Ellis, Rachael and Smith, Ian (2016) How do adolescents experience relationships during admission to a psychiatric inpatient unit? PhD thesis, Lancaster University.
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Abstract
This thesis, comprised of a literature review, research paper and critical appraisal, employs qualitative methods to explore the experiences of adolescents who have been admitted to an inpatient psychiatric unit and those who may come into contact with mental health services as a result of their self-harm. The literature review focusses upon young peoples’ experiences of self-harm. This review aimed to contribute to current understanding of self-harm and consider how young peoples’ qualitative experiences relate to the findings of quantitative literature. Existing literature was synthesised in accordance with Noblit and Hare’s (1988) meta-ethnographic approach. The findings of this review are discussed in relation to current theoretical perspectives and the clinical implications are explored. The research paper explores ten adolescents’ experiences of their relationships during admission to a psychiatric inpatient setting using interpretative phenomenological analysis (Smith, Flowers & Larkin, 2009). Participant’s reflected on the complexity of their relationships with professionals. These reports highlighted the tension between their perceptions of professionals who were, simultaneously, perceived to be friends and experts. Young people also reflected upon the intense and meaningful relationships they developed with their peers and the impact of witnessing their friends’ distress. Finally, young people experienced their admission as a period of respite from relational stressors within their usual environment. Admission was also experienced as an opportunity to repair ruptured relationships and experience different ways of relating to others. These themes are discussed with reference to psychological theory and implications for clinical practice are considered. Finally, in the third section of this thesis I discuss my epistemological position, further consider the strengths and weaknesses of the research and reflect on the challenges I encountered when conducting this research.