Accessible summary Dialectical behaviour therapy is a “talking” therapy developed by Marsha Linehan. It helps people who are living in the community and also living in hospitals and people who may have problems managing their emotions. In recent years, dialectical behaviour therapy has been used to help people with learning disabilities cope with feelings of anxiety, trauma‐related disorders and mood disorders, but there are not many research papers showing how it is used in forensic learning disability services. This research tells the story of seven women with learning disabilities who took part in dialectical behaviour therapy whilst living in a forensic service. Their story and experiences are important in research literature and will help other services to think about what is needed when they introduce a new type of therapy such as dialectical behaviour therapy . Abstract BackgroundThis research aimed to capture the experiences of women with learning disabilities living in secure services who undertook dialectical behaviour therapy (DBT); they were the first people to do this in the trust. It is hoped their experiences may guide and inform other services undertaking the same process. Materials and MethodsInterpretative phenomenological analysis (IPA) was used to provide a flexible framework to make sense of the way the women interpreted their experiences. Results and DiscussionThe analysis identified three main themes: How you do DBT, What we think about DBT, Using DBT. The qualitative approach adds a valuable contribution to the wider literature, highlighting the importance of capturing the women's voices. ConclusionAs most published literature regarding the effectiveness of DBT is not written from first hand service user experiences, it is hoped this research offers a unique insight into these women's experience.
Purpose – The purpose of this paper is to explore the lived experiences of staff and service-users regarding the introduction of dialectical behaviour therapy (DBT) into an NHS forensic learning disability (LD) service. Design/methodology/approach – Drawing on data from two recent qualitative research studies, the research team used a case-oriented approach to see beyond original findings to capture the shared experiences of the participants’ journeys, thus giving a deeper insight to the commonalities of the participants’ voices which is rarely reported in the literature (Sandelowski, 2011). Findings – A common set of phenomena became apparent when the cases were analysed, these included: trust, intensity and worthwhile. It is intended this paper gives some opportunity for reflection and shared empathetic responses to the similar experiences discussed. Originality/value – The case-orientated analysis adds value to the evidence base by highlighting the importance of the qualitative voice of both the staff and service user. This is important because most available literature reflects the process of setting up a team or DBT service, rather than describing the team experience. Equally, most published literature regarding the effectiveness of DBT is not written from the perspective of the people who receive the therapy.
<p>Currently within the Wellington region there is an abundance of green spaces hosting a variety of native and exotic wildlife species (Rastandeh, Brown, & Pedersen Zari, 2018; “The Sanctuary,” 2018). These species are somewhat confined to a ‘home’ green space, in that travel between habitats involves difficult navigation between dense urban and residential structures (Forman, 1995; Rastandeh, Brown, et al., 2018). Many native species are not able to make long distance flights (Wittern & Berggren, 2007); and as a result habitat fragmentation is occurring at a rapid ecological level. The built form is limiting and discouraging wildlife movement, as well as being dangerous for smaller animals (Forman, 1995; Santiago, 2014). Currently tiny patches of vegetation provide wildlife with a directional indication of intended movement, but overall urban planning is designed for humans only. Aside from the lack of possible movement between habitats, there is also an absence of human connections to these spaces. There is a missed opportunity to introduce humans to ecological spaces, in that it allows a physical link and understanding to be achieved, as well as additional wellbeing benefits (Ell, 1981a; Santiago, 2014). With these two existing elements; the lack of wildlife movement between established habitats and the connectivity of humans to these spaces, there is also a third element of how interaction between people and wildlife within urban locations is absent. People are stuck with contributing towards the rapid decline of habitat, there are very limited positive interactions that are being utilised (Rastandeh, Brown, et al., 2018; Santiago, 2014). Infrastructure and specific designed elements that provide the correct facilities to allow for interactions between wildlife and humans is largely non-existent and crucial in the face of biodiversity loss and fragmentation. This thesis aims to establish a set of design guidelines towards understanding how interaction can be utilised within the design profession, as a way to reduce biodiversity loss, fragmentation and to increase exposure to unique species. Exploration at different scales, macro, meso and micro will be addressing different issues to answer the question of what types of interactions will be occurring within these spaces.</p>
Purpose The purpose of this paper is to identify what key factors multi-disciplinary teams (MDT) deem as most important when making the decision to move service users from one level of security (including low, medium and high secure services) to another. The researchers used the findings from this study to further develop a tool; the assessment for level of security tool (ALS), which aims to structure and streamline this decision-making process. Design/methodology/approach Data from 18 interviews (MDT staff) were analysed using the Delphi technique (Dalkey and Helmer, 1963). This revealed a range of factors discussed when considering service users moves. Participants were asked to rate these factors in accordance with the Delphi which resulted in the removal of certain less important factors based on their scores. The researchers then compared these factors of relevance with a checklist of 16 items previously proposed by a consultant psychiatrist within the trust. This comparison allowed the researchers to highlight any similarities and differences present. Findings Findings from staff interviews revealed a range of 20 clinical factors perceived as essential to this process including procedural, relational and physical security aspects. However, variations were evident between the MDT priorities (20 items) and the originally proposed list. This emphasised the need for a tool which facilitates a holistic and streamlined approach. Practical implications The findings from this research have resulted in the development of the ALS tool comprising of 18 key factors. Originality/value It is envisaged the development of the ALS tool will not only facilitate and structure the decision-making process but also ensure a person-centred approach. This is because the ALS allows for a holistic approach based on an array of factors deemed important to that particular service user. Furthermore, the ALS tool contributes towards the paucity of published structured professional judgement tools needed to make such decisions.
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