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Background:While counsellor education becomes increasingly culturally diverse, little is known about international trainees' experiences of training.Objective:The present study explores one aspect of training, namely clinical practice from the perspective of international, non-native speaking trainees. In particular, this paper focuses on the challenges this group encounters when practicing in a second language.Methodology:Semi-structured interviews with four non-native English-speaking trainees were conducted and analysed following the principles of interpretative phenomenological analysis (IPA).Results:Findings suggest that participants encounter practical difficulties related to their non-native/foreign identity in practice, such as problems with articulate self-expression and understanding the client's speech. These difficulties generate anxiety and impact on the trainees' confidence.Conclusions and implications for counsellor training:This study elucidates language as a fundamental aspect of culture, and identifies second language use as a significant source of difference in counselling practice. This paper highlights the need for attention to linguistic diversity and for appropriate support during counsellor education. This will improve international trainees' experiences of training, but also enhance all trainees' understanding of difference, resulting in better service provision for the community. [ABSTRACT FROM AUTHOR]

Introduction: This paper describes a qualitative study focusing on counsellors' perceptions of client progression when working with clients who intentionally self‐harm and the impact this has on the therapist. Method: Semi‐structured interviews were employed and the constant comparative method utilised to analyse the data. Findings: Findings indicate that counsellors experience intense emotions in response to self‐harm including: shock; sadness; anxiety; anger; and frustration. Counsellors also struggled to manage the tension between multiple dualities, corresponding to professional opinions of a seemingly polar opposite nature. Although participants indicated a requirement to work in a client‐led way, they all had either an explicit or implicit agenda for change. These two conflicting states create a tension for a counsellor that is difficult to resolve. In addition there were various views of client progression, yet all participants agreed that progression was not simply about stopping self‐harm. Conclusion: There is a significant impact on the counsellor when working with clients who intentionally self‐harm and the complexity of the phenomenon appears to exacerbate their anxiety. Implications: Further research within the counselling field focusing on the ambiguous nature of the subject may increase understanding, which in turn may contribute to greater therapist efficacy when working with this client group. [ABSTRACT FROM AUTHOR]

Aim: To explore therapeutic activities and psychological interventions used by experienced cognitive behavioural and psychodynamic therapists to treat clients with medically unexplained symptoms (MUS). Method: Twelve in‐depth, semi‐structured, qualitative interviews with psychotherapists, recruited from two British National Health Service (NHS) Departments were conducted. Interview transcripts were analysed using grounded theory. Findings: Therapists from two modalities share the following therapeutic activities and psychological interventions in their work with MUS clients: working together with clients, sensitive, empathic responding and building trust, being flexible with techniques, keeping an open mind and multi‐disciplinary cooperation. They also use modality specific interventions discussed in this paper. Even though participants experienced difficulties in forming alliances with MUS clients early on in their work, they expressed the importance of nurturing hope, empowering and engaging clients in jointly constructing understandings, which helps symptom management. [ABSTRACT FROM AUTHOR]