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Purpose Although it is recommended that reflective practice groups (RPGs) are used to support staff in inpatient intellectual disability (ID) services, there is to date no research on their effectiveness or how staff perceive RPGs in these settings. This paper aims to evaluate staff perceptions of the RPGs in an assessment and treatment unit for people with ID and to ascertain the nature of any barriers for staff in attending the group. Design/methodology/approach Thirteen staff completed questionnaires ascertaining their views on the purpose, process and impact of the RPG run within the service. Questionnaires included a version of the clinical supervision evaluation questionnaire (CSEQ; Horton et al., 2008) adapted for this context and a questionnaire designed by the authors examining barriers to attending the group. Findings Staff responses indicated that they valued the group and perceived it as improving their clinical practice and their self-awareness. Staff did not always perceive group sessions as having clear aims and did not perceive the group as enhancing their well-being or their awareness of gaps in their skills. RPGs may be most effective if they form part of a service-wide approach to staff support and development. Originality/value To the best of the authors’ knowledge, this is the first evaluation of RPGs in inpatient ID services. The adapted CSEQ was found to be an easily implemented method of evaluating RPGs in an inpatient ID setting.

Aims and methodTo address the gap in qualitative research examining patients' experiences of ward rounds. In-depth interviews were conducted with five in-patients on an acute mental health ward. Data were analysed using thematic analysis.ResultsData were organised into three first-order themes, positioned within an overarching theme relating to patients' perceptions of the use of power and control within ward rounds.Clinical implicationsSystemic factors may make it difficult to facilitate ward rounds in a manner which leaves patients feeling fully empowered or in control, but there are practical measures to address these issues, drawn from participants' accounts.

Objectives: Although many diagnosed with Bipolar Disorder (BD) choose to manage their moods without medication at some point, their experiences of doing so are not well understood. This paper aims to explore the processes by which people manage bipolar moods without medication. Methods: Ten people diagnosed with BD who do not use medication were interviewed. Analysing their accounts using grounded theory methods led to developing a model of how they perceive the processes involved in managing moods without medication. Results: Participants engaged in repeated evaluative processes around their strategies for managing moods. Some participants decided not to influence elevated moods due to their perceived advantages. Participants' intentions and actions were influenced by their perceptions of themselves and by the meanings they attached to bipolar moods, which were in turn influenced by feedback from others. Conclusions: The complexity of the processes described by participants suggests that traditional models of explaining non-adherence may over-simplify some individuals' experiences. Future research could focus on identifying factors predictive of successful attempts to manage moods without medication. Professionals should place more emphasis on non-medication approaches in order to increase engagement with people who do not use medication. This may involve focussing on individual's longer-term goals rather than on modifying moods in shorter-term. Conclusions are based on participants who had experienced significant bipolar moods, but who largely seemed satisfied living without medication. Limitations: Future research should ascertain whether such processes apply to a wider group of individuals who do not use medication for bipolar moods. & 2014 Published by Elsevier B.V.