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Title: Translating policy into practice : an evaluation of a multidisciplinary training in psychosocial interventions for working with people who have serious mental health problems
Author: Repper, Julie
Awarding Body: The University of Manchester
Current Institution: University of Manchester
Date of Award: 2000
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This study investigates the impact of a one year, multidisciplinary training in psycho-social intervention skills (PSI). It utilises an embedded multiple case design, drawing on experimental and qualitative methods as recommended by Morley (1989). Thus both outcome and the reasons for that outcome are assessed on an individual (student and client) basis, over the training period and for a one year follow-up period. 9 of the 19 clients made a statistically reliable improvement on the total symptoms score, and all but three made progress on their personal goals. These outcomes were not, however, all attributable to specific evidence-based interventions taught on the course. They were also related to 'non-specific' skills used by students (which were none the less based on cognitive behavioural principles), and to other events in clients' lives and their 'readiness' to engage in a process of recovery. Although students' described a change in their own attitudes and approach (and clients recognised changes in the quality of contact), outcomes may have been improved if they had used evidence based intervention skills more effectively. The use of skills appeared to be related to the adequacy of teaching and clinical supervision, the complexity and unfamiliarity of the skills, clients' level of impairment, and the time available and support provided within the workplace. The Sheffield training was developed in tandem with the local NHS Trust. It provided an opportunity to evaluate an 'organic' programme developed to meet local needs drawing on local resources. As such the findings gave an insight into issues of fidelity of training to espoused curriculum and to research evidence; transferability of evidence generated in research trials to routine practice; relevance of a training in interventions most effective on symptoms - when clients' priorities lie in the social domain; and adequacy of the evidence available for work with people who have serious mental health problems. The study concludes with recommendations for research, practices and education. Training in PSI is explicit mental health policy: a means of improving the implementation of that policy. Lipsky's analysis of policy implementation 'Street Level Bureaucracy' (1980) focuses on the role of the individual worker in policy implementation. As such it provides a useful theoretical framework in the present study, informing the individual case method, and enhancing understanding of the findings.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available