Virtual reality as a tool to promote wellbeing in the workplace.

Background: NHS staff are disproportionately impacted by workplace stress, threatening not only quality of service delivery, but the sustainability, of this vital healthcare system. There is an urgent need for accessible and cost-effective interventions that promote the wellbeing of this integral workforce. Aim: The aim of this study was to explore the potential propensity of a short virtual reality (VR) nature experience, delivered during the workday, to induce positive mood states NHS clinicians. Method: NHS clinicians working in a fast-paced trauma service were offered the opportunity to take part in a short virtual reality (VR) relaxation session, during their working day, in which they were able to explore the "Green Meadows" experience available within the Nature Treks application. An indication of physiological arousal (heart rate) was obtained, and subjective measures of emotional state were employed to assess the effect of the intervention on participants' mood. Further, feedback was gathered to provide an initial indication of the acceptability of the experience. Results: Analysis of data from 39 clinicians revealed that, following the VR experience, participants reported significantly increased feelings of happiness (p < 0.001) and relaxation (p < 0.001), and significantly decreased feelings of sadness (p = 0.003), anger (p < 0.001) and anxiety (p < 0.001). No significant differences in reported levels of surprise (p = 0.603) or vigour (p = 0.566) were found. Further, the experience was associated with a significant reduction in heart-rate (p = 0.025), and had high acceptability ratings, despite participants' varied experience with computers and VR technology. Conclusions: The findings of this study indicate that the administration of VR for the promotion of NHS staff wellbeing in the workplace is a potentially fruitful avenue of exploration that warrants further investigation.

Considerations for minority ethnic young people in multisystemic therapy.

Research has indicated that multisystemic therapy (MST) is an effective treatment for youth with antisocial behaviours (Painter & Scannapieco, 2009). This qualitative study explored minority ethnic young peoples' experiences of MST, focusing on their understanding of their presenting difficulties and aspects of the intervention which facilitated or hindered engagement and change. Seven semi-structured interviews were conducted with London-based young people who had taken part in MST. A constructivist version of grounded theory analysis was employed. Culture-specific theoretical codes emerged; understanding the family culture and the practitioner acting as a cultural broker, consideration of acculturation differences within the family, exploring the young person's cultural identity and reflecting on cultural differences in the therapeutic relationship. Findings suggest potential advances to MST practice to meet the needs of minority ethnic young people, including the importance of appropriate training and supervision, sensitively working with salient cultural issues such as the impact of acculturation, and consideration of the role of therapist ethnicity and culture.

Multisystemic Therapy (MST) for Youth Offending, Psychiatric Disorder and Substance Abuse: Case Examples from a UK MST Team.

BACKGROUND: The paper illustrates the MST treatment model with three types of presenting problem in young people aged 14-15. METHOD: The MST model is described and then illustrated with detailed case material from a violent young person convicted of robbery, a young person with a history of serious self-harming behaviour and hospitalisation, and a young person persistently smoking cannabis. RESULTS: All three cases improved after the MST intervention despite disparate presenting problems that included re-offending, the elimination of self-harming behaviour and a significant reduction in the use of cannabis. The three young people were re-integrated into the education system. CONCLUSION: This case series illustrates the potential uses of the MST model in CAMHS although RCT data are needed to replicate the effectiveness of MST in the British context.