Doctorate in Clinical Psychology: Main Research Portfolio

: (Alternative Format Thesis) 1) How Have Compassion-Focused Approaches Been Used in the Treatment of PTSD? A Systematic Scoping Review; 2) Evaluating Outcomes and Experience of Eye Movement Desensitisation and Reprocessing Through a National Health Service Trust’s Staff Support Service; 3) Allegiance to an Organisation That Doesn’t Practice What It Preaches: Exploring the Experiences of Moral Distress in Mental Health Professionals.

Abstract

Background: Moral distress is a concept born out of the nursing literature, referring to distress arising when one is constrained by internal or external factors from pursuing the ethically right choice. It has subsequently been evidenced across several healthcare disciplines, however there is limited research exploring the experiences of mental health professionals (MHPs).

Objective: This study aimed to explore the extent that moral distress presents in different MHPs and whether existing measures accurately depict this. It also sought to explore the personal experiences and perceived impact of moral distress among MHPs in the context of Covid-19.

Method: Participants were recruited via social media and completed an online survey (n=315) before being invited to partake in semi-structured interviews. Thematic Analysis was used to explore the lived experiences of nine mental health professionals.

Results: Moral distress was evident across all professional groups surveyed. Post-hoc analyses of moral distress across different job settings and time spent working revealed highest levels of distress among those working in primary care and for those who had been working for 6-10 years. Accuracy of the MMD-HP varied between 60-81%, however several participants offered additional examples of moral distress within the mental health sector (n=91). Interviews identified four themes: positions of power(lessness), the vicious cycle of disconnection, you have to remind yourself that you are human too, and Covid-19 was worse, but not out of character to what has happened before.

Conclusions: There is a need to develop the narrative around moral distress and acknowledge the value conflict that often arises between mental health professionals and their employing organisation. Support and intervention should be developed and targeted toward empowering individuals to make changes within this system, while also implementing change at higher levels.

Date of Award	22 Sept 2023
Original language	English
Awarding Institution	University of Bath
Supervisor	Rachel Paskell (Supervisor) & Rosie Banting (Supervisor)