Compassionate Care in a Crisis Resolution and Home Treatment Setting: A Thematic Analysis

Abstract

Background: Compassion has been positioned as an integral element of healthcare delivery (Care Quality Commission, 2011) and service users have highlighted the need for increased compassion in crisis resolution and home treatment team (CRT) settings. Despite this, it remains unclear how the term ‘compassionate care’ is understood by CRT stakeholders, and how it can be consistently actualised at individual and service levels. Aims: This study aims to elucidate CRT staff conceptualisations of compassionate care, as well as the perceived barriers to, and facilitators of compassionate care within a CRT setting. Methodology: This qualitative study used individual, semi-structured interviews to explore staff conceptualisations of compassionate crisis care, and the facilitators and barriers to this in a crisis team setting. Twelve CRT staff members took part in the study. The resultant data were analysed using reflexive thematic analysis. Results: Four main themes and several related subthemes were generated from the study data. The main themes were: Going the Extra Mile; The Operation of Social Power; Centrality of Team Processes; and The Balancing Act. Conclusions: The findings provide an insight into CRT staff members’ understanding and experience of compassionate care in crisis teams. Compassionate crisis care was characterised as involving an ethos of ‘going the extra mile’ in various ways, such as through efforts at creating consistency in CRT care. The findings also highlight the importance of attending to compassionate crisis care as a complex, relational phenomenon, involving dynamics of social power. Further, processes within the team, and the tension caused by several dilemmas, such as the risk of perpetuating CRT dependence, were highlighted as central to understanding the generation and sustenance of compassionate crisis care. Overall, participants highlighted the need to understand and facilitate compassionate crisis care provision from organisational, service and policy levels, as well as at individual and relational levels.