Can we risk recovery? A grounded theory of clinical psychologists' perceptions of risk and recovery-oriented mental health services.
Can we risk recovery? A grounded theory of clinical psychologists' perceptions of risk and recovery-oriented mental health services.
复制标题
我们可以冒险恢复吗？
DOI：
10.1111/j.2044-8341.2012.02079.x
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
M. Hayward
中科院分区：
文献类型：
--
作者：
Anna Tickle;Dora Brown;M. Hayward
目标
本研究旨在探讨临床心理学家对“风险”和“康复”概念的看法，并将这些观点与精神健康服务相结合。
设计
一个探索性的，社会建构主义扎根理论的方法。
方法
11名临床心理学家在成人精神卫生服务工作，每个人都参加了一个单独的半结构化面试。
结果
研究的临床心理学家都知道恢复为导向的方法的出现，但觉得无法将其纳入实践中，因为被自己的局限性和他们的情况下，包括风险问题的约束，从而引起专业实践中的困境的看法。将风险等同于危险的狭义定义压倒了具有积极后果的广义风险概念。现有的精神保健服务文化被认为强调必须避免冒险的有害后果，而这反过来又限制了在实施以康复为导向的方法方面的创新。
结论
参与者以注重复原的方式开展工作的能力似乎受到服务部门认识和应对风险的方式的限制。与会者没有讨论由耻辱，社会排斥，种族主义，性别歧视或精神病治疗的医源性影响所产生的风险。在这项研究中看到的与伤害和危险有关的风险的狭义概念化有助于产生一种需要规避风险的感觉。然而，对实践的影响包括关于如何增加跨学科采用回收办法的可能性的想法。
OBJECTIVES
This study sought to explore the views of clinical psychologists towards the concepts of 'risk' and 'recovery' and to set those views against the context of mental health services.
DESIGN
An exploratory, social constructionist grounded theory methodology was adopted.
METHODS
Eleven clinical psychologists working in adult mental health services each participated in one individual semistructured interview.
RESULTS
The clinical psychologists studied were aware of the emergence of recovery-oriented approaches, but felt unable to incorporate them in practice because of perceptions of being bound by both their own limitations and those of their circumstances, including issues of risk, thus giving rise to dilemmas in professional practice. Narrow definitions of risk as equated to danger dominated over broader conceptualizations of risk with positive consequences. The existing culture of mental health services was seen as emphasizing the need to avoid harmful consequences of taking risks, which in turn was seen to limit innovations in implementing recovery-oriented approaches.
CONCLUSIONS
Participants' ability to work in a recovery-oriented manner seemed to be limited by the way in which services perceived and responded to risk. Participants did not discuss risks arising from stigma, social exclusion, racism, sexism, or iatrogenic effects of psychiatric treatment. Narrow conceptualizations of risk as related to harm and danger seen in this study contribute to a sense of needing to be risk averse. However, the implications for practice included ideas about what might increase the possibilities for adopting recovery approaches across disciplines.