Are coach education programmes the most effective method for coach development?

The purpose of this study is to establish whether coaches from a multi-sport context develop most effectively through coach education programmes and whether formal learning is fostering coach effectiveness. A sample of eight qualified male multi-sports’ coaches participated with an age range of 24 to 52 years (M = 32.6, ± = 8.9) and 9 to 18 years coaching experience (M = 12.6, ± = 3.8). Qualitative semi structured interviews were employed, lasting approximately 30 to 60 minutes. The data then underwent a thematic analysis process reducing the data into six overarching themes: values of the coach; the coach’s role on athlete development; forms of learning; barriers regarding coach education; role of governing bodies; coaches career pathway. The findings of the study indicated coaches access a wide range of sources to enhance their practice, but informal learning was preferred (interacting with other coaches and learning by doing). This resulted from numerous barriers experienced surrounding the delivery, cost and access to coach education programmes preventing coaches from progressing through the pathway. However, coaches in the study feel coach education should be a mandatory process for every coach. The findings have implications for policymakers and sport organisations in developing their coach education structure.

Care planning for aggression management in a specialist secure mental health service: user involvement

This paper describes an audit of prevention and management of violence and aggression care plans and incident reporting forms which aimed to: (i) report the compliance rate of completion of care plans; (ii) identify the extent to which patients contribute to and agree with their care plan; (iii) describe de-escalation methods documented in care plans; and (iv) ascertain the extent to which the de-escalation methods described in the care plan are recorded as having been attempted in the event of an incident. Care plans and incident report forms were examined for all patients in men's and women's mental health care pathways who were involved in aggressive incidents between May and October 2012. In total, 539 incidents were examined, involving 147 patients and 121 care plans. There was no care plan in place at the time of 151 incidents giving a compliance rate of 72%. It was documented that 40% of patients had contributed to their care plans. Thematic analysis of de-escalation methods documented in the care plans revealed five de-escalation themes: staff interventions, interactions, space/quiet, activities and patient strategies/skills. A sixth category, coercive strategies, was also documented. Evidence of adherence to de-escalation elements of the care plan was documented in 58% of incidents. The reasons for the low compliance rate and very low documentation of patient involvement need further investigation. The inclusion of coercive strategies within de-escalation documentation suggests that some staff fundamentally misunderstand de-escalation.

Experiences of women in secure care who have been prescribed clozapine for borderline personality disorder

Background: Clozapine is an atypical antipsychotic medicine which can cause significant side-effects. It is often prescribed off-license in severe cases of borderline personality disorder contrary to national treatment guidelines. Little is known about the experiences of those who take clozapine for borderline personality disorder. We explored the lived-experience of women in secure inpatient care who were prescribed clozapine for borderline personality disorder. Findings: Adult females (N=20) participated in audio-taped semi-structured interviews. Transcripts were subject to thematic analysis. The central themes related to evaluation, wellbeing, understanding and self-management; for many, their subjective wellbeing on clozapine was preferred to prior levels of functioning and symptomatology, sometimes profoundly so. The negative and potentially adverse effects of clozapine were explained as regrettable but relatively unimportant. Conclusions: When psychological interventions are, at least initially, ineffective then clozapine treatment is likely to be evaluated positively by a group of women with borderline personality disorder in secure care despite the potential disadvantages.