Developing a Centralised Groupwork Service at Broadmoor Hospital
| Pages | 16-20 |
| Published date | 01 March 2007 |
| Date | 01 March 2007 |
| DOI | https://doi.org/10.1108/13619322200700004 |
| Author | Derek Perkins,Estelle Moore,Alison Dudley |
| Subject Matter | Health & social care |
Developing a Centralised Groupwork
Service at Broadmoor Hospital
Derek Perkins
Head of Psychological Services, Broadmoor Hospital
Estelle Moore
Lead Clinical Psychologist, Broadmoor Hospital
Alison Dudley
Lead Nurse Therapist, Broadmoor Hospital
Case Study I…
roadmoor Hospital is one of the four
UK high secure psychiatric hospitals for the
treatment, under the Mental Health Act 1983, of
mentally disordered individuals who pose very high
levels of risk to others and sometimes to themselves.
For many years Broadmoor has run therapeutic
groups to address aspects of offending behaviour and
mental health problems (Cox, 1976; Quayle &
Moore, 1998). Groups provide a special opportunity
within which active contributors can gain from
sharing their experiences, obtain feedback from
others, and learn new ways of dealing with the
problems that had once overwhelmed them (Yalom,
1995). For offender patients, whose problems are
typically complex, and who experience isolation and
shame as a consequence of their actions, there may
be particular advantages in therapies that promote
psychosocial development, provided a sufficient
sense of safety about the objectives of the work can
be fostered (Norton, 2005).
As the therapeutic regime in Broadmoor Hospital
became moreintensively developed during the 1990s,
agreater demand for psychological therapies
highlighted inequities in the provision of groupwork.
It became evident that only some patients had a
reasonable chance of accessing groups, and this was
dependent on their location (ie wardbase) rather than
their potential to benefit.
The information that emerged from reviews of ward-
based groups indicated that:
■some patients on the wards needed a particular
group but were not appropriately prepared or
motivated to attend, and this sometimes resulted
Bin them embarking on a group without the interest,
skills or resources to maintain a place in it
■some patients who wereready and motivated to
attend a group with a particular theme (eg anger
management; interpersonal relationships;
sex/violent offending; fire-setting) often had to
wait a long time for other suitable group members
to become available to join the group, and this
delayed their progress through the hospital
■aminority of groups were run centrally (ie located
offthe ward in another building) and brought
together patients from several wards within the
hospital, but this raised problems of having a) a
suitable base for the groupwork and b) appropriate
escorting arrangements to ensure that patients
could get to the venue reliably and safely.
All these issues meant that groupwork failed to thrive
in a needs-led, timely and reliable way. Groups would
be set up, run for while, and then cease to exist as the
clinicians running them moved on, or as meeting rooms
ceased to be available, or as escorting arrangements
broke down. The energy required to maintain
enthusiasm for a group ‘programme’ often resided with
afew members of staff who dedicated their time and
expertise, but were not formally recognised for their
efforts. Furthermore, wheregroups wereperceived to
be an elitist treatment (available for some, but not all)
the wider culture of passive (or even active) resistance
undermined the efforts of the minority.
In the summer of 2000, partly building on these
localised initiatives, a series of discussions took place
between the service and clinical directors of the
16 The Mental Health Review Volume 12 Issue 1 March 2007 ©Pavilion Jour nals (Brighton) Limited 2007
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