The Significance of Ethics Reflection Groups in Mental Health Care: A Focus Group Study Among Health Care Professionals

Course overview

Course Description: This course is based on material published in BMC Medical Ethics and is available as an open-access article. Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of 'bricolage' which means our approach was inductive. Most participants report positive experiences with participating in ethics reflection groups: A systematic and well-structured approach to discuss ethical challenges, increased consciousness of formal and informal coercion, a possibility to challenge problematic concepts, attitudes and practices, improved professional competence and confidence, greater trust within the team, more constructive disagreement and room for internal critique, less judgmental reactions and more reasoned approaches, and identification of potential for improvement and alternative courses of action. On several wards, the participation of psychiatrists and psychologists in the reflection groups was missing. The impact of the perceived lack of safety in reflection groups should not be underestimated. Sometimes the method for ethics reflection was utilized in a rigid way. Direct involvement of patients and family was missing. This focus group study indicates the potential of ethics reflection groups to create a moral space in the workplace that promotes critical, reflective and collaborative moral deliberations. Future research, with other designs and methodologies, is needed to further investigate the impact of ethics reflection groups on improving health care practices. This course on ethical challenges in mental health care is designed for clinical social workers, psychologists, professional counselors, nurses, and substance abuse counselors who do clinical work. This course is appropriate for intermediate and advanced level practitioners who wish to develop their expertise with ethical challenges in mental health care. The course material includes a literature review of research. It may also be useful for licensed clinicians who require continuing clinical education courses for license renewal. The course is based on a journal article that includes research. It contains statistical analysis and data that some clinicians enjoy reading and others do not. A significant benefit of reading peer reviewed research-based articles for continuing education is that they provide practitioners with the latest findings in their field. Authors: Hem, Molewijk, Gjerberg, Lillemoen, Pedersen Learning Objectives: This course will provide the practitioner with detailed information regarding ethical challenges in mental health care. Specifically, a professional will: Recognize the effects of coercion in health care Describe experiences from systemic reflection on ethical challenges in mental health care Identify strategies for improving interdisciplinary cooperation Citation: Hem, M. H., Molewijk, B., Gjerberg, E., Lillemoen, L., & Pedersen, R. (2018). The significance of ethics reflection groups in mental health care: a focus group study among health care professionals. BMC medical ethics, 19(1), 54. https://doi.org/10.1186/s12910-018-0297-y