“Part of being human”: evaluating the 4Ps model to support inpatient staff teams in reflecting on interpersonal dynamics
| Published date | 27 June 2019 |
| DOI | https://doi.org/10.1108/JMHTEP-09-2018-0055 |
| Date | 27 June 2019 |
| Pages | 232-241 |
| Author | Lindsay Jones,Phyllis Annesley |
| Subject Matter | Health & social care |
“Part of being human”: evaluating the 4Ps
model to support inpatient staff teams in
reflecting on interpersonal dynamics
Lindsay Jones and Phyllis Annesley
Abstract
Purpose –An innovative training approach was developed to enable staff working with complex cases,
including personality disorder, to reflect on and work with the interpersonal dynamics of their interactions with
service users. The aim of this approach is to support effective, compassionate and boundaried care.
An overview of the model and development of the training is provided along with presentation and discussion
of outcome data. Implications for future practice are also considered.
Design/methodology/approac h –One-day workshops were provided within inpatient forensic
women’s services. Nine worksh ops were delivered with 9 6 multidisciplinary staff having attended i n
total. Evaluation tools were developed to ascertain participants’feedback regarding the training including
its relevance and potential for impact on practice. Feedback was analysed using a mixture of quantitative
and qualitative methods.
Findings –The evaluation demonstrated that the training was well received by a motivated group of
participants and was felt to be relevant to their clinical practice.
Research limitations/implications –The evaluation is limited by the lack of a follow-up to assess the
longer-term impacts of the training and whether the positive effects of the training were maintained.
Practical implications –The findings demonstrate that the training can be delivered within a short time
frame, which makes the training efficient and cost effective.
Social implications –The training can develop practitioners’skills in delivering compassionate and
boundaried care in line with key NHS drivers for staff working with complex service users.
Originality/value –The 4Ps model enables staff with little or no psychotherapy training to deliver
psychologically informed care which takes account of interpersonal dynamics and positively contributes to
relational security, with an emphasis on reflecting on self and others.
Keywords Training, Personality disorder, Cognitive analytic therapy, Staff teams
Paper type Research paper
Introduction
It is recognised that working with people with complex presentations, particularly those that
attract a diagnosis of personality disorder, can be challenging both to individual staff members
and teams and can sometimes lead to demoralisation, staff burnout and unhelpful responses to
service users (Murphy and McVey, 2010). There has been ongoing recognition of the need for all
staff to be trained and supervised in working with people with complex and challenging
presentations particularly those people with personality disorders (Moore, 2012, NCISH, 2018).
This is important as people with complex presentations such as personality disorder have often
had unhappy, difficult or traumatic experiences with caregivers early in life and experienced
complex social and system failures (Personality Disorder Consensus Group, 2018).
Consequently, they can be wary of people who try to help them in adulthood and struggle in
relating to others and engaging with services. Most frontline staff will therefore have encountered
feelings such as frustration, hopelessness, anxiety and guilt in working with this client group
(DH, 2014). Processes which can develop in working with people with complex and challenging
Received 18 September 2018
Revised 8 January 2019
Accepted 21 March 2019
Lindsay Jonesis based at Tees,
Esk and Wear Valleys NHS
Foundation Trust, York, UK.
Phyllis Annesley is based at the
Department of Clinical and
Forensic Psychology, Rampton
Hospital, Retford, UK.
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THE JOURNAL OF MENTALHEALTH TRAINING, EDUCATION AND PRACTICE
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VOL. 14 NO. 4 2019, pp.232-241, ©Emerald Publishing Limited, ISSN 1755-6228 DOI 10.1108/JMHTEP-09-2018-0055
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