Hostage/crisis negotiation has been described as a complex verbal dance between the negotiator and the subject. While one of law enforcement's most effective tools and most significant developments in law enforcement and police psychology over the past several decades, the acceptance of mental health professionals (MHP) on a hostage/crisis negotiation team is ambiguous. This study examined how mental health professionals working with hostage/crisis negotiation teams are perceived, if there is positive small group socialization within teams, whether the outcome of incidents is affected by designation of the MHP as a team member versus a consultant, and whether prior law enforcement experience influences team members' perception of the MHP. A comparative research design was utilized and data were collected from 362 hostage/crisis negotiators using the Hostage/Crisis Negotiation and Mental Health Professional Questionnaire. Independent sample t tests indicated that MHPs designated as team members scored higher on the Small-Group Socialization and Perception scales than those designated as consultants. Results indicated that MHPs with law enforcement experience were perceived more positively than those without. The type of MHP designation showed no significant effect on incident outcome. This study's outcome may produce positive social change in that the results will enhance and promote ideas and cohesion that involves the unity of the MHP and their law enforcement team members in a field that focuses in on preservation of human life in the worst possible conditions, with positive implications for the team, hostages, victims, communities, and even the individual in crisis.

Na atualidade, entende-se que o campo do conhecimento da saúde mental é amplamente complexo e intersetorial, abrangendo muitos saberes. Muitos estudos sobre os cuidadores do sujeito com transtorno mental no Brasil, que revelam que apesar da mudança do paradigma no tratamento psiquiátrico - ocorrida na segunda metade do século XX - ainda há violações dos direitos dos pacientes internados, além do sentimento, na equipe de atenção, de certo desamparo e falta de conhecimento sobre o lidar com o paciente. Este trabalho teve como objetivo buscar conhecera visão de auxiliares de enfermagem de um setor de agudos masculino e feminino de um hospital especializado em psiquiatria do interior do estado de são paulo a respeito de seu trabalho. mais especificamente, pretende-se conhecer, a partir de sua própria perspectiva, a trajetória e formação profissional dessas pessoas, o contexto institucional e as práticas cotidianas envolvidas em seu trabalho e suas concepções a respeito da clientela atendida. Foram entrevistados através da \"história de vida temática\" onze auxiliares de enfermagem. Essas entrevistas foram gravadas e transcritas na íntegra, e analisadas qualitativamente. A análise permitiu apontar os seguintes temas: suas trajetórias de vida, influências recíprocas entre a vida pessoal e do trabalho, a formação dos profissionais,o perfil do auxiliar, a rotina de trabalho e seus apoios a visão sobre o paciente psiquiátrico, sua família. Os relatos convergiram para a apresentação da maneira como se configura o trabalho do auxiliar de enfermagem, quanto às suas visões e condições para o trabalho cotidiano Considera-se que é importante promover a criação de espaços de reflexão, discussão e escuta entre os profissionais de saúde mental, dentro dos setting de trabalho, integrando principalmente os que lidam diretamente com o paciente, de modo que nesses espaços se possa conversar sobre questões da prática diária específicas, mas também transcender a elas; relacionando essa prática com repercussões da vida pessoal no trabalho, promovendo apoio ao trabalhador. / It\'s well known that the mental health knowledge field is complex and inter sectorial. Many studies about the mental health patient, in Brazil, have revealed that although there was a change in the psychiatric treatment, still there is patients rights violations, and the feeling in the attention group is of certain hopelessness and lack of knowledge in dealing with the patient. This work aims to explore a masculine and feminine acute unit nursing personnel, in a psychiatry specialized hospital in the inner State of São Paulo, from the point of view of their work. More specifically, it\'s intended to know, from their own perspective their professional pathways and education, the institutional context and their everyday practices concerning work and clients. Eleven nursing professionals were interviewed through \"thematic life history\" interview. Those interviews were taped and integrally transcript and analyzed qualitatively. The analysis showed their life pathways, influences of their personal lives on work, professional education, work routine, support on psychiatric patients and the patient\'s family concepts. It\'s considered that it\'s important to promote reflection, discussion and hearing spaces among mental health professionals, in the work setting, with those who deal directly with the patient and the whole team so it\'s possible to discuss on every day practices, transcend to them relating to personal life repercussions, promoting support for work.

People living with mental disorders (PLWMDs) are at an increased risk for developing obesity due to poor diet, physical inactivity, and antipsychotic medications. In the United States, the general-population obesity rate is 36% compared to more than 50% for PLWMDs. Mental health professionals (MHPs), focused on addressing psychiatric conditions, seldom recognize and clinically manage obesity. Furthermore, this population is socioeconomically disadvantaged with poor dietary habits while consuming psychiatric medications that stimulate hunger, further exacerbating the risk for obesity. The Promoting Action on Research Implementation in Healthcare Services (PARISHS) framework guided this quality improvement project to improve obesity awareness and management for PLWMD at a large state psychiatric hospital. An evidence-based education intervention was implemented to positively impact obesity awareness and clinical management or MHPs. The evaluation used a validated instrument with a pre- and posttest design. Paired t test was used to analyze multiple constructs from the MHP participants (N = 50). Overall, the pretest indicated 76% of MHPs were not involved in helping obese PLWMDs manage their weight; however, the posttest data (at 90-days) revealed that 90% were involved in this activity. This represents a positive shift in obesity perceptions and management knowledge. Future research needs to evaluate the impact of the perceptions on process measures and clinical outcomes. This project led to positive social change as MHPs are more likely to address obesity in PLWMD due to their increased awareness and knowledge. This project has broader implications as the program can be duplicated in other psychiatric hospitals.

This thesis is concerned with the impact of professional background on role fulfilment. In the United Kingdom current policy in health and social care in mental health is underpinned by integration; the idea that responsibilities can be accomplished irrespective of profession. Approved mental health practice is one example of a psychiatric statutory role and function, until recently carried out by the profession of social work, which is now extended to other, non-medical, mental health professions. This thesis aims to explore the role and experiences of current practitioners in order to understand the impact, if any, of professional background on the fulfilment of approved mental health practice and the way in which it is experienced. Qualitative data are generated through semi-structured individual interviews with twelve approved mental health practitioners: five nurses, two occupational therapists and five social workers and the use of rich pictures to supplement the interview discussions. Interpretative Phenomenological Analysis was applied to the verbatim transcripts. Key findings were that approved mental health practice can be accomplished irrespective of professional background. Its practitioners require particular shared attributes, specifically a cognitive and affective capacity to deal with and use discord and to manage the disparate emotions that occur. Conceptualised in this thesis as "pull," this finding constitutes a different understanding of the use of emotion in the workplace and provides evidence of a new emotional dimension; the active use of dissonance. Professional identity is also found to be influenced by approved mental health practice thereby turning on its head the original hypothesis of this thesis. Last, personhood is found to be an additional aspect of the moral framework for approved mental health practice and is being practiced in a different circumstance than previously considered. The implications of this work are that it challenges the perception that approved mental health practice is synonymous with the profession of social work. It also revives the theory that its normative moral framework is inherently contradictory. The present study appears to be the first to associate personhood with approved mental health practice and shows role fulfilment as sophisticated emotion management, primarily the active use of dissonance. Both provide new insights into the enactment of approved mental health practice and are important issues for the future training and development of practitioners. The influence on role of professional identity may also help policy makers better understand the impact that new ways of working in mental health might have on traditional professional roles and boundaries in integrated services.

Na atualidade, entende-se que o campo do conhecimento da saúde mental é amplamente complexo e intersetorial, abrangendo muitos saberes. Muitos estudos sobre os cuidadores do sujeito com transtorno mental no Brasil, que revelam que apesar da mudança do paradigma no tratamento psiquiátrico - ocorrida na segunda metade do século XX - ainda há violações dos direitos dos pacientes internados, além do sentimento, na equipe de atenção, de certo desamparo e falta de conhecimento sobre o lidar com o paciente. Este trabalho teve como objetivo buscar conhecera visão de auxiliares de enfermagem de um setor de agudos masculino e feminino de um hospital especializado em psiquiatria do interior do estado de são paulo a respeito de seu trabalho. mais especificamente, pretende-se conhecer, a partir de sua própria perspectiva, a trajetória e formação profissional dessas pessoas, o contexto institucional e as práticas cotidianas envolvidas em seu trabalho e suas concepções a respeito da clientela atendida. Foram entrevistados através da \"história de vida temática\" onze auxiliares de enfermagem. Essas entrevistas foram gravadas e transcritas na íntegra, e analisadas qualitativamente. A análise permitiu apontar os seguintes temas: suas trajetórias de vida, influências recíprocas entre a vida pessoal e do trabalho, a formação dos profissionais,o perfil do auxiliar, a rotina de trabalho e seus apoios a visão sobre o paciente psiquiátrico, sua família. Os relatos convergiram para a apresentação da maneira como se configura o trabalho do auxiliar de enfermagem, quanto às suas visões e condições para o trabalho cotidiano Considera-se que é importante promover a criação de espaços de reflexão, discussão e escuta entre os profissionais de saúde mental, dentro dos setting de trabalho, integrando principalmente os que lidam diretamente com o paciente, de modo que nesses espaços se possa conversar sobre questões da prática diária específicas, mas também transcender a elas; relacionando essa prática com repercussões da vida pessoal no trabalho, promovendo apoio ao trabalhador. / It\'s well known that the mental health knowledge field is complex and inter sectorial. Many studies about the mental health patient, in Brazil, have revealed that although there was a change in the psychiatric treatment, still there is patients rights violations, and the feeling in the attention group is of certain hopelessness and lack of knowledge in dealing with the patient. This work aims to explore a masculine and feminine acute unit nursing personnel, in a psychiatry specialized hospital in the inner State of São Paulo, from the point of view of their work. More specifically, it\'s intended to know, from their own perspective their professional pathways and education, the institutional context and their everyday practices concerning work and clients. Eleven nursing professionals were interviewed through \"thematic life history\" interview. Those interviews were taped and integrally transcript and analyzed qualitatively. The analysis showed their life pathways, influences of their personal lives on work, professional education, work routine, support on psychiatric patients and the patient\'s family concepts. It\'s considered that it\'s important to promote reflection, discussion and hearing spaces among mental health professionals, in the work setting, with those who deal directly with the patient and the whole team so it\'s possible to discuss on every day practices, transcend to them relating to personal life repercussions, promoting support for work.

The decisions made by Mental Health Professionals (MHPs) are of utmost significance for providing the highest quality care to service users. The assessment of risk is one of the pivotal processes that MHPs undertake frequently, as per government policy guidelines, and in order to safeguard patients and the public. Although Risk Assessment Proformas (RAPs) consume a proportion of MHP time and resources, very little research has been undertaken to address factors that might affect their most optimal utilisation in practice. Previous literature suggests that medical decisions, like decision making of other kinds, is fraught with difficulty including being susceptible to the influence of cognitive biases, pre-decisional affect, overconfidence, and subjectively held attitudes towards organisational policies and regulations. Specifically, the presentation of risk information can influence decisions. It has also been suggested that anxiety has the capacity to elicit risk aversive responses, and that overconfidence and negative attitude may lead to complacency in undertaking policy-led responsibilities and produce non-compliance for the same. However, much of what is known about medical decision making has been gleaned from outside of context of mental health. As such, the current programme of research aimed to explore decision making in mental health settings and with a view to raise awareness of the complexity of decision making amongst MHPs. The implementation of quantitative and qualitative techniques (studies 1 and 2) revealed negative attitudes from psychiatrists towards Risk Assessment Proformas (RAPs), which are essentially structured decision making aids. Psychiatrist, compared to other MHPs, spent less time completing RAPs, which may reflect their differing attitudes towards their usefulness, something that was consistently emphasised during in-depth qualitative exploration. It was also found that experience was an additional differentiating factor between MHPs. Relationships between experience and other factors such as anxiety, confidence and complacency were found via conversations with MPHs, experience members of staff being less inclined to provide comprehensive and detailed accounts of service user risk in RAPs. This is problematic since although there is, in the UK, a policy led requirement that RAPs are completed for each service user, it is clear that there are inter-professional variations in how RAPs are being used and this acts to inhibit the best information sharing between all those involved in patient care. Following previous work in the area of cognitive bias and its influence upon general and medical decisions, a clinical vignette was also developed (study 3) to establish whether the presentation of risk information influences psychiatric admission decisions. The current findings supported previous work in that decisions were susceptible to the framing effect. The findings here, and previously in the literature, reveal a necessity for MHPs to be informed of bias in decision making in an attempt to improve objectivity in risk assessment practices. The unearthing of the framing effect also further signals the need for proper use of RAPs, where many MHPs may not be using them to their full potential - i.e. an aid to the systematic consideration of a range of information about a service user. The final part of the thesis (study 4) turned to the piloting of an educational module incorporating content around the factors affecting decision making in an attempt to raise awareness amongst MHPs. The rationale being better awareness of the complexity of decision making may act to enhance decision making processes. Pre and post intervention analyses revealed an improvement of baseline to follow-up knowledge of decision making bias and statistical concepts and this knowledge was maintained to a moderate level at four weeks follow-up. Although individuals maintained their susceptibility to the framing effect, the bias was less prevalent in those who knew of its presence before taking part in the study. Overall the findings give some support to the use of education as an approach to raising awareness about decision making processes in MHPs, although what remains to be seen is whether such education acts to bring about changes in behaviour - for example, different use of RAPs. The PhD programme suggests that MHPs are just as susceptible to cognitive biases, such as the framing effect, as has been demonstrated in both general population and other groups of health practitioners. At the same time, attitudes to RAPs differ depending on exact job role, which psychiatrist being least likely to spend time on their completion and reporting them as a tool for noting decisions reached as opposed to an aid to the process. This acts reduce the quality and quantity of reported information shared with colleagues about a service user. It is possible that MHP behaviour aligns with general attitude-behaviour models, such as the Theory of Planned Behaviour. As such, whilst the current work has demonstrated that educational interventions may act to improve awareness of decision making processes and their influences, further research would benefit from considering if these types of approach affect actual behaviour. For example, improved used of RAPs as decision-aids, reduced susceptibility to framing effects, consciousness around how information is represented in RAPs given knowledge of how the information may be used by others.

The move toward reducing the prison population was driven by an increase in the number of reentry programs that focused on the needs of the offender, such as the provision of stable housing, employment, education, and sustaining strong familial bonds. While the literature supported these areas as being effective in reducing recidivism, there was no consensus that they were effective for offenders with mental illness (OMI). The purpose of this qualitative study was to analyze the impact of prerelease services for the OMI population from the perspective of former correctional mental health professionals who provided these services. The research questions were focused on understanding the needs of OMIs in a correctional setting, and in the community and how the ability or inability to meet these needs impacted their successful reentry. The conceptual framework for this qualitative phenomenological study was based on social construction of reality framework and the risk, needs, responsivity theory. Based on thematic analysis of data collected from interviews with former correctional mental health professionals, qualitative findings showed that reentry programming is offered at the same rate for non-OMI and was not specific to OMI risks and needs. The social change implications affect the OMI population as well as every community they reintegrate back into. The direct impact of social change for the OMI population could be a fiscal impact which affects all tax-paying citizens. An increase in the allocation of state and federal dollars to be directed to prerelease specific programming could have the potential to reduce the rate of homelessness, crime, and victimization by increasing the ability to meet the needs of the OMI population before they were released back to the community.

In our sedentary society, physical inactivity has become the biggest public health concern of the 21st century. In addition to physical health promotion, physical activity has been associated with a number of positive psychological and social outcomes. Psychologists are well positioned to provide physical activity counseling and may have ethical obligations to address physical activity with their clients. Training the next generation of psychologists about the role of physical activity and health is critical to ensure best practices in graduate education. Researchers have cited insufficient training as a barrier to integrating physical activity into clinical work, yet little is known about effective training in physical activity counseling. One way to address these barriers is to employ an online-based training program allowing greater accessibility for doctoral psychology students across the United States. This exploratory study evaluated the effectiveness of a constructivist online interactive intervention, and compared it with a more traditional online content intervention and a control group, for enhancing doctoral psychology students’ self-efficacy in using physical activity counseling. It was hypothesized that 1) online interactive intervention would enhance self-efficacy, knowledge, and use of physical activity counseling compared to the online content intervention; and 2) both of these active treatments would yield improvements in physical activity counseling outcomes (e.g. self-efficacy, knowledge of health benefits of exercise, practice of physical activity counseling with clients, and personal level physical activity) compared with a control group. Results partially supported the original hypotheses. Mixed ANCOVA analyses indicated that participants in both intervention groups showed more self-efficacy at post-intervention assessment compared to their control group peers but the interactive intervention was not more effective than the content based intervention. Participants in the intervention groups demonstrated more targeted knowledge of physical activity counseling at post-intervention compared to their control group peers. No differences were found in the practice of physical activity counseling with clients post intervention. This study indicates there may be promise in using online platforms for enhancing physical activity counseling self-efficacy among psychologists in training. Future studies should continue to assess the effectiveness of physical activity counseling and refine training interventions to examine the effects of such interventions among the next generation of psychologists.

Made available in DSpace on 2016-08-10T10:54:59Z (GMT). No. of bitstreams: 1 PEDRO URIEL GONCALVES LIMA.pdf: 785716 bytes, checksum: 2b01eb823bb69a2ffb205c6f57db876a (MD5) Previous issue date: 2016-03-11 / With the advent of the Psychiatric Reform and the enactment of Law 10.216 - 12 establishing a new vision for the treatment of people with mental illness, the implementation of Psychosocial and Therapeutic Residences Care Centers have been imposed as support for the new model of care for these patients. Through Satisfaction Assessment Scales Brazilian was aimed in this study to evaluate the degree of satisfaction of residents and staff of these homes, to reflect whether such dwellings or not brought benefits proposed by the Law. It was found that only 1.9% of the professionals they said very dissatisfied with the service, the majority, 62.7%, are satisfied with the work they do. With regard to residents, some data draw attention, such as 44.4% feel respected by professionals, 66.7% feel that professionals understand well your problems. After analyzing the verbal material collected in interviews of professionals and residents, it was possible to understand the dissatisfaction of professionals as to salary issues and incentives for training, and realize how much the occupant is received by the service. / Com o advento da Reforma Psiquiátrica e a promulgação da Lei 10.216-12 que instituiu uma nova concepção para o tratamento de pessoas com doenças mentais, a implantação dos Centros de Atenção Psicossocial e Residências Terapêuticas se impuseram como respaldo para o novo modelo de atendimento a estes pacientes. Por meio de Escalas Brasileiras de Avaliação da Satisfação objetivou-se neste estudo avaliar o grau de satisfação de moradores e funcionários dessas residências, para refletir se tais moradias trouxeram ou não benefícios propostos pela Lei. Foi constatado que apenas 1,9% dos profissionais se disseram muito insatisfeitos com o serviço, a maioria, 62,7%, estão satisfeitos com o trabalho que realizam. Com relação aos residentes, alguns dados chamam a atenção, tais como 44,4% se sentem respeitados pelos profissionais, 66,7% sentem que os profissionais compreendem muito bem seus problemas. Após analisar o material verbal coletado nas entrevistas dos profissionais e dos moradores, foi possível compreender as insatisfações dos profissionais quanto a questões salariais e incentivos à qualificação, além de perceber o quanto o morador é acolhido pelo serviço.

No description available.