The role of emotion regulation, coping, self-reflection and insight in staff interaction with patients with a diagnosis of personality disorder in forensic settings

Inez Oostvogels*, Ilja L. Bongers, Arno Willems

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Accessible summary What is known on the subject? ?

Interaction between staff and patients with a diagnosis of personality disorder in forensic settings is important for quality of care, but research is lacking on what determines this interaction. What the paper adds to existing knowledge? ?

Insight, emotion-focused coping and emotion regulation of staff influence the interaction between staff and these patients. Staff who understand their own thoughts, feelings and behaviour better (more insight) needed less support, encouragement or back-up from their patients. Staff who cope by getting upset, blaming themselves or fantasizing about solutions (emotion-focused coping) on the contrary needed more support from their patients. Emotion regulation had an impact on the relation between coping and hostile staff behaviour. When staff get upset (emotion-focused coping) and try to think differently about the situation (reappraisal), this makes them behave in a more hostile manner towards their patients. When staff suppress their emotions and also distract themselves or engage in social activities (avoidance-focused coping), they behave in a less hostile manner towards their patients. What are the implications for practice? ?

In order to provide compassionate care for their patients, staff ought to be trained in self-compassion. This may help them not to get upset, blame themselves or fantasize about solutions and to understand their own thoughts, feelings and behaviour better. As a result, staff may need less support, encouragement or back-up from their patients. Context is important: Staff ought to suppress their emotions when emotions run high, but only when they also care for themselves by distracting themselves or engaging in social activities. Facing and regulating their emotions by changing what they think about the situation (reappraisal) may be more appropriate once emotions have settled down. This may help staff to remain compassionate towards their patients in the long run and avoid burn-out or compassion fatigue due to ignoring their own needs and boundaries. Introduction Research is lacking on what determines interaction between staff and patients with a diagnosis of personality disorder in forensic settings. Aim To test whether coping, self-reflection, insight and emotion regulation are related to the behaviour of staff towards these patients, and to test the possible moderating and mediating effect of emotion regulation. Method Using a cross-sectional design, 76 direct care staff of a forensic clinic completed questionnaires on all variables. Relations were tested using simple linear regression, mediation and moderation analyses. Results Insight and emotion-focused coping of staff were related to seeking less and more support from patients, respectively. Emotion regulation by reappraisal combined with emotion-focused coping was associated with more hostile behaviour by staff, and suppression combined with avoidance-focused coping with less hostile behaviour. Conclusion Insight, emotion-focused coping and emotion regulation of staff influence the quality of care of patients with a diagnosis of personality disorder in forensic settings. Future research ought to include contextual factors. Implications for practice Enhancing self-compassion may improve insight and reduce emotion-focused coping.

Context is important: Taking the needs of staff into account may involve suppressing emotions combined with avoidance in a highly emotional situation while facing and reappraising the situation when emotions are low.

Original languageEnglish
Pages (from-to)582-600
JournalJournal of Psychiatric and Mental Health Nursing
Volume25
Issue number9-10
DOIs
Publication statusPublished - 2018

Keywords

  • context
  • coping
  • emotion regulation
  • forensic
  • insight
  • personality disorders
  • staff-patient interaction
  • INTELLECTUAL DISABILITIES
  • CHALLENGING BEHAVIOR
  • HEALTH-CARE
  • CLIENTS
  • COMPASSION
  • REAPPRAISAL
  • AGGRESSION
  • STRESS
  • VALIDATION
  • PSYCHOLOGY

Cite this

@article{b9f33495f0034f818735df9162f2072d,
title = "The role of emotion regulation, coping, self-reflection and insight in staff interaction with patients with a diagnosis of personality disorder in forensic settings",
abstract = "Accessible summary What is known on the subject? ?Interaction between staff and patients with a diagnosis of personality disorder in forensic settings is important for quality of care, but research is lacking on what determines this interaction. What the paper adds to existing knowledge? ?Insight, emotion-focused coping and emotion regulation of staff influence the interaction between staff and these patients. Staff who understand their own thoughts, feelings and behaviour better (more insight) needed less support, encouragement or back-up from their patients. Staff who cope by getting upset, blaming themselves or fantasizing about solutions (emotion-focused coping) on the contrary needed more support from their patients. Emotion regulation had an impact on the relation between coping and hostile staff behaviour. When staff get upset (emotion-focused coping) and try to think differently about the situation (reappraisal), this makes them behave in a more hostile manner towards their patients. When staff suppress their emotions and also distract themselves or engage in social activities (avoidance-focused coping), they behave in a less hostile manner towards their patients. What are the implications for practice? ?In order to provide compassionate care for their patients, staff ought to be trained in self-compassion. This may help them not to get upset, blame themselves or fantasize about solutions and to understand their own thoughts, feelings and behaviour better. As a result, staff may need less support, encouragement or back-up from their patients. Context is important: Staff ought to suppress their emotions when emotions run high, but only when they also care for themselves by distracting themselves or engaging in social activities. Facing and regulating their emotions by changing what they think about the situation (reappraisal) may be more appropriate once emotions have settled down. This may help staff to remain compassionate towards their patients in the long run and avoid burn-out or compassion fatigue due to ignoring their own needs and boundaries. Introduction Research is lacking on what determines interaction between staff and patients with a diagnosis of personality disorder in forensic settings. Aim To test whether coping, self-reflection, insight and emotion regulation are related to the behaviour of staff towards these patients, and to test the possible moderating and mediating effect of emotion regulation. Method Using a cross-sectional design, 76 direct care staff of a forensic clinic completed questionnaires on all variables. Relations were tested using simple linear regression, mediation and moderation analyses. Results Insight and emotion-focused coping of staff were related to seeking less and more support from patients, respectively. Emotion regulation by reappraisal combined with emotion-focused coping was associated with more hostile behaviour by staff, and suppression combined with avoidance-focused coping with less hostile behaviour. Conclusion Insight, emotion-focused coping and emotion regulation of staff influence the quality of care of patients with a diagnosis of personality disorder in forensic settings. Future research ought to include contextual factors. Implications for practice Enhancing self-compassion may improve insight and reduce emotion-focused coping.Context is important: Taking the needs of staff into account may involve suppressing emotions combined with avoidance in a highly emotional situation while facing and reappraising the situation when emotions are low.",
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author = "Inez Oostvogels and Bongers, {Ilja L.} and Arno Willems",
year = "2018",
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language = "English",
volume = "25",
pages = "582--600",
journal = "Journal of Psychiatric and Mental Health Nursing",
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The role of emotion regulation, coping, self-reflection and insight in staff interaction with patients with a diagnosis of personality disorder in forensic settings. / Oostvogels, Inez; Bongers, Ilja L.; Willems, Arno.

In: Journal of Psychiatric and Mental Health Nursing, Vol. 25, No. 9-10, 2018, p. 582-600.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - The role of emotion regulation, coping, self-reflection and insight in staff interaction with patients with a diagnosis of personality disorder in forensic settings

AU - Oostvogels, Inez

AU - Bongers, Ilja L.

AU - Willems, Arno

PY - 2018

Y1 - 2018

N2 - Accessible summary What is known on the subject? ?Interaction between staff and patients with a diagnosis of personality disorder in forensic settings is important for quality of care, but research is lacking on what determines this interaction. What the paper adds to existing knowledge? ?Insight, emotion-focused coping and emotion regulation of staff influence the interaction between staff and these patients. Staff who understand their own thoughts, feelings and behaviour better (more insight) needed less support, encouragement or back-up from their patients. Staff who cope by getting upset, blaming themselves or fantasizing about solutions (emotion-focused coping) on the contrary needed more support from their patients. Emotion regulation had an impact on the relation between coping and hostile staff behaviour. When staff get upset (emotion-focused coping) and try to think differently about the situation (reappraisal), this makes them behave in a more hostile manner towards their patients. When staff suppress their emotions and also distract themselves or engage in social activities (avoidance-focused coping), they behave in a less hostile manner towards their patients. What are the implications for practice? ?In order to provide compassionate care for their patients, staff ought to be trained in self-compassion. This may help them not to get upset, blame themselves or fantasize about solutions and to understand their own thoughts, feelings and behaviour better. As a result, staff may need less support, encouragement or back-up from their patients. Context is important: Staff ought to suppress their emotions when emotions run high, but only when they also care for themselves by distracting themselves or engaging in social activities. Facing and regulating their emotions by changing what they think about the situation (reappraisal) may be more appropriate once emotions have settled down. This may help staff to remain compassionate towards their patients in the long run and avoid burn-out or compassion fatigue due to ignoring their own needs and boundaries. Introduction Research is lacking on what determines interaction between staff and patients with a diagnosis of personality disorder in forensic settings. Aim To test whether coping, self-reflection, insight and emotion regulation are related to the behaviour of staff towards these patients, and to test the possible moderating and mediating effect of emotion regulation. Method Using a cross-sectional design, 76 direct care staff of a forensic clinic completed questionnaires on all variables. Relations were tested using simple linear regression, mediation and moderation analyses. Results Insight and emotion-focused coping of staff were related to seeking less and more support from patients, respectively. Emotion regulation by reappraisal combined with emotion-focused coping was associated with more hostile behaviour by staff, and suppression combined with avoidance-focused coping with less hostile behaviour. Conclusion Insight, emotion-focused coping and emotion regulation of staff influence the quality of care of patients with a diagnosis of personality disorder in forensic settings. Future research ought to include contextual factors. Implications for practice Enhancing self-compassion may improve insight and reduce emotion-focused coping.Context is important: Taking the needs of staff into account may involve suppressing emotions combined with avoidance in a highly emotional situation while facing and reappraising the situation when emotions are low.

AB - Accessible summary What is known on the subject? ?Interaction between staff and patients with a diagnosis of personality disorder in forensic settings is important for quality of care, but research is lacking on what determines this interaction. What the paper adds to existing knowledge? ?Insight, emotion-focused coping and emotion regulation of staff influence the interaction between staff and these patients. Staff who understand their own thoughts, feelings and behaviour better (more insight) needed less support, encouragement or back-up from their patients. Staff who cope by getting upset, blaming themselves or fantasizing about solutions (emotion-focused coping) on the contrary needed more support from their patients. Emotion regulation had an impact on the relation between coping and hostile staff behaviour. When staff get upset (emotion-focused coping) and try to think differently about the situation (reappraisal), this makes them behave in a more hostile manner towards their patients. When staff suppress their emotions and also distract themselves or engage in social activities (avoidance-focused coping), they behave in a less hostile manner towards their patients. What are the implications for practice? ?In order to provide compassionate care for their patients, staff ought to be trained in self-compassion. This may help them not to get upset, blame themselves or fantasize about solutions and to understand their own thoughts, feelings and behaviour better. As a result, staff may need less support, encouragement or back-up from their patients. Context is important: Staff ought to suppress their emotions when emotions run high, but only when they also care for themselves by distracting themselves or engaging in social activities. Facing and regulating their emotions by changing what they think about the situation (reappraisal) may be more appropriate once emotions have settled down. This may help staff to remain compassionate towards their patients in the long run and avoid burn-out or compassion fatigue due to ignoring their own needs and boundaries. Introduction Research is lacking on what determines interaction between staff and patients with a diagnosis of personality disorder in forensic settings. Aim To test whether coping, self-reflection, insight and emotion regulation are related to the behaviour of staff towards these patients, and to test the possible moderating and mediating effect of emotion regulation. Method Using a cross-sectional design, 76 direct care staff of a forensic clinic completed questionnaires on all variables. Relations were tested using simple linear regression, mediation and moderation analyses. Results Insight and emotion-focused coping of staff were related to seeking less and more support from patients, respectively. Emotion regulation by reappraisal combined with emotion-focused coping was associated with more hostile behaviour by staff, and suppression combined with avoidance-focused coping with less hostile behaviour. Conclusion Insight, emotion-focused coping and emotion regulation of staff influence the quality of care of patients with a diagnosis of personality disorder in forensic settings. Future research ought to include contextual factors. Implications for practice Enhancing self-compassion may improve insight and reduce emotion-focused coping.Context is important: Taking the needs of staff into account may involve suppressing emotions combined with avoidance in a highly emotional situation while facing and reappraising the situation when emotions are low.

KW - context

KW - coping

KW - emotion regulation

KW - forensic

KW - insight

KW - personality disorders

KW - staff-patient interaction

KW - INTELLECTUAL DISABILITIES

KW - CHALLENGING BEHAVIOR

KW - HEALTH-CARE

KW - CLIENTS

KW - COMPASSION

KW - REAPPRAISAL

KW - AGGRESSION

KW - STRESS

KW - VALIDATION

KW - PSYCHOLOGY

U2 - 10.1111/jpm.12506

DO - 10.1111/jpm.12506

M3 - Article

VL - 25

SP - 582

EP - 600

JO - Journal of Psychiatric and Mental Health Nursing

JF - Journal of Psychiatric and Mental Health Nursing

SN - 1351-0126

IS - 9-10

ER -