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Developing mental health occupational therapy practice to meet the needs of people with mental health problems and physical disability
- Authors:
- MILES Helen, MORLEY Mary
- Journal article citation:
- British Journal of Occupational Therapy, 76(12), 2013, pp.556-559.
- Publisher:
- Sage
It is well documented and evidenced that individuals with serious mental illness have an increased risk of developing a range of physical illnesses and conditions. This practice analysis describes how an initial audit of mental health occupational therapists identified a lack of clarity and protocols around working with individuals with associated physical conditions. Local joint care pathways and a skills development programme were introduced, and a follow-up audit completed to assess progress to date. The advancement in practice and production of a clear physical care pathway has made a positive difference to service users. (Publisher abstract)
An evaluation of the implementation of the recovery philosophy in a secure forensic service
- Authors:
- CORLETT Holly, MILES Helen
- Journal article citation:
- British Journal of Forensic Practice, 12(4), November 2010, pp.14-25.
- Publisher:
- Emerald
This paper investigated the employment of the recovery model in a medium secure NHS forensic service in Kent, UK. Twenty-six staff and 17 mentally disordered offenders were interviewed in 2009 from the rehabilitation and pre-discharges units. Their views on recovery were measured using the Developing Recovery Enhancing Environments Measure. Staff consistently rated all 24 elements of recovery as more important than the offenders. Staff also rated the elements of recovery as better implemented, except intimacy and sexuality. There was a significant effect of offenders’ forensic history on ratings of how well elements of recovery were implemented, such as restriction status and index offence type. Staff and mentally disordered offenders rated all elements of recovery as at least moderately important. The authors concluded that once identified as important, recovery elements can be used to guide service development. Further implications of the recovery philosophy in forensic mental health services are discussed.
'Just Say No': a preliminary evaluation of a three-stage model of integrated treatment for substance use problems in conditions of medium security
- Authors:
- MILES Helen, et al
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 18(2), June 2007, pp.141-159.
- Publisher:
- Taylor and Francis
Preliminary outcome data evaluating a three-stage model of integrated treatment for substance use problems in conditions of medium security are presented to address the lack of previous research in this area. Stage 1 and Stage 2 are 12-week treatment groups, supporting participants in becoming and remaining substance free, respectively, through motivational interviewing, psycho-education, and relapse prevention approaches. 'Just Say No' (JSN) is a participant-led social group to support continued abstinence throughout admission and up to six months post-discharge. Case notes of all in-patients in 2005 were screened, revealing that 32 (74%) of in-patients had a prior history of substance use problems. Of the 19 who received treatment, 14 (74%) became abstinent by the end of 2005, rising to 15 (79%, missing = 3) by the end of June 2006. However five refused, of whom three (60%) became abstinent, and eight were not referred due to unstable mental state or imminent discharge. There was a significant effect of treatment on whether or not in-patients became drug-free, although only JSN attendance had a significant effect on whether they remained drug-free. By the end of treatment (and maintained at six-month follow-up), participants' self-reported insight and confidence to make changes to their substance use had increased, and there was a trend towards participants reporting more adaptive beliefs about substances and less craving for cannabis. Participants were also satisfied with the treatment intervention
The effect of training on the quality of HCR-20 violence risk assessments in forensic secure settings
- Authors:
- RENOLDS Kelly, MILES Helen Louise
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 20(3), June 2009, pp.473-480.
- Publisher:
- Taylor and Francis
Training (full course: one and a half days; introductory course: half a day) on the HCR-20 risk assessment of violence in mentally disordered offenders was held for Kent Forensic Psychiatry Service (KFPS) staff in 2007 and 2008. KFPS inpatient files (n = 68) on 1 April 2008 were reviewed to locate completed HCR-20s. Overall and component parts (historical factors, clinical factors, risk management factors, and risk management plan) were rated for quality. Training significantly increased the quality of HCR-20 assessments. No significant differences in quality were found between those completed by qualified and by trainee staff. Training evaluations indicated that the most useful/helpful aspects of the training were the facilitator's training style and the pace of the day, while the least was training venue. Confidence in completing HCR-20s was also reasonably low, possibly due to perceptions of the time involved.
Retrospective and prospective cognitions in adolescents: anxiety, depression, and positive and negative affect
- Authors:
- MILES Helen, McLEOD Andrew K., POTE Helen
- Journal article citation:
- Journal of Adolescence, 27(6), December 2004, pp.691-704.
- Publisher:
- Academic Press
Research with anxious and depressed adults has suggested that anxiety is related to an increased anticipation of both negative memories and negative expectancies whereas depression is related to a reduction in positive memories and expectancies. The present study examined whether anxiety and depression in 123 school-aged adolescents would show the same pattern. Small groups completed a memory and future thinking task in which they were asked to generate future and past, positive and negative events. Adolescents with higher levels of depression and those with higher levels of anxiety reported significantly more negative events relative to controls, but neither group generated fewer positive events. The results provide support for the involvement of cognitions in mood disturbance although do not support the idea that these cognitions are different in anxiety and depression.