Wally Barr

Exploring the role of an emotional support and counselling service for people with visual impairments

There is growing evidence of the need for services to address the emotional support needs of people with visual impairments. This article presents findings from a mixed methods evaluation of an emotional support and counselling (ESaC) service delivered within an integrated low vision service, focusing primarily on the qualitative findings. Data collected using a standardised measure of psychological well-being (Clinical Outcomes in Routine Evaluation–Outcome Measure; CORE-OM) show an improvement in the psychological well-being of clients of the service between baseline and follow-up assessment. Qualitative findings from interviews with service users and service providers help to illustrate and explain the experiences underlying the quantitative findings. The ESaC services are shown to be helpful to service users in two particular ways: helping them to normalise their experiences by talking to an impartial listener and helping them to accept and adapt to the physical, emotional and social changes in their lives resulting from their visual impairment.

Quantitative findings from a mixed methods evaluation of once-weekly therapeutic community day services for people with personality disorder

Background: Quantitative findings are presented from a mixed methods study of four one-day-a-week therapeutic communities for people with personality disorder (qualitative findings from the same study are reported in a separate paper). The evaluation assessed both the clinical efficacy of the model and its acceptability to service users, service employees and those who refer clients to the services. Aims: The study aimed to clarify whether one-day therapeutic communities can be effective for people with personality disorder. Method: Changes in the functioning of service users who attended the day services were assessed every 12 weeks for up to 1 year. Results: We found significant improvements in both the mental health and social functioning of service users. Changes in patterns of self-harm and service use were suggestive of possible underlying improvements but failed to reach significance levels. We also found evidence of the possible offset of costs within 16 months of an individual leaving one of the services. Conclusions: This study suggests one-day therapeutic communities may be both clinically- and cost-effective for people with personality disorder.

Emotional support and counselling for people with visual impairment: Quantitative findings from a mixed methods pilot study

Aims: This paper reports on mainly quantitative findings from a mixed methods evaluation of a new model of emotional support and counselling for people with moderate visual impairment. Method: The CORE Outcome Measure was completed with service users at baseline and post-intervention to assess the impact of the new service on psychological wellbeing and social functioning. Their perceived needs and expectations of the service were also explored. Results: Of the 35 individuals providing data at each assessment time, mean item scores on the CORE fell significantly (p<.001), taking the sample from within a clinical population before therapy, to a mean score below this following therapy. A more positive outlook accompanied this improvement in functioning. Discussion: Findings from the study augment the growing evidence that emotional support and counselling services can play an important role alongside and within related vision services. Implications for practice: The study indicates that therapeutic input for the visually impaired client group may need to target both wellbeing (feelings about oneself and the future) and problems (depression, anxiety, physical health, and trauma). Conclusions: Our findings suggest that a dual model of emotional support and counselling offers considerable benefit for people with visual impairment.

Do older people who self‐harm receive the hospital care they need?

Although self‐harm is most common in younger people in Britain, the risk of suicide subsequent to an initial act of self‐harm is considerably greater in older age groups. Four characteristics have been shown to be associated with increased vulnerability in older people who self‐harm: increased suicidal intent, physical illness, mental illness and social isolation. This paper is part of a broader analysis of all self‐harm presentations to a British hospital accident and emergency department over a five‐year period. It examines the prevalence of these vulnerability indicators in patients aged 65 or over, and considers whether greater vulnerability in older patients is reflected in their clinical management within the hospital and in community support planning on discharge.At the first presentation older patients (n=91) exhibited greater vulnerability than did younger patients (n=2,326). Despite this, we found no evidence that older self‐harm patients were any more likely than younger patients to routinely receive either a psychosocial assessment from a member of staff with specialist mental health training, or community aftercare planning on discharge from the hospital. This study lends weight to recently published national guidelines recommending that all acts of self‐harm in older people be regarded as evidence of serious suicidal intent at the outset.

Coming to terms with sight loss Impact of RNIB’s ‘Finding Your Feet’ programmes on participants’ Quality of Life

A study using both qualitative and quantitative methods was undertaken to examine the impact of the Royal National Institute of Blind People (RNIB) Finding Your Feet (FYF) programmes on participants. A key component of the study involved looking at any impact attendance may have had on the Quality of Life (QoL) of those taking part. The Birmingham Assessment of Low Vision Focus QoL Questionnaire was used to record data relating to QoL. Sixteen participants completed the questionnaire both before and after their attendance on the programme. Data was analysed alongside transcripts from 17 interviews conducted with participants and observation notes of three separate programmes. Questionnaire results highlighted clear similarities between data gathered for this study and that of other studies, and suggest considerable commonality of experience in people with visual impairment. Qualitative data demonstrate the positive contribution programmes such as FYF can make to the well-being and QoL of participants.