Attitudes of relatives and staff towards family intervention in forensic services using Q methodology

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  Family interventions have a successful evidence base in the treatment of schizophrenia, yet they are not easily implemented within services.
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  There are various barriers to the successful implementation of family intervention services. Attitudes of relatives of service users and clinical staff can have an impact on successful delivery of family intervention services. Yet little work has focused on the attitudes in the forensic services.
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  This study describes an investigation of attitude towards family intervention in forensic services, with an aim to explore if family interventions are accepted by relatives and staff. A new technique to family intervention is presented.
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  The study found that both relatives and staff hold overall positive attitudes towards family intervention. The results revealed that the use of a novel technique, using a web camera to facilitate family intervention (e-FFI) was not dismissed by relatives or staff. Instead neutral and open-minded attitudes were produced towards e-FFI from both relatives and staff.
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  The implications of these results may be encouraging for the future of telepsychology and specifically e-FFI within forensic mental health services, in providing positive outcomes for families and staff via the modernization of services.

Attitudes about family interventions have been identified as a possible reason for the poor implementation of such treatments. The current study used Q methodology to investigate the attitudes of relatives of forensic service users and clinical staff towards family interventions in medium secure forensic units, particularly when facilitated by a web camera. Eighteen relatives and twenty-nine staff completed a sixty-one item Q sort to obtain their idiosyncratic views about family intervention. The results indicated that relatives and staff mostly held positive attitudes towards family intervention. Relatives showed some uncertainty towards family intervention that may reflect the lack of involvement they receive from the forensic service. Staff highlighted key barriers to successful implementation such as lack of dedicated staff time for family work and few staff adequately trained in family intervention. Despite agreement with the web-based forensic family intervention technique and its benefits, both staff and relatives predicted problems in the technique.