Psychological resilience in people experiencing schizophrenia and suicidal thoughts and behaviours.

Background: Negative stressors can aggravate the impact of schizophrenia. However, some people find ways of combating such stressors. There is a dearth of research examining factors which enable individuals with schizophrenia to show psychological resilience.Aims: The goal of this study was to investigate resilience to negative stressors in people with disorders on the schizophrenia spectrum using a qualitative methodology.Methods: Data were collected from 23 participants who had experienced schizophrenia and suicidal thoughts and behaviours. Semi-structured interviews followed a topic guide. Participants were asked (i) what resilience meant to them, (ii) which stressors they had experienced over 12 months and (iii) how they had counteracted those stressors. Thematic analysis was conducted to identify re-occurring themes across interviews.Results: A continuum of psychological mechanisms described participants' views about the meaning of resilience which ranged from passive acceptance to resistance (e.g. withstanding pressure), and then to active strategies to counter stressors (e.g. confronting). These themes were also evident in narratives expressing personal resilience strategies but, additionally, included emotional coping techniques. External factors were highlighted that supported resilience including social support, reciprocity and religious coping.Conclusions: People with schizophrenia develop ways of being resilient to negative events which should inform therapeutic interventions.

Implementing family intervention within forensic services: the perspectives of clinical staff.

BACKGROUND: Few studies have investigated the perspectives of staff on the implementation of family intervention in forensic services. This may be crucial to overcome the barriers to successful implementation of this therapy. AIMS: To investigate the perspectives and experiences of forensic staff in implementing family interventions in forensic settings. METHOD: Staff responded to two open-ended questions about the (i) barriers and (ii) solutions to poor implementation of family intervention. Responses were subject to thematic analysis. RESULTS: Twenty-five forensic staff responded. The analysis showed that five themes represented the barriers of family intervention: insufficient time, poor support, lack of training, deficient information sharing and geographic limitations. In response to these barriers, staff provided practical solutions for a family intervention service: a clear pathway, protected staff time, revised policy and structure specific to family intervention, improved supervision, increased managerial support, shared education and modernisation. CONCLUSION: By including staff with a wealth of experience of working within forensic services and delivering family interventions, this study generated rich information on the implementation of family interventions. Staff themes highlighted key barriers, together with solutions to those barriers, in order to successfully implement a family intervention service within forensic services.