C A Butler

Increasing the confidence of nursing staff to address the sexual health needs of people living with HIV: the use of motivational interviewing

The need to promote safer sexual behaviour has taken on new urgency in the UK because of large increases in the number of sexually transmitted infections (STIs). The sexual health needs of people living with HIV and AIDS (PLHA) also require attention as part of health promotion efforts. Many sexual health clinics are however struggling with high demand and limited resources. Within this context, this paper describes an innovate attempt at STI prevention with PLHA. Specifically, nursing staff were trained in the use of motivational interviewing to address sexual health issues and safer sexual behaviour in PLHA. We describe the training package and the impact upon participants. We conclude that by providing a positive training experience, front-line health staff that see the highest volume of PLHA with repeat STIs, can be assisted in developing their skills and confidence in prevention work with clients.

Intersectionality in family therapy training: inviting students to embrace the complexities of lived experience

While intersectionality has become an established and much used theory in feminist and critical race studies, the concept remains relatively underused by systemic family therapists and on family therapy training courses. And yet systemic therapy embraces the multiplicity of human existence and examines the interplay of power relations. This article attempts to fill this gap by emphasizing the usefulness of intersectionality in representing the complexities of lived experience and by presenting an exercise to introduce students to intersectionality in family therapy training. Practitioner points Therapists and trainers should be aware of the privileges and oppressions that the intersections of their social locations create. Therapists and trainers should be ready to initiate conversations with clients and students about intersecting identities and their influence. Help students to apply intersectionality theory through structured, well-paced exercises with plenty of in-built reflexive discussion.

A Qualitative Analysis of the Information Needs of Parents of Children with Cystic Fibrosis prior to First Admission

Purpose Hospitalization can be stressful for patients and their families. Pre‐hospitalization information is crucial in establishing a good basis for patient satisfaction. In order to develop better preparatory material for parents, this qualitative study explored whether parents of children with cystic fibrosis, admitted to a UK Childrens Hospital, felt adequately prepared for their childs admission. Design and Methods Data were collected from twelve parents whose children had been admitted within the last two years for routine intravenous antibiotics. Semi‐structured interviews were analyzed using thematic analysis. Results Four themes emerged from the analysis: (1) preparing for admission, (2) the ward as a challenging environment, (3) changes in the parent‐professional relationship and (4) the parental role in medical care. Conclusion Provision of adequate preparatory information is essential in reducing parental stress, influencing how future experiences are appraised and managed. Effective parent‐professional communication and opportunities to participate in care are likely to improve parental satisfaction. Practice Implications Preparatory information prior to hospital admission greatly assists parents in making informed decisions and working as joint advocates in their childs inpatient care. HighlightsThis study uniquely qualitatively explores the preparatory needs of parents of children with CFS prior to first admission.The analysis provides an in‐depth description of the parents’ ‘journey’ from the clinic to the hospital ward.The impact of medical interventions, such as the need to isolate patients, are described in detail in the parents’ own words.Clear preparatory information and open communication between health care professional and parents is stressed.

Sex and relationships education for individuals with Cystic Fibrosis:a service-directed approach

Increasing life expectancy within cystic fibrosis (CF) raises challenges around previously neglected topics such as sexual and reproductive health (SRH). The study aimed to gather retrospective experiences of service provision around SRH to consider the role of the CF service, age of information provision and unmet needs highlighting possible improvements to provision. A mixed-methods retrospective survey-based design was employed. An Adult CF team participated in a consultation session generating survey questions around SRH. A 20-item online survey was constructed and disseminated to adult CF patients. Unmet needs were found in SRH provision in pediatric and adult CF services, with further information required by patients on topics including parenthood and fertility. Results support previous research findings highlighting the need for standardized provision around SRH. Age of SRH provision suggested individual differences in need within the pediatric service. Further research could explore format and specific age of SRH information provision.

The adaptation of a Solution Focused Brief Therapy domestic violence perpetrator programme: a case study with a client with a learning disability

Re-offending rates of perpetrators of domestic violence are high (Hester et al., 2006) and there is a need for perpetrator programmes to reduce victimization. There is no clear evidence for the effectiveness of existing programmes (Bowen, Gilchrist and Beech, 2005; Herman, Rotunda, Williamson and Vodanovich, 2016; Smedslund et al., 2011). A new perpetrator programme based on Solution Focused Brief Therapy has been developed (Bowen, 2013), and whilst in its infancy it has received positive feedback from services and clients (International Innovation, 2016). Solution Focused Brief Therapy has been found to be effective in the reduction of aggression and criminal behaviours (Gingerich and Peterson, 2013), and has been effectively used with people with a learning disability (Smith, 2005). This case study will explore the effectiveness of the new perpetrator programme with someone with a learning disability on their attitudes towards domestic violence and abuse as well as self-esteem. Practitioner points Solution Focused Therapy for domestic violence has been found to successfully change the behaviour and improve the self-esteem of a man with a learning disability Where children are at risk of harm, longer-term interventions remain the recommended therapy The mainstream model for treatment was adapted by using visual aids and role play to work with someone with learning disabilities and these were found to be useful by the client

Measuring competence in systemic practice: development of the ‘Systemic Family Practice – Systemic Competency Scale’ (SPS)

Ensuring that practitioners are competent in the therapies they deliver is important for training, therapeutic outcomes and ethical practice. The development of the Systemic Practice Scale (SPS) is reported - a measure to assess the competence of novice systemic practitioners trialed by Children and Young Person’s Improving Access to Psychological Therapies (CYP-IAPT) training courses. Initial reliability assessment of the SPS with twenty-eight supervisors of systemic practice evaluating students’ competence using an online recording of a family therapy session is detailed. The SPS was found to be a reliable measure of systemic competence across training settings. Rating variability was noted, with training and benchmarking to improve rating consistency recommended. Further research using the SPS to further establish the reliability and validity of the scale is required.

Burnout in clinicians working with offenders with personality disorder

Purpose The purpose of this paper is to examine the levels of clinician burnout in a community forensic personality disorder (PD) service, and explores how burnout may arise and be minimised within a service of this nature. Design/methodology/approach A mixed methods approach was utilised, assessing levels of burnout and making comparisons with a comparable previous study. Focus group data regarding burnout and suggestions for reducing the risk of burnout were analysed using thematic analysis. Findings Levels of burnout were generally found to be higher in the current sample when compared with the generic PD services. Qualitative data suggest that working in a forensic PD setting may pose a range of additional and complex challenges; these are explored in detail. Minimising burnout might be achieved by developing resilience, utilising humour, team coherence and ensuring that breaks are taken, and developing one’s own strategies for “releasing pressure”. Practical implications The risk for burnout in clinicians working with offenders with PD may be higher than other groups of mental health clinicians. Despite this, attempts to minimise burnout can be made through a range of practical strategies at the individual, team and organisational level. Originality/value This is the first project to assess levels of burnout specifically in a team of clinicians working with offenders with PD, and offers an exploration of how burnout may manifest and how it can be managed in this unique area of mental health.