Essen Climate Evaluation Schema Research Articles

Social Distance Behind Bars: Vergleich der Wahrnehmung des sozialen Klimas während der COVID-19-Pandemie zwischen Insassen und Vollzugsbediensteten in deutschen Gefängnissen

AbstractThe COVID-19 pandemic presented challenges to prison officers and inmates alike. Since it impacted all areas of the working and living environment, it was assumed that the social climate in prison changed as a result. As part of the Corona Behind Bars project, this study had two objectives: first, to compare how the social climate (Essen Climate Evaluation Schema) is perceived by inmates (N = 956) and prison officers (N = 502) as a result of the pandemic. Second, to analyze the impact of the burden of contact restrictions between inmates and prison officers on their respective perceptions of the social climate. In line with the differences between inmates and prison officers reported in the literature, inmates reported significantly higher values on the dimension experienced safety than did prison officers, while prison officers reported significantly higher values on the dimension therapeutic hold. No significant difference was found for the dimension inmate cohesion. Compared to norm values both the prison officers and the inmates rated the social climate as clearly below average. The moderation analysis revealed an interaction of status group × burden of contact restriction: The impact of the burden of contact restriction on social climate perception was more pronounced for inmates than for prison officers. Overall, the results suggest that the perception of the social climate was adversely affected by the pandemic for the prison officers and the inmates. However, the specific factors contributing to this deterioration appear to be group-specific.

Developing ward social climate and sense of community within a high security forensic psychiatric service: Evaluating a sense of community and social climate intervention

ABSTRACT Inpatient ward social climate and sense of community can influence the recovery and care experiences of forensic mental health patients. This research evaluated an intervention designed to improve social climate and sense of community within a high-secure psychiatric hospital in the UK. The intervention was offered across six wards: two wards received the full intervention, two received the partial intervention, and two received no intervention (control). Social climate and sense of community were measured prior to the start of the intervention 6 and 18 months into the intervention, using the Essen Climate Evaluation Schema and the Sense of Community Index-2. Changes in frequency of disruptive behaviour were also monitored across time points. Results revealed that the full and the partial intervention groups reported greater feelings of social climate than the control group. This effect was also observed across time points, with higher social climate scores in the full and partial intervention groups compared to control group at 6 and 18 months. Furthermore, social climate scorespredicted a significant reduction in frequency of incidents across time in the full intervention. These findings provide longitudinal evidence of the importance of developing ward social climate and sense of community within forensic inpatient settings.

The SECURE STAIRS framework: preliminary evaluation of the impact on therapeutic climate in a secure children’s home (SCH)

PurposeThe SECURE STAIRS framework for integrated care is a trauma-informed approach to supporting staff and young people within the Children and Young People’s Secure Estate (CYPSE) in the UK. Within secure settings, therapeutic climate is a concept that encapsulates an individual’s perception of safety, connectedness with others and level of support within the environment. To support evaluation of the SECURE STAIRS framework, a Secure Children’s Home (SCH) within the North East of England examined therapeutic climate for staff and young people annually using the Essen Climate Evaluation Schema (EssenCES) over a three-year period. This paper aims to present the findings.Design/methodology/approachOver the three years, a total of 71 young people and 214 staff EssenCES questionnaires were administered. Between 2020 and 2021, the setting also experienced significant changes resulting from the COVID-19 pandemic. Numbers of young people also decreased within the setting over the three-year period.FindingsResults indicated a positive trend for therapeutic climate sub-scores. For example, Experienced Safety for young people significantly increased from 2020 to 2021. Additionally, therapeutic hold for staff was significantly higher in 2020 and 2021 in comparison to 2018.Originality/valueFindings are discussed in relation to implementation of the SECURE STAIRS framework and providing trauma-informed care for vulnerable young people within secure settings. Implications for practice are explored.

Immigrant Patients Adapt to the Culture of Admission and Experience Less Safety in Forensic Psychiatric Care.

Patients with an immigrant background are overrepresented in forensic psychiatric hospitals. As a result, daily work is impeded by language barriers and cultural differences. Furthermore, general therapy processes have not yet been adapted to this special patient population, and little reliable knowledge is available. All immigrants go through an acculturation process, which is related to their mental well-being. Four acculturation strategies exist: integration, separation, assimilation, and marginalization. The strategy chosen depends on the extent of someone’s orientation toward their country of origin and the country of admission. The current study aimed to expand knowledge of forensic patients with a migration background in Germany by evaluating their self-reported acculturation processes and associated individual and social factors, e.g., the ward climate. Therefore, we studied forensic patients with a migration background from 11 forensic hospitals in Bavaria, Germany. Besides completing the Frankfurter Acculturation Scale (FRACC) and Essen Climate Evaluation Schema (EssenCES), the participants provided information on their clinical and biographical history. We recruited 235 patients with a migration background and found that the participants oriented themselves more toward the culture of admission and less toward the country of origin than the reference sample did. Moreover, the patients experienced significantly less safety on the ward than the forensic reference sample did. A possible explanation for the patients’ orientation is the lack of possibilities to adhere to their cultural traditions. Patients may feel less safe because of their limited knowledge of German and cultural misunderstandings.

‘Grounding a PIE in the sky’: Laying empirical foundations for a psychologically informed environment (PIE) to enhance well‐being and practice in a homeless organisation

While psychologically informed environments (PIEs) are gaining in prominence in efforts to improve well-being and practice in the homeless sector, their empirical foundations remain tenuous. We present a unique scoping needs analysis of staff and client well-being, staff attitudes and the social-therapeutic climate in a UK-based homeless prevention organisation (prior to PIE implementation). Our aims were: (a) to apply a robust framework to pinpoint need and target forthcoming PIE initiatives and (b) to establish a validated needs baseline that informs and measures efficacy of PIE for its future development. Four established personal and practice well-being measures were administered to 134 (predominantly 'frontline') staff and 50 clients. Staff completed the: Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS), Professional Quality of Life Scale (measuring compassion satisfaction [CS], burnout [BO] and secondary traumatic stress [STS]), Attitudes related to Trauma-informed Care Scale (ARTIC-10; measuring practice attitudes towards trauma-informed values) and the Essen Climate Evaluation Schema (EssenCES; measuring perceptions of client cohesion, safety and practitioner relationships in housing projects). Clients completed the WEMWBS and EssenCES. Vulnerability to STS was evident in nearly two-thirds of frontline staff and it was a statistically significant predictor of BO. It was not, however, associated with lesser levels of CS. We discuss this complex dynamic in relation to highlighted strategic recommendations for the PIE framework, and the identified potential challenges in implementing trauma-informed and reflective practice in the organisation. We conclude with a critique of the value and the lessons learnt from our efforts to integrate stronger empirical substance into the PIE approach.

The Effects of the Civility, Respect, and Engagement in the Workplace (CREW) Program on Social Climate and Work Engagement in a Psychiatric Ward in Japan: A Pilot Study.

Background: Good social climate and high work engagement are important factors affecting outcomes in healthcare settings. This study observed the effects of a program called Civility, Respect, and Engagement in the Workplace (CREW) on social climate and staff work engagement in a psychiatric ward of a Japanese hospital. Methods: The program comprised 18 sessions installed over six months, with each session lasting 30-min. Participation in the program was recommended to all staff members at the ward, including nurses, medical doctors, and others, but it was not mandatory. A serial cross-sectional study collected data at four time-points. Nurses (n = 17 to 22), medical doctors (n = 9 to 13), and others (n = 6 to 10) participated in each survey. The analysis of variance was used to evaluate the changes in the following dependent variables, the Essen climate evaluation schema (EssenCES), the CREW civility scale, and the Utrecht work engagement scale (UWES) over time. Result: We found no significant effects. The effect size (Cohen’s d) for EssenCES was 0.35 from baseline to post-installation for all staff members. Effect sizes for EssenCES for medical doctors and UWES for nurses were 0.79 and 0.56, respectively, from baseline to post-program. Conclusions: Differences in social climate and work engagement among Japanese healthcare workers between the baseline and post-installation of the CREW program were non-significant.

Living conditions of migrants in bavarian forensic psychiatry – acculturation, language competence and perceived ward climate

IntroductionFrom 2014 on, the rate of persons with a migration background in Germany rose steadily, in forensic psychiatric hospitals even disproportionally. Although daily work is aggravated through language barriers and cultural differences, general therapy processes have not been appropriately adapted yet and extensive research is lacking.ObjectivesTherefore the aim was to get a picture of the current situation of patients with a migration background in 11 Bavarian forensic psychiatry.Methods237 Patients with a migration background (first or second generation) were asked about their sociocultural background, their acculturation tendency (by rating the Frankfurter Acculturation Scale), their German language ability and their estimation of the ward climate (by the Essen Climate Evaluation Schema).Results51.8% of the participants were able speak German on an A- level, 13.1% on a B- level and 35.1% on a C- level. Patients of our sample oriented themselves more towards Germany and less towards their country of origin, compared to the control sample. Further, they experienced safety significantly lower and patient cohesion and mutual support higher than the forensic reference sample.ConclusionsOne possible explanation for the patients’ orientation is the lack of possibilities to act out their cultural traditions. Because of the patients’ limited German knowledge and cultural misunderstandings, they could feel less safe. To conclude, the group of patients with a migration background is important not solely due to its size. But its heterogeneity makes universally applicable statements not easy. Migration backgrounds have to be considered within the psychiatric setting and individual therapy plans have to be made.

Exploring the social climate in a UK therapeutic community prison: The influence of anti-social personality traits and suicidal ideation

Social climate refers to how an individual experiences and perceives their environment. Within a therapeutic community (TC) prison, social climate is pertinent in supporting residents’ therapy and the therapeutic environment. This study sought to explore the relationship between social climate, assessed using the Essen Climate Evaluation Schema (EssenCES), and anti-social personality traits, suicidal ideation and suicide potential as measured using the Personality Assessment Inventory (PAI). Data from a total of 167 adult male residents within a UK TC prison was included in the analysis. Correlational analysis revealed that anti-social personality traits were not significantly correlated with social climate. Suicidal ideation was also not significantly correlated to social climate. This may be due to the unique setting in which this research was conducted: a TC wherein a therapeutic culture is imperative, which may influence these factors’ effect on social climate. Anti-social personality traits were found to have a significant negative correlation with positive impression management. The results are limited in generalisability; however, this is the first exploration of the impact of anti-social personality traits and suicidal ideation on social climate within a TC. The implications and further limitations are discussed, with directions for future research outlined.

Validating the Essen Climate Evaluation Schema modified for people with learning disabilities in a low-risk secure forensic setting.

Research has shown that an empowering and nurturing yet challenging work climate is beneficial for people receiving clinical services as it increases patient satisfaction, motivation, engagement, therapeutic alliance and functional improvement. Therefore, for inpatients, monitoring, encouraging and understanding ward climate holds considerable potential for improving forensic mental health services. To date, the most widely employed tool for ward-climate, the Essen Climate Evaluation Schema (EssenCES), has been evidenced as useful in medium and high security hospitals, but little tested with people with learning disabilities or in low security services. To establish the internal consistency and factor validity of the EssenCES, modified for easier reading, in a low secure hospital unit for people with learning disabilities. Language in the EssenCES was simplified and picture supplements added to facilitate comprehension. Patients completed the scale as part of their clinical routine, supported by National Health Service (NHS) employed psychology assistants. The research team, entirely independent of NHS staff, extracted data from the electronic records of purposively sampled residents in a low-secure forensic hospital setting for people with learning disabilities. Two hundred and twenty-seven records (70% men) were acquired. The EssenCES was shown to have good factor validity and retained the original three factor model including the subscales: therapeutic hold, safety and cohesion. One single-item from the 'therapeutic hold' subscale was removed to improve the internal consistency (p < 0.05). This study adds preliminary support for the use of the EssenCES (with removal of one item) in individuals with learning disabilities within low-risk secure forensic hospital settings.

Comparing social climate across therapeutically distinct prison wings

PurposeThe purpose of this paper is to explore the social climate of therapeutic wings and mainstream wings within one prison, to identify positive areas of social climate that can be built upon and areas for improvement.Design/methodology/approachIn total, 1,054 social climate questionnaires (the Essen Climate Evaluation Schema – EssenCES) were sent to prisoner-facing staff and all prisoners within an English Category B prison holding indeterminate sentenced prisoners. Perceptions of social climate on therapeutic wings and mainstream wings and perceptions of social climate between staff and prisoners were compared.FindingsThe results showed that the therapeutic wings felt safer, there were better staff-prisoner relationships and there was better peer support among prisoners than people on the mainstream wings. Also, prisoners felt safer than staff, staff rated the overall social climate as more positive than prisoners and staff felt that they supported prisoners, but prisoners did not feel the same.Research limitations/implicationsThe main limitation is that the EssenCES measure does not explain the participants’ ratings of the social climate.Practical implicationsThere is a need to transfer the principles and values of therapeutic wings to mainstream wings. In addition, there is significant room for improvement in the social climate of this prison.Originality/valueThis is the first study to compare the social climate of therapeutic and mainstream wings within one single prison. The research has a valuable contribution to the development of positive social climates conducive to better clinical outcomes.

Impact of the implementation of the safewards model on the social climate on adolescent psychiatric wards.

The Safewards model was created to reduce conflict and containment in psychiatric inpatient units. The model suggests alternative methods for containment and aims to create a safer hospital experience for both patients and staff. The evaluation of this model has provided evidence that it might be implemented on adolescent psychiatric wards. This study evaluated the impact of the implementation process of the Safewards model on the social climate of adolescent psychiatric inpatient wards by using the Essen Climate Evaluation Schema questionnaire. The study was carried out on six closed wards of one Finnish hospital district. Data were collected at baseline (42 adolescent inpatients and 134 staff members) and after the implementation of the model (39 inpatients and 115 staff members). The data were analysed using the Mann-Whitney U-test. The findings of this preliminary study indicate that inpatients' experience of patient cohesion and therapeutic hold and staff members' experience of safety on adolescent psychiatric wards might be improved by the implementation of the Safewards model on adolescent psychiatric wards.

Social climate and aggression in IDD services

PurposeThe purpose of this paper is to adapt a social climate measure for use within a forensic intellectual and developmental disabilities (IDD) service and examine perceptions of social climate and the links with patient aggression across three levels of security.Design/methodology/approachFour staff participated in a focus group to discuss how the Essen Climate Evaluation Schema (EssenCES) could be adapted for IDD patients. Subsequently, a pilot study with three patients highlighted some difficulties in administering the adapted measure. Alterations in the administration of the measure were implemented with a further ten patients residing across three levels of security. The EssenCES was adapted to include more visual prompts to assist in the patients’ completion of the measure. The frequency of aggressive incidents in each of the three settings was also collated.FindingsStatistical analysis revealed a non-significant trend where positive social climate ratings increased as the security level decreased. There was a significant difference in the frequency of aggressive incidents across the three levels of security; however, there were no significant relationships found between the questionnaire ratings and the frequency of incidents.Research limitations/implicationsThe results lacked statistical power due to the low number of participants. Further studies with adapted social climate measures need to be conducted to assess the implications of social climate on individuals with IDD in secure forensic services.Originality/valueThe study adapted and piloted a social climate measure for individuals in a forensic IDD service.

"There's More to It Than Just a Box Check ": Measuring Prison Climate in Three Correctional Facilities.

The imperative to heed social environment and power of the situation, particularly as applied to prison settings, dates to the 1971 Stanford Prison Experiment; the widely cited study concluded that situational factors, not personality, created the damaging conditions observed. Despite critical need for research on prison climate, measurement has met stiff challenges, and little research on prison culture exists in the United States. This study applies a 17-item scale, primarily based on Essen Climate Evaluation Schema (EssenCES), an instrument validated in Australia, Germany, and the United Kingdom. It was administered to inmates and staff in three correctional facilities in the U.S. Midwest, one medium security and two maximum security. Survey results demonstrate higher levels of cohesion at the medium-security facility, but multivariate analysis suggests a much more complex relationship between facility and environment, varying particularly in response to perceived inmate threat. Qualitative data suggest that understanding these associations is vital to building socially adaptive conditions and prosocial change.

Ward Climate in a High-Secure Forensic Psychiatric Setting: Comparing Two Instruments

The psychometric properties and associations between the Essen Climate Evaluation Schema (EssenCES) and the Group Climate Instrument-revised (GCI-r) were examined. These self-report questionnaires assessing ward climate were filled out by 123 male patients, residing in 3 high-secure forensic psychiatric facilities. Good internal consistency was found for all subscales of both instruments. The original factor structure was confirmed for the EssenCES, but not for the GCI-r. Bivariate correlation analyses indicated that the instruments measure related concepts. The results of this study call for further development and validation and for finding common grounds in the definition and operationalization of ward climate.

Positive Effects of an Anti-Aggression and De-Escalation Training on Ward Atmosphere and Subjective Safety May Depend on Previous Training Experience.

Anti-aggression and de-escalation (ADE) trainings of health-care professionals working on psychiatric inpatient wards have been shown to increase staff knowledge and confidence, which could be connected with higher subjective safety. Additionally, a potential reduction of aggressive incidents could improve ward atmosphere. Thus, the current study aimed to investigate the effects of ADE training on ward atmosphere and subjective safety. In 2015, an ADE training was established at the Psychiatric University Clinics (UPK), University of Basel. Nursing staff from 22 wards received theoretical and practical training over the course of 5 days. Ward atmosphere and subjective safety were assessed using the Essen Climate Evaluation Schema (EssenCES). A total of 46 people had been assessed in 2012 before training implementation (baseline), and 45 persons in 2016 after implementation. In the 2016 group, 23 people had previously participated in an ADE training, and 22 were first-time participants. Patients’ coherence (p = 0.004), subjective safety (p = 0.004), and ward atmosphere (p = 0.001) were rated significantly higher by first-time ADE training participants compared to baseline, and patients’ coherence (p = 0.029) and ward atmosphere (p = 0.011) were rated significantly higher by first-time ADE training participants than by nurses with prior ADE training. There were no significant differences regarding any EssenCES ratings by nurses with prior ADE training compared to baseline. ADE training was exclusively connected with higher ratings on most EssenCES scales for first-time participants. This indicates that the positive effects of ADE training may depend on previous training experience.

Predictors of quality of life among inpatients in forensic mental health: implications for occupational therapists

Optimising quality of life (QOL) for service users in a forensic hospital is an important treatment objective. The factors which contribute to QOL in this setting are currently unclear. The aim of this study was to analyse the predictors of QOL amongst service users within an inpatient forensic mental health hospital. This study is a naturalistic, cross-sectional, observational study. Fifty-two male service users with schizophrenia or schizoaffective disorder participated in the study. QOL was measured using the World Health Organisation QOL Bref. We used the Engagement in Meaningful Activity Survey (EMAS), ward atmosphere was measured using the Essen Climate Evaluation Schema (EssenCES), occupational functioning was assessed using the Social and Occupational Functioning Scale (SOFAS). We also collected level of ward security, length of stay and community leave data. Stepwise regression showed that meaningful activity, level of ward security, and therapeutic hold on the EssenCES significantly predicted QOL on a range of specific QOL domains. These variables accounted for 40% of the variance for total QOL score. Engagement in meaningful activity added the largest contribution to total QOL score accounting for 30% of the variance. This study shows that provision of meaningful activities, level of ward security and therapeutic hold may contribute to QOL amongst forensic mental health inpatients.

Psychometric Properties of the Essen Climate Evaluation Schema (EssenCES) in a Sample of General Psychiatric Wards

ObjectiveThe questionnaire EssenCES (Essen Climate Evaluation Schema) is a widely used instrument to assess social climate in forensic psychiatric and correctional institutions. The purpose of this study was to evaluate the EssenCES in a general psychiatric setting, where it had not previously been evaluated. DESIGN648 staff members and 551 patients from 47 general psychiatric wards across 16 hospitals in Germany completed the EssenCES. Factor-, correlation- and scale-analyses were carried out to inspect the questionnaire's properties. RESULTSThe proposed three-dimensional factor structure of the instrument was confirmed. Results indicated that the EssenCES subscales Patients' Cohesion and Experienced Safety had high internal consistency, whereas elimination of item 16 would improve the internal consistency of Therapeutic Hold. Correlations between the EssenCES subscales and other measures supported the validity of the questionnaire. CONCLUSIONThe results suggest that the EssenCES is suitable for usage in general psychiatric settings. Along with its brevity, it seems useful as an economic and valid screening instrument for a ward's social climate. Reasons are given why item 16 should be retained.

Einfluss einer „Offenen-Tür-Politik“ auf die Stationsatmosphäre: Auswirkungen auf die Behandlungsqualität

To compare the ward atmosphere, safety, therapeutic hold, and patients' coherence on recently opened (1 year), opened (4 years) and open (> 20 years) psychiatric wards in a longitudinal naturalistic study design. The question was if a patient shift from formerly locked to open wards might deteriorate the ward atmosphere on the open and opened wards. Ward atmosphere on two recently opened (n = 2), opened (n = 2) and open (n = 2) wards was examined using the Essen Climate Evaluation Schema (EssenCES) in a follow-up study after 4 years. Structural as well as clinical data were extracted. Global ward atmosphere, safety, and patients' coherence on the recently opened wards was significantly increased; on always opened wards and long-term opened wards it remained unchanged. Coercive measures and discharges against medical advice decreased during the open door process. Opening locked psychiatric wards can help to establish a positive therapeutic atmosphere without changing the therapeutic climate on the other already open wards. A better ward atmosphere might be connected with a better therapeutic quality.

Zusammenhänge des Stationsklimas mit objektiven Rahmenbedingungen psychiatrischer Stationen

Investigate inter-relations of objective conditions and a ward's social climate. Staff and patients on 104 wards filled in the short Essen Climate Evaluation Schema (EssenCES). Assessments were related to setting variables (like open vs. closed wards, forensic vs. general psychiatric wards, ward size, staffing). Setting variables and climate characteristics are strongly associated. The EssenCES, originally catered for forensic settings, proved to be useful to characterize general psychiatric wards. A number of suggestions regarding relevant setting conditions are clearly confirmed (like staffing level; open vs. closed wards). Remarkably, staff experience a higher level of Safety on forensic than on general psychiatric wards. Patients' Cohesion and Therapeutic Hold are rated higher on general psychiatric wards. Heterogeneity of patients (vs. specialization of wards) is not positively related to climate characteristics; staff experiences less Safety on non-specialized wards.

Measuring Social Climate in German Prisons Using the Essen Climate Evaluation Schema

Sociotherapeutic prison units have been criticized for their close operational connection with traditional prison systems. This research compared the social climate of German therapeutic prison units with that of traditional prison units, using the Essen Climate Evaluation Schema (EssenCES). The EssenCES was administered in conjunction with the shortened Correctional Institutions Environment Scale. Results indicate significant differences between therapeutic and traditional units’ social climates, with the former demonstrating more supportive, safe, and therapeutic climates. Findings further confirm the psychometric properties of the EssenCES and support its use as a social climate measurement instrument.