There has been very little research into work stress experienced by staff working in day care settings. This study describes the steps taken to assess and attempt to reduce stress levels in a day centre for people with learning disabilities. The work was prompted by concern over a high incidence of minor chronic ailments among staff. Assessment was by interview, discussion and questionnaires. High levels of stress were found in staff. The main sources of stress appeared to be ‘work load’ and organisational structure reflecting recent external pressures on the centre. Three one hour long intervention sessions were arranged and plans were made to address the sources of stress. At eight months follow‐up staff were positive about the intervention and specific organisational changes had occurred. Statistically significant changes in stress levels were not found, however. The results and their implications for other day care settings are discussed.
This research uses Q methodology to collate a number of techniques, and to investigate what techniques are used to encourage engagement across a number of clinical psychology specialities. Eleven groups of participants from different clinical specialities were interviewed in order to develop a set of 51 statements reflecting engagement techniques that clinicians felt that they were likely to use with 'hard to engage' clients. Seventy-five participants from a similar range of specialities were then asked to Q sort these statements and provide other demographic information. Forty-four participants returned completed Q sorts which were factor analysed by a tailored program (PQ Method) to investigate how the statements fall into patterns that reflect ways clinicians approach engagement. Varimax rotation produced five factors, four of which were able to be interpreted by participant information and comments. These accounts were taken back to some of the initial participants for 'reflexive correction' (Stainton Rogers, 1995). The four factor patterns are discussed in relation to existing literature and the research questions. These identified factors are: (i) the client focused approach; (ii) the interpersonal professional; (iii) the 'eclectic' or systemic approach; (iv) the expert listener. The implications for training, clinical practice and research are discussed.
Day to day maintenance of confidentiality by clinical psychologists is one of several areas of ethical practice that has been little researched in the UK. This study describes results from a survey of clinical psychologists working in the adult mental health speciality and a comparison group of trainee psychologists. Respondents rated the frequency with which they practised 11 behaviours relating to unintentional disclosure of information, discussion of cases and securing files. They also rated the ethical acceptability of the same 11 behaviours. Qualitative data on the constraints on maintaining confidentiality were also collected. Results demonstrated that absolute confidentiality was not the norm and that clinicians' practices fell short of their beliefs about ethical acceptability. The results and their implications are discussed along with suggestions for further research.
Managing therapeutic boundaries is a key professional issue for clinical psychologists. This article considers the nature of boundaries and the implication of significant boundary violation, before examining how ‘ethical thinking’ can be developed as a guide to understanding and managing this complex and important area of clinical practice.
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