Approaches and challenges to assessing risk of violence in first episode psychosis: a qualitative interview study of clinicians, patients and carers

<p><strong>Aim:</strong> Clinical services for early psychosis seek to improve prognosis for a range of adverse outcomes. For some individuals, perpetration of violence is an important potential outcome to reduce. How these clinical services currently assess this risk however is un...

Full description

Bibliographic Details
Main Authors: Whiting, D, Glogowska, M, Fazel, S, Lennox, B
Format: Journal article
Language:English
Published: Wiley 2024
_version_ 1826317736910782464
author Whiting, D
Glogowska, M
Fazel, S
Lennox, B
author_facet Whiting, D
Glogowska, M
Fazel, S
Lennox, B
author_sort Whiting, D
collection OXFORD
description <p><strong>Aim:</strong> Clinical services for early psychosis seek to improve prognosis for a range of adverse outcomes. For some individuals, perpetration of violence is an important potential outcome to reduce. How these clinical services currently assess this risk however is uncertain. This study aimed to address this gap by using qualitative methods to examine in depth current approaches, attitudes and challenges to assessing violence risk in this clinical setting, from the perspectives of multidisciplinary clinicians, patients and carers.</p> <br> <p><strong>Methods:</strong> Participants were recruited from two UK Early Intervention in Psychosis services. Semi-structured individual interviews were undertaken using a topic guide. In addition, clinical vignettes were presented to clinician participants as a probe to prompt discussion. Data were analysed using thematic analysis, informed by the constant comparative method.</p> <br> <p><strong>Results:</strong> We conducted 30 qualitative interviews, of 18 clinicians and 12 patients and carers. Themes developed from clinician interviews included key difficulties of low confidence, limited training, accessing collateral information and variation in how risk is appraised and communicated. Potential stigma and sensitivity of the topic of violence were perceived as barriers to its discussion. Patient and carer perspectives provided insight into how to address barriers, and highlighted the importance of an open approach, including with families.</p> <br> <p><strong>Conclusions:</strong> We recommend developing contextually appropriate pathways to collaboratively assess violence risk and identify modifiable needs to reduce this risk, and for practical improvements in training and information-sharing.</p>
first_indexed 2025-03-11T16:58:39Z
format Journal article
id oxford-uuid:dd26fac4-c6a3-4151-b997-ba1c8284359d
institution University of Oxford
language English
last_indexed 2025-03-11T16:58:39Z
publishDate 2024
publisher Wiley
record_format dspace
spelling oxford-uuid:dd26fac4-c6a3-4151-b997-ba1c8284359d2025-03-03T16:12:41ZApproaches and challenges to assessing risk of violence in first episode psychosis: a qualitative interview study of clinicians, patients and carersJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:dd26fac4-c6a3-4151-b997-ba1c8284359dEnglishSymplectic ElementsWiley2024Whiting, DGlogowska, MFazel, SLennox, B<p><strong>Aim:</strong> Clinical services for early psychosis seek to improve prognosis for a range of adverse outcomes. For some individuals, perpetration of violence is an important potential outcome to reduce. How these clinical services currently assess this risk however is uncertain. This study aimed to address this gap by using qualitative methods to examine in depth current approaches, attitudes and challenges to assessing violence risk in this clinical setting, from the perspectives of multidisciplinary clinicians, patients and carers.</p> <br> <p><strong>Methods:</strong> Participants were recruited from two UK Early Intervention in Psychosis services. Semi-structured individual interviews were undertaken using a topic guide. In addition, clinical vignettes were presented to clinician participants as a probe to prompt discussion. Data were analysed using thematic analysis, informed by the constant comparative method.</p> <br> <p><strong>Results:</strong> We conducted 30 qualitative interviews, of 18 clinicians and 12 patients and carers. Themes developed from clinician interviews included key difficulties of low confidence, limited training, accessing collateral information and variation in how risk is appraised and communicated. Potential stigma and sensitivity of the topic of violence were perceived as barriers to its discussion. Patient and carer perspectives provided insight into how to address barriers, and highlighted the importance of an open approach, including with families.</p> <br> <p><strong>Conclusions:</strong> We recommend developing contextually appropriate pathways to collaboratively assess violence risk and identify modifiable needs to reduce this risk, and for practical improvements in training and information-sharing.</p>
spellingShingle Whiting, D
Glogowska, M
Fazel, S
Lennox, B
Approaches and challenges to assessing risk of violence in first episode psychosis: a qualitative interview study of clinicians, patients and carers
title Approaches and challenges to assessing risk of violence in first episode psychosis: a qualitative interview study of clinicians, patients and carers
title_full Approaches and challenges to assessing risk of violence in first episode psychosis: a qualitative interview study of clinicians, patients and carers
title_fullStr Approaches and challenges to assessing risk of violence in first episode psychosis: a qualitative interview study of clinicians, patients and carers
title_full_unstemmed Approaches and challenges to assessing risk of violence in first episode psychosis: a qualitative interview study of clinicians, patients and carers
title_short Approaches and challenges to assessing risk of violence in first episode psychosis: a qualitative interview study of clinicians, patients and carers
title_sort approaches and challenges to assessing risk of violence in first episode psychosis a qualitative interview study of clinicians patients and carers
work_keys_str_mv AT whitingd approachesandchallengestoassessingriskofviolenceinfirstepisodepsychosisaqualitativeinterviewstudyofclinicianspatientsandcarers
AT glogowskam approachesandchallengestoassessingriskofviolenceinfirstepisodepsychosisaqualitativeinterviewstudyofclinicianspatientsandcarers
AT fazels approachesandchallengestoassessingriskofviolenceinfirstepisodepsychosisaqualitativeinterviewstudyofclinicianspatientsandcarers
AT lennoxb approachesandchallengestoassessingriskofviolenceinfirstepisodepsychosisaqualitativeinterviewstudyofclinicianspatientsandcarers