{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T19:25:06Z","timestamp":1785871506498,"version":"3.56.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T00:00:00Z","timestamp":1605139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Criminal Behav Ment Health"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>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\u2010climate, 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>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\u2010secure forensic hospital setting for people with learning disabilities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Two hundred and twenty\u2010seven records (70% men) were acquired. The EssenCES was shown to have good factor validity and retained the original three factor model including the subscales: <jats:italic>therapeutic hold, safety<\/jats:italic> and <jats:italic>cohesion<\/jats:italic>. One single\u2010item from the \u2018<jats:italic>therapeutic hold\u2019<\/jats:italic> subscale was removed to improve the internal consistency (<jats:italic>p<\/jats:italic> &lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study adds preliminary support for the use of the EssenCES (with removal of one item) in individuals with learning disabilities within low\u2010risk secure forensic hospital settings.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cbm.2175","type":"journal-article","created":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T18:00:27Z","timestamp":1605204027000},"page":"143-150","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Validating the Essen Climate Evaluation Schema modified for people with learning disabilities in a low\u2010risk secure forensic setting"],"prefix":"10.1002","volume":"31","author":[{"given":"Lindsie","family":"Barker","sequence":"first","affiliation":[{"name":"Tees Esk and Wear Valley NHS Foundation Trust  Teesside UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"McKeown","sequence":"additional","affiliation":[{"name":"NHS Cumbria Northumberland and Tyne and Wear Local Area Team  Newcastle UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Small","sequence":"additional","affiliation":[{"name":"Tees Esk and Wear Valley NHS Foundation Trust  Teesside UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7333-9775","authenticated-orcid":false,"given":"Jenny","family":"Meggs","sequence":"additional","affiliation":[{"name":"Lancaster University Lancaster  Lancaster UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,12]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2011.05.011"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/01612840701869858"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/01612840701354513"},{"key":"e_1_2_6_5_1","first-page":"156","article-title":"Assessing the social climate of Australian prisons","volume":"427","author":"Day A.","year":"2011","journal-title":"Trends & issues in crime and criminal justice"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/14789949.2014.903505"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0306624X8803200310"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2006.01608.x"},{"key":"e_1_2_6_9_1","volume-title":"Principles of psychological measurement","author":"Helmstadter G.","year":"1964"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/cbm.745"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1348\/1476083042555415"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/09585189708412015"},{"issue":"27","key":"e_1_2_6_13_1","first-page":"1","article-title":"Violent events, ward climate and ideas for violence prevention among nurses in psychiatric wards: A focus group study","volume":"10","author":"Lantta T.","year":"2016","journal-title":"International Journal of Mental Health Systems"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cbm.791"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1176\/ps.47.7.721"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0447.2001.00102.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/cbm.1878"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0026600"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-6712.2008.00597.x"},{"key":"e_1_2_6_20_1","first-page":"171","volume-title":"The Essen Climate Evaluation Schema measure of social climate in a secure service for people with intellectual disabilities","author":"Quinn M.","year":"2012"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/08039480600583894"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0447.2003.00191.x"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0447.2003.02082.x"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0020764008090689"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/cbm.677"},{"key":"e_1_2_6_26_1","volume-title":"Handbook of learning disabilities","author":"Swanson H. 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