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Individuals’ experiences with Brief Admission during the implementation of the Brief Admission Skåne RCT, a qualitative study

Helleman, Marjolein; Lundh, Lars-Gunnar LU ; Liljedahl, Sophie LU ; Daukantaité, Daiva LU and Westling, Sofie LU (2018) In Nordic Journal of Psychiatry
Abstract
Background: Brief admission (BA) is an adjunctive treatment option for individuals with self-harming behavior, having traits of borderline personality disorder (BPD). It is offered alongside outpatient psychotherapy for the purpose of strengthening autonomy, self-reflection and self-care and to increase the likelihood of being able to stay in therapy by avoiding lengthy inpatient hospitalizations. Aims: To investigate participants’ experiences with BA during the pilot phase of the Brief Admission Skåne Randomized Controlled Trial (BASRCT), in order to detect possible strengths and limitations of the intervention and gain knowledge to facilitate implementation of BA at other treatment centers. Method: Eight participants randomized to BA... (More)
Background: Brief admission (BA) is an adjunctive treatment option for individuals with self-harming behavior, having traits of borderline personality disorder (BPD). It is offered alongside outpatient psychotherapy for the purpose of strengthening autonomy, self-reflection and self-care and to increase the likelihood of being able to stay in therapy by avoiding lengthy inpatient hospitalizations. Aims: To investigate participants’ experiences with BA during the pilot phase of the Brief Admission Skåne Randomized Controlled Trial (BASRCT), in order to detect possible strengths and limitations of the intervention and gain knowledge to facilitate implementation of BA at other treatment centers. Method: Eight participants randomized to BA were interviewed to obtain their experience of BA, or alternatively their reasons for choosing not to use BA. Thematic analysis was conducted upon their transcribed interviews. Results: Reported as most helpful by the participants was the structure/routines at the ward and the positive attitudes from the staff. However, some individuals reported problems with perceived negative attitudes from the staff administering BA and negative rumination about themselves. The reported reasons to request BA were: preventing urges to self-harm from escalating; ending isolation; preventing longer admissions and forced admission; feelings of emotional exhaustion, and the need for rest and support in re-creating a daily routine. Reasons for not requesting BA were fear of rejection, questioning the method; presumed room shortage; difficulties in deciding whether one’s problems are serious enough; experiencing the situation to be too clinically acute. Conclusion: The results from this study indicated the importance of repeated staff education on all aspects of BA when it is being newly implemented, as well as the importance of working with attitudes of staff delivering BA. These were the key ingredients in making BA implementation successful. Our findings may be of value to other treatment centers implementing BA for the first time. Trial registration: NCT02985047. (Less)
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author
organization
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Contribution to journal
publication status
in press
subject
in
Nordic Journal of Psychiatry
publisher
Informa Healthcare
external identifiers
  • scopus:85046009665
ISSN
1502-4725
DOI
10.1080/08039488.2018.1467966
language
English
LU publication?
yes
id
5a917125-e081-408c-899a-b97ed5d7803d
alternative location
https://www.tandfonline.com/eprint/YSrxHCUQ3GDUfGzMEcgP/full
date added to LUP
2018-04-18 15:13:18
date last changed
2018-05-29 09:25:16
@article{5a917125-e081-408c-899a-b97ed5d7803d,
  abstract     = {Background: Brief admission (BA) is an adjunctive treatment option for individuals with self-harming behavior, having traits of borderline personality disorder (BPD). It is offered alongside outpatient psychotherapy for the purpose of strengthening autonomy, self-reflection and self-care and to increase the likelihood of being able to stay in therapy by avoiding lengthy inpatient hospitalizations. Aims: To investigate participants’ experiences with BA during the pilot phase of the Brief Admission Skåne Randomized Controlled Trial (BASRCT), in order to detect possible strengths and limitations of the intervention and gain knowledge to facilitate implementation of BA at other treatment centers. Method: Eight participants randomized to BA were interviewed to obtain their experience of BA, or alternatively their reasons for choosing not to use BA. Thematic analysis was conducted upon their transcribed interviews. Results: Reported as most helpful by the participants was the structure/routines at the ward and the positive attitudes from the staff. However, some individuals reported problems with perceived negative attitudes from the staff administering BA and negative rumination about themselves. The reported reasons to request BA were: preventing urges to self-harm from escalating; ending isolation; preventing longer admissions and forced admission; feelings of emotional exhaustion, and the need for rest and support in re-creating a daily routine. Reasons for not requesting BA were fear of rejection, questioning the method; presumed room shortage; difficulties in deciding whether one’s problems are serious enough; experiencing the situation to be too clinically acute. Conclusion: The results from this study indicated the importance of repeated staff education on all aspects of BA when it is being newly implemented, as well as the importance of working with attitudes of staff delivering BA. These were the key ingredients in making BA implementation successful. Our findings may be of value to other treatment centers implementing BA for the first time. Trial registration: NCT02985047.},
  author       = { Helleman, Marjolein and Lundh, Lars-Gunnar and Liljedahl, Sophie and Daukantaité, Daiva and Westling, Sofie},
  issn         = {1502-4725},
  language     = {eng},
  month        = {04},
  publisher    = {Informa Healthcare},
  series       = {Nordic Journal of Psychiatry},
  title        = {Individuals’ experiences with Brief Admission during the implementation of the Brief Admission Skåne RCT, a qualitative study},
  url          = {http://dx.doi.org/10.1080/08039488.2018.1467966},
  year         = {2018},
}