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Development of a compassion-focused and contextual behavioural environment and validation of the Therapeutic Environment Scales (TESS)

  • David Veale (a1), Sarah Miles (a1), Iona Naismith (a1), Maria Pieta (a1) and Paul Gilbert (a2)...
Abstract
Aims and method

The aims of the study were to develop a scale sensitive enough to measure the interpersonal processes within a therapeutic environment, and to explore whether the new scale was sensitive enough to detect differences between settings, including a community based on compassionate mind and contextual behaviourism. The Therapeutic Environment Scales (TESS) were validated with 81 participants in three different settings: a specialist service for anxiety disorders, a specialist in-patient ward and a psychodynamic therapeutic community.

Results

TESS was found to be reliable and valid. Significant differences were seen between the services on the dimensions of compassion, belongingness, feeling safe, positive reinforcement of members' acts of courage, extinction and accommodation of unhelpful behaviours, inconsistency and high expressed emotion. These processes were over time associated with improved outcomes on a specialist service for anxiety disorders.

Clinical implications

The TESS offers a first step in exploring important interpersonal relationships in therapeutic environments and communities. An environment based on a compassionate mind and contextual behaviourism offers promise for the running of a therapeutic community.

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Copyright
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence to David Veale (david.veale@kcl.ac.uk)
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Declaration of interest

P.G. is a Trustee of the Compassionate Mind Foundation, workshop leader and author of books on a compassionate mind. D.V. and I.N. acknowledge funding support from the Maudsley Charity and salary support from the National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and the IoPPN, King's College London. M.P. acknowledges Capes scholarship (#12499129).

Footnotes
References
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1 Cozolino, L. The Neuroscience of Human Relationships: Attachment and the Developing Brain. Norton, 2007.
2 Cozolino, L. The Social Neuroscience of Education. Norton, 2013.
3 Weng, HY, Fox, AS, Shackman, AJ, Stodola, DE, Caldwell, JZK, Olson, MC, et al. Compassion training alters altruism and neural responses to suffering. Psychol Sci 2013; 24: 1171–80.
4 Veale, D, Gilbert, P, Wheatley, J, Naismith, I. A new therapeutic community: development of a compassion-focussed and contextual behavioural environment? Clin Psychol Psychother 2014; doi: 10.1002/cpp.897.
5 Gilbert, P. An introduction to compassion focused therapy in cognitive behavior therapy. Int J Cog Ther 2010; 3: 97112.
6 Tsai, M, Kohlenberg, RJ, Kanter, JW, Kohlenberg, B, Follette, WC, Callaghan, GM (eds) A Guide to Functional Analytic Psychotherapy: Awareness, Courage, Love, and Behaviorism. Springer Science + Science Media, 2008.
7 Schalast, N, Redies, M, Collins, M, Stacey, J, Howells, K. EssenCES, a short questionnaire for assessing the social climate of forensic psychiatric wards. Crim Behav Ment Health 2008; 18: 4958.
8 Rossberg, JI, Friis, S. A suggested revision of the ward atmosphere scale. Acta Psychiatr Scand 2003; 108: 374–80.
9 Goodman, WK, Price, LH, Rasmussen, SA, Mazure, C. The Yale-Brown Obsessive Compulsive Scale: I. Development, use, and reliability. Arch Gen Psychiatr 1989; 46: 1006–11.
10 Helmstadter, G. Principles of Psychological Measurement. Appleton Century Crofts, 1964.
11 Johnson, R, Haigh, R. Social psychiatry and social policy for the 21st century: new concepts for new needs – the ‘Enabling Environments’ initiative. Ment Health Soc Incl 2011; 15: 1523.
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BJPsych Bulletin
  • ISSN: 2056-4694
  • EISSN: 2056-4708
  • URL: /core/journals/bjpsych-bulletin
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Development of a compassion-focused and contextual behavioural environment and validation of the Therapeutic Environment Scales (TESS)

  • David Veale (a1), Sarah Miles (a1), Iona Naismith (a1), Maria Pieta (a1) and Paul Gilbert (a2)...
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