'Conditioning' in forensic settings : nurses' understanding of conditioning processes within the nurse-client relationship, as a precedent to boundary crossings

There is a paucity of literature around 'conditioning' processes prior to boundary transgressions. This study aims to explore how 'conditioning' processes are understood by nurses working with patients in forensic settings, as a precedent to boundary crossings. Design A repertory grid interview technique was used to explore nurses' implicit constructs around the topic of' conditioning'. A content analysis was performed on the grid data set, using participants' ratings, to gain a preliminary understanding of nurses' constructs. A thematic analysis was conducted on the transcripts of the grid interviews, to understand how these constructs were discussed more broadly. Participants Eleven mental health nurses with over one year's experience of working in forensic settings, including medium secure units, were recruited from two forensic services. Results Content analysis of the grids identified 11 categories associated with nurses feeling influenced to cross boundaries. These included having a strong, positive regard for the patient and a lack of awareness for the consequences of the decision. These ideas were further supported by six key themes which emerged from the thematic analysis: 1) Level of decision-making 2) Viewing the patient as a 'person' 3) Over-familiarity 4) Personal identity roles 5) Team cohesiveness 6) Awareness of patients' intentions as inhibiting transgressions. Implications Nurses appeared to draw on internal, unconscious processes, rather than motivated actions of the patient towards them, when crossing boundaries. The implications of these findings and applications to Clinical Psychology are discussed, as well as implications for future research.EThOS - Electronic Theses Online ServiceGBUnited Kingdo