Interprofessional Care and Mental Health A Discursive

Exploration of Team Meeting Practices

Visit the link below to download the full version of this book:

https://medipdf.com/product/interprofessional-care-and-mental-health-a-discursiv
e-exploration-of-team-meeting-practices/

Click Download Now

Editors
Cordet Smart
School of Psychology, University of Plymouth, Plymouth, UK

Timothy Auburn
School of Psychology, University of Plymouth, Plymouth, UK

The Language of Mental Health

ISBN 978-3-319-98227-4 e-ISBN 978-3-319-98228-1
https://doi.org/10.1007/978-3-319-98228-1

Library of Congress Control Number: 2018950735

© The Editor(s) (if applicable) and The Author(s), under exclusive

license to Springer International Publishing AG, part of Springer Nature
2018

This work is subject to copyright. All rights are solely and exclusively
licensed by the Publisher, whether the whole or part of the material is
concerned, specifically the rights of translation, reprinting, reuse of
illustrations, recitation, broadcasting, reproduction on microfilms or in
any other physical way, and transmission or information storage and
retrieval, electronic adaptation, computer software, or by similar or
dissimilar methodology now known or hereafter developed.

The use of general descriptive names, registered names, trademarks,

service marks, etc. in this publication does not imply, even in the
absence of a specific statement, that such names are exempt from the
relevant protective laws and regulations and therefore free for general
use.

The publisher, the authors and the editors are safe to assume that the
advice and information in this book are believed to be true and accurate
at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, express or implied, with respect to the material
contained herein or for any errors or omissions that may have been
made. The publisher remains neutral with regard to jurisdictional
claims in published maps and institutional affiliations.

Cover illustration: fotostorm/gettyimages

This Palgrave Macmillan imprint is published by the registered

company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham,
Switzerland
Acknowledgements
We would like to firstly thank our service user and carer group based at
Plymouth University, for their comments on the research programme at
intervals from its inception to its completion, and all of the service
users and carers who have commented along the way, in particular
Christianne Pollock, who we recognise as a carer who has had profound
personal challenges to manage, and has still kindly and helpfully
commented on our work and even found time to author some chapters.
Kind thanks also go to Jacqui Stedmon, Emma Newton and
Nneamaka Ekebuisi for their hard work with reviewing chapters. Jacqui
Stedmon is an Associate Lecturer and the Course Director of Plymouth
University’s Clinical Psychology Programme. She is a clinical
psychologist specialising in children’s mental health and bereavement
and kindly reviewed Chapter 15 for us. Emma Newton and Nnemaka
Ekebuisi are both currently third-year clinical psychology trainees and
kindly took time out in their busy year to review chapters. Emma
Newton reviewed several chapters including Chapters 5 and 7 , and
Nnemaka reviewed Chapter 3 . We would also like to thank all of our
participants for taking part in the research and engaging so fully in the
process. In addition, we would like to thank our clinical commentators,
including Dr. Jane Suzanne, a specialist clinical psychologist in Devon
Partnership Trust, and Dr. Sarah Whittham, a specialist clinical
psychologist in Cornwall Foundation NHS Trust. Both of these people
have provided valuable insights and reflections around how the
research worked.
Our research assistants have also worked hard, including Brajan
Stovac, Holly Reed and Nancy Froomberg, all of whom have contributed
to the organisation of the data and the administration of the project.
Abbreviations
ADHD Attention Deficit Hyperactivity Disorder
ADI Autism Diagnostic Inventory
ADOS Autism Diagnostic Observation Schedule
ASD Autism Spectrum Disorder
BPS British Psychological Society
CA Conversation Analysis
CDP Critical Discursive Psychology
CMHN Community Mental Health Nurse
CMHT Community Mental Health Team
CPN Community Psychiatric Nurse
DA Discourse Analysis
DP Discursive Psychology
DSM Diagnostic and Statistical Manual
EI Early Intervention in Psychosis
IAPT Improving Access to Psychological Therapies
IDK ‘I Don’t Know’ Utterances
ILD Intellectual Learning Disability
IPE Interprofessional Education
IPL Interprofessional Learning
LD Learning Disability
MD Medical Doctor
MDT Multidisciplinary Team
OCD Obsessive Compulsive Disorder
OT Occupational Therapist
PLD Person living with dementia
PPI Public and Patient Involvement
QAA Quality Assurance Agency
SALT Speech and Language Therapist
TCU Turn Construction Unit
TRP Transition Relevance Place
Contents
1 Introduction:​Problems and Prospects for Multidisciplinar​y
Team Meetings
Cordet Smart, Jennifer Dickenson, Timothy Auburn and
Nancy Froomberg
Introduction
Multidisciplinar​y Team (MDT) Meetings as a Focal Research
Context
The Challenges of Poor Communication
Aims and Methods of the MDTsInAction Research Programme
The Development of a Conversation Analytic Project
Organisation of the Book
References
Part I Researching Multi-disciplinary Teams Using a Language
Based Perspective
2 Inside the Meeting:​Discursive Approaches as a Framework for
Understanding Multidisciplinar​y Team Meetings
Timothy Auburn, Cordet Smart and Madeleine Tremblett
Background
The Principles of Conversation Analysis and Discursive
Psychology
Conclusion:​Implications for Interprofessiona​l Teamworking
References
3 Healthcare Meetings Where the Service User Is Absent:​The
Ethical and Values-Based Implications for Research
Cordet Smart, Lindsay Aikman, Madeleine Tremblett,
Jennifer Dickenson and Sifiso Mhlanga
Introduction
Main Ethical Issues
 Project Overview
Researcher Reflections
Recommendations for Interprofessiona​l Team Working
Summary
References
Part II Identifying and Understanding the Complexities of MDT
Meetings
4 Theorising Multidisciplinar​y Team Meetings in Mental Health
Clinical Practice
Cordet Smart and Timothy Auburn
Introduction
Project Overview
Summary and Conclusions
References
5 Power Struggles in MDT Meetings:​Using Different Orders of
Interaction to Understand the Interplay of Hierarchy, Knowledge
and Accountability
Cordet Smart, Christianne Pollock, Lindsay Aikman and
Erica Willoughby
Introduction
Definitions of Power
Power and Hierarchies in Mental Health Settings
Project Overview
Findings
Implications for Interprofessiona​l Working
Summary
References
6 ‘Unspoken’ Outcomes:​The Unintended Consequences of
Interactions in MDT Meetings as Supporting Staff Well-Being and
the Delivery of Compassionate Care
Lindsay Aikman
Introduction
Project Overview
Results
Discussion
Summary
References
Part III Clinical Applications—Team Formulations in Mental Health
MDTs
7 Conversation Analysis of Psychological Formulation Discussions
in Adult Learning Disabilities Teams
Katherine Peckitt and Cordet Smart
Introduction
Project Overview
Psychological Formulations:​Tentative Statements with ‘aha’
Moments
Psychological Formulations:​An Opportunity to Express
Emotional and Delicate Views
Summary
Implications for Clinical Practice and Interprofessiona​l
Working
References
8 Does This Child Have Autism?​Exploring Team Discussions When
Diagnosing Autistic Spectrum Disorder
Nicole Parish
Introduction
 Project Overview
Analysis
Discussion
Recommendations for Interprofessiona​l Working
Further Research
Summary
References
9 Negotiating Resources During CMHT Team Meetings:​Exploring
Requests for Joint Working
Sifiso Mhlanga and Timothy Auburn
Introduction
Project Overview
Findings
Recommendations for Interprofessiona​l Working
Summary
References
10 Sharing Information and Retelling Stories in a Memory Clinic
MDT Meeting
Jennifer Dickenson and Cordet Smart
Introduction
Project Overview
Method
Analysis
Summary
Implications for Interprofessiona​l Working
References
Part IV Patient Centred Interactions in Team Meetings
11 Advocacy for Service Users and Carers in Community Learning
Disability Team Meetings When Service Users and Carers Are
Absent
Cordet Smart and Holly Reed
Introduction
Project Overview
Findings
Summary
Recommendations for Interprofessiona​l Working
References
12 Concern Constructions in Multidisciplinar​y Team Meetings:​
Risk or Patient Focused?​
Madeleine Tremblett
Introduction
Method
Findings
Recommendations for Interprofessiona​l Team Working
References
13 Listening to ‘Early Intervention in Psychosis Teams’ Talk About
Psychosis and Its Meaning:​The Perspective of Those with Lived
Experience of Psychosis
Claire Whiter, Ben Durkin and Ashley Tauchert
Introduction
Project Overview
Method
Findings
Reflections on the Process of Involvement in the Project
Recommendations for Interprofessiona​l Team Working
 Summary
References
Part V Interventions—Supporting Teamwork in Mental Health
Care
14 Using Joint Conversation Analysis Between Clinicians and
Researchers:​Developing Reflexivity in Community Mental Health
Teams
Cordet Smart, Holly Reed, Madeleine Tremblett and
Nancy Froomberg
Introduction
Joint Analysis
Project Overview
Stages of Joint Analysis
Summary
Reflections on the Process of Joint Analysis
Implications for Interprofessiona​l Working
Appendix A—Handouts Used
References
15 Training for Enhanced Team Performance in Mental Healthcare
Contexts:​A Workshop and Its Fit with Interprofessiona​l Care
Cordet Smart, Holly Reed, Brajan Sztorc, Dominique Clancy and
Emily Connolly
Introduction
Training for Interprofessiona​l Working in Mental Health
Contexts and Beyond:​Interprofessiona​l Education (IPE)
Training in Interprofessiona​l Working for Professionals
Project Overview
Recommendations for Interprofessiona​l Team Working
Summary
 References
16 Conclusions:​Advancing Team Working in Community Mental
Health Settings
Cordet Smart and Timothy Auburn
Introduction
Overview
Summary:​Main Themes
Appendix:​Jeffersonian Transcription Conventions
Glossary
Index
List of Tables
Table 1.1 CASP ratings for literature review on poor communication

Table 1.2 A summary of the articles selected for the literature review

Table 13.1 Four main repertoires

Table 14.1 Transcription symbols adapted from Jefferson (1984)

Notes on Contributors
Dr. Lindsay Aikman is working as a highly specialist clinical
psychologist in an acute inpatient mental health unit in the UK. Before
moving in to mental health in 2009, Lindsay spent almost ten years
working internationally in management consultancy and specialised in
team dynamics and organisational change. She now works in ways that
blends these two fields, promoting the importance of interprofessional
team working as a key factor in facilitating joined-up experiences of
health and social care. Her commitment to this philosophy earned her
an award from the Division of Clinical Psychology for co-founding an
interdisciplinary learner-led initiative while completing her Doctorate
in Clinical Psychology. An awareness of organisational systems and how
they support best practice, innovation and change has continued to be
of interest to Lindsay, noticing how differently MDT practices can be
operationalised within services. Lindsay passionately believes that
supporting clinicians to be the best versions of themselves is core to the
sustainable delivery of compassionate care, and so nurturing
compassionate working environments is central to her practice, and a
research topic she presented on at the Compassionate Mind
Foundation’s 4th International Conference in 2015.

Timothy Auburn is an Associate Professor in the School of

Psychology, University of Plymouth. He has had a long-standing interest
in the uses of conversation analysis for understanding the way society’s
core institutions work and for promoting changes in these institutions
at the level of interaction. As well as his current interest in
multidisciplinary team meetings and their role in health care, his other
research interests include problem-solving for offenders in the lower
courts, and the barriers and outcomes of altruistic kidney donation.

Dominique Clancy is a third-year trainee clinical psychologist on the

Doctorate in Clinical Psychology at the University of Plymouth. Her
doctoral research is focused on exploring the experience of students
attending Schwartz Rounds conducted in the University context.
Dominique has a Master’s in Forensic Psychology from the University of
York and a Bachelor of Science with Honours in Psychology from the
University of York. She was worked across child and adult mental
health and learning disability services and has a keen interest in
supporting the well-being of staff working in health care.

Emily Connolly is a trainee clinical psychologist at Plymouth

University. She is interested in how reflective practice works within
clinical practice, and is engaged in a number of interprofessional
working initiatives. This includes the development of ‘Bridges’, where
students from different professionals come together to enhance
integrated learning and thinking.

Dr. Jennifer Dickenson is working as a clinical psychologist within

an NHS older people’s mental health service in the UK. She works
within both community and inpatient MDTs who provide services both
people with a diagnosis of dementia and people who are experiencing
mental health difficulties. Jenny values MDT working and encourages
psychological formulation within all aspects of her work.

Ben Durkin Peer Support Organisation, Exeter, UK.

Nancy Froomberg is a Research Assistant based at Plymouth

University. Her interests lie in discourse analysis with a focus on
conversational analysis as a methodology for examining the way in
which language works and how we achieve social actions within this.
Dr. Sifiso Mhlanga is a clinical psychologist, currently working
within an acute inpatient mental health service in the NHS. Her
previous experience includes working within forensic and locked
rehabilitation services in the NHS and in the private sector. Her current
clinical and research interests include promoting a psychotherapeutic
culture through facilitating reflective practice groups and providing
colleagues with regular training informed by a variety of psychological
approaches.

Nicole Parish is a clinical psychologist, currently working for the

NHS within the Noah’s Ark Children’s Hospital for Wales. She is
particularly interested in the benefits of interprofessional working and
the use of psychological ideas to promote well-being within wide
organisations such as hospitals and schools.

Dr. Katherine Peckitt is a Clinical Psychologist with a special interest

in psychosis.

Christianne Pollock has a particular interest in learning disability

and autism and has been involved in this project as an expert by
experience. She has previously used Conversation Analysis to look at
interactions of children with severe autism. She now runs a business
providing Jeffersonian transcription for researchers and is currently
training to be a speech and language therapist.