Simms-Sawyers Cassandra, Miles Helen, Harvey Joel
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Kent Forensic & Specialist Care Group, Kent & Medway NHS & Social Care Partnership Trust (KMPT) & Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Psychiatr Psychol Law. 2020 Apr 7;27(4):578-600. doi: 10.1080/13218719.2020.1734981. eCollection 2020.
Psychologists working within forensic mental health (FMH) services face challenges around supporting clients' informed consent when engaging in psychological assessment and treatment. Given that there is little research in this area, this qualitative study interviewed ten forensic inpatients from a low secure FMH service, to determine the impact of any perceived coercion to engage with psychologists. Interviews were transcribed and subject to Thematic Analysis. Three over-arching themes emerged from the analysis: 'Awareness of Coercive Power', 'Experiencing and Responding to Coercion' and 'Psychological Treatment is Helpful, But…'. Participants perceived coercion to engage with psychologists. Perceived coercion led to psychological distress, wanting to resist, and superficial engagement. Despite this, therapeutic alliance was established with the psychologist but the quality of the therapeutic alliance was compromised. The findings have implications for psychologists working in FMH services. Suggestions for reducing perceived coercion and future directions for research are discussed.
在法医精神卫生(FMH)服务机构工作的心理学家在为客户提供心理评估和治疗时,围绕支持客户的知情同意面临挑战。鉴于该领域的研究较少,这项定性研究采访了来自一家低戒备FMH服务机构的十名法医住院患者,以确定任何感知到的参与心理学家工作的强制力的影响。访谈内容被转录并进行了主题分析。分析中出现了三个总体主题:“对强制力的意识”、“体验和应对强制力”以及“心理治疗是有帮助的,但是……”。参与者感知到参与心理学家工作存在强制力。感知到的强制力导致心理困扰、想要抗拒以及表面参与。尽管如此,仍与心理学家建立了治疗联盟,但治疗联盟的质量受到了损害。这些发现对在FMH服务机构工作的心理学家具有启示意义。讨论了减少感知到的强制力的建议以及未来的研究方向。