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Off-Campus Leave as a Therapeutic Intervention: A Program Evaluation

Sarah Newton's honours project summary

Sarah Newton

on 12 October 2012

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Transcript of Off-Campus Leave as a Therapeutic Intervention: A Program Evaluation

"To date it remains unclear how a patient actually progresses within a forensic in-patient service from admission to discharge" (Doyle, Logan, Ludlow, & Holloway, 2012, p. 54).

Current documentation relating to leave is not representative of the performance capacities of patients Introduction Thomas Embling Hospital

Forensic Patients

Canning Unit

Off-Campus Leave Background Successful community living

Importance of Documentation

Limited literature exists of processes within forensic psychiatric settings

Smith, Jennings and Cimino (2010)

Walker, Farnworth &Lapinski (In Press) Literature Proceeding study

Canning unit service improvement plan

Because mental health matters Relevance To evaluate the effectiveness of a new, off-campus leave observation tool. Aim Does documentation of leave relate to patients’ individual care and treatment plan and how does this differ before and after the implementation of the off-campus leave observation tool?

Does documentation of leave suggest how to improve leave, as a therapeutic intervention, for each patient and how does this differ before and after the implementation of the off-campus leave observation tool?

Does documentation of leave indicate when a patient is ready to progress through the graded leave system and to community re-entry?

What are escorting staff members’ experience of leave documentation before and after the implementation of the off-campus leave observation tool and how does this impact on the quality of the notes? Research Questions Qualitative research methodology

Pre-post program evaluation


Two participant groups

Data collection
file entries related to leave
off-campus observation tool
focus groups Design Permission to look at file entries related to leave --> leave progress notes, ICTP, off-campus leave observation tool
Reside in Canning unit
Attends escorted off-campus leave at the time of data collection
Via posters
Announcement at Community meeting
Attend information session
Receive explanatory statement and consent form
Discuss research with primary nurse Forensic Patients Participants Involvement in one or both focus groups related to off-campus leave. One before the implementation of the off-campus leave observation tool and another after
Work on Canning unit
Escorting staff member for off-campus leave for at least 2 months
Announcement at staff meeting
Attend information session
Receive explanatory statement and consent form Escorting staff members File entries
Photocopied by Canning Occupational Therapist
Focus group
Run in Canning unit
Transcribed verbatim Data Collection Content analysis Data Analysis During data collection
Data will be stored in the chief Occupational Therapists office in a locked filing cabinet and on a password protected USB
After data collection
Data will be stored in the Chief Occupational Therpaists office in a locked filing cabinet
It will kept for 5 years and destroyed via confidentiality bins Storage of data Consent
Research Merit and Integrity
Risk and harm
coercion Additional Ethical Considerations Crimes (Mental Impairment and Unfitness to be Tried) Act 1997.

Dearing, K. S. (2004). Getting it, together: How the nurse patient relationship influences treatment compliance for patients with schizophrenia. Archives of psychiatric nursing, 18(5), 155-163.

Department of Human Serivces. (2009). Because Mental Health Matters, Victorian Mental Health Reform Strategy 2009- 2019. Melbourne. www.health.vic.gov.au/mentalhealth/reformstrategy/

Doyle, M., Logan, C., Ludlow, A., & Holloway, J. (2012). Milestones to recovery: Preliminary validation of a framework to promote recovery and map progress through the medium secure inpatient pathway. Criminal Behaviour & Mental Health, 22(1), 53-64. doi: 10.1002/cbm.818

Draine, J., Wolff, N., Jacoby, J. E., Hartwell, S., & Duclos, C. (2005). Understanding community reentry of former prisoners with mental illness: a conceptual model to guide new research. Behavioral sciences & the law, 23(5), 689-707.

Liamputtong, P. (2009). Qualitative Research Methods. Melbourne: Oxford.

McCarney, R., Warner, J., Iliffe, S., Van Haselen, R., Griffin, M., & Fisher, P. (2007). The Hawthorne Effect: a randomised, controlled trial. BMC medical research methodology, 7(1), 30.

Mental Health Act 1986 (1986).

Munthe, C., Radovic, S., & Anckarsäter, H. (2010). Ethical issues in forensic psychiatric research on mentally disordered offenders. Bioethics, 24(1), 35-44.

National Health and Medical Research Council, Australian Research Council, & Australian Vice-Chancellors' Committee. (2007). National Statement on Ethical Conduct in Human Research. ACT: Australian Government.

Parkinson, S., Forsyth, K., & Kielhofner, G. (2006). User's Manual for the Model of Human Occupation Screening Tool (MOHOST) (version 2.0). Illinois: Model of Human Occupation Clearinghouse, Departments of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago.

Smith, R., Jenning, J., & Cimino, A. (2010). Forensic continuum of care with Assertive Community Treatment (ACT) for persons recovering from co-occurring disabilities: long-term outcomes. Psychiatric Rehabilitation Journal, 33(3), 207-218. doi: 10.2975/33.3.2010.207.218

Victorian Institute of Forensic Mental Health. (2012). Forensicare Retrieved 21st August, 2012, from http://www.forensicare.vic.gov.au/

Walker, A. (2009). Community day leaves and their contribution to successful community re-entry for forensic patients. Bachelor of Occupational Therapy Honours, Monash University, Frankston.

Walker, A., Farnworth, L., & Lapinski, S. (In Press). A recovery perspective on community day leaves. British Journal of Forensic Practice. References Used for analysing forms of communication.
Make inferences about the consequences of communications
Describe trends in communication content
Describe patterns of communication Off-Campus leave as a therapeutic intervention: A program evaluation
Full transcript