users ’ progress within the group . Improvements were seen in individuals ’ confidence in a group environment and their social skills .
Where limited improvement was observed in an individual , the group still enabled an excellent opportunity to assess in detail service users ’ communication skills and deficits , which can be used for care planning in future .
Service user feedback was sought , and was overall positive , with the three regular attendees stating they would like to continue to attend the group .
One regular attendee also supported me in presenting the group to the recovery outcomes and wellness meeting , to share the findings with professional leads across the clinic , ensuring that the service user voice was central to evaluating and sharing the outcomes of the group .
As a pilot , there were a number of areas that have been identified for development if the group is to be facilitated again in future .
One service user stated they found the character that was created alienating , as the character had been recently discharged from Reaside Clinic , which was not relatable to this individual .
It had been felt that to get a good range of role play scenarios it would be helpful to have a character who could access the community , particularly environments that service users might be less familiar with . In future , it may be better to state the character is a current inpatient , but with access to section 17 leave .
It is acknowledged that , despite trying to directly teach good social skills in communitybased role plays , the group did not replicate a real-world environment . Williams and Chard ( 2016 ) state that in forensic mental health settings , improving service users ’ social skills is hindered as interactions in real world contexts are limited , and this can be the case for prolonged periods of time , due to the length of admissions . This group therefore should not be the only intervention that addresses poor social skills and follow-up intervention within community settings would be beneficial .
However , the group does provide an introduction to managing good social skills and building norm awareness , which may be particularly helpful for those who do not have access to community leave yet or are just gaining access to leave .
It also may be beneficial to supplement the VdT MoCA assessment tool with one that specialises in assessing communication skills – potentially the Assessment of Communication and Interaction Skills ( ACIS ) ( Forsyth et al 1998 ).
The drop-out rate within the group was disappointing and does limit what can be evaluated from the group .
However , I am hopeful that , in the future , COVID-19 guidance will relax to allow different wards to mix . This would give a bigger pool of service users to select from and hopefully allow us to identify individuals who are best placed in their hospital stay and mental state to attend all six sessions .
Although there are changes and adaptations to be made , I am excited to keep working on this group and being able to introduce it to the wider service user population .
R
De Witt P ( 2005 ) Creative ability – a model for psychiatric occupational therapy . In Crouch R and Alers V ( eds ) Occupational therapy in psychiatry and mental health . 4th Edition . London and Philadelphia : Whurr Publishers
Forsyth K , Salamy M , Simon S and Kielhofner G ( 1998 ) The Assessment of Communication and Interaction Skills ( ACIS ). Chicago : Model of Human Occupation Clearinghouse
Ikebuchi E ( 2007 ) Social skills and social and non-social cognitive functioning in schizophrenia , Journal of Mental Health , 16 ( 5 ): 581-94
Kelly A ( 2003 ) Talkabout Activities : developing social and communication skills . London : Routledge .
NICE ( 2017 ) Mental health of adults in contact with the criminal justice system . NICE Guidelines ( NG66 ) Available online at : www . nice . org . uk / guidance / ng66 > [ accessed 6 August 2021 ]
Sedgewick O , Young S , Das M and Kumari V ( 2016 ) Objective predictors of outcome in forensic mental health services – a systematic review . CNS Spectrums , 21 ( 6 ): 430-444
Williams B and Chard G ( 2016 ) Using the evaluation of social interaction ( ESI ) with men in a low secure forensic unit . British Journal of Occupational Therapy , 79 ( 4 ): 206-211
Words NICKY PHILLIPS , senior occupational therapist , Reaside Clinic , Birmingham and Solihull Mental Health NHS Foundation Trust
28 OTnews January 2022