A systematic review and narrative synthesis of indirect psychological intervention in acute mental health inpatient settings

Objectives: Psychologists frequently deliver indirect psychological interventions in mental health inpatient settings to support staff to reflect upon and improve their clinical practice. However, research into these interventions is sparse. Therefore, this study aimed to undertake a systematic review and narrative synthesis of the indirect psychological interventions used in mental health inpatient settings. Methods: MEDLINE, PsycINFO and Embase were searched for eligible studies and forward citation searching was undertaken. A narrative synthesis was undertaken to synthesise results. The quality of studies was assessed using the Mixed Methods Appraisal Tool. Results: Ten studies were included in the review, and all utilised a small to moderate sample size. We identified five categories of interventions involving a range of methodologies and the studies were assessed to be of good to adequate quality. The most common type of indirect intervention employed were case formulation sessions. Other types of indirect interventions included formal clinical supervision, reflective practice, and staff practice-based education sessions. Overall, the utilisation of indirect psychological interventions shows promise, particularly clinical case formulation sessions. Conclusions: Exploration of indirect psychological interventions within mental health inpatient settings can have useful implications for the service users and for the provision of care as a professional member of the ward. Additional larger-scale research is required to further develop the evidence-base of indirect interventions for this setting