An exploration of the relationships between inpatients and clinical psychologists in forensic mental health services

Recent studies with offenders have identified a growing distrust in psychologists and that this may be due to the changing role of clinical psychologists working within these settings. In addition to the traditional role of alleviating psychological distress, psychologists in these settings also have the additional role of providing expert risk assessment. Clinical psychologists working in forensic mental health settings (FMHS) are also tasked with this ‘dual role’. To date, there is no research exploring the impact of this dual role in FMHS.
Semi-structured interviews were carried out with eight inpatients in two medium secure units. A grounded theory analysis produced a model of how trust was built and relationships developed.
Despite the ‘dual role’ held in these settings, with an approach that is transparent, open, collaborative, and patient-centred; service users are able to build trusting relationships. Furthermore, they report making positive therapeutic gains.
Where ‘coercive’ experiences were described, this appeared to be a representation of more distant times, with recent experiences being described as more satisfactory. Clinical psychologists also seem to be placed in a position of ‘mediator’ amongst the wider care team.
Further research is required to explore these findings and whether they apply in other secure settings.