Strengthening relationships within intensive psychiatric care: staff perceptions of an attachment training intervention

Abstract

Introduction: intensive psychiatric care units can be challenging environments in which to build strong staff-patient relationships. Attachment theory may provide a useful model for strengthening relationships in this setting. Aim: The aim of this study was to explore staff perceptions of the utility of attachment theory for understanding patient behaviour in the intensive psychiatric care setting. 

Methods: semi-structured interviews were conducted with 11 multi-disciplinary staff members. Interviews focused on the staff member's experience of learning about attachment theory and applying this perspective to their work on the ward. Transcripts were analysed using reflexive thematic analysis. 

Results: the analysis led to the development of three themes: engaging the reflective self, new perspective on others and cohesive ward culture. 

Conclusion: staff reported that learning about attachment theory supported them to better understand patient distress and associated behaviours. Notably, staff also used attachment theory to reflect on both their own internal states and the internal states of their colleagues. These reflections were suggested to bolster staff wellbeing and improve the ward milieu. 

Implications for practice: integrating attachment theory into team formulation, ward rounds and reflective practice groups could have a benefit for clinical practice, staff wellbeing and team cohesion in this setting.

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