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Other Clinical Disorders

Psychodynamic clinical supervision for staff

The study aims to evaluate how acceptable and feasible group psychodynamic clinical supervision (PCS) plus treatment-as-usual (TAU) is for staff working with service users with definite or possible personality disorders (PDs) in community mental health teams (CMHTs). It also aims to determine preliminary estimates of the efficacy of group PCS for reducing levels of burnout, stress and sickness rates, and improving attitudes towards working with service users with PDs in CMHT staff.

Why carry out the research? 

Service users with PDs have been described as the most challenging type of patients to work with (Cleary et al., 2002). Helping service users with PDs to cope with intense emotions and unstable relationships and to manage risky behaviours can be difficult and stressful for mental health professionals. Consequently, there is a need to support staff working with service users with PDs, and one way in which this may occur is through clinical supervision. 

Clinical supervision typically involves reflection on clinical practice, provision of emotional support, and development of professional skills and knowledge. Evidence suggests that it can reduce burnout, stress and sickness rates, and increase perceptions of coping and support in staff (Edwards et al., 2006; Gonge & Buus, 2011). Clinical supervision informed by psychodynamic theory may be particularly helpful for staff working with service users with PDs due to its focus on understanding how and why people may relate to each other, ways that people defend themselves, and reasons why people may behave in certain ways (e.g. Andersson, 2008). 

Group PCS has been shown to increase confidence and lower sickness rates in general hospital nurses (Ashburner et al., 2004), as well as reduce stress in primary care physicians (Eubank et al., 1991). However, no study to date has examined group PCS for staff working with service users with PDs in CMHTs. 

The study aims to: 

1) Evaluate how acceptable and feasible group PCS plus treatment-as-usual (TAU) is for staff working with service users with PDs in CMHTs; 

2) Determine preliminary estimates of the efficacy of group PCS for reducing levels of burnout, stress and sickness rates, and improving attitudes towards working with service users with PDs in CMHT staff. 

How is the research being undertaken? 

The study aims to recruit 24 care coordinators from a variety of professional disciplines in CMHTs within the Mental Health of Older Adults Clinical Academic Group (MHOA&D CAG) in South London and Maudsley NHS Foundation Trust (SLaM). Group PCS plus TAU will occur fortnightly for 12 months within the CMHTs. Care coordinators will continue to receive routine clinical supervision (i.e. TAU), in addition to group PCS aimed specifically at working with service users with definite or possible PDs. A number of outcome measures are being used to evaluate the feasibility, acceptability and efficacy of group PCS. These include ratings on staff satisfaction questionnaires, rates of group non-attendance and attrition, scores on questionnaires measuring burnout and stress, staff absenteeism rates due to sickness, and a questionnaire assessing attitudes towards working with service users with definite or possible PDs. Outcome measures are being collected before and after the 12-month intervention period. 

Where is it happening? 

CMHTs within the MHOA&D CAG in SLaM

Who is involved? 

Clinicians based at the Institute of Psychiatry and in the MHOA&D CAG within SLaM, including: 

Dr Rebecca Gould (clinical psychologist), Ms Jo van den Bosch (consultant psychotherapist), Mr Neil Farrelly (psychotherapist), Mr Jack Nathan (consultant psychotherapist), Mr Steve Boddington (consultant clinical psychologist), Mr Durand Darougar (clinical service manager) and Professor Robert Howard (Professor of Old Age Psychiatry and Psychopathology). 

What is the timescale?

It is anticipated that recruitment will start in autumn 2014. 

To find out more please contact:-

Dr Rebecca Gould
rebecca.gould@kcl.ac.uk

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