Forensic Forum - Paper Session.

“The use of reflection for OTS in a forensic personality disorder unit.”

Rawdon CP, Stiles S, Northumberland Tyne and Wear NHS Trust.

There are many different uses and positives to reflecting, one being that effective reflection can inform clinical reasoning and deepen understanding of the behaviours of the above defined clinical group.

Within this paper Gibbs model of reflection was used by both staff and patients.

Staff reflection – Why?

·         Transfererance of emotions

·         Boundaries

·         Entitlement

·         Behaviours

·         Stops taking work/emotions home.

How?

·         Supervision

·         Reflective practice

·         Informal reflection

·         Humour

·         Peer reflection.

Patient reflection – why?

·         Enables ‘enlightenment’

·         Helps them clarify and make sense of things.

·         Helps them to visually and cognitively see problems and the solutions.

When using reflective methods with patients it is important to be careful of patient discomfort when flaws are laid out in front of them – no one likes to come face to face with their flaws! Also try and minimise as much as possible the feeling of always being watched/scrutinized and judged.

I really liked the idea of this paper, which was to encourage both MDT and patient uptake in reflective practice however I think the chosen model could be altered. From my personal opinion although I think that the Gibbs model has some definite positive points there are so many other, newer, models out there which could be utilised. For example I like Driscolls cycle (2000) as it is a more simplified model and would suit a wider range of patients perhaps, especially if they have any cognitive or processing difficulties. Also Johns model of reflection (1994) has been helpful over my three years of studying.