Developing an emotional coping skills workbook for inpatient psychiatric settings: a focus group investigation.
Open accessAbstract
BACKGROUND: Evidence suggests an unmet need for provision of psychological interventions in inpatient psychiatric settings. However, inpatient wards can present a challenging environment in which to implement interventions. The authors developed the Emotional Coping Skills workbook, a psychosocial intervention designed to overcome these challenges and provide inpatients with an opportunity for psychologically-informed therapeutic engagement. The workbook includes information and exercises to empower inpatients to understand their emotions and learn to cope with their distress. METHODS: A qualitative study using thematic analysis was undertaken in two UK inpatient psychiatric hospitals to explore staff's views about whether and how the workbook could be implemented, and on barriers to its use. Thirty-five nursing and occupational therapy staff members participated in four focus groups, and a further two psychologists in semi-structured interviews. RESULTS: Staff identified key barriers to successful implementation of the workbook. These were firstly, the difficulty in finding time and space for therapeutic work in the stressful ward environment. Secondly, staff identified a culture of emotional neglect whereby neither staff nor inpatients felt able to talk about emotions, and patients' physical needs and medication were prioritised. Thirdly, staff discussed how psychotic symptoms and emotional distress could limit patients' ability to engage with the workbook material. Staff suggested ways in which the feasibility of using the workbook could be enhanced. Firstly, they discussed the importance of encouraging staff to value psychological approaches and to view the workbook as a resource to help them manage their existing tasks. Secondly, they emphasised the value of staff drawing on their expertise to deliver the workbook flexibly in different formats and settings, depending on each patient's particular presentation. Thirdly, they advocated empowering staff to decide the timing of intervention delivery in the context of each inpatient's fluctuations in distress and progress towards recovery. CONCLUSIONS: The study has highlighted key principles for flexible and well-integrated intervention delivery; these principles will be helpful for enhancing the feasibility of any nurse-delivered psychological intervention in inpatient settings.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Main limitations for psychotherapy in acute settings consist of short hospital stays and patients' difficulties to engage due to treatment resistance, high distrust, emotional distress, severe cognitive deficits, and dual diagnoses.
“Main limitations consist of short hospital stays (111) and patients’ general difficulties to engage with traditional psychotherapy concepts due to treatment resistance (112, 113), high distrust levels toward the entire environment (114), emotional distress (115), severe cognitive deficits (116), and dual diagnoses (117).”
From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [114]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Using thematic analysis in psychology
Braun, V., & Clarke, V. (2006) · Qualitative Research in Psychology · doi:10.1191/1478088706qp063oa · Cited by 194,414 · see citing works
Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009) · Implementation Science · doi:10.1186/1748-5908-4-50 · Cited by 14,496 · see citing works
Developing and evaluating complex interventions: the new Medical Research Council guidance
Craig, P., Dieppe, P., Macintyre, S., Michie, S., Nazareth, I., & Petticrew, M. (2008) · BMJ · doi:10.1136/bmj.a1655 · Cited by 10,995 · see citing works
(1996) · Consulting Psychologists Press eBooks · Cited by 7,863 · see citing works
(1993) · Cited by 7,136 · see citing works
Qualitative research. Introducing focus groups.
Kitzinger, J. (1995) · BMJ · doi:10.1136/bmj.311.7000.299 · Cited by 6,939 · see citing works
Cognitive-Behavioral Treatment of Borderline Personality Disorder
Cary, G. L. (1994) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.1994.48.1.155 · Cited by 6,300 · see citing works
Framework for design and evaluation of complex interventions to improve health
Campbell, M. (2000) · BMJ · doi:10.1136/bmj.321.7262.694 · Cited by 3,474 · see citing works
Evolving guidelines for publication of qualitative research studies in psychology and related fields
Elliott, R., Fischer, C. T., & Rennie, D. L. (1999) · British Journal of Clinical Psychology · doi:10.1348/014466599162782 · Cited by 2,491 · see citing works
(2011) · Cited by 2,032 · see citing works
Murray, E., Treweek, S., Pope, C., MacFarlane, A., Ballini, L., Dowrick, C., Finch, T., Kennedy, A., Mair, F., O'Donnell, C., et al. (2010) · BMC Medicine · doi:10.1186/1741-7015-8-63 · Cited by 1,478 · see citing works
Development of a theory of implementation and integration: Normalization Process Theory
May, C. R., Mair, F., Finch, T., MacFarlane, A., Dowrick, C., Treweek, S., Rapley, T., Ballini, L., Ong, B. N., Rogers, A., et al. (2009) · Implementation Science · doi:10.1186/1748-5908-4-29 · Cited by 1,409 · cited 1× · see citing works
“It is also in line with the tenets of Normalisation Process Theory [31] - a theory that delineates factors that promote and inhibit the routine incorporation of complex interventions into everyday practice.”
ResultWhat about N? A methodological study of sample-size reporting in focus group studies
Carlsen, B., & Glenton, C. (2011) · BMC Medical Research Methodology · doi:10.1186/1471-2288-11-26 · Cited by 670 · cited 1× · see citing works
“Four focus groups, each with 6–12 participants, were conducted in order to ensure sufficient group members to draw out conflicting points of view and generate discussion, whilst allowing each person to talk in adequate detail about their point of view – a balance between quantity and quality [36].”
BackgroundAarons, G. A., & Sawitzky, A. C. (2006) · Psychological Services · doi:10.1037/1541-1559.3.1.61 · Cited by 482 · see citing works
Stressors, burnout and social support: nurses in acute mental health settings
Jenkins, R., & Elliott, P. (2004) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2004.03240.x · Cited by 426 · see citing works
Webb, T. L., & Sheeran, P. (2008) · British Journal of Social Psychology · doi:10.1348/014466607x267010 · Cited by 351 · see citing works
Berking, M., Ebert, D., Cuijpers, P., & Hofmann, S. G. (2013) · Psychotherapy and Psychosomatics · doi:10.1159/000348448 · Cited by 328 · see citing works
Cancer expert doubts claims about prostate cancer trial
Cole, A. (2008) · BMJ · doi:10.1136/bmj.a979 · Cited by 255 · see citing works
Research Methods in Clinical Psychology
Barker, C., Pistrang, N., & Elliott, R. (2002) · Wiley eBooks · doi:10.1002/0470013435 · Cited by 255 · see citing works
Self-citationCritical realism: a way forward for evaluation research in nursing?
McEvoy, P., & Richards, D. A. (2003) · Journal of Advanced Nursing · doi:10.1046/j.1365-2648.2003.02730.x · Cited by 203 · see citing works
What do we know about life on acute psychiatric wards in the UK? a review of the research evidence
Quirk, A., & Lelliott, P. T. (2001) · Social Science & Medicine · doi:10.1016/s0277-9536(00)00457-3 · Cited by 158 · see citing works
Vassilev, I., Rowsell, A., Pope, C., Kennedy, A., O’Cathain, A., Salisbury, C., & Rogers, A. (2015) · Implementation Science · doi:10.1186/s13012-015-0238-9 · Cited by 137 · see citing works
The fundamentals of workforce competency: implications for behavioral health
Hoge, M. A., Tondora, J., & Marrelli, A. F. (2005) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-005-3263-1 · Cited by 119 · see citing works
From the asylum to community care: learning from experience
Killaspy, H. T. (2006) · British Medical Bulletin · doi:10.1093/bmb/ldl017 · Cited by 116 · see citing works
Reasons for admission and their implications for the nature of acute inpatient psychiatric nursing
Bowers, L. (2005) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2004.00825.x · Cited by 111 · see citing works
Nurse and patient activities and interaction on psychiatric inpatients wards: A literature review
Sharac, J., McCrone, P., Sabés-Figuera, R., Csipke, E., Wood, A., & Wykes, T. (2010) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2010.03.012 · Cited by 111 · see citing works
The nature and purpose of acute psychiatric wards: The tompkins acute ward study
Bowers, L., Simpson, A., Alexander, J., Hackney, D., Nijman, H. L. I., Grange, A., & Warren, J. (2005) · Journal of Mental Health · doi:10.1080/09638230500389105 · Cited by 103 · see citing works
Bloom, J. M., Woodward, E. N., Susmaras, T., & Pantalone, D. W. (2012) · Psychiatric Services · doi:10.1176/appi.ps.201100311 · Cited by 103 · see citing works
Dialectical behaviour therapy: An increasing evidence base
Feigenbaum, J. (2007) · Journal of Mental Health · doi:10.1080/09638230601182094 · Cited by 100 · see citing works
Mental health nurses establishing psychosocial interventions within acute inpatient settings
Mullen, A. (2009) · International Journal of Mental Health Nursing · doi:10.1111/j.1447-0349.2008.00578.x · Cited by 97 · see citing works
Service users’ strategies for managing risk in the volatile environment of an acute psychiatric ward
Quirk, A., Lelliott, P. T., & Seale, C. F. (2004) · Social Science & Medicine · doi:10.1016/j.socscimed.2004.04.005 · Cited by 74 · see citing works
Cognitive therapy with depressed inpatients: Specific effects on dysfunctional cognitions.
Whisman, M. A., Miller, I. W., Norman, W. H., & Keitner, G. I. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.59.2.282 · Cited by 67 · see citing works
Johansson, C., Åström, S., Kauffeldt, A., Helldin, L., & Carlström, E. (2013) · Health Policy · doi:10.1016/j.healthpol.2013.07.014 · Cited by 65 · see citing works
Mental Health Policy and Practice
Glasby, J., & Tew, J. (2015) · doi:10.1007/978-1-137-11944-5 · Cited by 63 · see citing works
Improving patient experiences of mental health inpatient care: a randomised controlled trial
Wykes, T., Csipke, E., Williams, P. R., Koeser, L., Nash, S., Rose, D. S., Craig, T., & McCrone, P. (2017) · Psychological Medicine · doi:10.1017/s003329171700188x · Cited by 58 · see citing works
The Effects of Child Behavior Problems on the Maintenance of Intervention Fidelity
McConnachie, G., & Carr, E. G. (1997) · Behavior Modification · doi:10.1177/01454455970212001 · Cited by 51 · see citing works
Dillon, J., Johnstone, L., & Longden, E. (2014) · Palgrave Macmillan UK eBooks · doi:10.1057/9781137304667_14 · Cited by 43 · see citing works
Cognitive therapy with depressed inpatients: Specific effects on dysfunctional cognitions.
Whisman, M. A., Miller, I. W., Norman, W. H., et al. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.59.2.282 · Cited by 43 · see citing works
CBT for Psychosis : A Symptom-based Approach
Hagen, R., Turkington, D., Berge, T., et al. (2013) · Cited by 31 · see citing works
Laker, C., Callard, F. J., Flach, C., Williams, P. R., Sayer, J., & Wykes, T. (2014) · Implementation Science · doi:10.1186/1748-5908-9-23 · Cited by 31 · see citing works
Cognitive Behaviour Therapy for Acute Inpatient Mental Health Units
(2008) · Routledge eBooks · doi:10.4324/9780203596845 · Cited by 27 · see citing works
Veltro, F., Vendittelli, N., Oricchio, I., et al. (2008) · Journal of Psychiatric Practice · doi:10.1097/01.pra.0000336755.57684.45 · Cited by 17 · see citing works
Fowler, J. C., Allen, J. G., Hart, J. M., Szlykh, H., Ellis, T. E., Frueh, B. C., & Oldham, J. M. (2014) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/2051-6673-1-19 · Cited by 15 · see citing works
Less Time To Do More: Psychotherapy on the Short-Term Inpatient Unit
Roukema, R. W. (1995) · Psychiatric Services · doi:10.1176/ps.46.4.414 · Cited by 7 · see citing works
Less Time to Do More: Psychotherapy on the Short-Term Inpatient Unit
(1993) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615376285 · Cited by 4 · see citing works
Less Time to Do More: Psychotherapy on the Short-Term Inpatient Unit
Gabbard, G. O. (1994) · American Journal of Psychiatry · doi:10.1176/ajp.151.8.1237 · Cited by 3 · see citing works
Barker, P., & Buchanan‐Barker, P. (2005) · Nursing Standard · doi:10.7748/ns.19.24.26.s40 · Cited by 3 · see citing works
Lloyd‐Evans, B. (2010) · UCL Discovery (University College London) · Cited by 2 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Barnicot, K., Michael, C., Trione, E., Lang, S., Saunders, T., Sharp, M., & Crawford, M. J. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101929 · Cited by 45 · see citing works
Self-citationGussmann, E., Lucae, S., Falkai, P., Padberg, F., Egli, S., & Kopf-Beck, J. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1160075 · Cited by 2 · see citing works
“Main limitations consist of short hospital stays (111) and patients’ general difficulties to engage with traditional psychotherapy concepts due to treatment resistance (112, 113), high distrust levels toward the entire environment (114), emotional distress (115), severe cognitive deficits (116), and dual diagnoses (11…”
Background
- Authors
- Sharp, M., Gulati, A., Barker, C., & Barnicot, K.
- Affiliations
- University College London (GB)
- Imperial College London (GB)
- Corresponding author
- Barnicot, Kirsten
- Venue
- BMC Psychiatry
- Published
- 2018-06-22
- Volume
- 18
- Issue
- 1
- Pages
- 208-208
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC6013871
- OpenAlex
- W2808802416
- Cited by
- 7
- References
- 48
- Citations by year
- 2025: 2 · 2023: 2 · 2020: 2 · 2019: 1
- FWCI
- 0.88
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- City Research Online (City University London) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UCL Discovery (University College London) (submittedVersion)
- Spiral (Imperial College London) (submittedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- psychiatric inpatient care, psychosocial interventions, staff perspectives, implementation barriers, emotional neglect, emotional distress, psychotic symptoms, employee empowerment, treatment engagement
- MeSH terms
- Adaptation, Psychological, Adult, Attitude of Health Personnel, Decision Making, Emotions, Female, Hospitals, Psychiatric, Humans, Inpatients, Male, Middle Aged, Psychotherapy, Surveys and Questionnaires, Focus Groups, Qualitative Research, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
