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Title: Exploring the personal and systemic factors impacting on wellbeing and effective working in mental health professionals
Author: Keith, S. A.
ISNI:       0000 0004 7658 5391
Awarding Body: University of Liverpool
Current Institution: University of Liverpool
Date of Award: 2018
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Since the publication of the Francis Report (Francis, 2013) and its subsequent recommendations, National Health Service (NHS) services have become more accountable for supporting the wellbeing and development of their workforce. The Francis Report highlighted serious failings of services in the delivery of adequate and safe care in the context of a healthcare system working under immense clinical and financial pressures (NHS England, 2014). The importance of "effective care from caring, compassionate and committed staff" is central to supporting positive client outcomes (Francis, 2013, p.67). The publication of the Francis Report increased NHS senior managers' and services' awareness of the relationship between staff wellbeing and quality healthcare provision and also, the importance of training, leadership, and supervision in supporting staff to work effectively in their professional role. The Five Year Forward view (NHS England, 2014) set out a vision for the continued improvement and evolution of future NHS services and highlighted the importance of supporting workplace health for staff including mental wellbeing (e.g., Schwartz rounds, resilience training). The implementation of interventions to support staff wellbeing is supported by National Institute for Health and Care Excellence (NICE) (2009, 2015). The drive for more caring and compassionate NHS services can be observed through both organisational and service-level changes implemented to support staff to work most effectively in their role. Within the literature little focus has been specifically given to mental health professionals (MHPs) regarding the personal and systemic factors impacting upon their wellbeing and ability to work effectively in their role. This thesis synthesises and extends existing literature concerning the personal and systemic factors impacting upon MHPs based both within and outside of the NHS. It examines their experience of and ability to work with clients with complex mental health difficulties, associated with presentations relating to psychological trauma in chapter one and eating disorders in chapter two. This thesis comprises two papers including a systematic literature review and an empirical research paper. The systematic review was prepared for submission to Psychology and Psychotherapy: Theory Research and Practice. The systematic review implemented a robust, systematic search strategy to identify papers exploring the association between MHP attachment style and negative personal outcomes including burnout, compassion fatigue, and associated constructs. Nine peer-reviewed papers were deemed eligible for inclusion in the review. A quality assessment was completed for each paper. Findings identified an association between attachment insecurity, particularly attachment anxiety, and negative personal outcomes for MHPs in relation to clinical working with a range of complex mental health difficulties. Findings are discussed in relation to the impact of attachment style influencing MHPs' psychological wellbeing and the support required by them to reduce potential vulnerabilities to negative personal outcomes in relation to clinical working. The empirical paper was prepared for submission to the British Journal of Psychology. The empirical paper used a grounded theory methodological approach with twelve eating disorder (ED) psychological therapists. A theoretical model was developed to comprehensively explain the processes in which personal and systemic factors enable therapists to work effectively with challenge in their role. Findings are discussed in relation to factors identified to support effective working for ED therapists and their experience of consequential job satisfaction, supporting them to continue working in the field, alongside the clinical implications of this.
Supervisor: Bennett, Kate ; Yelland, Irina Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral