This document summarizes a study conducted by Dr. Michelle Carr, a forensic psychologist. The study used qualitative and quantitative methods to examine the experiences of women in secure hospitals who self-harm or have difficulties adjusting. It involved phenomenological interviews and questionnaires with 6 participants over 8 weeks. Thematic analysis identified themes of self, others, and environment. Results from coping style, depression, self-esteem, and general health questionnaires administered before and after indicated improvements in some areas. The study aims to understand these women's experiences better to help patients and inform future research.

1. Dr Michelle Carr
Forensic Psychologist

2.  To give an overview of the rationale for the study
 To give a brief case study incorporating the issues
which were brought to the group
 Explain the methods of analysis and why this was
used
 To give an explanation of the results
 To explain what this means for the patients and
women in secure hospitals
 Future directions for research and how this
contributes to the field of study

3.  Thematic Review of women's prisons high rates of
self injury and adjustment difficulties.
 Researched this further and became aware of
relational theory.
 This theory, the findings and my experience
allowed my to make some hypotheses.
 Site and participant choice
 8 weeks study beginning in October 2012-
January 2013
 Analysis and write up- Complete for April 2013

4.  Introduced the study
 Informed Consent
 Pre Psychometrics and phenomenological interviews
 “Providing a description of human experience as
experienced by the person themselves”
 Bentz & Shapiro
 Six participants with average communication of
approximately two hours.

5.  Qualitative and Quantative Methods
 Four Questionnaires (BDI, CFSEI, GHQ, CSQ)
 Transcriptions of the six group sessions
 Interpretative Phenomenological Analysis
 5 Stages of analysis:
 Familiarization- immersion and coding
 Identification- annotate transcripts, linking
 Indexing- key issues, concepts
 Charting- Rearranging
 Mapping and Interpretation

6.  ‘Self’
 I don’t like the term personality disorder, it feels
defective. The word ‘disorder’ implies there is
something wrong. I prefer the word difficulties”
Self Others Environment
3 Subordinate
themes
7 subordinate
themes
2 subordinate
themes

7.  ‘Others’
 “I lied to protect my dad, I wanted to be in control. I
didn’t understand why I hurt myself, maybe I
wanted to be in control of the hurting”
 “I watch a lot, I’m quite a quiet person I don’t talk
and I’m always aware of what’s going on around
me and like I watch people it’s not that I’m judging
them I see their behaviour and I just don’t want to
be around it, it’s not the sort of thing that. I find it
quite disturbing at times to be around behaviour
like that.”

8.  ‘Others’
 “I felt horrible, degraded with them in control. The voices
returned but it felt like they were nice voices and a way
of coping”
 “Just because she doesn’t want to talk don’t leave her.
Don’t be put off by her quietness. You could watch tele
together or get a drink”
 Being able to relate/ understanding
 Non-judgemental and trustworthy
 Control
 Point of intervention

9.  ‘Environment’
 I” would like to see people that have self harmed and
got through it. I want that in a group I want that. If
someone came who self harmed what’s now
recovered and same for eating. Because at the
minute I don’t feel like I’m ever going to get there but
if somebody comes in there is hope. At the minute
we haven’t got the hope that we are going to get
recovered so for someone to come in that has been
through it, it might help us and I think “

10.  ‘Environment’ Cont
 “it’s an unpredictable environment, you want to get
out but its locked doors with no escape”
 Spoke of their ‘safe space’ being the bedroom
area. A sort of haven and ‘escape’ from the ward
environment.
 Room searches and material items.

11.  Would anyone like to share their reflections on the
qualitative results which have been shared?
 Are there any tentative ideas as to theoretical
links?

12. Table showing CSQ results pre
and post
P Pre Post Diff RCI Sig
1 Det 12
Rat 11
Det 21
Rat 17
Det 9
Rat 6
4.29
7.15
Yes
No
2 Det 5
Rat 9
Det 5
Rat 10
Det 0
Rat 1
4.29
7.15
No
No
3 Det 19
Rat 25
Det 16
Rat 27
Det -3
Rat 2
4.29
7.15
No
No
 Coping style
results show

13. Table showing BDI results pre
and post
P Pre Post Diff RCI Sig
1 39 15 24 Yes
2 37 44 7 No
3 10 10 0 No
 BDI Results suggest

14. Table showing CFSEI-2
results pre and post
P Pre Post Diff RCI Sig
1 10 27 17 5 Yes
2 19 10 9 5 Yes
3 24 26 2 5 No
 CFSEI-2 results show

15. Table showing GHQ-28
results pre and post
P Pre Post Diff Sig
1 Dep 11
Anx 14
Dep 1
Anx 8
10
6
Yes
Yes
2 Dep 7
Anx 14
Dep 14
Anx 11
7
3
Yes
Yes
3 Dep 0
Anx 12
Dep 1
Anx 8
1
4
No
Yes
 GHQ-28
results show
that

16.  Would anyone like to share their reflections on the
quantative results which have been shared?

19.  “Starting off research from women’s lives will
generate less partial and distorted accounts not
only of women’s lives but also of men’s lives and
of the whole social order.”
Harding 2004, p56

20. Any Questions?