You and your experience of the ward
Research type
Research Study
Full title
The effects of early experiences, attachment and schemas on perceptions of ward environment and restrictive practice in forensic settings.
IRAS ID
258450
Contact name
Alice Bennett
Contact email
Sponsor organisation
RIGO, University of Surrey
Duration of Study in the UK
1 years, 6 months, 27 days
Research summary
Research Summary:
Forensic service users are vulnerable individuals who often have histories of trauma and adverse childhood experiences, resulting in complex needs relating to their mental health and offending behaviour. Services must strike a balance between the need for care and security. The ward environment has been viewed and shown throughout the literature to be an important factor in influencing client’s wellbeing and successful treatment in forensic settings, however, the restrictive nature of forensic services contravenes many ideals of recovery principles. This results in increased lengths of stay and attachment to services which is detrimental to service user mental health and costly.
Literature shows that our early relationships and experience shape the way we interact with the world and our surroundings through what we call our attachment styles and schemas. Adverse childhood experiences or trauma can result in attachment styles and schemas that perceive the world in more negative and threatening ways. There is no known research to date that looks at the relationship between early adverse experiences, attachment styles or schemas and how these affect service user perceptions of forensic services.
This study consists of two parts; part one aims to address the relationship of early adverse experiences, schemas and the perception of the ward environment, whilst part two explores the relationship between attachment style and service user perception of restrictive practice. The study will be conducted in secure forensic services and participants will be requested to complete four questionnaires, predicted to take no longer than one hour in total. They will also be asked some short open-ended questions about the forensic ward.
Findings hope to highlight the importance of service user perceptions on their environments, particularly how their past experiences may shape these, enabling improvements to be made to services, benefitting service user mental health and service outcomes.Summary of results:
Thirty male forensic inpatients were recruited from high, medium and low secure forensic mental health hospitals within the UK. A mixed-methodology was undertaken. Participants completed quantitative measures and answered open-ended questions in face-to-face meetings within the hospitals. Additionally, details of participant trauma histories were gathered from clinical records. Interviews were transcribed and interpreted using deductive reflexive thematic analysis.
Results: Analysis of the qualitative data generated 3 themes of ‘Unpredictability disrupts the desired ‘settled’ ward’, ‘Satisfaction of psychological needs’ and ‘Frustration of psychological needs’. No statistically significant relationships were found relating to adverse childhood experiences. Statistically significant relationships were found between schemas and perception of ward atmosphere.
Participants reported both satisfaction and frustration of their needs, within both qualitative and quantitative data. Overall their perceptions appeared to be predominately positive.REC name
London - Harrow Research Ethics Committee
REC reference
19/LO/0772
Date of REC Opinion
9 Jul 2019
REC opinion
Further Information Favourable Opinion