviews with six fathers in south east England. Five master themes showed that these fathers experienced the onset of their partners' postnatal mental health difficulties as unexpected and traumatic. Fathers needed to acknowledge limits in their ability to help, and the necessity of calling on specialist services. During admission, fathers felt pulled physically and emotionally between managing their own needs, and the needs of their partner and new baby. Themes showing the MBU admission challenged their fathering role and identity were contrasted with the importance fathers placed in treatment needing to be a 'family affair', inclusive and supportive of the father, and mindful of the impacts on the couple relationship. The impact of culture on fathers' adjustment to involvement at the MBU was noteworthy. In conclusion, this research helps understand the importance of including the father where appropriate in a mother's recovery programme, and helping the father define a role alongside the clinical team. The findings of the study validate the efforts of government policy to build effective family focused perinatal services. Section C sets out the journey taken from the ethnographic inception of the research idea, through dilemmas encountered in carrying out the study, to reflections on what was learnt during the process.
48
Trustam, Emma. "Exploring recovery in people with learning disabilities." Thesis, Canterbury Christ Church University, 2014. http://create.canterbury.ac.uk/12767/.
Full textAbstract:
A literature review examines how mental health difficulties may differ for people with learning disabilities (PwLD) and the general population; with respect to their vulnerability to mental ill-health and the definition, presentation and treatment of mental health problems. Factors which have been found to positively impact on the mental health of PwLD are then explored. The review considers methodological limitations and gaps in our understanding, highlighting a need for further research focusing on mental health recovery for individuals with learning disabilities. Section B presents a study exploring what recovery means for people with learning disabilities and mental health difficulties. Interviews were conducted with nine individuals and Interpretative Phenomenological Analysis used. A model was developed which described participants’ entry to the therapeutic service and their progression towards recovery. The model firstly describes how participants felt entering the service, their Mental Health/Therapy Experience, and explains how these experiences were validated and the recovery process enabled through the therapeutic alliance. Once enabled, the second dimension of the model is detailed, that of the Client Recovery Experience which extends across three phases of recovery. The first phase, Feeling Better describes elements perceived as integral to improved mental health. The second phase, Recovery Ongoing identifies that more input is required. Thirdly, Attainability?: Reality, Ideals and Fantasy, reveals PwLD’s perceptions of recovery and the techniques used in striving to achieve this. Salient features of recovery specific to PwLD are recognised as important to clinical practice, and results suggest there is a need to openly discuss LD identity, and address idealisations surrounding a non-LD one. This would involve setting realistic goals and managing expectations accordingly and focussing on social integration as a way of enabling ongoing recovery.
49
Bostedt, Daniel, and Khosht Salman El. "Hälsofrämjande för äldre - lindring av depressiva symtom. : En litteraturöversikt." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-397093.
Full textAbstract:
Bakgrund: Depression är lika vanligt som demens hos äldre, men ofta inte lika studerat eller diskuterat. I dagsläget finns det flertalet olika bedömningsformulär för att finna dessa patienter men depression hos äldre är ofta odiagnostiserat. Konsekvenserna med en depression i sen ålder kan vara mycket ogynnsamma, både för individen och samhället. Allt eftersom den äldre befolkningen kommer att öka så kommer även depression att öka.Syfte: Syftet med denna studie är att undersöka olika metoder för att lindra depressiva symtom hos den äldre befolkningen. Metod: Beskrivande design med litteraturöversikt med systematisk ansats som metod.Resultat: Tolv originalartiklar med kvantitativ experimentell metod inkluderades. Fyra artiklar tog upp självhjälp och hjälp till självhjälp av olika slag som intervention, fyra tog upp fysisk aktivitet som intervention, två tog upp KBT som intervention, en använde samtalsterapi som intervention och två artiklar hamnade under mer än en underrubrik. Nio av artiklarna hade interventioner som visade sig fungera för att lindra depressiva symtom. Slutsats: Att kombinera motion med socialt umgänge, rätt kost och en aktiv vardag kan lindra depressiva symtom i stor utsträckning. Det viktigaste arbetet borde vara att upptäcka och börja sätta in åtgärder i ett tidigt skede, för att förhindra att en depression utvecklas. Detta kan leda till minskat lidande för patienten och minskade kostnader för samhället.Introduction: Depression is as common as dementia in the elderly, but often not as well studied or discussed. At present, there are several different assessment forms for finding these patients, but depression in the elderly is often undiagnosed. The consequences of a late-age depression can be vary unfavorable, both for the individual and society. As the older population increases, so will depression. Aim: The purpose of this study is to investigate various methods to relieve depressive symptoms in the elderly population. Methods: Descriptive design with literature review with systematic approach as method. Results: Twelve original articles with a quantitative experimental method were included. Four articles addressed self-help and self-help of various kinds as intervention, four took up physical activity as intervention, two took up KBT as intervention, one used conversational therapy as intervention and two articles ended up with more than one sub-heading. Nine of the articles had interventions that were found to work to relieve depressive symptoms. Conclusion: Combining exercise with social interaction, the right diet and an active everyday life can greatly alleviate depressive symptoms. However, the most important work should be to discover and take measures at an early stage, to prevent a depression to develop. This can lead to reduced suffering for the patient and reduced costs for society.
50
Pinho, Eurides Santos. "Processos de trabalho de um centro de atenção psicossocial tipo III: reflexão de práticas e saberes." Universidade Federal de Goiás, 2015. http://repositorio.bc.ufg.br/tede/handle/tede/6554.
Full textAbstract:
Submitted by JÚLIO HEBER SILVA (julioheber@yahoo.com.br) on 2016-12-01T17:34:41Z
No. of bitstreams: 2
Dissertação - Eurides Santos Pinho - 2015.pdf: 1983126 bytes, checksum: 484a5897cce2dd43b87b7b8891405725 (MD5)
license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Approved for entry into archive by Jaqueline Silva (jtas29@gmail.com) on 2016-12-02T11:51:31Z (GMT) No. of bitstreams: 2 Dissertação - Eurides Santos Pinho - 2015.pdf: 1983126 bytes, checksum: 484a5897cce2dd43b87b7b8891405725 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)
Made available in DSpace on 2016-12-02T11:51:31Z (GMT). No. of bitstreams: 2 Dissertação - Eurides Santos Pinho - 2015.pdf: 1983126 bytes, checksum: 484a5897cce2dd43b87b7b8891405725 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2015-12-15
Comprehending the ongoing (re)building process of the substitutive psychosocial model to the nursing home care model for people suffering from mental disorders, it is worthwhile to know the healthcare dynamic of a substitutive service, in order to identify any issues within the team, which could interfere with the quality of care they provide. The aim of this study was to identify the working process of professionals at a Type III Psychosocial Care Center (PCC). This is an interventional study using a qualitative approach, that is based on the problem-based method, known as Arco de Maguerez. It consists of five stages: reality observation, key points, theorizing, problem-solving hypothesis, and application to reality. The development of the study was based on lightweight technology sources mediated by group technique. In the first stage, strong and weak points of the service were identified, followed by a discussion of issues related to the patient, family, teamwork, territory, and management. From this, the strengths and weaknesses of the staff and service were discussed. Following this, the participants emphasized the importance for discussion on the difficulty of integration and coordination of the Psychosocial Care Network. In the next step, problems regarding key points in question were expressed and this guided the active search in the literature for theorizing, which would guide in developing possible solution options. Therefore, permanent health education to perform the matricial and approaches to disclose the PCC territory were debated, and subsequently strategies were developed and applied to reality. Through the research process, the strengths of the team that would help them to overcome their shortcomings were identified. While some restraining forces that precluded this movement were also identified. In this context, the awareness-making process and the participants’ willingness to embrace change were evident throughout the study. This highlights the acceptance of the proposal of the interventional research that is based on the problematization of the service. It is evident that the spaces validity for the exchange of practices and knowledge, reflection-action-reflection, are imperative to the production of knowledge, which supports professionals for the qualification of care in mental health.
Entendendo o processo contínuo de (re)construção do modelo psicossocial substitutivo ao modelo de assistência asilar a pessoas com sofrimento ou transtornos mentais, considera-se fundamental conhecer a dinâmica assistencial de um serviço substitutivo, com vistas a delinear junto à equipe situações problemas que interferem na qualidade do cuidado que oferecem. A pesquisa teve o objetivo de conhecer os processos de trabalho dos profissionais de um Centro de Atenção Psicossocial tipo III. Estudo do tipo de intervenção, de abordagem qualitativa, direcionada pela metodologia problematizadora do Arco de Maguerez, que compreende cinco etapas sucessivas: Observação da Realidade, Pontos-chave, Teorização, Hipóteses de Soluções e Aplicação à Realidade. Seu desenvolvimento foi norteado utilizando-se essencialmente recursos das tecnologias leves, mediadas por técnicas grupais. Na etapa inicial, foram elencados pontos frágeis e fortes do serviço, seguidos da discussão de questões relativas ao usuário, família, equipe, território e gestão. A partir desse momento discutiram-se os entraves e pontos propulsores da equipe e do serviço. Na sequência, os participantes elegeram como ponto prioritário de discussão a dificuldade de integração e articulação da Rede de Atenção Psicossocial. A etapa seguinte privilegiou-se a problematização dos pontoschaves em questão, que orientaram a busca ativa na literatura para a teorização que orientaria as possíveis hipóteses de soluções. Assim, a educação permanente em saúde para realizar o matriciamento e formas de divulgação do CAPS no território foi debatida e, posteriormente, estratégias de ações foram aplicadas à realidade. No caminhar do processo de pesquisa, constataram-se forças propulsoras da equipe para o enfrentamento de suas dificuldades e também algumas forças restritivas que impediam este movimento. Neste contexto, os processos de tomada de consciência e de mudança dos participantes ficaram evidentes ao longo do estudo, salientandose a aceitação da proposta da pesquisa intervencionista, fundamentada na problematização do cotidiano do serviço. É perceptível a validez dos espaços de trocas de práticas e saberes, reflexão-ação-reflexão, para a produção de conhecimento que subsidiem os profissionais para a qualificação do cuidado em Saúde Mental.