2021.09 62-2 Psychologists' Experiences on Home-based Mental Health Services for the Bereaved Crime Victims

The mental health issues caused by violent death of family members have attracted a lot of attention, and the bereaved ones may experience both symptoms of trauma and grief, and high mental health risks, such as depression, post-traumatic stress disorder, and complicated grief would also be derived from these incidences. In Taiwan, The Association for the Protection of Crime Victims (AVS) is the main unit that provides psychological trauma recovery services for the victims. This AVS often adopts home-based mental health service delivery mode. However, the home-based mental health service model is not common to the psychologists who have always accepted the office treatment training model. This research is to explore the psychologists' views on the home- based mental health services regarding the bereaved families of crime victims, as well as the challenges perceived during the services and coping strategies.

In this study, a qualitative research method of discovery orientation was used to collect the experiences in home-based mental health service of 12 psychologists (including 4 clinical psychologists, 8 counseling psychologists, a total of 5 males and 7 females) who have more than two years of experience in providing services in a semi-structured interview. The data analysis method adopts analysis strategies such as open coding, axial coding and selective coding based on grounded theory research.

The results indicated that these psychologists' views on home-based mental health services can be divided into four aspects: (1) The origin of home counselling and the meaning of continuous services for psychologists. The origin is to increase the volume of service delivery, and the psychologists are willing to continue to serve because of professional recognition and social responsibility; (2) Advantages of home counseling, including empathy and deep understanding, easy to build relationships naturally. It is beneficial to facilitate emotion and awareness; (3) Adjustments to home-based mental health services, including flexibility to meet client needs and background, immediate adjustment and maintain the treatment structure; (4) The effectiveness and reasons of service, which refer to good counseling effectiveness from being able to manage real life issues and the effectiveness is naturally implemented in life; the limited effectiveness of counseling is related to the lack of preparation of the client, the insufficient dominant power of the psychologist, and the interference in the house environment that affects the depth of the session.

Psychologists perceive the challenge of home counseling with two themes. First of all, the subversion of the inertia of counseling work, including loss of safety and familiarity, and difficulty in controlling the structure of the interview. Second, the blurring of professional roles and relationship boundaries which includes blurred professional roles and the crossing of professional boundaries. In response to challenges, psychologists have developed multiple strategies to ensure personal safety, the structure of meetings, and balance the emotional bond and boundaries of relationships.

Although the origin of home-based mental health services is to increase the rate of service received by bereaved victims, this study believes that the home-based mental health services has the meaning for social justice. The effectiveness of home-based mental health services may be related to the traumatic bereavement process and preparation of the victims. Such service also strengthens the emotional bond between the psychologists and clients.

In addition, it also makes psychologists caught in the pull of emotional bond and boundary. Psychologists would consider maintaining the emotional bond between each other while setting boundaries. This has also prompted researchers to reflect on the norms of therapeutic relations and boundaries under Western counseling education.

 

Keywords
Association for victims support, bereaved crime victims, home-based counseling, mental health service delivery.

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