Group-work therapeutic engagement in a high secure hospital: Male service user perspectives

Purpose: This paper aims to discuss a service user perspective of factors that influence engagement in therapeutic group-work within a high secure hospital environment. Design/methodology/approach: An opportunistic sample of 11 male service users were interviewed, using a semi-structured protocol. This was underpinned by social and psychological factors highlighted within the literature, and concepts drawn from the Health Belief Model (HBM). In accordance with service-user led initiatives, interview questions were open-ended, designed to invite and encourage exploration of themes through general discussion. Research findings were analysed through an interpretative phenomenological analysis (IPA) approach to identify emergent themes of apparent influence. Themes were identified, and were categorised into emergent themes and related sub themes. Emergent themes were then considered in relation to the theories and concepts that underpinned and connected them. Findings: It was found that the most substantial theme was culture of the environment, closely linked to the concepts of choice, which stem from and are greatly influenced by culture. Participants highlighted additional influential areas, namely relationships, trust, motivation, group-work content and expected outcomes. Originality/value: Given the complexities of need presented by service users within high secure settings, professionals recognise a range of approaches and treatment modalities incorporating individual therapy, occupational and vocational engagement and therapeutic group-work. It is specifically service users' views of engagement in such group-work that is considered within this paper.