Additional case studies

STARR template – Digital Storytelling Case Study

Authors

Dudeck M, Muller JL, Vollm BA, Khalifa N, (2020) Editorial Therapeutic process and well-being in forensic psychiatry and prison. Frontiers in Psychiatry 2020; 11: 626241.

Situation

When prisoners enter prison they lose much of their autonomy, freedom and sense of control. This can make their future outlook more negative and see their incarceration as a great burden. This is purported to be a major reason behind the higher suicide rates in prisons compared to the general population. This book looks at 23 studies on the therapeutic process with prisoners and their well-being.

Task

A study by Busslemann et al. (2020) looked at the quality of living conditions in 12 German forensic psychiatric hospitals. The main thrust of their conclusion were that creating a positive environment through supportive therapeutic alliances reduced depressive symptoms and suicidal ideation better than the typical custodial interventions.

Actions

Inmates from an immigrant background and those with fewer social relationships in prison had the worst outcomes, this means a holistic, person centred history of the patient should ask about the prisoners social capital.

Results

The main thrust of their conclusion were that creating a positive environment through supportive therapeutic alliances reduced depressive symptoms and suicidal ideation better than the typical custodial interventions.

Reflections

This highlights the need for improving healthcare practitioners awareness of the prisoner mind set and beliefs and the importance of developing positive therapeutic relationships with them. Vorstenbosch and Castelletti (2020) evaluated a questionnaire that could be used as part of the history taking for prisoners to assess their quality of life. The lower the needs identified from the questionnaire, the better the quality of the life of the prisoner, this was rated as moderate to high for 74% of the prisoners they studied. Downsides of this questionnaire were that the agreement level between clinician and patient on what counted as a need were less than 0.40 for Kappa values for 64% of the total needs and 46% of the unmet needs. This means the questionnaire could be useful but may show significant variation between clinicians who use it so perhaps not reliable enough.

References

Busselmann M, Nigel S, Otte S, Lutz M, Franke I, Dudeck M, Streb J, (2020) High quality of life reduces depression, hopelessness, and suicide ideations in patients in forensic psychiatry. Frontiers in Psychiatry 23 January 2020.

Vorstenbosch E, Castelletti L, (2020) Exploring needs and quality of life of forensic psychiatric inpatients in the reformed Italian system, implications for care and safety. Frontiers in Psychiatry, 3 April 2020.

STARR template – Digital Storytelling Case Study

Authors

Goodman (2018)

Situation

Digital storytelling highlighted the negative stereotypes of opioid users in North America that is, in part, caused by photographers trying to highlight the problem.

Task

Opioid use is an epidemic in North America and becoming that way in the UK, there are lots of negative stereotypes of opioid users that may hinder the setting up and maintenance of programs to help users recover. The aims of this study were to tackle these stereotypes in policy makers whilst first improving the self-confidence of users using DST.

Actions

He studies the first heroin-assisted treatment program in North America, which used DST for 10 heroin users from a 3 day workshop.

Results

8 of them completed a DST and they reported increased agency in how they represent themselves.

Reflections

Goodman also suggested DST could help reduce prejudice in the general public and amongst decision makers, although he provides no long-term evidence of this.

References

Goodman A, (2018) Digital Storytelling with Heroin users in Vancouver. International Quarterly Community Health Education 2019 Jan; 39(2): 75-89.