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Recovery from Psychosis in a Forensic Service: Assessing Staff and Service Users’ Perspectives Using Q Methodology
Journal of Forensic Psychology Practice Pub Date : 2019-02-06 , DOI: 10.1080/24732850.2018.1556516
Dr Kim Jackson-Blott 1 , Dr Dougal Hare 1 , Dr Sara Morgan 2 , Dr Bronwen Davies 3
Affiliation  

Recovery has become a guiding principle for mental health service delivery. However, the implementation of recovery-oriented services is hindered by conceptual multiplicity, and forensic services in particular face additional challenges. The perspectives of both those receiving and providing services are central in understanding how the recovery approach can best be supported in practice. Therefore, this study used Q methodology to explore staff and service-users’ views regarding factors deemed important to recovery from psychosis in a forensic service. Ten service-users and 13 mental health professionals completed a 60-item Q-sort to obtain their idiosyncratic views about recovery in this context. Q analysis produced a four-factor solution (accounting for 60% of the variance), revealing four distinct perspectives. The first placed emphasis on “personal growth and psychosocial aspects of recovery,” the second on “gaining insight and reducing recidivism,” the third placed importance on “self-focused aspects of recovery,” and the final factor highlighted “making amends & service engagement” as important to recovery. The heterogeneity of recovery beliefs indicated that multiple dimensions of recovery are important in clinical practice. The bio-medical model of care appeared most prominent, suggesting the need for greater choice in alternative treatments and improved access to alternative models of care. To better apply recovery values, service-users and mental health professionals require a better understanding of the various recovery dimensions, and this broad conceptualisation of recovery should be reflected in service provision.



中文翻译:

法医部门从精神病中康复:使用Q方法评估员工和服务使用者的观点

康复已成为提供精神卫生服务的指导原则。然而,面向恢复的服务的实施受到概念多样性的阻碍,尤其是法医服务还面临其他挑战。接收和提供服务的人员的观点对于理解如何在实践中最好地支持恢复方法至关重要。因此,本研究使用Q方法论来探讨工作人员和服务使用者关于被认为对法医服务中的精神病康复至关重要的因素的观点。10位服务用户和13位心理健康专业人员完成了60个项目的Q排序,以获取他们在这种情况下对康复的特殊看法。Q分析产生了四因素解决方案(占方差的60%),揭示了四个不同的观点。第一个重点放在“个人成长和恢复的社会心理方面”,第二个重点放在“获得见识并减少累犯”,第三个重点放在“自我关注的恢复方面”,最后一个因素强调“做出修正和服务”参与”对于恢复至关重要。恢复信念的异质性表明,多维恢复在临床实践中很重要。生物医学护理模式似乎最为突出,这表明在替代治疗中需要更多选择,并需要更多机会获得替代护理模式。为了更好地应用恢复价值,服务用户和精神卫生专业人员需要更好地了解各个恢复维度,并且这种广泛的恢复概念应反映在服务提供中。

更新日期:2019-02-06
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