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‘A ward full of emotional, aggressive people’: Social climate and interpersonal relationships in forensic settings caring for patients with borderline personality disorder

Title: ‘A ward full of emotional, aggressive people’: Social climate and interpersonal relationships in forensic settings caring for patients with borderline personality disorder
Authors: Rodwell, Devon; Frith, Hannah
Source: International Journal of Mental Health Nursing ; volume 33, issue 4, page 1049-1061 ; ISSN 1445-8330 1447-0349
Publisher Information: Wiley
Publication Year: 2024
Collection: Wiley Online Library (Open Access Articles via Crossref)
Description: Therapeutic relationships play a central role in maintaining a positive social climate in forensic settings. The interpersonal difficulties characteristic of Borderline Personality Disorder, alongside the secure environment of forensic wards, can make developing positive therapeutic relationships with this patient group challenging. Qualitative interviews aimed to explore how ward staff understand and experience the interaction of interpersonal relationships and social climate when caring for patients with Borderline Personality Disorder on forensic wards. Interviews with 11 staff members working across UK forensic inpatient settings were analysed using Reflexive Thematic Analysis and reported following COREQ guidelines. Six interrelated themes were generated; three describe relational cycles that occur between ward staff and patients with Borderline Personality Disorder and three describe systemic factors that influence the context in which ward staff operate. From these themes, an integrative model was developed to summarise how factors in the wider forensic system and the interpersonal relationships between staff and patients with Borderline Personality Disorder in forensic wards influence one another, affecting staff experiences of the social climate of forensic settings. The model illustrates how complex cycles within the therapeutic relationships with staff and patients with Borderline Personality Disorder can interact with systemic influences in the wider forensic context to influence staff experiences of forensic settings. Clinical implications of the model are discussed, offering recommendations for improving therapeutic relationships and the social climate on forensic wards caring for patients with Borderline Personality Disorder, to better support staff and patient wellbeing.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1111/inm.13308
Availability: https://doi.org/10.1111/inm.13308; https://onlinelibrary.wiley.com/doi/pdf/10.1111/inm.13308
Rights: http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.F14681A6
Database: BASE