{"title":"Exploring Therapeutic Risk in the Recovery Process of Adolescents at Risk of Self-harm: A Thematic Analysis of Support Staff Perceptions","authors":"Tomos Redmond","doi":"10.2174/2210676610999200623114504","DOIUrl":null,"url":null,"abstract":"\n\nThe high prevalence of adolescent self-harm\nwithin mental health services presents considerable management concerns, exacerbated\nby a lack of clear evidence regarding therapeutically effective approaches. This shortfall\nperpetuates traditional risk-averse practice, despite likely inadequacies in mitigating\nself-harm through failing to address underlying psychological mechanisms. Therapeutic\nrisk, defined as an approach whereby clinicians support individual risk-taking,\nmay be an alternative that yields improved recovery outcomes. However, related research\nis adult-focused and provides limited detail on its features, practical delivery\nand impact on recovery. Consequently, the current study explored the experiences of\nprofessionals delivering a therapeutic risk ethos, including their conceptualisation of it\nand its impact on young people.\n\n\n\nSemi-structured interviews were conducted with seven mental health support\nworkers employed by a residential healthcare provider, which promotes a therapeutic\nrisk approach. The provider supported service users aged 15 - 20 experiencing complex\npsychopathology who, following inpatient discharge, presented a high risk of self-harm\nand suicidality. Interview data was thematically analysed.\n\n\n\nStaff participants provided their understanding of a therapeutic\nrisk approach, suggesting risk is viewed as positive and beneficial to recovery,\nalongside the promotion of service user freedom and flexible therapeutic risk management.\nThe perceived therapeutic risk incorporates both permission and support, which facilitate\nthe exploration of underlying feelings and alternative actions. Additionally, therapeutic\nrisk promotes positive recovery outcomes due to empowered service users having\nincreased control over their lives. They argued this can reduce psychological distress, encouraging\nthe development of emotional regulation and adaptive coping strategies.\n","PeriodicalId":43326,"journal":{"name":"Adolescent Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.4000,"publicationDate":"2020-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Adolescent Psychiatry","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2174/2210676610999200623114504","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
The high prevalence of adolescent self-harm
within mental health services presents considerable management concerns, exacerbated
by a lack of clear evidence regarding therapeutically effective approaches. This shortfall
perpetuates traditional risk-averse practice, despite likely inadequacies in mitigating
self-harm through failing to address underlying psychological mechanisms. Therapeutic
risk, defined as an approach whereby clinicians support individual risk-taking,
may be an alternative that yields improved recovery outcomes. However, related research
is adult-focused and provides limited detail on its features, practical delivery
and impact on recovery. Consequently, the current study explored the experiences of
professionals delivering a therapeutic risk ethos, including their conceptualisation of it
and its impact on young people.
Semi-structured interviews were conducted with seven mental health support
workers employed by a residential healthcare provider, which promotes a therapeutic
risk approach. The provider supported service users aged 15 - 20 experiencing complex
psychopathology who, following inpatient discharge, presented a high risk of self-harm
and suicidality. Interview data was thematically analysed.
Staff participants provided their understanding of a therapeutic
risk approach, suggesting risk is viewed as positive and beneficial to recovery,
alongside the promotion of service user freedom and flexible therapeutic risk management.
The perceived therapeutic risk incorporates both permission and support, which facilitate
the exploration of underlying feelings and alternative actions. Additionally, therapeutic
risk promotes positive recovery outcomes due to empowered service users having
increased control over their lives. They argued this can reduce psychological distress, encouraging
the development of emotional regulation and adaptive coping strategies.
期刊介绍:
Adolescent Psychiatry a peer-reviewed journal, aims to provide mental health professionals who work with adolescents with current information relevant to the diagnosis and treatment of psychiatric disorders in adolescents. Adolescent Psychiatry reports of original research, critical reviews of topics relevant to practitioners, clinical observations with analysis and discussion, analysis of philosophical, ethical or social aspects of the fields of psychiatry and mental health, case reports with discussions, letters, and position papers. Topics include adolescent development and developmental psychopathology, psychotherapy and other psychosocial treatment approaches, psychopharmacology, and service settings and programs. The primary focus of the work should be on adolescents, transition-aged youth, The primary focus of the work should be on adolescents, transition-aged youth, or emerging adults, that is, persons 12-24 years of age . Articles on families of adolescents, or adults who have been followed since adolescence will also be considered.