“It’s a dent, not a break”: an exploration of how care co-ordinators understand and navigate boundaries in early intervention in psychosis services

Journal article


Bone, A., Terry, R. and Whitfield, R. 2022. “It’s a dent, not a break”: an exploration of how care co-ordinators understand and navigate boundaries in early intervention in psychosis services. Psychosis. https://doi.org/10.1080/17522439.2022.2108489
AuthorsBone, A., Terry, R. and Whitfield, R.
Abstract

BACKGROUND Early Intervention in Psychosis Services (EIP) offer a unique service model for people experiencing a first episode of psychosis. They are intensive case-management services which adopt an assertive outreach approach, employing flexible boundaries to meet clients in the community, and support them towards recovery and holistic goals. Current boundary theory is therefore not easily applied to this clinical context.

This study aimed to explore how care-co-ordinators in EIP develop their understanding and practise around navigating boundaries.

METHODS Participants were 13 EIP care co-ordinators. Semi-structured interviews with participants were conducted and analysed using grounded theory.

RESULTS A concentric model emerged, defining different layers of influence impacting care co-ordinators’ navigation of boundaries. This included higher governing levels (e.g. professional codes of conduct), factors and challenges specific to EIP culture, client characteristics and individual care co-ordinator decision-making processes. A flexible, case-by-case approach was adopted in response to challenges.

DISCUSSION Findings suggest clinical implications for how care co-ordinators can jointly construct appropriate boundaries with clients and families, and discuss dilemmas using the team resource. This model can be used as a tool in clinical practice to aid clinicians’ thinking and reflection around boundaries within EIP.

KeywordsPsychiatry ; Mental health; Psychosis; Intervention
Year2022
JournalPsychosis
PublisherTaylor & Francis
ISSN1752-2439
1752-2447
Digital Object Identifier (DOI)https://doi.org/10.1080/17522439.2022.2108489
Official URLhttps://www.tandfonline.com/doi/full/10.1080/17522439.2022.2108489
FunderCanterbury Christ Church University
Publication dates
Online12 Aug 2022
Publication process dates
Accepted22 Jul 2022
Deposited22 Aug 2022
Accepted author manuscript
License
Output statusPublished
Page range1-13
Permalink -

https://repository.canterbury.ac.uk/item/92066/-it-s-a-dent-not-a-break-an-exploration-of-how-care-co-ordinators-understand-and-navigate-boundaries-in-early-intervention-in-psychosis-services

Restricted files

Accepted author manuscript

  • 14
    total views
  • 0
    total downloads
  • 0
    views this month
  • 0
    downloads this month

Export as

Related outputs

A Systematic Review and Thematic Synthesis of Qualitative Literature on Personal Recovery and Voice Hearing.
Hall, B., Terry, Rachel and Hayward, Mark 2022. A Systematic Review and Thematic Synthesis of Qualitative Literature on Personal Recovery and Voice Hearing. Clinical Psychology & Psychotherapy. https://doi.org/10.1002/cpp.2814
A grounded theory study exploring change processes following cognitive behavioural therapy for distressing voices
Hall, B., Hayward, M. and Terry, R. 2022. A grounded theory study exploring change processes following cognitive behavioural therapy for distressing voices. Psychosis: Psychological, Social and Integrative Approaches. https://doi.org/10.1080/17522439.2022.2044896
Factors relating to boundaries and self-disclosure within mental health contexts
Bone, A. 2021. Factors relating to boundaries and self-disclosure within mental health contexts. DClinPsych Thesis Canterbury Christ Church University Salomons Institute for Applied Psychology
Adolescent sex offenders with autism spectrum conditions: currently used treatment approaches and their impact
Schnitzer, G., Terry, R. and Joscelyne, T. 2019. Adolescent sex offenders with autism spectrum conditions: currently used treatment approaches and their impact. The Journal of Forensic Psychiatry & Psychology. https://doi.org/10.1080/14789949.2019.1659388
“We deal here with grey”: a grounded theory of professional boundary development in a forensic inpatient service.
Pettman, H., Loft, N. and Terry, R. 2019. “We deal here with grey”: a grounded theory of professional boundary development in a forensic inpatient service. Journal of Forensic Nursing. 16 (2), pp. 118-125. https://doi.org/10.1097/JFN.0000000000000250