Aims and method: Non-engagement with psychological therapy groups in mental health settings is a long-standing problem, with implications on group processes and service delivery. Little is known about service user-related factors hindering this engagement, especially on inpatient wards. We aimed to investigate the perspectives of service users on barriers to engagement with a therapeutic group facilitated by assistant psychologists. Experiences of therapy groups were explored via focus groups and in-depth semi-structured interviews with 16 participants on two acute wards.Data were analysed by means of thematic analysis adopting an inductive approach embedded in a constructivist paradigm.Results: The analysis identified three higher-order themes: ways that facilitators might encourage group attendance; a need for safe therapeutic conditions within the groups; and a need for good applicability of group content to recovery outside of hospital. The results are discussed with reference to psychological approaches, group therapy research and trauma-informed care.
Conclusion:Findings bear implications on clinical practice within inpatient mental health settings, specifically: (a) the need to approach service users individually to invite to groups and establish role expectancies; (b) supervision for facilitators focussing on difficult group dynamics and creating robust groups agreements to facilitate containment; (c) working with teams to ensure stable, protected physical spaces for groups on wards, in turn avoiding the re-traumatising effects of disruption; (d) emphasising that participation does not require sharing difficult personal information, to prevent destabilisation and improve uptake of group offer; and (e) increasing focus on applicability of skills through consideration of potential obstacles to their real-life application. K E Y W O R D S engagement, group cohesiveness, inpatient psychology groups, qualitative research, service user perspectives | 371 HARRIS et Al.
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