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Post-incident treatment following coercive measures: a Delphi study
BMC Psychiatry volume 7, Article number: S113 (2007)
Coercive measures may traumatize patients and may disturb their relationship to carers. To maintain a good therapeutic relationship and to help avoid future coercion carers should address the aftermath of coercion with the patients involved. Much variation exists regarding post-incident treatment and Swiss data show that only about 30% of patients receive such treatment. Thus, the study objective was to ascertain the possible content of post-incident treatment.
A Delphi study including 28 psychiatric professionals (nurses, psychologists, psychiatrists) was conducted. The major themes presented in the first round were: terminology, objectives, timing, content, necessity, contra-indications and exemption, carer responsibility, atmospheric aspects, recording, and general remarks.
22 (79%) of the surveyed institutions have no guidelines regarding post-incident treatment and in the hospitals with guidelines only 3 (50%) use them systematically. After three Delphi rounds a positive consensus was established on the following themes: Professionals view post-incident treatment as supportive and helpful in helping to cope with trauma, to promote the patient-carer relationship, and to help prevent future coercion. Trying to convince patients of the justification of the coercive measures or using the post-incident treatment to debrief personnel were consensually rejected. No consensus was established e.g. on the "right" time or the frequency for the post-incident treatment or on regarding possible re-traumatisation of patients as a contraindication for post-incident treatment.
Post-incident treatment is generally viewed as helpful although some details are difficult to regulate (timing, possible re-traumatisation). Minimal standards/guidelines could possibly motivate carers to increase the number of post-incident treatment. However, the expert opinion established on post-incident treatment must be subjected to empirical testing.
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Grywa, D., Needham, I. Post-incident treatment following coercive measures: a Delphi study. BMC Psychiatry 7, S113 (2007). https://0-doi-org.brum.beds.ac.uk/10.1186/1471-244X-7-S1-S113
- Public Health
- Expert Opinion
- Empirical Testing
- Major Theme
- Study Objective