Dignam, Paul (2022) “They open up their madness to you” – An Exploration of Forensic Mental Health Nurses' Experience of the Therapeutic Relationship and the Impacts of Patients' Psychopathology and Offending Backgrounds. Honours thesis, University of Southern Queensland. (Unpublished)
Abstract
Situated within an increasing global nursing workforce crisis, forensic mental health nurses are tasked with the care and containment of society’s most acutely unwell, mentally disordered offenders. With little to no specialised training, forensic mental health nurses are expected to develop and maintain effective therapeutic relationships with this highly stigmatised, marginalised, and vulnerable population of forensic patients. Forensic mental health nurses are set the serious challenge of navigating the conceptual ambiguity of the therapeutic relationship and the complex and significant offending backgrounds and psychopathology of their patients. Whilst previous studies have been undertaken to examine the factors that impact this therapeutic relationship, there is currently little research that examines this from the perspective of forensic mental health nurses. In an attempt to address this research gap, this study aimed to understand how forensic mental health nurses working in a secure forensic inpatient service in Australia understand the therapeutic relationship regarding their patients' psychopathology and offending history. Twenty-seven forensic mental health nurses participated in semi-structured interviews within the highsecure forensic inpatient hospital setting. Reflexive thematic analysis generated four main themes: “Seeing the Illness, Not the Patient”, “Seeing the Patient, Not the Illness”, “Seeing the Offence, Not the Patient”, and “Seeing the Patient, Not the Offence”. Considered within existing conceptualisations of the therapeutic relationship, the forensic mental health nurses expressed idealised expectations of unconditional positive regard and maintaining a nonjudgmental approach to their patient’s psychopathology and offending backgrounds. They also reported significant challenges in implementing these approaches to their therapeutic relationships due to the extreme presentations of their patients' psychopathology, their often visceral response to their patients’ offences and their self-reported biases against patients diagnosed with personality disorders (particularly borderline personality disorder).
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| Item Type: | Thesis (Non-Research) (Honours) |
|---|---|
| Item Status: | Live Archive |
| Additional Information: | Current UniSQ staff and students can request access to this thesis. Please email research.repository@unisq.edu.au with a subject line of SEAR thesis request and provide: Name of the thesis requested and Your name and UniSQ email address |
| Faculty/School / Institute/Centre: | Current – Faculty of Health, Engineering and Sciences - School of Psychology and Wellbeing (1 Jan 2022 -) |
| Supervisors: | Michael Ireland; Casey Roberts |
| Qualification: | Bachelor of Science (Honours) |
| Date Deposited: | 28 May 2025 01:43 |
| Last Modified: | 28 May 2025 01:43 |
| Uncontrolled Keywords: | Therapeutic Relationships; Forensic; Mental Health Nurse; Mental-Illness Related Stigma; Offence-Related Stigma |
| Fields of Research (2008): | 17 Psychology and Cognitive Sciences > 1799 Other Psychology and Cognitive Sciences > 179999 Psychology and Cognitive Sciences not elsewhere classified |
| Fields of Research (2020): | 52 PSYCHOLOGY > 5299 Other psychology > 529999 Other psychology not elsewhere classified |
| URI: | https://sear.unisq.edu.au/id/eprint/52269 |
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