Birmingham and Solihull Mental Health Foundation Trust, Lancashire and South Cumbria Foundation Trust, Birmingham, UK.
Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK.
Crim Behav Ment Health. 2022 Dec;32(6):377-388. doi: 10.1002/cbm.2264. Epub 2022 Nov 8.
Relationships are at the core of recovery, particularly in secure services where patients have usually had difficulties with authority figures and can have mentalisation deficits. Early indications are that avatar-based virtual world software may help facilitate communication and emotional expression.
To establish the feasibility of using avatar-based virtual world software in a medium secure hospital, adjunctive to standard staff-patient interactions during clinical interventions and staff activities including reflective practice and training; to explore patient, staff participant and facilitator experiences using it.
Use of the software was offered across an 89-bedded unit as an optional adjunct to clinical interventions, reflective practice and training sessions. Qualitative data were collected using semi-structured interviews and analysed using thematic analysis. Volunteer sampling was used. Five patients volunteered and were matched with an equal number of staff facilitators and participants.
Eighty four sessions were completed using the avatar software with between 1 and 11 participant(s) per session, totalling 347 participant sessions. No adverse events occurred relatable to the sessions. An overarching theme of 'adding value' emerged, encompassing subthemes such as 'concrete visual presence and imagery', 'mentalisation processes' and 'enhanced focus, depth and problem solving'. Experiences of added value were affected by moderators which were 'power and relationship dynamics', the 'ability to use software', 'practical processes' and 'literacy'.
Avatar software is feasible to implement, acceptable to patients and staff and may offer an opportunity to aid mentalisation and reflection. By definition, everyone engaging in this study was a volunteer, even an enthusiast, so it would now be useful to extend evaluation to those who need some encouragement to use avatar software. Research to quantify benefits and establish the cost impact is now indicated, as our findings show it may offer a novel way of connecting with hard-to-reach patient groups.
人际关系是康复的核心，尤其是在安全服务中，患者通常与权威人士存在困难，并且可能存在心理化缺陷。初步迹象表明，基于头像的虚拟世界软件可能有助于促进沟通和情感表达。
在中等安全医院中，建立使用基于头像的虚拟世界软件的可行性，作为临床干预和员工活动（包括反思实践和培训）中标准员工-患者互动的辅助手段；探索患者、员工参与者和促进者使用它的经验。
在一个 89 张床位的病房中提供软件使用，作为临床干预、反思实践和培训课程的可选辅助手段。使用半结构化访谈收集定性数据，并使用主题分析进行分析。使用志愿者抽样。有 5 名患者自愿参加，并与数量相等的员工促进者和参与者相匹配。
共完成了 84 次使用头像软件的课程，每次课程有 1 到 11 名参与者，总计 347 名参与者课程。与课程相关的没有发生任何不良事件。出现了一个总体主题“增加价值”，包括“具体的视觉存在和意象”、“心理化过程”和“增强的焦点、深度和问题解决”等子主题。增值体验受到“权力和关系动态”、“使用软件的能力”、“实践流程”和“读写能力”等因素的影响。
头像软件易于实施，患者和员工都可以接受，并且可能为促进心理化和反思提供机会。根据定义，参与这项研究的每个人都是志愿者，即使是热心参与者，所以现在将评估扩展到那些需要一些鼓励来使用头像软件的人是有用的。现在需要进行研究以量化效益并确定成本影响，因为我们的研究结果表明，它可能为与难以接触的患者群体建立联系提供一种新途径。
