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dc.contributor.authorAlexander, Kelly J.
dc.identifier.citationAlexander, K,J. (2019) 'Risk and relationship in mental health practice: a grounded theory of situational connection.' PhD thesis University of Bedfordshire.en_US
dc.description"A thesis submitted to the University of Bedfordshire in partial fulfilment of the requirements for the degree of Doctor of Philosophy".en_US
dc.description.abstractThis thesis reports the findings of a qualitative study that answers the question, ‘How do mental health practitioners working in adult community mental health settings respond emotionally to the assessment and management of risk in practice?’ Current research relating to risk assessment and management in mental health practice considers ways in which risk is understood and assessed, focusing primarily on definition, application and technical processes. Less is known about the emotional effect of the risk-related aspects of the mental health practitioners’ role. This aim of this study was to explore the experience of mental health professionals by considering: the ways in which they conceptualised risk, the emotional effect of assessing and managing risk and, the ways in which their relationships with professional colleagues and service users did, or did not, mitigate this effect. The study was undertaken using grounded theory and collected data via in-depth, semi-structured interviews with 18 participants, representing the range of disciplines usually present in multi-disciplinary teams in statutory adult mental health care. The main contribution of this study is that it provides evidence of the changing nature of mental health practice and how this is creating new organisational and personal contexts for practitioners. The current focus in mental health practice appears to be the efficiency of pathways for service users. This focus has led to organisational structures that reduce the space and time practitioners have for connection with each other. The remodelling of the organisational context is creating a new ethos in practice in which practitioners feel less attention is given to their experience of relationship, skill and therefore safety. This study has found that a consequence of professionals’ sense of lack of safety is to assess risk posed by service users as higher than they would if contained in their own practice. The evidence for this emerges from practitioners’ reflections on fragmenting teams, changing working spaces, sense of isolation and responsibility, particularly in relation to the care coordination role. Enabling practitioners to feel emotionally anchored in their work context in relation to the assessment and management of risk will facilitate the emotional management of the effect of their role. The benefit for service users will be a greater focus on recovery and less risk averse approaches. This study concludes with a model for situationally connected practice that is the emerging theory from the research. This theory was shaped by the analysis from participants for whom situational connection was both present and absent. The conclusion is that greater attention to facilitating situational connection for practitioners with regard to relationship-based practice with colleagues will contribute to the creation of safer conditions for practice.en_US
dc.publisherUniversity of Bedfordshireen_US
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.subjectsituational connectionen_US
dc.subjectmental healthen_US
dc.subjectrelationship-based practiceen_US
dc.subjectgrounded theoryen_US
dc.titleRisk and relationship in mental health practice: a grounded theory of situational connection.en_US
dc.typeThesis or dissertationen_US
dc.publisher.institutionUniversity of Bedfordshireen_US

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