Alec Grant

Clinical implications of attentional bias in anxiety disorders: An integrative literature review.

Research on information processing biases has been motivated by the hope that it would lead to new and more efficient psychotherapeutic interventions. The literature is abundant with empirical data of attentional biases toward threat stimuli in anxiety disorders. This article aims to review the existing literature on the topic of attentional bias in anxiety disorders and discuss important implications for clinical practice. We adopted an integrative approach to link research data on attentional bias, information processing, and cognitive accounts (automaticity and controllability) with clinical practice in cognitive-behavioral therapy. It is important to develop and apply therapeutic interventions that can effectively reduce negative attentional biases while treating the main problems associated with anxiety disorders. However, it remains to be seen whether cognitive therapy interventions targeting more voluntary, strategic information processing can have a positive impact on automatic, involuntary processing involved in attentional biases. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Contemporary British Autoethnography

This engaging, informative book makes an exciting contribution to current discussions about the challenges and uses of contemporary autoethnography. Authors from a range of disciplines ‘show and tell’ us how they have created autoethnographies, demonstrating a rich blend of theories, ethical research practices, and performances of identities and voice, linking all of those with the socio-cultural forces that impact and shape the person.

The corporate construction of psychosis and the rise of the psychosocial paradigm: Emerging implications for mental health nurse education

A major shift is underway that is changing what counts as lay and professional knowledge of ‘the psychoses’, with the emerging psychosocial paradigm increasingly challenging longstanding biomedical understandings in this area. This places a demand on international mental health nurse education, in countries where biomedical understandings of psychosis inform dominant lay and professional assumptions and practices, to both clarify its moral purpose and consider emerging implications for pedagogic practice and curricular content (BPS, 2014; Grant, 2015; Read and Dillon, 2013). Inaction will maintain the status quo of nurse educators causing minimal trouble to often socially and personally damaging institutional psychiatric business-as-usual. At a more troubling level, it will signal continued complicity with the corporate construction of such extremes of human distress as disease (BPS, 2014; Mosher et al., 2013).

The book, the stories, the people: an ongoing dialogic narrative inquiry study combining a practice development project. Part 1: the research context

This paper, part one of a two paper report, describes key aspects of the research context of an ongoing practice development project, conducted on two UK sites. The paper begins with a discussion of the projects origins within a community of people working in the recovery paradigm, including the contributory strand of the first authors recovery and survivor writing. The discussion then turns to three inter-related areas within which the research component sits and which provide it with philosophical, theoretical and conceptual coherence. Each area will be unpacked and its significance explained. This will provide a platform for discussing the focus, methodology and methods of the research, and related assumptions governing both data collection and analysis. The paper concludes with a research commitment to a mental health nursing practice allied to recovery as narrative healing. Links are made to the second paper which describes the context and specifics of a Writing for Recovery project for users, survivors and carers. This shares with, and builds on, the overall projects research context and its assumptions.

A critique of the representation of human suffering in the cognitive behavioural therapy literature with implications for mental health nursing practice.

This paper is informed by interpretivist understandings and practices, and the authors own conversion to interpretivist writing practice. The aim of the paper is to critique the ways in which suffering people are represented in the mainstream cognitive behavioural therapy (CBT) literature with a view to identifying some implications for mental health nursing practice. It will begin by identifying key assumptions governing the textual portrayal of human experience, and will argue that the language used to describe human suffering is a potential site for struggles over meaning and more adequate representation. However, reductionist portrayals of individuals and their problems have largely gone unchallenged in much of the CBT literature since its early development in the 1970s. This is arguably because of the socialization of new members of the CBT community into established cultural and textual practices. A comparison of reductionist CBT writing with more fleshed out, more fully human possibilities will further clarify that forms of representation are never neutral, given the danger of reductionist representations facilitating reductionist interventions. The paper will end with the following emerging implications for mental health nursing practice: the therapeutic power of self-narratives, narrative research and the recovery movement, and the promising possibilities for autoethnographic research for mental health nurses and for day to day interactions between nurses and service users.

Narrative competence: A neglected area in undergraduate curricula.

According to many inter-disciplinary scholars, including, notably, Alasdair MacIntyre and Jerome Bruner, human action draws on and is shaped by available cultural narratives. Nursing is no exception to this fact, and it is this which has prompted the creation of this paper which argues that the development of narrative competence in nursing ought to be a pressing curricular imperative. At a broad level, narrative competence refers to a finessed, ethically-charged respect for human lived and storied experience. At the level of professional development, it demands that nurses must constantly strive to improve on their abilities around attending, interpreting and intelligently responding to the stories of people in their care (Charon 2007, Bach and Grant, 2015). Doing so facilitates empathic and trustworthy practice through sensitive attunement to existential qualities such as inner hurt, despair, hope, grief, and moral pain. All of these qualities accompany the health problems that patients and clients experience, and are of course more fundamentally inscribed within the human condition.

The book, the stories, the people: an ongoing dialogic narrative inquiry study combining a practice development project. Part 2: the practice development context

This paper is the second part of a two-article practice development report. It builds on the first part by introducing and discussing a Writing for Recovery practice development project, conducted at two UK sites. The paper begins by briefly describing the project within the context of helping mental health users, carers and survivors develop skills in creative writing in order to engage in the process of narrative re-storying in line with preferred identity. A selective overview of broad and focal background literature relevant to the project is then provided in order to position it within a values-based mental health nursing practice. Following this, the specific plan for running the project is briefly summarized, covering actual and anticipated ethical issues. The paper ends with a discussion of dissemination aims.

Neoliberal higher education and nursing scholarship: power, subjectification, threats and resistance

Critique of neoliberalised higher education, with an emphasis on nursing scholarship. As a narrative scholar, I represent and hopefully role model critical reflexive scholarship in the social and human sciences and in nursing and mental health nursing (e.g.Grant, 2013). Along with colleagues in my own and other universities internationally (e.g.Shields et al., 2012), I hold that critical thinking, in the form of grappling with the political, thus policy, shaping contexts of knowledge over and above simply knowledge content, should form the core of nursing education, research and, by implication, practice.

A rationale for a clinical supervision database for mental health nursing in the UK

Clinical supervision (CS) is regarded as a valuable resource for mental health nursing. While there is considerable anecdotal reports of its implementation throughout the UK, these attempts are not without difficulty. A common tension reported in the literature relates to its provision being more akin to managerial supervision within a line-management hierarchy which jars with its original intention and spirit. This paper will provide a discussion on the implementation of CS in mental health nursing in the UK, beginning with its suggested importance for the discipline. Following on from this, the rationale for a CS database and description of one NHS Boards attempts at developing a resource, initially focusing on clinical supervisors of psychological therapies, will be presented.Accessible summary •  Clinical supervision (CS) is a valuable resource for mental health nurses. Through guided reflection and supportive facilitation, the recipient of CS works towards developing their therapeutic practice. •  In many parts of the UK, the implementation of CS does not equate to best practice. This provision undermines and thwarts the potential gains that effective CS can produce. •  The development of a database of clinical supervisors may ensure that best practice guidelines are implemented. •  Information about a database that focuses on clinical supervisors of psychological therapies, including its rational, clarifying the intention of CS, and criteria of supervisors, are described. Abstract Clinical supervision (CS) is regarded as a valuable resource for mental health nursing. While there is considerable anecdotal reports of its implementation throughout the UK, these attempts are not without difficulty. A common tension reported in the literature relates to its provision being more akin to managerial supervision within a line-management hierarchy which jars with its original intention and spirit. This paper will provide a discussion on the implementation of CS in mental health nursing in the UK, beginning with its suggested importance for the discipline. Following on from this, the rationale for a CS database and description of one NHS Boards attempts at developing a resource, initially focusing on clinical supervisors of psychological therapies, will be presented.

Between a rock and a softer place—A discourse analysis of helping cultures in crisis resolution teams

Crisis resolution teams are a community-based service, targeting adults experiencing acute mental health crises. The rationale for the development of crisis resolution teams is both value and efficacy-based: crisis resolution teams should contribute to the humanizing of mental health services and to enhanced efficacy. This diversity in purpose appears to affect the practices of help that are offered by crisis resolution teams, which research has shown to vary greatly. A discursive approach recognizes that practices are shaped by external paradigms and structures, and clinicians’ construction of professional identities and practices through their talk and meaning making. Thus, this study used a discursive psychological approach to identify discourses through which crisis resolution team clinicians talk about and understand helpful help in mental health crises. Focus group interviews with clinicians from eight crisis resolution teams revealed two broad and contradictory discourses: helpful help as something “made” with crisis resolution team workers as creators of collaborative and innovative practices, and helpful help as something “given” with the crisis resolution team workers as representatives of a predefined specialist mental health service culture. The contradictions between these discourses reflect the diverse rationale for the development of crisis resolution teams and the possible tensions and pressures under which crisis resolution team work is conducted. In this overall context, the study further critically examined the tensions between the discourse of constructing new practices, and existing practices constituted by the specialist mental health services’ traditional discourse. Failing to constantly reflect upon and question these tensions in collaboration with service users, carers, and other services can impair creativity and the development of humanizing helpful help.