Management of clients who self-harm in UK secure forensic units

Cole, Samantha (2016) Management of clients who self-harm in UK secure forensic units. D.Clin.Psych. thesis, Canterbury Christ Church University.

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Abstract

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’.

Item Type: Thesis (Doctoral)
Subjects: R Medicine > RA Public aspects of medicine > RA1001 Forensic Medicine. Medical jurisprudence. Legal medicine > RA1148 Forensic psychology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine > RA0790 Mental health services. Mental illness prevention
Divisions: Faculty of Social and Applied Sciences > School of Psychology, Politics and Sociology > Salomons Centre for Applied Psychology
Depositing User: Mrs Kathy Chaney
Date Deposited: 19 Oct 2016 13:48
Last Modified: 08 Oct 2017 16:26
URI: https://create.canterbury.ac.uk/id/eprint/15030

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Last edited: 29/06/2016 12:23:00