- Title
- Working with adolescents who self-harm: interventions and clinician resilience
- Creator
- Russell, Kathryn
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2015
- Description
- Masters Research - Master of Clinical Psychology (MClinPsych)
- Description
- Purpose: The purpose of this study was to examine how clinicians cope when dealing with adolescents who self-harm. The way clinicians managed their stress, including what interventions, both clinical and personal might help with this process was investigated. Two kinds of resilience were assessed, one being the ability to “bounce back”, together with the personality traits of emotional resilience, involvement and self-control. The impact of working with adolescents who self-harm on resilience and other personality traits was examined, as well as stress, depression and anxiety. Methodology: Clinical staff who worked in the area of adolescent mental health care in Australia were surveyed, including clinicians from the Child and Adolescent Mental Health Service (CAMHS) within Hunter New England Local Health and staff from Headspace services in the Hunter area. Other psychologists were accessed via an invitation in the Australian Psychological Society (APS) newsletter. A Clinician Survey, written for this study was used which collected demographic data and information on participants’ experience of working with adolescents, including interventions and self-care. Other validated scales applied were the Brief Resilience Scale, created to measure resilience as the ability to recover from stress, the 21-item short from of the Depression Anxiety Stress Scales and the Health Professions Value Survey. This scale measured the personality traits of emotional resilience, involvement and self-control. The Clinician Survey and other scales were placed online by means of the School of Psychology, University of Newcastle server, and staff at CAMHS and Headspace invited to participate via an e-mail from their manager. The APS was also approached and information and the relevant link to the study published in their newsletter. Results: Forty three participants commenced the questionnaire array, with only 28 (65%) completing all the questionnaires. Participants ranked suicidal ideation as the most stressful presentation to work with and oppositional behaviour as the most difficult. Self-harm was ranked 4th highest in terms of how stressful it was to work with. Participants reported using a number of interventions when working with adolescents who self-harm, with 76% of participants using DBT or parts of the therapy. When asked what interventions they found effective, 67% stated DBT or its various techniques. There were a number of significant correlations, including a significant negative correlation between how difficult clinicians found working with adolescents who self-harm and the number of years experience working with adolescents. There was also a significant negative correlation between the number of hours spent working in public health and how often participants received supervision. A negative correlation was found between the average weekly caseload of participants and how often they thought negatively about their work. There was also a significant correlation between how stressful and how difficult clinicians found working with adolescents who self-harm and how often they thought negatively of their work. Levels of resilience were impacted by factors such as how well clinicians managed their stress, years of experience, how satisfying they found working with adolescents who self-harm, all which aided their resilience. Resilience scores on the BRS were impacted negatively by how difficult and frustrating the participants found working with adolescents who self-harm. Scores for Stress and Depression on the DASS were affected by how frustrated participants found working with adolescents who self-harm. However the Stress score and participants’ level of stress management was significantly and negatively correlated as was the Stress score and level of resilience on the BRS. Interestingly, there was a significant negative correlation between working in private practice and Anxiety and Depression scores on the DASS. The scores for the HPVS all correlated significantly with the clinician level of stress management, with scores for Involved and Self-Control correlating negatively. Resilience scores were affected positively and significantly by level of stress management as well as the number of years clinicians had worked with adolescents. Resilience scores were negatively correlated with reported levels of stress, difficulty and frustration when working with adolescents who self-harm. Conclusion: This study revealed some interesting and unexpected results in regard to the factors that impact clinician resilience. It seems that working with adolescents who self-harm can be considered stressful, however it is possible for clinicians to remain resilient whilst doing this work, although it is still unclear as to the exact process of how this occurs. Implications: This research provides support for the need to build clinician resilience for those working in the area of mental health, particularly those who work with adolescents who self-harm. Resilience can be aided by various coping strategies and self-care, together with the use of evidence-based practice.
- Subject
- clinician stress; self-harm; compassion fatigue; vicarious traumatisation
- Identifier
- http://hdl.handle.net/1959.13/1300104
- Identifier
- uon:20010
- Rights
- Copyright 2015 Kathryn Russell
- Language
- eng
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