Training staff in a secure psychiatric unit to set boundaries and communicate empathetically with patients

Abstract

The field of ABA has placed recent emphasis on a more compassionate approach, however little research exists on how to train empathetic skills. Empathetic responding is positively associated with a number of factors, including higher satisfaction of care, trust, rapport, compliance to treatment and clinical outcomes. A requirement of empathetic care is reflective listening, which is defined as the listener takes his understanding of what the speaker is verbalizing and puts in his own words before mirroring back his perception to the speaker. Patients who have spent time in psychiatric care emphasize structure and social relationships. Ensuring that structure and safety protocols are followed using limit setting strategies is effective in challenging situations. The present study investigated the effect of behavior skills training in teaching effective boundary setting and empathetic responding in the form of reflective statements among staff members in a psychiatric intensive care unit. Three participants took part in the study and a multiple baseline across participants design was utilized. BST was shown to be effective in training target skills. Reflective responses improved by 26%, 33%, and 38% and the boundary making statements improved by 73%, 30%, and 66% for the three participants from baseline to post-intervention. More research is needed to isolate what has an effect on behavior and whether a lack of skill or lack of motivation maintains employee’s behavior. Using a checklist to assess why staff are not performing as they should would be a good first step.