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Purpose: The purpose of this paper was to determine the attachment strategies of prospective adoptive parents and any correlation between attachment and the defensive strategies they used when talking about loss of fertility. The study also examined whether attachment strategy of the applicants had a bearing on the decision by the local authority to place a child. Design/methodology/approach: The sample was comprised of 48 respondents (21 couples) representing 84 per cent of all people who applied to one UK Social Services Department in a 12-month period. Placement of a child was reviewed two years following the assessment. The study used the dynamic maturational model version of the adult attachment interview (DMM-AAI), together with added questions on loss of fertility to assess the applicants' attachment strategies together with unresolved loss and trauma and the DMM modifiers. Findings: Unlike adoption studies using the Main and Goldwyn system, this study rated very few of the applicants' AAIs as secure (13 per cent), 48 per cent were in the normative low-risk range and 52 per cent of the AAIs were coded in the more complex DMM insecure strategies. There was a significant bias towards marriages where the partners deployed opposite low-risk/DMM strategies (13 (62 per cent) of couples). Compared with data on non-clinical populations the AAIs showed a high level of unresolved loss or trauma (58 per cent). Using a six-way distribution (A1-2, C1-2, B, A3-4, C3-6 and A/C) there was an 87 per cent correspondence between discourse about loss of fertility and that about attachment, thereby supporting the established proposition that reproduction is part of the attachment system. Twenty one per cent of the AAIs were coded as "disorientated" and this is discussed in terms of conflict for adoptive of parents concerning the raising of a child who carries their own genes or those of strangers. A case is made to conceptualise negative impact of infertility in terms of unresolved trauma rather than loss. Research - limitations/implications: This study adds to research showing that the DMM approach is more finely calibrated than the ABC+disorganised model with the latter likely over coding for security. The results emphasise that fertility and reproduction are legitimate subjects for attachment studies and that AAI discourse analysis is a valid methodology for future research. However coder agreement as to whether or not loss of fertility was resolved was only fair (64 per cent) κ. 0.25 (po0.33). More work is required in order to determine what constitutes unresolved loss of fertility and what impact, if any, this has on parenting an adopted child. Practical implications: The practice implications are considered in a separate paper. Social implications: The findings are contentious in that they suggest a significant number (48 per cent) of adoptive parents have needs not dissimilar to other clients of psychological services. Originality/value: This is the first DMM-AAI study with prospective adoptive parents and the findings show significant differences when compared with previous studies using the Main and Goldwyn AAI. It is also the first study to establish fertility as a legitimate area for attachment studies by using AAI discourse analysis. [ABSTRACT FROM AUTHOR]

Purpose Co-existing health conditions and frequent hospital usage are pervasive in homeless populations. Without a home to be discharged to, appropriate discharge care and treatment compliance are difficult. The Medical Respite Centre (MRC) model has gained traction in the USA, but other international examples are scant. The purpose of this paper is to address this void, presenting findings from an evaluation of The Cottage, a small short-stay respite facility for people experiencing homelessness attached to an inner-city hospital in Melbourne, Australia.Design/methodology/approach This mixed methods study uses case studies, qualitative interview data and hospital administrative data for clients admitted to The Cottage in 2015. Hospital inpatient admissions and emergency department presentations were compared for the 12-month period pre- and post-The Cottage.Findings Clients had multiple health conditions, often compounded by social isolation and homelessness or precarious housing. Qualitative data and case studies illustrate how The Cottage couples medical care and support in a home-like environment. The average stay was 8.8 days. There was a 7 per cent reduction in the number of unplanned inpatient days in the 12-months post support.Research limitations/implications The paper has some limitations including small sample size, data from one hospital only and lack of information on other services accessed by clients (e.g. housing support) limit attribution of causality.Social implications MRCs provide a safe environment for individuals to recuperate at a much lower cost than inpatient admissions.Originality/value There is limited evidence on the MRC model of care outside of the USA, and the findings demonstrate the benefits of even shorter-term respite post-discharge for people who are homeless. [ABSTRACT FROM AUTHOR]

Purpose Homeless people experience extreme health inequalities and high rates of morbidity and mortality (Aldridge et al., 2017). Use of primary care services are low, while emergency healthcare use is high (Mathie, 2012; Homeless Link, 2014). Duration of admission has been estimated to be three times longer for homeless patients who often experience poor hospital discharge arrangements (; ). This reflects ongoing and unaddressed care and housing needs (Blackburn et al., 2017). The paper aims to discuss these issues.Design/methodology/approach This paper reveals how GPs employed in secondary care, as part of Pathway teams, support improved health and housing outcomes and safe transfer of care into community services. It draws on published literature on role of GPs in working with excluded groups, personal experience of working as a GP in secondary care, structured interviews with Pathway GPs and routine data collected by the team to highlight key outcomes.Findings The expertise of GPs is highlighted and includes holistic assessment, management of multimorbidity or "tri-morbidity" – the combination of addictions problems, mental illness and physical health (Homeless Link, 2014; Stringfellow et al., 2015) and research and teaching.Originality/value The role of the GP in the care of patients with complex needs is more visible in primary care. This paper demonstrates some of the ways in which in-reach GPs play an important role in the care of multiply excluded groups attending and admitted to secondary care settings. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to illustrate the hostility many young women who are also mothers experience within their everyday lives.Design/methodology/approach The paper will draw on qualitative research, incorporating a narrative approach, to illustrate the hostility many young mothers experience on a daily basis. The research design included a focus group, semi-structure interviews and participant observations.Findings The paper reports the findings of a study that explored the experiences of young women who are also mothers. The author presents the findings that indicate that many young women, who are also young mothers, experience hostile reactions and interactions as part of their everyday lives.Research limitations/implications The small sample size means that this study cannot be generalised, but it does contribute to the growing body of qualitative evidence in relation to young mothers.Practical implications The findings suggest that there needs to be more recognition and acknowledgement of the hostility young women experience. Such hostility could have deleterious consequences on the young women, their parenting ability and also on the children.Originality/value This paper documents the experiences of young women who are also mothers and how they experience hostility as a daily occurrence. The hostility ranged from verbal to non-verbal and how they felt they were being treated, inferences about their sexuality to stereotyping. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore keyworkers’ experience and perceptions working with people experiencing homelessness and the use of psychologically informed approaches in an Irish context.Design/methodology/approach In this paper a qualitative descriptive methodology was employed and face-to-face in-depth semi-structured interviews were conducted. Data collected were analysed using a thematic framework and transcribed by the researcher.Findings It was the view of the keyworkers psychological approaches allowed them greater understanding of psychological trauma and its effects promotes safe physical and emotional environments builds rapport between staff and clients and enables keyworkers to work more effectively with people with complex needs. There was also convincing evidence staff are quite receptive to training.Originality/value Given there is no research exploring the use of psychologically informed approaches in homelessness service settings, this study researched an area that has not yet been explored in Ireland. This qualitative descriptive research provides a platform from which further research can be conducted. It is hoped that highlighting the psychological issues of homeless people, the data obtained will help improve Irish homeless services, and the findings extracted beneficial in terms of future service developments, professional training and education. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to describe the barriers and facilitators to an effective transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). It also presents a new entry into considering how the transition can be improved.Design/methodology/approach Insights into the transition from CAMHS to AMHS were gathered through eight semi-structured interviews with mental health professionals. Two methods of data analysis were employed to explore the emerging themes in the data and the observed deficit approach to organisational development.Findings The findings identified a vast volume of barriers in comparison to facilitators to the transition. Adolescents who transition from CAMHS to AMHS initially experience difficulty adapting to the differences in the services due to the short duration of the transition period. However, despite the established barriers to the transition, adolescents tend to adapt to the differences between the services. Findings also showed a negative framing towards the transition amongst the mental health professionals which resembles a deficit approach to organisational development.Originality/value This paper explores mental health professionals’ perspectives regarding the transition in Dumfries and Galloway, Scotland. The transition is increasingly recognised as an area in health care that requires improvement. This research provides a new way to consider the transition by exploring the perceived deficit approach to organisational development in the services. [ABSTRACT FROM AUTHOR]

Purpose Notwithstanding heightened awareness of the issues faced by homeless people, the notion that homelessness is the result of individual failings and weaknesses persists. The purpose of this paper is to challenge that perception by giving voice to this marginalised group and exploring the mechanisms through which they made and remade as homeless and may be protected.Design/methodology/approach Semi-structured interviews (n=23) were carried out with a sample of homeless people who had accessed a range of homelessness services in the study area.Findings It is argued that largely deprived of the private sphere, which arguably renders them in most need of public space, homeless people find themselves most subject to scrutiny, surveillance, social disapprobation and exclusion.Research limitations/implications The authors reiterate that rather than simply being associated with rooflessness, homelessness is as a function of ongoing geographical marginalisation and social alienation.Practical implications The authors suggest that dedicated spaces for homeless people to occupy during the day continue to be in need of development because, whilst not unproblematic, they can disrupt processes associated with homelessness.Social implications Further resources should be directed towards homelessness and the issues that arise during daytime for homeless people.Originality/value The paper supports the literature which highlights the spatial practices by which stigmatised groups come to be separated from mainstream society. [ABSTRACT FROM AUTHOR]

Purpose The Prison Rape Elimination Act has brought significant attention to the issue of sexual victimization within correctional institutions. While the actual risk of sexual victimization remains low, the perception of rape among inmates is high. Given how one's fear can translate into behavior, understanding how institutions impact the culture surrounding prison rape highlights areas for reducing violence within prisons. The paper aims to discuss these issues. Design/methodology/approach This study includes secondary analysis of a quantitative database created from semi-structured interviews with 564 high security, general population inmates. Using fear of rape as the outcome of interest, bivariate and logistic regression analyses are used to comment on the impact of individual and facility level characteristics on this outcome. Findings In general, the results from this study suggest that the greatest risk factors for fearing rape while in prison are being male, having a mental health issue, and hearing about rape within the institution. From these specific findings a few general lessons can be learned with the hope that practitioners can translate these lessons into policy initiatives in order to combat fear of rape among our inmate population. Originality/value This paper aims to fill a gap in the research on how the facility contributes to the fear of rape within prison. The end goal is to inform policy makers so that suggestions can be made to combat this problem and prevent further misconduct within these facilities. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to report on the evaluation of a one-day mental health wellness workshop which was delivered to male prisoners in an urban prison in the Republic of Ireland. Design/methodology/approach A mixed methods approach was used to evaluate the workshop. This paper presents the findings of the qualitative arm of the evaluation. Qualitative data were collected using semi-structured telephone interviews with ten participants who had completed the programme. Findings The participants were overwhelmingly positive about the wellness workshop and the qualitative interviews articulated the ways that the workshop impacted on their ability to manage their own and other peoples mental health. Originality/value As prisons attempt to limit the negative impact of prison life, implementing recovery orientated approaches such as the wellness workshop can have a positive impact on prisoners' mental health as well as raising their awareness and improving their attitudes towards mental distress and suicide. The concepts of self-help and peer support, espoused by the workshop offer a real opportunity to equip interested prisoners with skills to support themselves and other prisoners who are in distress. [ABSTRACT FROM AUTHOR]

Purpose The perspectives of people with dementia and their care partners regarding “extra care” housing are currently unknown. The purpose of this paper is to report findings of a consultation study exploring the perceived barriers and facilitators of a relocation to extra care housing, from the perspective of people living with dementia, and their care partners.Design/methodology/approach Fieldwork consisted of paired or 1-1 interviews and small focus groups with potential users of an alternative model of extra care support for people living with dementia in the South of England. The consultation took place between June and August 2013. The interviews and focus groups were audio recorded, transcribed verbatim. The transcripts were analysed thematically.Findings Benefits of extra care were identified as the opportunity for couples to remain living together for longer, creating a supportive, dementia-friendly community, and a reduction in the strain experienced by the care partners. Barriers centred on a sense of loss, stress and uncertainty. Living and caring at home was perceived as preferable to shared care.Research limitations/implications The findings presented here have limited generalisability for two reasons. First, the shared care approach consulted on was very specific. Second, the participants form a purposive sample and as such are not representative of a wider population. Despite best intentions, the voice of people with dementia, are underreported in this consultation. Only one person with early on-set dementia was interviewed and the remaining two people with dementia were interviewed alongside their care partner.Practical implications The findings cast doubt on the viability of extra care facilities, designed for couples living with dementia, if extra care continues to be conceptualised and marketed as a preventative lifestyle choice. The findings indicate the value of consulting with people with dementia, and their care partners, when designing new forms of housing with care specifically for people living with dementia.Social implications The findings of this consultation exemplify the wish of couples living with dementia to remain together, in what they perceive to be “home”, for as long as possible. Couples living with dementia are therefore unlikely to wish to move into an extra care facility as a lifestyle choice option, early into their journey with dementia. This raises questions about the suitability of extra care, as a form of housing with care, for couples living with dementia.Originality/value This paper contributes to the body of literature, exploring the feasibility of new and innovative alternative care and housing options, for people with dementia. This paper is one of the first to explore extra care as a housing and social care option for couples with dementia. [ABSTRACT FROM AUTHOR]

Purpose This paper explores service provision for young fathers through analysis of data from the three-year ESRC funded project Following Young Fathers. The purpose of this paper is to explore the idea that young fathers are a “hard to reach” group. It begins with a discussion of literature and research evidence on this theme. The empirical discussion draws on data collected in interviews and focus groups with practitioners, service managers and those working to develop and deliver family support services.Design/methodology/approach The ESRC Following Young Fathers study used qualitative longitudinal methods to research the perspectives of fathers under the age of 25, mapping the availability of services to support them and investigating professional and policy responses to their needs. The strand reported on here focussed on the perspectives of a range of practitioners, service managers and those involved in developing and commissioning services.Findings The research findings, and those of other projects discussed in the paper, challenge the idea that young fathers are “hard to reach”, suggesting that we should, conversely, consider that many services are actually hard to access. Thus, increasing young fathers’ engagement requires better understanding of their often complex needs and a reshaping of service design and delivery to account for them. The paper highlights how the configuration, funding and delivery of services can inhibit young fathers’ use of them, and identifies ways in which they could be made more accessible.Originality/value The ESRC Following Young Fathers Study filled an important gap in knowledge about the lives of young fathers, developing understandings of their experiences and support needs. The strand reported on here draws on research with practitioners to provide an in-depth discussion of how services currently support young fathers, and how they could be better configured to address their often complex and diverse needs. [ABSTRACT FROM AUTHOR]

Purpose: Employing brief, low-intensity, face-to-face parenting programs can result in improvements in parenting and child behavior; however, their usefulness is often limited by low participation rates. Online technologies are increasingly presented as a panacea for promoting program reach in a cost-effective way. The extant literature, however, provides limited guidance on issues around the implementation of online parenting programs. Grow is a universal, health-promoting parenting program that targets families with 5–10 year olds and was developed for face-to-face delivery and then adapted for a web-based format. The purpose of this paper is to present implementation results from feasibility proof of concept studies of Grow Face-to-Face and Grow Online and explores issues regarding mode of delivery and parent participation. Design/methodology/approach: Data were gathered from participants using attendance records, end-of-module/session surveys and semi-structured, in-depth interviews, and were examined using descriptive statistics and inductive thematic analysis. Findings: Findings suggest that, compared to the online implementation, recruitment was more difficult for the face-to-face implementation. Conversely, retention in the online program was poorer than in the face-to-face program. Participants from both programs self-reported high levels of engagement and satisfaction. Parents who completed Grow Online expressed a desire for more interpersonal interactions, which suggests a possible need for hybrid programs that combine online technologies with traditional face-to-face modes of delivery. Originality/value: These findings challenge the idea that the internet can fully address barriers to parenting program participation by showing that while parents may sign up more readily for an online program, they may struggle to complete all modules. This is problematic as program dosage can influence parent and child outcomes. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine Family Development Centre (FDC) staff’s[1] perspectives on their roles and capacity to promote early childhood language learning through good parenting.Design/methodology/approach This research employed in-depth interviews with 30 FDC coordinators and volunteer staff, supported by limited field observations.Findings Identifying risk, surveillance of at-risk families, building community solidarity and activities to support parenting and children, emerged as key components of FDC work. Volunteers softened their surveillance role by emphasising their social support function and personal links to local communities. Most activities aimed to strengthen family bonding and relationships, with fewer specifically addressing early childhood language deficits. Volunteers found the latter challenging, and generally sought to work in cooperation with education, public health and child care staff where projects involved language development.Practical implications Most volunteers said they lacked the capacities to promote early language development effectively and required additional training in such areas as partnerships and collaboration, family and parenting support, and project management. The authors argue that the importance given to partnerships reflects volunteers’ recognition that they need to draw on outside expertise to address children’s language problems. Given resource constraints, volunteers will remain central to family support work for the immediate future. Even with training lay volunteers will not become language experts, and future policy should centre on building a framework of professional support for the community teams.Originality/value This study fills a gap in knowledge about FDC volunteer roles and suggests a need for training that focuses on teamwork rather than specialist language expertise. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to provide an exploratory account of the links between devolution, homelessness and health in the UK. Specifically, it focusses on the policy context and governance structures that shape the systems of healthcare for homeless people in London, Scotland, Wales and Northern Ireland.Design/methodology/approach Empirically the paper draws on semi-structured interviews with a small sample of policy and practice actors from the devolved territories. Qualitative interviews were supplemented by a comparative policy analysis of the homelessness and health agenda within the devolved regions. Theoretically, it takes inspiration from Chaney’s concept of the “issue salience of homelessness” and explores the comparative character of healthcare as pertains to homeless people across the devolved territories.Findings The paper provides clear evidence of areas of divergence and convergence in policy and practice between the devolved regions. These features are shown to be strongly mediated by the interplay of two factors: first, the scope and scale of national and local homelessness prevention strategies; and second, intra-national variation in public health responses to homelessness.Originality/value The paper offers considerable insight from a comparative policy perspective into the nature of healthcare provision for homeless people in the devolved regions. [ABSTRACT FROM AUTHOR]

Purpose – The critical potential of hospital discharge policies and practices to ameliorate the health and social care needs of homeless people has become the focus of considerable interest in England. Central to this rise in policy formation and practice development is an acute understanding of the multiple exclusions homeless people face in navigating public health and social care systems. In ways small and large this nascent landscape is serving to redefine and reshape hospital arrangements for homeless people, and opening-up new ways to deliver care across clinical, social and therapeutic boundaries. The purpose of this paper is to seek to add empirical vigour and theoretical rigour to this unfolding policy and practice terrain. Design/methodology/approach – This paper draws on findings from a case study concerned with exploring and explaining how statutory and voluntary sector organisations use specialist hospital discharge policies and practices to coordinate pathways of care for homeless people. Findings – This paper illustrates how people affected by homelessness and ill-health are routinely denied access to statutory housing support, social work assessments and district nursing provision through acts of institutional gatekeeping and professional abrogation. Originality/value – This paper makes an important contribution to understandings of the connections between hospital discharge arrangements for homeless people and statutory housing, social work and district nursing provision. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to present a qualitative analysis of the facilitators of recovery in in-patient psychiatric rehabilitation from the service users' perspective. Design/methodology/approach -- Interviews with 31 in-patients were coded and analysed thematically at an interpretive level using an inductive approach. Findings -- The dominant themes identified were hope, agency, relationships and opportunity. Totally, 20 subthemes were identified. Agency was more important to men than women and agency, hope and relationships were all more important to detained patients. Research limitations/implications -- Interview data were collected in writing rather than taped. The results may not be transferrable to patient populations with significantly different demographic or service factors. Practical implications -- Services need to target interventions at the areas identified by service users as important in their recovery. The findings suggest both environmental and relational aspects of care that may optimise recovery. Services also need to be able to measure the quality of the care they provide. A brief, culturally valid and psychometrically assessed instrument for measuring the recovery orientation of services is required. Originality/value -- As far as the authors are aware no qualitative work to date has examined the recovery experiences of psychiatric rehabilitation in-patient service users in order to understand what services require to do to enable recovery from their perspective. The conceptual framework identified in this paper can be used to develop a service user self-report measure of the recovery orientation of services. [ABSTRACT FROM AUTHOR]

Purpose -- The ability to tell a story, whether personal or fictional, is a skill which can enable people to build a sense of identity, friendship, community and self-advocacy. However, narrative is rarely prioritised in services. The paper aims to discuss these issues. Design/methodology/approach -- This paper describes two approaches to the development of storytelling for people with learning disabilities used by the charity Openstorytellers. Reflections from interviews are used to illustrate how individuals view their experiences as storytellers, and the benefits that come in the wake of learning to tell and listen to stories. Findings -- Storytelling led to an increased sense of purpose, confidence, communication and value. The findings are based on subjective perceptions by the people concerned, and were not obtained through independent research. However, they represent a first step towards evaluating the impact of multidimensional interventions. Practical implications -- Services need to consider how they enable their members to participate actively in the sharing of experience, and imaginative and creative activities. Storytelling, both mythic and personal, can help to develop social relationships and active participation in one's community. Originality/value -- Both of the approaches described here (Learning to Tell; Storysharing™) are innovative approaches which are new in the field of learning disabilities. [ABSTRACT FROM AUTHOR]

Purpose - 22q11.2 deletion syndrome (22q11.2DS) is a rare genetic syndrome involving high risk of psychiatric disorders with average intellectual functioning in the lower borderline range. Due to the cognitive and social problems many adolescents with 22q11.2DS experience, adaptions may be needed to teach these adolescents cognitive behavioral therapy (CBT) skills. The purpose of this paper is to assess psychosocial functioning in adolescents with 22q11.2DS and to adapt CBT with this group. Design/methodology/approach - Totally twelve adolescents (M age=14.5 years, SD=1.4, range 12-17 years; 25 percent boys) with 22q11.2DS were recruited from a competence center for rare disorders. Their parents completed the Child Behavior Checklist and the Kiddie SADS screening interview. The adolescents participated in 7×45-minute CBT group sessions, comprising emotional awareness, cognitive restructuring tasks, and problem-solving skills. Findings - Adolescents had poor parent-reported social and school functioning at onset. The most frequent disorders indicated by screening interviews were attention deficit hyperactivity disorder (92 percent), anxiety (58 percent), depression (50 percent), autism spectrum disorders (50 percent), and potential post traumatic stress disorder (50 percent). Practical implications - The main adaptions made to CBT groups were shorter sessions, frequent breaks, and repetition of main points, limited use of written materials and items that could distract participants (e.g. balloons, papers), extensive and explicit use of turn taking, and two adult group facilitators per group. Originality/value - Offers practical advice on teaching CBT skills to adolescents with 22q11.2DS, which may also be applicable to other adolescents with lower borderline intellectual functioning or intellectual disabilities. [ABSTRACT FROM AUTHOR]

Purpose – Homelessness often results from the loss of social networks and individuals are tested in being able to sustain or develop new positive social networks necessary to rebuild lives. The purpose of this paper is to present findings from an exploratory study which investigated how different agencies and professionals support people experiencing multiple exclusion homelessness (MEH) to develop and maintain their social networks amid other competing priorities, such as reducing substance misuse and re-offending. Design/methodology/approach – The study was undertaken in England 2010-2011 in three case study sites. Data were collected in 76 interviews with practitioners and managers, from disciplines including housing support, social work, criminal justice, mental health and substance misuse services. Totally, 56 interviews and five focus groups were also undertaken with people with experiences of MEH. Data were analysed thematically. Data from one site in particular permitted a focus on personal relationships and social networks which were seen as beneficial but also potentially problematic. These data are drawn upon to reflect on the implications for housing providers and practitioners. Findings – While multiple factors had often led to the loss of social networks among homeless people, findings revealed that practitioners working with homeless people may be able to promote existing social networks, such as partnerships, help develop new ones, and support people withdrawing from less positive relationships. The authors conclude that practitioners should be alert to structural changes that threaten social networks and may need to enhance skills in creating opportunities to foster existing positive relationships in direct work with their clients and in collaboration with other professionals. The need to be careful of blurring professional boundaries is also observed. Practical implications – This paper suggests approaches that may encourage practitioner reflection and commissioning practice in achieving good outcomes for people with experiences of MEH by highlighting the importance of social networks and the potential for practitioners to foster supportive relationships. Originality/value – This paper considers the often under-researched area of day-to-day engagement with social networks and the implications of working to support these as part of the role of homelessness services. While drawing primarily on recent research in England the themes raised will have wider relevance to housing and care services generally. [ABSTRACT FROM AUTHOR]

Purpose Bowring et al. describe ways of using the Behavior Problems Inventory – Short Form, illustrating how to use clinical norms to evaluate change. This commentary focuses on the importance of considering information gained directly from people with intellectual and developmental disabilities (IDD) during assessment. The paper aims to discuss these issues.Design/methodology/approach A pilot project involved interviews with four children with IDD. A Talking Mats® (TM) framework was used to gather children’s views regarding challenging behaviours (CBs) and variables relevant to a functional behavioural assessment, such as things they found to be reinforcing, things that set the occasion for CB and things that helped prevent this.Findings The children were able to provide information and insight into several areas that are influential in the maintenance of behaviour that challenges. Some of this information may not have been obtainable from other sources or informants using traditional assessment methods alone.Originality/value Gathering the views of people with IDD is important. The Convention on the Rights of Persons with Disabilities (United Nations, 2009) states that people have the right to be heard. Many people with IDD have difficulties communicating. A TM framework is one method by which people may be able to express their views. Taking the views of the individual into account during the process of gathering information about behaviours that challenge should lead to greater understanding of the functions of any behaviours and therefore to more targeted, acceptable and effective forms of support. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to investigate perceptions towards a career in psychiatry among medical students and psychiatrists and identify how recruitment into the specialty may be improved.Design/methodology/approach This study locally compares medical student and psychiatric doctor responses to a structured online survey and structured interviews with key managerial figures in the Humber NHS Foundation Trust.Findings Comparison across two main areas (pre-decision exposure to psychiatry and reasons for considering a psychiatric career) found that both students and doctors were influenced to make a choice about a career in psychiatry during medical school. Medical students found compatibility with family life to be more important when considering psychiatry, whereas doctors cited content-based reasons as significant pull factors. Stigma and fear of being harmed deterred some students from choosing a career in psychiatry. Structured interview responses reiterated the importance of pre-medical school and undergraduate mentorship in bolstering future recruitment to psychiatry.Practical implications Medical students perceive certain career issues differently to their postgraduate counterparts. Widening the content-based appeal of psychiatry and optimising the medical school experience of the specialty via varied and high-quality placements may be a key step towards tackling the national shortfall in qualified psychiatrists.Originality/value This is the first published study comparing medical student and psychiatric doctor perceptions of a career in psychiatry. [ABSTRACT FROM AUTHOR]

Purpose Problems related to sexual functioning have been reported in patients with anxiety disorders in general and panic disorder in particular. The past literature has shown the association of sexual conflicts of panic disorder patients with sadomasochism, and revealed the themes of: guilt, self-punishment, role of unconscious conflicts about sexuality, anger and separation. The purpose of this paper is to explore sexual conflicts in patients with panic disorder and their beliefs regarding guilt around sexual fantasies and dreams.Design/methodology/approach Interpretative paradigm and case study method was employed. For collecting data, semi-structured interviews were recorded, transcribed and subjected to within and cross-case analyses. Clarifying researcher’s bias and rich thick description were used for verification of data.Findings Cross-case analyses revealed themes of negative emotions, positive emotions and ambivalence. Negative emotions (i.e. guilt and anger) were experienced as threatening and harmful and caused distress to participants. Positive emotions, such as, satisfaction, pleasure and happiness were revealed in response to questions related to sexual fantasies, thoughts dreams, emotional attachment and sexual relations. Ambivalence was shown in response to questions related with reactions toward sexual fantasies, masturbatory practices, sexual relations and/or emotional attachment.Research limitations/implications The participants of this study consisted of two self-selected individuals who had diagnosis of panic disorder with agoraphobia. The main limitation of the study is a small sample size comprising of men only. This research can provide grounds for more Asian studies in future especially by including females.Practical implications The findings point toward addressing sexual conflict in therapeutic intervention of panic disorder.Social implications The findings have implications in society in expanding the awareness and knowledge about sexual conflicts in clinical population and general population suffering from anxiety symptoms.Originality/value This research study adds understanding of psychological issues in Pakistan’s socio-cultural context. [ABSTRACT FROM AUTHOR]

Purpose – The quality of the attachment relationship between children and their parents is important for children's social-emotional development and can have profound consequences for adaptational processes in later life. The purpose of this paper is to give an overview of the current knowledge about sensitive parenting and its role in affecting infants’ attachment security, and developmental outcomes of attachment. The authors end with a brief discussion of evidence-based interventions aimed at improving sensitive parenting and the attachment relationship between children and parents. Design/methodology/approach – The authors refer to meta-analyses as quantitative reviews in which all available studies conducted on a particular subject (such as maternal sensitivity and attachment) are included. Findings – The authors conclude that numerous empirical studies and meta-analyses have confirmed the importance of sensitive parenting and attachment security for children's social-emotional development, providing a robust evidence base for translation, implementation, and intervention in practice. Originality/value – This paper gives an overview of the current knowledge about attachment security, the role of sensitive parenting and the developmental outcomes of attachment, and provides a brief discussion of attachment-based interventions. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to examine the support experiences of older people who have been abused in Ireland. Design/methodology/approach – Recruited through dedicated elder abuse services, nine older people who had experienced elder abuse participated in in-depth, semi-structured interviews. The data were analysed using thematic content analysis. Findings – The study highlighted the help-seeking pathways of abused older people and revealed that few older people sought help for themselves and most were unaware of the services available to support and protect older people. Data analysis identified the range and type of help received from family, friends, voluntary and statutory services, as well as the perceived barriers to accessing help and support. Research limitations/implications – The research did not include abused older people who lacked mental capacity or who had experienced self-neglect, criminal victimisation by strangers or who had not received statutory support services. This field may benefit from future research that seeks to examine the support experiences of these groups. Practical implications – Family, staff and professionals who care for older people need to be cognisant of the signs of elder abuse, and bring them to the attention of older people should they have concerns, as older people may not always recognise that they are being abused. Originality/value – The paper contributes to our understanding of the support needs of older people in Ireland and the perceived barriers to accessing help and support. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore how those engaged in service user involvement (SUI) initiatives perceive involvement and recovery; whether involvement is related to their recovery process and, if so, how.Design/methodology/approach An exploratory qualitative method, social constructionist grounded theory, was adopted throughout the research process. Nine semi-structured interviews were undertaken with participants who self-defined as having current or previous mental health problems and who were engaged in SUI initiatives.Findings Most participants identified explicit links between their own experiences of SUI and recovery. These links represented a connection between the characteristics they perceived to be inherent to involvement and their personal definitions of recovery. In contrast, experiences of consultation and involvement as patient service users was limited and identified as an area for improvement. The core of the tentative grounded theory constructed suggests that individuals found in involvement elements which were concordant with and supported their own definitions of recovery and which were not apparent in their experiences as patients.Research limitations/implications The small sample and narrow constituency of participants limit the nature of the claims made by the study.Practical implications This study highlights the value of involvement in promoting recovery and indicates the merit of promoting meaningful involvement across the spectrum of the service user experience.Originality/value This study offers a unique contribution to the current literature, highlighting the links made between involvement and personal recovery. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to critically evaluate an innovative collaboration between health, housing and social care by exploring the “short stay project” apartments from service users’ perspectives and considering the effectiveness of this service model as part of enabling provision locally.Design/methodology/approach The qualitative methodology for this evaluation was interpretative phenomenological analysis (Smith, 2011), critically exploring service users’ personal lived experience of the “short stay project”. Three service users (n=3) participated in semi-structured interviews.Findings This study has identified the “short stay project” can prevent admission into and facilitate discharge from care and health services by offering a temporary stay in self-contained, adapted accommodation. Service users found value in staying at the apartments for differing reasons. However, practitioners must address service users’ emotional and social needs as well as physical needs to reduce the risk of occupational deprivation.Research limitations/implications Sample size is not fully representative of the total population making transferability limited.Practical implications This research found there is demand for temporary housing provision for service users with health, housing and/or social care needs.Social implications Key drivers of demand for the service are social inequalities relating to homelessness, poverty and gender-based violence rather than the health-related issues that could have been expected. Further research into the development of effective integrated services which maximise service users’ wellbeing and occupational performance is recommended.Originality/value Service models which integrate health, housing and social care can be innovative and maintain service users’ independence and wellbeing in the community. Commissioners across health, housing and social care could utilise the Better Care Fund to deliver integrated services to meet rising demands. [ABSTRACT FROM AUTHOR]

Purpose Research shows that growing up in unsafe neighbourhoods is a risk for the social and emotional development of children. At Home in the Street (TOS) is a community intervention that aims to create a clear, decent and emotionally safe environment for children in neighbourhoods. This programme is implemented in many communities in the Netherlands. The purpose of this paper is to determine the effectiveness of TOS.Design/methodology/approach This study has a longitudinal (three waves), quasi-experimental design, which includes 644 children who live in either ten experimental or ten control neighbourhoods. The effects are examined by using the strengths and difficulties (SDQ) instrument and propensity score matching control techniques. Multilevel methods were used on multi-imputed data sets.Findings The intervention does not have a statistically significant effect on the social and emotional development of children. However, exploratory analysis suggests that it may have a positive effect if the intervention is used more intensively.Research limitations/implications Future research may be conducted for a longer period to identify more precisely the different effects of the intervention on the development in SDQ scores in relation to age and gender.Practical implications The intervention may be effective in the case of high programme quality. Developers should therefore continue to invest in programme quality. This also applies to other social interventions: in order to accomplish effective social investments, these should be combined with sound research, as shown in this study.Originality/value This study suggests that community interventions may be effective if used with particular regularity. The authors have also demonstrated that implementing this type of complex research is feasible if certain methods are used that help overcome these challenges. [ABSTRACT FROM AUTHOR]

Purpose Many homeless people have significant levels of early adverse experiences and consequent mental health difficulties. The purpose of this paper is to examine the experiences of residents and staff living and working in a psychologically informed environment (PIE), a new model of hostel for homeless people which aims to update and make more flexible the principles of the therapeutic community, thereby meeting the psychological and emotional needs of residents.Design/methodology/approach Semi-structured interviews were carried out with nine residents, ten staff and five psychotherapists at two PIE hostels in London. The data were analysed using thematic analysis with a phenomenological epistemological approach.Findings Analysis generated 18 themes for residents and staff combined, organised into five domains: what makes a home, resident needs, managing relationships, reflective practice and theory vs practice of PIEs. The study suggests that PIEs broadly meet their aim in providing a different type of environment from standard hostels. Efforts to build relationships with residents are particularly prioritised. This work can be challenging for staff and reflective practice groups provide a supportive forum. There are limits to the extent to which the theoretical PIE can be put into practice in the current political and economic climate.Originality/value This is one of the first qualitative studies of PIEs. It provides perspectives on their theoretical background as well as how they operate and are experienced in practice. It may be informative to services intending to establish a PIE and to commissioners in assessing appropriate resources. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to extend our understanding of the issues facing those who experience multiple moves around homelessness projects. It considers these issues and how they relate to best practice, informing the delivery of psychologically informed environments (PIEs).Design/methodology/approach A qualitative design was employed, with interviews undertaken with men currently residing in hostels for those with additional needs. These men had already experienced multiple moves within the hostel system. Interpretative phenomenological analysis was used to analyse the data.Findings Main themes consider issues and challenges associated with hope and moving forward; help and the conditional or temporal nature of this; identity and stigma; and intimacy and relationships. Clinical implications of these findings are discussed.Research limitations/implications Implications include best practice for future planning with service users, the relational nature of hope, how best to manage endings and practical guidance for service developments in these settings.Originality/value These findings further the understanding of the challenges faced by service users with complex needs and how best to address them. They build on PIE guidance, offering tangible advice for practice. [ABSTRACT FROM AUTHOR]

Purpose - The present qualitative study aims to address the gap in what one knows about the life experiences of adults diagnosed with mild learning disabilities from minority ethnic communities and to generate a deeper understanding of their experiences.Design/methodology/approach - The paper individually interviewed four adults with mild learning disabilities receiving support from an independent living project using semi-structured interviews. The interviews were recorded and transcribed verbatim. The data collected were qualitatively analysed using interpretative phenomenological analysis.Findings - The findings showed that participants felt socially isolated and did not have a wide social network. Participants also reported that they had suffered some form of abuse in the past. Participants also said that they found employment satisfying and finally that they did not receive support with their cultural needs.Originality/value - This paper highlights that greater emphasis should be placed on examining the social support needs of individuals with mild learning disabilities in order for them to live independently without risking social isolation. [ABSTRACT FROM AUTHOR]

Purpose – The Adult Support and Protection (Scotland) Act 2007 places a duty on Councils to investigate the circumstances of adults who, because of a disability, health condition or illness are unable to safeguard themselves from harm. Public partner agencies, including the NHS have a statutory obligation to bring to the attention of the Council those individuals who may be at risk of harm. Health professionals cooperate with adult protection investigations and participate in the development of adult support and protection plans, yet do not appear to be initiating adult protection referrals with the Council. Low reporting by health has also been recognised as a national issue. The purpose of this paper is to explore what promotes and what prohibits the identification and reporting of situations of abuse within the Scottish Legislative Framework. Understanding the decision-making processes of prospective reporters would potentially allow the barriers to be reduced and the supports to be strengthened. Design/methodology/approach – The research strategy is based on a literature review, a web-based survey and semi-structured interviews with health professionals within community learning and community mental health teams. Findings – The findings point to a number of inter-related factors which impinge upon the professional’s confidence to initiate adult protection referrals. Workers must first recognise harm as conduct which needs to be reported and addressed. They need to be familiar with referral procedures and be assured that their concerns will be dealt with appropriately. Health professionals are more likely to report if they are based in an environment which supports honest and open discussion regarding harm, without over-concern about agency reputation or resources. Access to multi-disciplinary consultation and support, particularly in relation to more ambiguous protection situations, was viewed as fundamental to reporting. Originality/value – This small scale study adds to a developing bank of literature providing a Scottish perspective on protecting adults. It offers some insight into reporting decisions from the viewpoint of community health professionals. [ABSTRACT FROM AUTHOR]

Purpose – The perspectives of frontline clinical staff working with individuals in later life within an inpatient mental health setting, of their role in recovery, have not yet been explored. The purpose of this paper is to understand what recovery means within an inpatient mental health setting for older adults. The authors address clear implications for clinical practice. Design/methodology/approach – Semi-structured interviews were conducted with 11 multidisciplinary participants across two specialist older adult recovery units at an independent hospital in the UK. Thematic analysis was applied to the transcripts. Findings – Three main themes were identified: participants identified their normative task as the promotion of “moving on” (clinical recovery) and their existential task as personal recovery. The context in which recovery happens was highlighted as the third theme. These represented competing workplace goals of clinical and personal recovery. This highlights the need to give permission to personal recovery as the process that enables mental health recovery in older adults. Originality/value – Staff working in a inpatient mental health service for older adults discussed the meaning of recovery and their role in enabling recovery. This has implications for sustainable clinical practice in this setting. Recovery-orientated practice in this setting is required but the detail is not yet understood. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to investigate how service professionals involved in the provision of services to clientele who use solvents and are often without stable housing understand the process of healing and recovery in their work. Design/methodology/approach – Using a narrative methodology, semi-structured interviews were conducted with 12 human service professionals (i.e. social workers, case managers, etc.) employed in providing recovery-based services to individuals who use volatile solvents. Findings – Despite the dominant cultural story about “street addicts” and solvent users’ limited possibilities for recovery, professionals indicate that they view their clients as “just like everyone else.” The dominant storyline was that of advocating for the capability of the client group. These stories are discussed in relation to hope for professionals who provide health and housing services to clientele with complex and multi-systemic needs. Originality/value – The findings have implications for how human service providers maintain hope and purpose in their work with stigmatized populations (e.g. homeless individuals, those with alcohol or other drug-related problems). This study highlights how human service professionals make sense of their role in their work and how they maintain hope for themselves and for the recovery of the clientele they work alongside. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to consolidate policy, research, evidence and good practice around strategies tackling fuel poverty and affordable warmth for older people aged over 60 to support the development of more effective services for this life course stage and to tackle physical and mental health inequalities. Design/methodology/approach – The authors consolidate current policy, research, evidence and examples of good practice in exploring effective interprofessional approaches that contribute to affordable warmth for older people through “desktop analysis”. The authors support this with qualitative data from Health and Wellbeing Boards (HWBs), health inequalities and environmental health from research comprising four longitudinal case studies in the Midlands and North of England over 18 months and semi-structured interviews with members and support officers. A total of 50 interviews were undertaken and 55 hours of HWB meetings observed. Findings – There are numerous older people living in fuel poverty. The depth of fuel poverty increases with age particularly the over 75s and physical and mental ill health are affected. There are an increasing number of tools to help estimate health care costs around the cost effectiveness of interventions and there is a real need for more local evidence about what is working well, how and why. However, there is no mandatory requirement for fuel poverty strategies and more creative local strategies are required taking organisational and interprofessional relationships into account. The emphasis in integrated care provides new impetus and scope to encourage preventative services but these new partnerships need to be effective in what is a complex policy environment. There is still a long way to go in places. The challenges of ageing are numerous, complex and not fully understood and sit across multiple policy areas. Originality/value – Fuel poverty strategies tend to be delivered on a geographical or income bases rather than by life course approach and a focus on older people. We need to focus more specifically on older people, a rapidly growing population and to better understand thermal properties of our ageing housing stock and how best to intervene to protect and improve health and safety. Emerging approaches need to overcome artificial statutory and non statutory divides and move towards sustainable, evidence based affordable warmth strategies for older people to protect and improve health. [ABSTRACT FROM AUTHOR]

Purpose – Homeless populations are a politically contentious problem and researchers struggle to achieve a balanced approach. They place emphasis on sharply contrasting factors, such as; institutional structures, ideologies or individual dispositions and differences. Central questions remain unanswered, i.e., is homelessness an outcome of society’s failings related to housing shortages, or a personal choice, as in the status of “intentional homelessness?” The purpose of this paper is to set aside assumptions, to explore experiences of homelessness and psychosis. Design/methodology/approach – An existentially informed hermeneutic phenomenological analysis; exploring transcribed narratives from semi-structured interviews with three men. Findings – These participants started to wander as a spontaneous response to distressing life experiences. Without any plan they travelled to new locations living on the street. Being contained and treated against their will in the psychiatric system was another source of distress. They did not choose homelessness through a rational calculation of their best interests. They felt at odds with society, which did not protect them and failed to meet their needs. Research limitations/implications – In qualitative research, findings are not generalisable to other settings. Practical implications – Homeless services should be enhanced by psychological expertise along with more person-centred emphatic approaches; the authors of social policies should consider their philosophical assumptions. Social implications – Systemised mental healthcare does not solve complex problems; fails to meet needs. Originality/value – The analysis informs the design of further research, prompts practitioners to review their understandings and provides grounds for the rewriting of policies. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to report on a small telehealth pilot in local authority sheltered housing in NE England. This explored the training and capacity building needed to develop a workforce/older person, telehealth partnership and service that is integrated within existing health, social care and housing services. Design/methodology/approach – A qualitative case study approach on the implementation and deployment of a pilot telehealth service, supporting sheltered housing tenants with Chronic obstructive pulmonary disease (n=4). Findings – Telehealth training and capacity building, needs to develop from within the workforce/older person partnership, if a usable and acceptable telehealth service is to be developed and integrated within existing health, care and housing services. To be adaptable to changing circumstances and individual need, flexible monitoring is also required. Practical implications – Service users and workforces, need to work together to provide flexible telehealth monitoring, that in the longer term, may improve service user, quality of life. Originality/value – The pilot explored a workforce/older person partnership to consider how to add and implement telehealth services, into existing health and housing services. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to explore the lived experiences of women without children experiencing housing instability and homelessness in Calgary, Canada; and narratives of what triggered their journeys were constructed according to the tenets of hermeneutic phenomenology, and suggest a framework for assisting these women. Design/methodology/approach – The design for this study is qualitative, approached through hermeneutic phenomenology rooted in Gadamerian philosophical hermeneutics (Gadamer, 2004). Hermeneutic phenomenology, as a research method has provided insight into understanding phenomena and human experiences that are important to human science professionals. Findings – The experience of homelessness for women without children started while they still lived at home, but after they lost all sense of “being at home” as a consequence of identifiable negative home experiences, such as abuse. The effects or impacts of stable childhood or adult home experiences and the implications of such in contributing to the feelings of homelessness were pervasive in the stories told by these women. Practical implications – Access to housing does not mean getting out of the feeling of homelessness, because the trauma that triggers the experience for the clients often last for a life time. Long-term engagement with the client will be synonymous to increasing the possibility that they can be stabilized permanently. Resources dedicated to these clients must be tailored to each client’s needs, with strong agency collaboration with the mainstream systems. Social implications – Community health nurses and other support workers for individuals experiencing homelessness need to build bridges with inter-professional groups to close the gap created by societal attitudes toward women and domestic abuse survivors through advocacy and education, especially in countries where women are still treated as second class citizens. Originality/value – Although there has been a considerable amount of research conducted on the determinants of homelessness and housing instabilities in women or their pathways into homelessness, the plight of women without children and their experiences while homeless have received little attention in literature. This study explored the lived experiences of women without children experiencing homelessness and narratives of what triggered their journeys were constructed according to the tenets of hermeneutic phenomenology, and suggest a framework for assisting these women. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to explore how staff attend to their well-being when working in an inpatient mental health setting with older adults with dementia and complex mental health needs; how staff understand the link between their well-being and the well-being of patients. Design/methodology/approach – A semi-structured group interview was held with 11 members of two multidisciplinary teams. The discussion was audio-recorded and analysed using thematic analysis. Findings – Staff reported managing their well-being by both connecting with and avoiding the difficult emotions of the work. The team avoided the gravity of the work through humour, a task-focus, an absence of thinking and the displacement of workplace frustrations onto an outgroup. Connecting with emotions was done in tolerable ways: in contained reflective spaces, in the presence of supportive others, through genuine connections with patients as people and when the organisation demonstrated care for the staff. Practical implications – Avoidant strategies appeared to represent short-term ways of maintaining staff well-being, while connecting with the gravity of the work appeared to represent what we hope is a more sustainable approach to managing well-being. A crucial premise for staff well-being is teams embedded within organisations that care for their employees. Originality/value – Poor staff well-being can have serious consequences for an organisation, particularly in the existentially challenging environment of dementia care. This study offers a unique opportunity to explore staff well-being in a UK inpatient mental health setting with older adults with dementia and complex mental health needs. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to examine the significance of social isolation and the factors that create social isolation for residents of inner-city high-rise apartment communities. We critically examine how the physical environment and perceptions of safety in apartment buildings and the inner-city implicate the quality of interactions between residents and with their neighbourhood community. Design/methodology/approach – The authors used mixed-methods consisting of survey questionnaires supplemented by semi-structured interviews and focus group discussions using stratified random sampling to access predetermined key strata of inner-city high-rise resident population. Using coefficient of correlation we examine the significance of the association between social isolation, age and ethnicity amongst Auckland's inner-city high-rise residents. Findings – The authors found the experience and expression of social isolation consistent across all age groups, with highest correlation between functional social isolation and “being student”, and older adults (60+ years), length of tenure in current apartment and length of time residents have lived in the inner-city. Research limitations/implications – As a case study, we did not seek in this research to compare the experience and expressions of social isolation in different inner-city contexts, nor of inner-city high-rise residents in New Zealand and other countries, although these will be useful areas to explore in future studies. Practical implications – This study is a useful starting point to build evidence base for professionals working in health and social care services to develop interventions that will help reduce functional social isolation amongst young adults and older adults in inner-city high-rise apartments. This is particularly important as the inner-city population of older adults grow due to international migration, and sub-national shifts from suburbs to the inner-cities in response to governmental policies of urban consolidation. Originality/value – By identifying two forms of social isolation, namely functional and structural social isolation, we have extended previous analysis of social isolation and found that “living alone” or structural social isolation did not necessarily lead to functional social isolation. It also touched on the links between functional social isolation and self-efficacy of older adults, particularly those from immigrant backgrounds. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to add to the understanding of homelessness by exploring and analysing the homeless pathway of a young expectant mother as she negotiates her way through temporary accommodation and comes to terms with her circumstances and new identity as a person without a home. Design/methodology/approach – A phenomenological interviewing approach was used in order to gain insights into the subject's lived daily world from her perspective. Themes were then identified that encapsulated the essential qualities of the interview. Findings – The stress and negative emotions of being homeless appear to be accentuated significantly due to pregnancy, taking the potential for the positive feelings associated with pregnancy away from the participant. Structural factors such as the homelessness legislation and affordable housing supply had a strong influence over her homeless pathway, resulting in feelings of a loss of control over her destiny and choices and subsequent feelings of low self-worth, which she had to try to come to terms with. However, the pregnancy was also used as a positive coping strategy, as was family support. Originality/value – Minimal research has been undertaken on the experiences of homeless women who are pregnant. The results point to the need to understand the deeply negative impacts that homelessness can have on individuals, particularly expectant mothers. The value of examining homelessness as a pathway is also shown. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to analyse the reflective journals kept by 62 students researching and interviewing people with learning disabilities. The aim was to explore the content and discover any themes that were generated throughout the journals as a result of the pre-, during- and post-interview process. Design/methodology/approach - The method used to analyse the journals was Interpretative Phenomenological Analysis (Smith and Osborn, 2008). Findings - The results showed that there was a shift from negative to positive reflections as the frequency of contact with people with learning disabilities increased and that the majority of students reported a change in attitude towards this group of individuals after experiencing direct contact (two to three meetings over a period of two months). Research limitations/implications - Implications of the findings are for government policies, promoting social inclusion through education, to offer the opportunity for direct contact with people with learning disabilities, (in keeping with All port's, 1954 Contact Theory) at an earlier stage in education, fostering an environment for earlier attitude change and increased social inclusion. Social implications - Changing society's attitude through our education system may decrease marginalisation by the public as well as discriminatory and abusive behaviour found in some social and community care settings. Originality/value - This piece of research may add value to social, government and educational policies. Finding an evidence base to continue to build policies for decreasing marginalisation and promoting social inclusion for people with learning disabilities. [ABSTRACT FROM AUTHOR]

Purpose -- Recovery is a key organising principle underlying mental health services, but remains under-researched in primary care. The purpose of this paper is to explore what recovery from psychosis means from multiple perspectives, the role of primary care in fostering recovery, and interventions that might enhance its promotion in primary care. Design/methodology/approach -- A total of 20 patients who had experienced psychosis and 24 General Practitioners (GPs) with varying expressed interest in mental health participated in semi-structured interviews, and were invited to two subsequent mixed focus groups. Data were analysed using Framework Analysis. Findings -- Recovery was conceptualised by GPs without a specialist clinical interest in mental health as improvements in symptomatic outcomes, by GPs with a special interest as improvements in social or functional outcomes, and by patients as a process involving a "whole person" approach. Both GPs and patients highlighted benefits of primary care including continuity, accessibility, and the role primary care professionals can play in supporting patients' families, and helping patients expand social support networks. Despite feeling "fobbed off' at times, patients desired a shift in responsibility for psychosis from secondary to primary care. Practical implications -- Reflective peer supervision meetings for GPs and patient-led training might improve primary care's ability to provide a more recovery-focused environment. Originality/value -- This study provided original and valuable findings regarding how GPs viewed their own role in promoting recovery from psychosis. This study also provided original findings regarding how patients viewed the role of primary care in promoting recovery from psychosis. [ABSTRACT FROM AUTHOR]

Purpose – The protection of vulnerable adults from abuse is paramount for those working in adult protection. However, staff supporting vulnerable adults who are alleged to have abused them can feel very vulnerable and their needs must also be taken into account. The purpose of this paper is to consider the impact of adult protection investigations from the experiences of people who have been identified as alleged perpetrators in adult protection cases in order to identify improvements in practice. Design/methodology/approach – This limited study used qualitative semi-structured interviews to collect data that reflected views of the issues and experiences of participants. Findings – This study shows that expectations set out in the Wales Interim Policy and Procedures document under “support for alleged perpetrators” do not match with the experience of those who took part in this study. The experience of some alleged perpetrators is that the investigation process can be protracted, they may be left isolated with little or no information and feel very vulnerable. Research limitations/implications – A limitation of this study was the small number of participants who were interviewed and the selection and bias. Participation was on a voluntary basis and the participants were self-selecting. The participants were all paid staff. Vulnerable adults who had been identified as alleged abusers were excluded from the study on the premise that their experiences were likely to be quite different. Practical implications – It is vital that alleged perpetrators are not themselves abused by the process. The findings from this study should be used to develop recommendations to improve practice. Originality/value – The effects on staff who have been investigated as alleged abusers under adult protection policy and procedures has been under-researched. This study will make a contribution to addressing this. [ABSTRACT FROM AUTHOR]

Purpose - This paper seeks to report upon psychiatric trainees' experience of providing psychodynamic therapy for the first time and their experience of group supervision.Design/methodology/approach - A total of five trainees, undertaking training in psychodynamic therapies, were interviewed on multiple occasions over an 18-month period - before, during, and after undertaking their first case of psychodynamic therapy. A semi-structured, qualitative interview approach was used to explore providing psychodynamic psychotherapy and participating in psychodynamic supervision groups. Interviews were transcribed in full and data analysed following the conventions of thematic analysis.Findings - Trainees' anxieties about working psychodynamically and their concerns for developing new competencies are recognised. Personal and professional challenges associated with this therapeutic approach are identified and the importance of "looking after" trainees is stressed; the role of trainee supervision groups in this is advocated. The potential challenges of integrating psychodynamic thinking into general psychiatric practice are discussed and suggestions to address these difficulties are proposed.Research limitations/implications - The small sample size reflects the total number of trainees participating in training at the time of the study; for future work, a larger sample drawn from multiple training centres would be recommended.Originality/value - Training in psychotherapy is now mandatory for all trainee psychiatrists and this is something which many trainees find daunting; training in psychodynamic techniques is particularly challenging. A fuller awareness and understanding of trainees' experiences is important in nurturing clinicians who are competent in psychodynamic thinking, and who might consequently apply these skills clinically. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to explore the experiences of policewomen to determine the extent to which female officers face resistance and obstacles to police work, to examine the coping mechanisms female officers utilized to overcome impediments encountered, and to establish common themes in female officers' success stories of acceptance and integration. Design/methodology/approach - Owing to the difficulty in accessing female officers, the current research utilizes in-depth qualitative interviews through snowball sampling. This methodology provided a rich sample of tenured female officers' experiences to explore resistance and integration. Findings - The findings suggest despite early occupational experiences of sexual harassment, discrimination, and disrespect, after long tenures, female officers do achieve acceptance in police work. Female officers are holding high civil service ranks in police agencies and achieving new "firsts" every day, including breaking into stereotypically masculine assignments. Practical implications - As police departments nationwide are having difficulties maintaining recruitment standards and full rosters, the current study can provide insight into the obstacles women face when joining police agencies and methods to alleviate these impediments, revealing an under-recruited population for police agencies nationwide. Originality/value - This study extends past literature by: examining female officers' experiences in a variety of agencies previously ignored in the literature; analyzing the tenure of the officers' careers to determine the onset and desistance of female officers' experiences with resistance and acceptance; and suggesting women do survive and, in some instances, thrive in an "all boys club." [ABSTRACT FROM AUTHOR]