Increasing physical activity through motivational interviewing with adult forensic psychiatric inpatients

Lyon, R.G.

Abstract

The treatment and recovery of forensic psychiatric inpatients can take many months and often years, within which time health issues such as obesity and diabetes can develop. Encouraging beneficial health behaviours with this client group is notoriously difficult for a variety of reasons and anti-psychotic medication paradoxically often serves to exacerbate physical health concerns. There is a dearth of research concerning effective interventions for improved physical health for this client group, perhaps because security and staffing issues present significant challenges to conducting research in this environment.

This exploratory piece of action research employed multi-staged Motivational Interviewing (MI) sessions in nine case studies, the aim of which was to explore the utility of the approach in increasing physical activity (PA) with forensic psychiatric inpatients. Changes in PA and intrinsic motivation were assessed over three months and clients were surveyed on their views of the approach. A question exists over the propriety of client-centred care in a setting that is often necessarily restrictive and controlled. Challenges to a broader implementation of MI for health promotion amongst the multi-disciplinary care team (MDT) are considered, and were explored through the use of a staff survey. Outcomes for the research suggest that MI is a useful and valued approach to facilitating changes in physical activity levels with forensic psychiatric clients. There may be others from this environment for whom the approach is inappropriate, and there is a need for further research with clients whose health concerns are significant but who do not readily present for activity sessions. Outcomes from this research further suggest some of the MDT may be philosophically aligned with some aspects of the client-centred ethos of MI, yet still maintain a belief in the propriety of directive and authoritarian methods for promoting health. This may present a challenge to the training of MI if a broader implementation of MI for physical health issues is considered, and limited survey data may not have revealed the full extent of this challenge.

Citation

Lyon, R. Increasing physical activity through motivational interviewing with adult forensic psychiatric inpatients. (Thesis). University of the West of England. Retrieved from https://uwe-repository.worktribe.com/output/822139

• Thesis Type: Thesis
• Deposit Date: Jan 14, 2014
• Publicly Available Date: May 7, 2016
• Keywords: physical activity, motivational interviewing, forensic, psychiatric, mental health, mental illness, inpatient
• Public URL: https://uwe-repository.worktribe.com/output/822139
• Award Date: Jan 6, 2014