Balance of Power
Is pertinent to note that FMHN is different to mainstream mental health settings. Some of the most confronting issues were violence, hostile attitude and behaviour posed when working with forensic patient. At times, some clinicians/nurses have found it too threatening to discuss their own responses to a patient’s crime with other staff members, and have remained silent. The patients’ crimes had a significant impact on the ongoing development of the therapeutic relationships between clinicians and forensic patients (Harris et al, 2015). Several clinicians stated that knowledge of the crimes contributed to the development of horrible images in their minds: The adjustment to working with forensic patient instilled a sense of horror …show more content…
For example, Miller et al. (2010) stressed the importance of interpersonal skills and the ability to think critically is one of those. Furthermore, Bowring-Lossock (2006) also highlighted the importance of interpersonal skills and stressed personal maturity and the establishment of relationships with forensic patients. Gildberg et al. (2010) studied characteristics of staff interactions within forensic mental health inpatients and the significance the interactions had for the patients. They pointed out that relationships may be paternalistic, as nursing practice includes rule enforcements, confrontations and setting limits; in this sense, the relationship had little therapeutic relevance for patients. However, they also stressed that care is quality dependent due to relational and personal characteristics, as staff express positive attitudes towards the patients by being honest, relaxed and laid-back and showing interest in the patients. Another study addressed the positive outcomes of interacting with patients in psychiatric forensic settings in an empathetic manner; the therapeutic relationships were more likely to be preserved by patients in comparison to an authoritarian approach (Maguire et al. 2014). Just as Maguire et al. reported on authoritarian styles, Hörberg (2008) reported similar findings, which she identified as ‘noncaring’, involving interactions between patients and staff that do not …show more content…
They comment how the public, politicians and the media can be influential surrounding policy formulation and procedures that ultimately show an ethos of security not therapy. Mason et al (2008), further state that the therapeutic relationship stems from the multidisciplinary teams’ desire to maintain control of the population and the formulation of the relationship can be “long and tense”. Furthermore, the nurses’ sincerity and geniuses are qualities to be exploited and the quality of the relationship is based on what the patient is getting from the situation. Mason et al (2008), suggest skills in team work, communication and multi-disciplinary team working as well as avoiding team splitting, competing and boundary violation as methods to prevent this type of relationship developing. The points raised by Mason et al (2008) are valid to a certain degree but the author feels to have this view of a therapeutic relationship leaves little space for advocating recovery, hope and empowering the patient. The dilemmas raised by Mason et al (2008) mirror what Gildberg et al (2012) observed during their primary research study, stating the therapeutic relationship can be damaging when the FMHN tries to deliver corrective care to
Is pertinent to note that FMHN is different to mainstream mental health settings. Some of the most confronting issues were violence, hostile attitude and behaviour posed when working with forensic patient. At times, some clinicians/nurses have found it too threatening to discuss their own responses to a patient’s crime with other staff members, and have remained silent. The patients’ crimes had a significant impact on the ongoing development of the therapeutic relationships between clinicians and forensic patients (Harris et al, 2015). Several clinicians stated that knowledge of the crimes contributed to the development of horrible images in their minds: The adjustment to working with forensic patient instilled a sense of horror …show more content…
For example, Miller et al. (2010) stressed the importance of interpersonal skills and the ability to think critically is one of those. Furthermore, Bowring-Lossock (2006) also highlighted the importance of interpersonal skills and stressed personal maturity and the establishment of relationships with forensic patients. Gildberg et al. (2010) studied characteristics of staff interactions within forensic mental health inpatients and the significance the interactions had for the patients. They pointed out that relationships may be paternalistic, as nursing practice includes rule enforcements, confrontations and setting limits; in this sense, the relationship had little therapeutic relevance for patients. However, they also stressed that care is quality dependent due to relational and personal characteristics, as staff express positive attitudes towards the patients by being honest, relaxed and laid-back and showing interest in the patients. Another study addressed the positive outcomes of interacting with patients in psychiatric forensic settings in an empathetic manner; the therapeutic relationships were more likely to be preserved by patients in comparison to an authoritarian approach (Maguire et al. 2014). Just as Maguire et al. reported on authoritarian styles, Hörberg (2008) reported similar findings, which she identified as ‘noncaring’, involving interactions between patients and staff that do not …show more content…
They comment how the public, politicians and the media can be influential surrounding policy formulation and procedures that ultimately show an ethos of security not therapy. Mason et al (2008), further state that the therapeutic relationship stems from the multidisciplinary teams’ desire to maintain control of the population and the formulation of the relationship can be “long and tense”. Furthermore, the nurses’ sincerity and geniuses are qualities to be exploited and the quality of the relationship is based on what the patient is getting from the situation. Mason et al (2008), suggest skills in team work, communication and multi-disciplinary team working as well as avoiding team splitting, competing and boundary violation as methods to prevent this type of relationship developing. The points raised by Mason et al (2008) are valid to a certain degree but the author feels to have this view of a therapeutic relationship leaves little space for advocating recovery, hope and empowering the patient. The dilemmas raised by Mason et al (2008) mirror what Gildberg et al (2012) observed during their primary research study, stating the therapeutic relationship can be damaging when the FMHN tries to deliver corrective care to