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Purpose: The purpose of the paper is to present an integrated methodology for identifying trends in a particular subject area based on a combination of advanced text mining and expert methods. The authors aim to test it in an area of clinical psychology and psychotherapy in 2010–2019. Design/methodology/approach: The authors demonstrate the way of applying text-mining and the Word2Vec model to identify hot topics (HT) and emerging trends (ET) in clinical psychology and psychotherapy. The analysis of 11.3 million scientific publications in the Microsoft Academic Graph database revealed the most rapidly growing clinical psychology and psychotherapy terms – those with the largest increase in the number of publications reflecting real or potential trends. Findings: The proposed approach allows one to identify HT and ET for the six thematic clusters related to mental disorders, symptoms, pharmacology, psychotherapy, treatment techniques and important psychological skills. Practical implications: The developed methodology allows one to see the broad picture of the most dynamic research areas in the field of clinical psychology and psychotherapy in 2010–2019. For clinicians, who are often overwhelmed by practical work, this map of the current research can help identify the areas worthy of further attention to improve the effectiveness of their clinical work. This methodology might be applied for the identification of trends in any other subject area by taking into account its specificity. Originality/value: The paper demonstrates the value of the advanced text-mining approach for understanding trends in a subject area. To the best of the authors' knowledge, for the first time, text-mining and the Word2Vec model have been applied to identifying trends in the field of clinical psychology and psychotherapy. [ABSTRACT FROM AUTHOR]

Purpose: Bipolar disorder is associated with poor mental and physical health outcomes, and therefore, it is crucial to research and develop effective interventions for this population (Grande et al., 2016). Unfortunately, research on the efficacy of current interventions shows only small improvements in symptoms and quality of life (Oud et al., 2016). Additionally, individuals with bipolar disorder face barriers to accessing care like social stigma, isolation and financial constraints (Blixen et al., 2016). This paper aims to introduce and examine the effectiveness of an accessible, peer-led group program, Mood Lifters (Votta and Deldin, 2022), in those who completed the program and also self-reported a diagnosis of bipolar disorder. Design/methodology/approach: Mood Lifters is a 15-week, peer-led group program that approaches mental wellness from a biopsychosocial framework using strategies from a variety of evidence-based treatment methods (e.g. cognitive-behavioral therapy, dialectical behavior therapy, interpersonal psychotherapy, etc.). Participants meet once a week for 1 hour to review various mental health topics, including behavioral changes and insight into mood patterns. Individuals who participated in nonacademic groups in a company setting and self-reported a bipolar diagnosis were surveyed at the beginning and end of their program to measure various aspects of psychological functioning. Findings: Results suggest that these individuals experienced significant improvements in depression, anxiety, social functioning and perceived stress, along with flourishing and positive and negative affect. Originality/value: These findings are promising, given that bipolar disorder is historically difficult to treat (Grande et al., 2016). Based on this preliminary evidence, the authors have developed a Mood Lifters program specifically for individuals with bipolar disorder and are launching a randomized control clinical trial. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to understand the lived experience of people with intellectual disability of their anxiety and of being co-design partners in developing a multi-component approach to the management of anxiety. Design/methodology/approach: The development of an anxiety manual and programme was part of a service development which allowed existing and established psychological therapies to be adapted for people with intellectual disability. A qualitative approach was used to better understand the views of people who experienced anxiety on a daily basis. The feedback generated was used to make modifications to the manuals and the anxiety management programme. Findings: The study has demonstrated the value of involving people with intellectual disability in the co-production of an anxiety management programme. Additional findings identified the real-life challenges and experiences of the impact anxiety has on people's lives. Originality/value: To our knowledge, this is the first study to involve people with intellectual disability in developing an anxiety management programme as co-production partners. This paper underlines the value of understanding and involving people as co-production partners in developing clinical interventions. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore waiting times in improving access to psychological therapies (IAPT) services before and throughout the COVID-19 pandemic. The paper aims to help develop a better understanding of waiting times in IAPT so that interventions can be developed to address them. Design/methodology/approach: IAPT national data reports was analysed to determine access and in-treatment waiting times before, during and after the COVID-19 pandemic. Time-series data was used to examine referral patterns, waiting list size and waiting times between the period of November 2018 and January 2022. The data covers all regions in England where an IAPT service has been commissioned. Findings: There was a dramatic drop in referrals to IAPT services when lockdown started. Waiting list size for all IAPT services in the country reduced, as did incomplete and completed waits. The reduction in waiting times was short-lived, and longer waits are returning. Practical implications: This paper aims to contribute to the literature on IAPT waiting times both in relation to, and outside of, COVID-19. It is hoped that the conclusions will generate discussion about addressing long waits to treatment for psychological therapy and encourage further research. Originality/value: To the best of the authors' knowledge, there is no published research examining the performance of IAPT waiting times to second appointment. The paper also contributes to an understanding of how IAPT waiting times are measured and explores challenges with the system itself. Finally, it offers an overview on the impact of the COVID-19 pandemic on waiting time performance nationally. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to evaluate the effectiveness of psychological treatments and identify required adaptations to increase acceptability and improve outcomes for people with dementia or mild cognitive impairment who experience psychological distress. Design/methodology/approach: The Cochrane Dementia and Cognitive Improvement Group Specialised Register and other databases were searched for eligible studies. Inclusion criteria identified nine randomised controlled trials comparing a psychological intervention (cognitive behavioural therapy, relaxation training therapies, multimodal therapies, psychodynamic therapy, counselling and cognitive rehabilitation) with usual care, with measures of depression and/or anxiety as an outcome. The appraisal of papers was conducted using the Mixed Methods Appraisal Tool. Data was analysed using meta-analysis. Findings: A small, significant effect size before to after intervention was revealed, suggesting that psychological treatments may be effective in reducing psychological distress in people with dementia, with several therapy adaptations identified. Research limitations/implications: Because of methodological limitations and a small number of studies evaluated, the quality of evidence was low for outcomes for depression, and there were no significant outcomes in anxiety. Originality/value: The current review offers a unique contribution in identifying specific adaptations deemed helpful in improving the accessibility and acceptability of therapy for people with dementia, suggesting therapy can be adjusted enough to support this client-group. Future studies should use high-quality trials using standardised psychological interventions, of sufficient length, with long-term follow-up and offer of specific adaptations to increase accessibility and outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to underline the importance of using a collaborative approach when designing and adapting a post diagnostic psychosocial intervention of cognitive stimulation therapy (CST) for people with intellectual disability and dementia. Design/methodology/approach: As part of a service improvement, a manual of CST was adapted, for delivery in clinical practice. A qualitative co-production method allowed participants with a lived experience to provide regular feedback relating to the development of the adapted CST manual and intervention programme. This feedback was used to make continual development changes to the CST manual. Findings: The study demonstrated co-production with those who provide care is valuable in adapting psychosocial therapies for people with an intellectual disability and dementia. Additional findings identified the need for carer education in ageing, dementia care and the physical health needs for older people with intellectual disability. Originality/value: To the best of the authors' knowledge, this is the first study that has used a co-production approach with families and carers in adapting a group therapy programme for people with an intellectual disability. This paper underlines the need for post diagnostic clinical interventions for people with dementia and those who provide care. [ABSTRACT FROM AUTHOR]

Purpose: Psychometrically sound measures are essential for clinical practice to provide appropriate therapeutic input. Vlissides et al. (2016) reviewed measures used in psychological therapies with people who have intellectual disabilities (ID). This paper aims to review the evidence for the psychometric properties of recent clinical measures published since/overlooked by Vlissides et al. (2016). Design/methodology/approach: A literature search was conducted to identify relevant clinical measures. Experts in the field also were contacted. Twenty papers were identified, relating to five novel clinical measures: psychological therapies outcome scale – intellectual disabilities, clinical outcome in routine evaluation – learning disabilities scale 30, quality of early relatedness rating scale, scale of emotional development – short and the Frankish assessment of the impact of trauma. Findings: Evidence was found supporting a proportion of the psychometric properties of each measure, and some measures were found to be useful in directing interventions and informing clinical decisions. None of the measures identified, however, are yet to be fully psychometrically investigated, requiring further research. Originality/value: To the best of the authors' knowledge, this paper is the first to review the evidence of psychometric properties for these five emerging clinical measures and as such contributes an original perspective on their current state and requirements for future development. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the extent to which principles of recovery-oriented practice are evident in the published perspectives and experiences of health professionals and service users on seclusion in adult mental health services. Design/methodology/approach: A systematic review informed by PRISMA guidelines was conducted, drawing from four databases, which were searched in August 2018 and August 2022. Only original empirical studies rated as having "major" relevance were included. Data were extracted from 31 studies and qualitatively synthesised through deductive analysis using recovery principles as themes. Findings: There was limited evidence of perceptions of seclusion being being consistent with recovery principles, with greater evidence of perceptions that directly opposed them. Studies of service user perspectives highlighted this more often than staff perspectives. The findings highlight paradoxical relationships between care and control and conflicting rights and emphasise the need to openly acknowledge the complexity of seclusion and its interface with recovery. Research limitations/implications: This review was developed in line with international best practice and the protocol was registered. Using a search string with only three components maximised sensitivity during searches and minimised the risk of relevant literature being missed. Limitations include the focus on studies where the full text was published in English. Originality/value: This review makes a unique contribution, highlighting that, to the best of the authors' knowledge, no studies to date have explicitly explored the perspectives and experiences of staff and service users on the use of seclusion in the context of recovery-oriented practice. The findings are relevant to clinical practice, policy and future research, including amending procedures and practices to partially reconcile seclusion and recovery where the seclusion is deemed necessary. [ABSTRACT FROM AUTHOR]

Purpose: Services are increasingly exploring the use of remote conferencing to deliver psychological interventions, which have become particularly important given the COVID-19 pandemic and infection control guidelines. This paper aims to explore the feasibility, acceptability and preliminary effectiveness of delivering psychological therapy remotely to adults with intellectual disabilities (ID). Design/methodology/approach: As part of routine practice within an adult ID community health service, this paper develops a six-session programme based on compassion-focused therapy (CFT) and delivered it to six clients. Clients completed the psychological therapy outcome scale for ID 2nd edition, at assessment, pre- and post-therapy, as well as a feasibility and acceptability measure. Findings: Six clients engaged in telephone therapy; four clients individually, while the remaining two were supported by their caregiver. Most clients found the intervention helpful, enjoyable and were pleased that they received telephone-delivered psychological therapy. A reduction was observed at post-therapy in distress (g = 0.33) and risk (g = 0.69). No difference was reported in psychological well-being. Five clients were subsequently discharged from psychological therapy. Originality/value: To the knowledge, this is the first study examining the use of telephone therapy (including CFT) for individuals with ID. Findings add to the growing evidence suggesting individuals with ID can benefit from receiving adapted psychological therapies. Research is required to further explore the effectiveness of remote-therapies, who would most likely benefit from this approach and how remote treatments could be used within existing pathways. [ABSTRACT FROM AUTHOR]

Purpose: Primary care psychological interventions for people with common mental health problems in England are primarily delivered through Improving Access to Psychological Therapies (IAPT) services. People with learning disabilities within IAPT have poorer key clinical outcomes than people who do not identify as having a learning disability. During the global COVID-19 pandemic remote consultations have accounted for nearly 90% of all contacts in IAPT services; this paper aims to report the effects of these on outcomes for people with learning disabilities. Design/methodology/approach: Publicly available national data from the COVID-affected period are compared to the most recent available comparison periods that are not during the COVID pandemic. Data are presented graphically. Findings: People with learning disabilities differ little from those with no disabilities on several key process and outcome variables, although their clinical recovery is very much lower than those without disabilities. People with learning disabilities appear to have been affected by the changes in service delivery in a similar way to those without learning disabilities. Originality/value: Despite the shift to predominantly remote therapy delivery, outcomes for people with learning disabilities have not been differentially affected compared to those who have no recorded disability. The potential to learn what has worked and not worked in the delivery of remote interventions for people with learning disabilities is highlighted. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore the views of psychologists working in community teams for people who have intellectual disabilities (ID) on the provision of psychological therapies to those with ID and autism spectrum disorder (ASD). Design/methodology/approach: Semi-structured interviews were carried out with seven clinical psychologists working across a large geographical area. Interviews concerned the accessibility and effectiveness of psychological therapies. These were transcribed and analysed thematically. Findings: Participants expressed concern about lack of access to mainstream services, the lack of visibility of their service and the suitability of the physical space to deliver therapy. They were positive about the effectiveness of therapy but emphasised the importance of adaptations and managing expectations. Research limitations/implications: There is a lack of research in this area, and further research is needed with service users to develop a fuller understanding of their needs. Practical implications: Consideration needs to be given on how to optimally deliver psychological therapies for this group. This will need services to become more flexible and focussed on the needs of this group of service users. Originality/value: This paper provides insights into the views of psychologists on providing psychological therapy to people who have autism and ID. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to discuss the work of Dr Valerie Sinason and her contribution to working with people with an intellectual disability with psychotherapy. Design/methodology/approach: Dr Valerie Sinason is a psychoanalyst, and the author is trained in psychoanalytic psychotherapy. Findings: The author believes there is important value in reading Valerie Sinason's contribution to the literature of psychotherapy with people with intellectual disabilities. Originality/value: It is a review of Sinason's contribution, and the author believes she's very original and important thinker. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to assess the quality of systematic reviews on the effectiveness of psychological therapy for adults with intellectual disabilities (ID) and mental health difficulties. Design/methodology/approach: Four electronic databases were used: Cochrane, PsycINFO, PubMed and Scopus. Studies were included if they were a systematic review focused primarily on psychological therapy for adults with ID and mental health difficulties. Systematic reviews focused on anger were also considered for inclusion. These reviews were rated for quality on the Amstar-2, a quality rating tool designed to evaluate systematic reviews. Findings: Twelve relevant systematic reviews were identified, which included seven reviews focused primarily on cognitive behavioural therapy, two on psychodynamic therapy and three on third-wave therapies. The AMSTAR-2 indicated that all 12 reviews were of "critically low" quality. Thus, there are significant problems with the evidence base. Originality/value: To the best of the authors' knowledge, this is the first systematic review of systematic reviews of the effectiveness of psychological therapies for people who have ID. It provides an overview of the quality of the evidence base into one place. [ABSTRACT FROM AUTHOR]

Purpose: The novel coronavirus and associated restrictions have resulted in mental health services across the UK having to adapt how they deliver psychological assessments and interventions. The purpose of this paper is to explore the accessibility and prospective acceptability of providing telephone and videoconference-mediated psychological interventions in individuals with intellectual disabilities. Design/methodology/approach: As part of a service evaluation, a mixed-methods questionnaire was developed and completed by clients who had been referred for psychological therapy at an adult intellectual disabilities' community health service in the north of England. All clients were assessed using the Red/Amber/Green (RAG) system by a consultant clinical psychologist for risk and potential suitability for indirect service delivery given their ability and needs. Findings: Overall, 22 clients were invited to take part, of which, only seven (32%) were accepting of telephone or videoconference-mediated psychological therapy. Most of the clients were unable to engage in video-conference therapy and therefore, only suitable for phone therapy. This paper presents the remaining findings and discusses the clinical implications and unique considerations for intellectual disability services drawing on the existing literature. Originality/value: This is the first paper that the authors are aware of, examining videoconference-mediated psychological therapy in this population. It is hoped the data will be used to help inform practice or policy when using such therapeutic approaches in adults with an intellectual disability. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to determine the effectiveness of an adapted compassion-focused therapy (CFT) group treatment programme for individuals with an intellectual disability (ID), specifically aimed to help address maladaptive conceptualisations of masculinity. Design/methodology/approach: Outcome measurements were competed at pre- and post-group and the effectiveness of the intervention were assessed using a Wilcoxon signed ranks test. Findings: Findings demonstrated that the treatment group showed significant differences in their "gender role conflict" subscales including the Success, Power, Control and "Restrictive Affectionate Behavior Between Men" subscales; however, no significant differences were found on the Restrictive Emotionality or Conflicts Between Work and Leisure subscales. Furthermore, no significant differences were found on participants psychological well-being, psychological distress, anxiety, self-compassion or quality of life measures. Research limitations/implications: Limitations include that a lack of qualitative information regarding outcomes, a lack of control group and a small number of participants may have impacted the outcome of the research. Practical implications: The Men's Masculinity group had a positive impact on the participant's sense of success, power and control, so it could be considered that this group enabled participants to feel more powerful and in control of their difficulties which is associated with the "drive" system of CFT. Originality/value: Overall, this study adds to the small but growing literature that supports using CFT groups as a stand-alone psychological intervention when working with people with an ID. [ABSTRACT FROM AUTHOR]

Purpose: There is growing literature on the application of Dialectical Behaviour Therapy (DBT) with adults with intellectual disabilities (IDs). To draw upon the evidence-base from mainstream approaches, adapted interventions must remain true to their theoretical foundations and retain key components. The purpose of this paper was to establish the extent to which DBT has been adapted for adults with ID, and whether existing adapted protocols can still be considered DBT. Design/methodology/approach: The theoretical underpinnings and key components of DBT were identified. Six DBT studies were critiqued according to these criteria. Findings: In terms of content, only one intervention comprised all necessary elements. All of the remaining interventions included a skills group; two included individual therapy and another two included group consultation. None of the remaining interventions provided 24-h telephone support. Furthermore, none of the studies explicitly described using dialectical strategies. Originality/value: To the best of the authors' knowledge, this is the first paper to critically examine the evidence-base for the use of DBT in ID, particularly its fidelity. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to evaluate the effectiveness of a stepped-care primary care psychology service through triangulating clinical outcome data, service user satisfaction ratings and feedback from referrers. Design/methodology/approach: A mixed method approach including a repeated measures design (pre- and post-clinical data on standardised psychometrics) for clinical outcomes and an online and postal survey with quantitative and qualitative elements offered to all service users and referrers to the service. Findings: In total, 125 service users completed a full intervention with the service with 56% treatment completers demonstrating a reliable reduction in the symptoms of low mood and 49.6% in anxiety. Of those within the clinical range for depression at assessment, 66.67% achieved clinical recovery following an intervention. Of those within the clinical range for an anxiety disorder at assessment, 62.03% achieved clinical recovery following an intervention. Service users reported high levels of satisfaction with the service specifying particular interpersonal qualities of the therapists and the individualisation of service provision as crucial positive factors. Referrers similarly reported high levels of overall satisfaction with the service, specifying that the speed of response to referral and length of intervention was of greatest importance to them. Practical implications: Stepped-care psychological interventions reduce psychological distress in treatment completers with mild to moderate symptoms of anxiety and low mood. The overall interpersonal experience may be of greater importance to service users in their evaluation of a service than clinical outcomes. In their relationship to a Psychology service, referrers value speed of response and ongoing feedback. Building a robust, highly valued service may require the triangulation of evidence from all key stakeholders. Originality/value: This paper provides a pragmatic template of how a rigorous evaluation of a primary care psychology service requires evidence from multiple stakeholders. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to provide an insight into xylophagia, its treatment, intervention options, etiological causes and possible relationship with other diseases. Design/methodology/approach: A systematic search was performed across four scientific databases (i.e. Ovid Medline, Embase via Ovid, PubMed and ProQuest). All of the qualitative studies reporting on xylophagia from the inception of databases until August 2019 have been included. The quality of included studies was assessed through a ten-item checklist given by Kmet et al. (2004). Findings: A total of 18 studies were included, and five primary themes emerged after analysis: precipitation/onset of xylophagia, co-morbid psychiatric or medical illnesses, assessment and investigation modes to confirm diagnosis, outcomes of xylophagia and treatment options comprising medical care, psychological care, counseling and duration of recovery. There were 16 females and 9 males in included studies. The mean ages and standard deviations of males and females were 29.25(12.17) years and 32.81(11.92), respectively. The mean duration and standard deviation of paper pica were 4.80(4.27) years. Research limitations/implications: Despite the limitation that this meta-synthesis is based upon findings from case studies, results show that standardized medication regimens for treating xylophagia are still not available or are unknown. There is a dire need for further research in order to better understand the disorder. The healthcare professionals need to use reciprocal, mutually constituent influence of biological and sociocultural factors in order to screen, diagnose and manage complex psychological problems like xylophagia. Originality/value: The findings advance our understanding of the positive effects of patients and family members undergoing counseling or cognitive behavior therapy in reducing stress and enhancing coping skills thus, avoiding self-damaging behaviors. [ABSTRACT FROM AUTHOR]

Purpose: The novel coronavirus and associated mitigation efforts have caused significant increases in stress for adults with intellectual disabilities. Such increases in life stress predict an increased risk of relapse following psychological therapy. This contributes to the high global disease burden of common mental health difficulties. Therefore, this paper aims to explore service user experiences of maintaining gains following therapy within the context of the Covid-19 pandemic. Design/methodology/approach: A mixed-methods evaluation was completed in a psychology service based in the North of England which specialises in supporting adults with intellectual disabilities. Descriptive statistics and effect size calculations were used to examine therapeutic outcomes pre-therapy, post-therapy, and at follow-up. These findings informed a framework analysis of eight semi-structured interviews. Findings: Overall, outcome results improved post-therapy and regressed at follow-up. The framework analysis revealed facilitators to maintenance include a recollection of specific aspects of therapy and the regular utilisation of strategies and resources. Conversely, barriers to maintenance include a recollection focussed on personal outcome, a reliance on social support and an inability to remember therapy. Originality/value: This is the only study to the authors' knowledge examining service user experiences of maintaining gains following therapy within the context of Covid-19. It is hoped that these findings will inform further research and be useful for services in preparing service users for discharge as the Covid-19 pandemic continues and moves towards the post-pandemic phase. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to introduce and explore stuckness as a felt phenomenon in psychiatric practice in order to stimulate clinicians in mental health settings to be on the lookout for stuckness and on the lookout for unexpected solutions to difficult clinical scenarios. Design/methodology/approach: Signs of stuckness are looked at and then proposed causal factors of stuckness in clinical practice are reviewed. These are divided conceptually into four main groupings: patient factors, clinician factors, service factors and societal factors. Findings: Although clinicians are encouraged to acknowledge when stuckness is present and to try to address possible causes with their patients, clinicians are also advised to work on understanding stuckness as a natural part of creative processes. It is suggested that services should draw on a psychoanalytic ethos to support staff to tolerate and respond to stuckness better. Originality/value: Feeling stuck with patients' partial recoveries or "revolving door" cycles is uncomfortable. In stretched psychiatric services in particular stuckness may go unnoticed, and instead the difficulty of the work with patients may inadvertently drive therapeutic mania or rejection of the patients, which can lead to harm. This paper offers a simple scheme to use when thinking about stuck patients in the psychiatric setting with the hope that this can stimulate clinicians to search for new creative solutions for patients. [ABSTRACT FROM AUTHOR]

Purpose: Human Givens (HG) Rewind technique is a graded trauma-focused exposure treatment for post-traumatic stress disorder and trauma. The purpose of this paper is threefold: first, to describe the technique; second, to provide an outline of its potential benefits; and third, to present some preliminary evidence. Design/methodology/approach: This paper provides an overview of HG therapy and describes the stages of HG Rewind trauma treatment and its potential benefits. Similarities and differences between Rewind and other Cognitive Behavioural Therapy techniques are explored. Possible underlying mechanisms are discussed. Findings: Preliminary evidence suggests that Rewind could be a promising trauma treatment technique and that HG therapy might be cost effective. The findings highlight the need for further research and a randomised controlled trial (RCT) on Rewind is warranted. Practical implications: During the rewind technique, the trauma does not need to be discussed in detail, making treatment potentially more accessible for shame-based traumas. Multiple traumas may be treated in one session, making it possible for treatment to potentially be completed in fewer sessions. Social implications: This UK-based treatment may be cost effective and make treatment more accessible for people who do not want to discuss details of their trauma. Originality/value: This is the first description of HG Rewind in the peer-reviewed literature. Alternative explanations for mechanisms underlying this trauma treatment are also presented. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to focus on how mental health professionals involved in the therapeutic treatment of children in public mental health facilities in Greece experience and talk about the impact of the socioeconomic crises on the psychotherapeutic process.Design/methodology/approach In all, 21 semi-structured interviews were conducted and phenomenologically informed thematic analysis was used in analysing the data.Findings The results coalesced into two all-encompassing thematic structures articulating the following: first, the socioeconomic crises have permeated society and therapeutic praxis like a torrential and chronic rain storm. This has resulted in a deluge in demand for therapeutic services within the public mental health sector; second, mental health professionals describe their positioning and work as “a constant tug-of-war” where they are inundated and often overwhelmed with work, find themselves identifying with service users and taking on several roles simultaneously, and being challenged to find solutions often in dire and complex situations. They describe how creativity and flexibility are in demand in their day-to-day interactions and if they are to intervene in place of a health and welfare system that is faltering. Doing therapeutic work under such circumstances appears to be both emotionally onerous and stimulating with regard to conceptualising new ways of intervening in such complex psychosocial situations.Research limitations/implications The study is limited in that only mental health professionals presented their experiences and service users were not included. The findings do highlight how severe austerity policies impact mental health services and peoples’ lives.Practical implications The study has implications for policy regarding the provision and organisation of mental health services in contexts where crises and economic turmoil prevail.Social implications The results associate severe austerity with major changes in family and community life.Originality/value The paper provides insights and implications on how mental health services are impacted by socioeconomic conditions. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to assess the effects of compassion-focussed therapy (CFT) on anxiety in a small sample of adults with intellectual disability.Design/methodology/approach A mixed-methods design was employed. Participants (n=3) completed questionnaire measures of anxiety and self-compassion on three occasions: pre-intervention, post-intervention and, at three months follow-up. Post-intervention, they also took part in recorded interviews that were analysed using interpretive phenomenological analysis. Findings were then synthesised to develop a comprehensive understanding of their overall experience.Findings Final data synthesis revealed five themes: participant anxiety decreased (reliable for all participants); the faulty self; improved positive compassionate attitudes; increased sense of common humanity; and mindful distraction techniques.Research limitations/implications This research paper offers in-depth analysis of three participants’ experiences rather than reporting in less detail about a larger number of participants. The self-compassion scale required considerable support and reasonable adaptation to be used with these clients.Originality/value Only two other studies have explored the use of CFT with people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore the importance of equal access to Improving Access to Psychological Therapies (IAPT) for people with intellectual disabilities.Design/methodology/approach The paper identifies barriers to access and shows how a reference group can work to solve the barriers and increase access.Findings The paper evaluates the authors’ progress to date and how the authors plan to continue to take the work forward.Practical implications The paper highlights some of the factors responsible for the authors’ success and gives information that will be helpful to other areas who are interested in facilitating equal access.Originality/value The paper demonstrates how the focus of a reference group can drive improvements across services to improve access for people with intellectual disabilities to IAPT services. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to describe service user experiences of an art psychotherapy group which drew on occupational therapy perspectives to help adults with severe and enduring mental health difficulties move forward in their recovery. Design/methodology/approach: A case study approach incorporating outcome data was used. The data gathered comprised attendance, facilitators' clinical notes, photographs of participant artworks, the Psychological Outcome Profiles questionnaire (PSYCHLOPS: www.psychlops.org), a post-therapy feedback form, discussion at post-therapy individual review sessions and participants' achievements post-group. Findings: All but one participant scored the group as "very helpful" or "helpful" and all felt that the group had helped them with the personal aims they had identified. The PSYCHLOPS questionnaire yielded a large average effect size, indicating positive change in terms of problems, functioning and well-being. Participants identified several ways in which the group was helpful, and their artwork and reflections indicate how they used the art making in the group to pursue their recovery goals. The service user experiences and outcomes suggest that this group was effective in facilitating recovery for these adults with severe and enduring mental health difficulties. Originality/value: This group was innovative in integrating approaches from the different professional specialisms and the findings encourage further investigation into this way of working. [ABSTRACT FROM AUTHOR]

Purpose: Evidence-based psychological therapies are available for severe and enduring mental health problems, but resources and access to these are limited within England. Practitioners in community mental health teams (CMHTs) can act as gatekeepers for access to psychological therapies for those in secondary care, but little is known about how they make referral decisions. This paper aims to understand how CMHT practitioners make decisions about who to refer or not, to secondary care psychological therapy services (PTS). Design/methodology/approach: A total of 11 CMHT practitioners were interviewed to understand the decision making processes underpinning their referrals or otherwise, to a PTS within NHS England. The data were analysed qualitatively using thematic analysis. Findings: Thematic analysis resulted in 11 sub-themes under three main themes of the self, the organisation and wider structure and the service user. Results indicated that some participants were referred automatically for psychological therapy if a service user asked or if there was external pressure to refer, while others' decisions were informed by contextual information such as the service user's ability to engage or change, risk status and limited organisational resources. Originality/value: This study explores the decision making of multi-disciplinary professionals referring to PTS. The findings have important implications for understanding some of the factors that can influence patient access to psychological treatment in secondary care. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to outline what is known about the prevalence, causes and treatment of depression for people with learning disabilities, with a focus on psychosocial interventions. Design/methodology/approach: This is a narrative review, and will provide evidence-based guidance for practitioners and those managing service delivery. Findings: Depression is just as prevalent among people with learning disabilities as it is in the wider population and they are frequently exposed to known vulnerability factors for low mood such as lack of social support and purposeful activity. Yet there remains a paucity of evidence about effective interventions for depression. Originality/value: Growing evidence about the effectiveness of psychological interventions for people with learning disabilities and depression is promising but insufficient. To make meaningful change, there also needs to be an implementation strategy that encompasses the broader context of people's lives, including family, care and work settings. [ABSTRACT FROM AUTHOR]

Purpose: Awareness of psychological problems is essential to address the problems adequately. It also contributes positively in the overall psychosocial well-being of a society. The rates of mental health literacy have been investigated in many countries and have been found to be lower than expected. The purpose of this study was to explore public awareness of psychological problems and psychological treatment in Pakistan. Design/methodology/approach: The current study explored the latest levels of public awareness of psychological problems in the country by involving 3,500 respondents from five major cities. The sample of the study was sufficiently rich to represent Pakistanis based on gender, age, education, profession and income. Data were gathered from 3,500 respondents through interviews and a self-respondent questionnaire. Findings: The study revealed that the awareness of psychological problems in Pakistan was 36 per cent. Several significant variations were also found based on different demographic factors. The study also revealed that 42.17 per cent of the respondents were aware of psychotherapy as a possible way of treating psychological problems followed by their awareness of social support (17.29 per cent), medicine (16.74 per cent), supernatural practices (6.29 per cent), religious practices (5.60 per cent) and self-help (3.57 per cent). Practical implications: As a result of the findings of unsatisfactory levels of public awareness of psychological problems, this paper has implications for mental health practitioners and policymakers to play their active part in improving the situation. Originality/value: The current study is the first large-scale study in the country. [ABSTRACT FROM AUTHOR]

Purpose There remains a lack of clarity regarding what constitutes “normal” or “complicated” grief within this client group. The purpose of this paper is to identify the factors that complicate grief and considers interventions which would be beneficial.Design/methodology/approach The paper draws on previous research by the author and others to comment on some of the issues discussed by Hannah Young in her article.Findings Three domains contribute to complicated grief in people with learning disabilities. These are the learning disability itself, environmental factors and the impact of disability on attachment.Practical implications A relational approach to support is important in preventing complicated grief. If the grief becomes complicated, a relational psychotherapy is recommended as the preferable intervention.Originality/value This paper gives important consideration to practical factors that can lower vulnerability to complicated grief for this client group. [ABSTRACT FROM AUTHOR]

Purpose: Rewind is a trauma-focussed exposure technique that is part of Human Givens (HG) therapy. However, there have been no controlled studies examining the effectiveness or acceptability of Rewind, and a previous study comparing HG therapy outcomes with cognitive behaviour therapy (CBT) benchmarks has yet to be replicated. The paper aims to address these issues. Design/methodology/approach: This preliminary investigation used an observational, quasi-experimental design. Using both between-subject and within-subject designs, the outcome measures of those who had Rewind in the second session and participants who had treatment-as-usual (TAU) in the second session followed by Rewind in the third session were compared. Pre–post treatment scores were used to evaluate the overall HG therapy and to compare with benchmarks. Findings: Rewind was more effective than control treatment sessions, with 40 per cent recovered and 57 per cent having reliably improved or recovered after the Rewind treatment session. Rewind sessions were rated as acceptable as other treatment sessions. The effect size of HG therapy was above the CBT Clinical Outcomes in Routine Evaluation Outcome-10 (CORE-10) benchmark of 1.22. The recovery rate for treatment completers was 63 per cent, with 91 per cent recovered or reliably improved and was equivalent to the top quartile of services. Practical implications: Rewind is a promising alternative trauma treatment, as people need not discuss details of the trauma, multiple traumas can be treated in one session and fewer treatment sessions may be needed. Originality/value: There are few HG studies reported in the peer-reviewed literature. This preliminary study is the first controlled study of Rewind. The findings are also in line with previous research on HG therapy. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper, a qualitative study, is to explore service users' experiences of attending clinical psychology within a public community adult mental health service. Design/methodology/approach: Six individuals who had completed at least 16 sessions of psychotherapy participated in semi-structured interviews. Data were transcribed and analysed using interpretative phenomenological analysis. Findings: The results showed the following overarching domains: the relationship and its impacts, structure and focus, and participant factors – timing/readiness. The importance of the use of language was also identified. Participants appeared to value a sense of humanity within the relationship. Interestingly, the personal impact of therapy as perceived by the participants was not focussed on symptom reduction, but on broader changes. The results are discussed in relation to the relevant literature. Practical implications: Suggested principles for practice include maintaining attentiveness to relational factors, to client factors such as readiness for change and to the use of structure and flexibility. The use of recovery focussed and alliance measures are recommended. Originality/value: For clinical psychologists providing psychotherapy within the public system, there are valuable lessons we can learn from asking the service users directly about their experiences, in terms of focussing on the human element of the relationship, and striking a balance between professionalism and humanity. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to understand staff experiences of cognitive analytic team formulation, within an inpatient unit for women with a diagnosis of personality disorder. Design/methodology/approach: In total, 16 staff completed an online questionnaire, rating their views on how helpful formulation sessions had been in regards to ten domains. Following this, six staff participated in semi-structured interviews exploring their experiences of the process and impact of cognitive analytic team formulation. Transcripts were analysed using thematic analysis. Findings: Responses from questionnaires indicated the general process of team formulation was helpful across each domain. Interviews highlighted benefits such as an increased capacity to think and work relationally. This was impacted upon by staff's confidence in using the model and the practicalities of attending sessions. Practical implications: Team formulation has been described as the facilitation of a group of professionals to create a shared understanding of service-users' difficulties. Team formulation continues to demonstrate benefits for staff working within complex mental health. The challenges of this are considered, however overall, a cognitive analytic framework seems to offer staff the opportunity to integrate learning from a service-user's history, and current relational difficulties, in a way that develops reflective capacity and informs intervention. Originality/value: Limited research has explored the theoretical models underpinning team formulation, and the impact for staff learning and practice. The current study develops previous work by specifically focussing on the contribution of cognitive analytic theory to team formulation. [ABSTRACT FROM AUTHOR]

Purpose: There are few publications on personality disorder in adults with intellectual disability (ID), and on borderline personality disorder (BPD) specifically. Publications concerning treatment are sparse, despite the high symptom burden in these patients. This paper aims to discuss these issues. Design/methodology/approach: Six patients with BPD and ID were recruited from the same inpatient unit. Behaviour problems and mental health symptoms were scored on admission and discharge. Information about treatment, length of stay, etc. was taken from case files. Findings: Both mental health symptoms measured by the SCL-90-R, and behaviour problems measured by the Aberrant Behaviour Checklist were significantly reduced on discharge. In the active treatment period, the two main aspects of treatment were validation and practicing new solutions when emotional and behavioural problems occur, i.e. skills training. Research limitations/implications: The limitations related to this study are that the study is conducted in one milieu only. Another limitation is that the patients were admitted over a five-year period, where, some changes were made in the treatment approach. Practical implications: Inpatient treatment of this patient group seems to be effective if individually adjusted to the patient's psychopathology, ID and communication style. Close co-operation between the individual therapist and milieu therapists is essential. Originality/value: There is a need for intervention studies on BPD in ID. This study may be a valuable contribution. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore significant events in psychotherapy with clients with intellectual disabilities (IDs).Design/methodology/approach Four therapy dyads, each consisting of one client and one therapist, were recruited. Following the brief structured recall procedure (Elliott and Shapiro, 1988), semi-structured interviews focused on helpful events in psychotherapy, using video of particular sessions as a stimulus to help prompt recall of that session.Findings Using interpretative phenomenological analysis, five super-ordinate themes were identified: “The Uniqueness of the Therapeutic Relationship”; “Using adaptations to Express Emotions”; “Client Behaviour/Therapist Behaviour”; “Hope and Paternalism”; and “Meaning-Making”. The results provide additional evidence that significant therapy events occur for clients with IDs. Furthermore, the research enabled insights to be gained about the process of therapy for this client group and for exploration of therapeutic factors that may be involved in facilitating a significant therapy event.Research limitations/implications This study highlights the need for therapists to work in such a way as to facilitate significant events in therapy. Whilst this study was a necessary first step, owing to the non-existence of research in this area, the sample size and qualitative design may limit any wider generalisation of the findings.Originality/value Significant events have not previously been explored in psychotherapy with clients with IDs. This research could therefore make an important contribution to our understanding of the process of psychotherapy for this client group. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine the outcome of psychodynamic psychotherapy for people with intellectual disabilities (ID), which has a limited but supportive evidence base.Design/methodology/approach The study is a systematic open trial of flexible-length psychodynamic therapy offered in an urban community to 30 people with mild and moderate ID, presenting with significant emotional distress on the Psychological Therapies Outcome Scale for people with intellectual disabilities (PTOS-ID). Allocation to therapy was made according to an established stepped care approach according to need, and the mean number of sessions was 22.03 (range 7–47). Treatment fidelity was checked via notes review and cases excluded from analysis where there were other significant psychological interventions.Findings On both self-report (PTOS-ID) and independent ratings (Health of the Nation Outcome Scales-Learning Disability (HoNOS-LD)) recipients of therapy: did not improve while waiting for therapy; improved significantly during therapy, with large pre–post effect sizes; and retained improvements at six-month follow-up.Research limitations/implications While it is important to conduct further controlled trials, the findings provide support for previous studies. High rates of abuse and neglect were found in the sample, suggesting that more trauma-informed and relational approaches should be explored for this client group.Originality/value No other study of this size has been completed which used dedicated standardised outcome measures, with this therapy type, with both waiting list and follow-up control and with account of model fidelity. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to report the evidence base for the practice of individual psychodynamic psychotherapy with adults with intellectual disabilities (IDs).Design/methodology/approach Literature review.Findings In total, 14 papers were reviewed. From these, one existing review and seven individual papers provided enough evidence to support effectiveness of individual psychodynamic psychotherapy for people with IDs.Research limitations/implications This research indicates individual psychodynamic psychotherapy to be of benefit. Indeed, all studies reviewed supported individual psychodynamic psychotherapy, but methodological shortcomings weakened the confidence placed in findings for some studies. Limitations of this review include methodological shortcomings of studies reviewed, a small number of existing studies and reliance on case studies.Practical implications Therapists and commissioners of services should routinely make individual psychodynamic psychotherapy available as part of a spectrum of therapies available to people with IDs who experience emotional and behavioural problems. This is because it is needed for some clients and they benefit.Social implications Individual psychodynamic psychotherapy for people with IDs adds to the range of therapies available to alleviate emotional distress and enhance well-being. These are necessary to provide a foundation for meaningful contribution to society, particularly for those who have experienced psychological trauma (Frankish, 2016).Originality/value This review includes more relevant studies than previous reviews and adds to a limited number of reviews in this area. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is mainly to present a general review of third generation cognitive-behavioural therapies (CBTs), and to debate whether these approaches are applicable to persons with neurodevelopmental disorders (NDD). Design/methodology/approach – Despite the lack of consistent literature focused on this population, the authors have considered the available general literature on the third generation of CBTs and analysed core issues of the processes within the context of intellectual disabilities and Autism spectrum disorder. Findings – The evidence from typical developing population studies and the emerging literature specific to people with NDD is convincing, but there is a need for studies exploring how and when these therapeutic approaches can be applicable. Two behavioural approaches of third generation therapies – acceptance and commitment therapy and mindfulness-based CBT – appear to have the most potential to be adapted for robust intervention for the broad spectrum of persons with NDD. Research limitations/implications – The number of studies and methodologies applied are a clear limitation and the present paper is only exploratory. Originality/value – The paper supports clinicians to use the emerging protocols, and to replicate and implement procedures and techniques. [ABSTRACT FROM AUTHOR]

Purpose – Narrative therapy is aligned with government priorities for learning disabilities as it promotes inclusion and seeks to empower. While research on narrative therapy in learning disability services is emerging, it has not been critically evaluated. The purpose of this paper is to identify, summarise and critique the extant literature that has explored narrative therapy for adults with learning disabilities, and consider the implications for research and clinical practice. Design/methodology/approach – A literature search identified seven relevant case studies that described individual narrative therapy interventions for adults with learning disabilities. A qualitative review of these studies was carried out. Findings – Overall, the reviewed studies offer tentative evidence for the short-term usefulness of narrative therapy for difficulties with anger and qualitative benefits for ritualistic behaviour, social anxiety and stealing behaviour. Research limitations/implications – A number of methodological issues are identified, particularly concerning the use of outcome measures and the generalisability of findings. The research is limited due to a reliance on case study evidence and outcome measures that lack validity and reliability. Both larger scale and more robust research, and high quality practice-based evidence, are required. Practical implications – Learning disability services could consider providing narrative therapy for people with learning disabilities experiencing anger problems and other psychological difficulties. Clinical practice suggestions are identified, such as choosing relevant metaphors and including the individual’s wider system. Originality/value – This paper provides an up-to-date, comprehensive review of the literature on narrative therapy for people with learning disabilities that will be of use to clinicians providing therapeutic support and to people commissioning such services. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to reflect on “Narrative therapy in a learning disability context: a review”. Design/methodology/approach – This commentary reflects on the use of Narrative therapy and considers it in the wider context of assisting people with learning disabilities to develop self-understanding. The commentary makes connections between the use of Narrative therapy and narrative approaches to research reporting. Findings – The use of Narrative therapy can assist in the development of positive personal stories for individuals with learning disabilities. Case study research provides a useful reference point from which to develop future work. Reporting of case studies sometimes omits data that might be useful for others attempting to replicate findings. Originality/value – This paper highlights the need for authors to ensure that the “small details” are included in research reporting. A narrative approach, rich in detail of research participants might enable authors to tell a “thicker” story, thus improving generalisability. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to outline research which aimed to explore psychotherapists’ experience of working with despair, in the UK prison setting, through a qualitative phenomenological approach. Within the forensic psychological literature, despair is considered a pathology, associated with suicide and self-harm, resulting from the prisoners histories and the coercive prison setting. In turn, therapeutic writings outline the importance of therapy in the prison setting with despair in providing coping skills, containment and learning opportunities for the prisoners involved. Design/methodology/approach – Within the study, ten psychotherapists were interviewed as to their experience of working with clients in despair in the prison setting. The data were analysed via the phenomenological research method Empirical Phenomenological Analysis (EPA), and a secondary analysis through reverie. Findings – Through the analysis by EPA, despair emerged in the prison setting as a destabilising phenomenon to which there was no protocol for working with it. Participants also described the prisoners’ despair and the despairing prison setting, touching on their own sense of vulnerability and despair. However, drawing on the secondary analysis by reverie, the researcher also became aware of how the phenomenon of despair emerged not simply through the said, but also through the intersubjective. Originality/value – It was therefore through the secondary analysis by reverie that the importance of the attendance to aspects of intersubjectivity in prison research emerged. This paper contributes to the therapeutic writings on despair in the prison setting, alongside holding implications for qualitative research in the prison setting. [ABSTRACT FROM AUTHOR]

Purpose – The IAPT programme has been rolled out across England in the last ten years. Although undoubtedly many people have benefited from having greater access to psychological therapy there are several issues with the practicalities of Improving Access to Psychological Therapies (IAPT) and also with its ideology. The paper aims to discuss these issues. Design/methodology/approach – This is a personal reflection of working within the IAPT system for several years. Significant statements heard or interpretations of what has been said are presented alongside an analysis of the implications. Findings – A number of important concerns are presented. The overarching concept of the “McDonaldization” process is discussed as a way of encapsulating the IAPT experience; with its theoretical reliance on the medical model and the real world impact of tendering for services in the modern NHS. The impact of IAPT on cognitive behavioural psychotherapy is also highlighted. Originality/value – A lot has been written in the press and online about IAPT. Many of the criticisms seem to derive from people outside of the IAPT system, many of whom have their own personal or professional agenda for attacking IAPT and Cognitive Behavioural Therapy (CBT); often the criticisms are uninformed. This paper is a reflection of working within the IAPT system and not just an uninformed critique of CBT. Several concerns are raised that without remedy may seriously hold back the progress that psychological therapy has made in recent years. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is threefold: to document the relationship between intellectual disability (ID) and psychopathology; to raise awareness of the ongoing lag in professional training for psychologists in the area of mental health treatment for people with intellectual disabilities; and, to provide recommendations for advancing professional education and, ultimately, adequate mental health treatment availability for people with intellectual disabilities. Design/methodology/approach - The paper reviews the literature on prevalence of mental health problems in people with intellectual disabilities. At the same time, the paper reviews the training of psychologists relative to the burgeoning growth in awareness of the mental health needs of people with intellectual disabilities. Findings - The paper concludes that ID is a significant risk factor for psychopathology. In addition, the paper concludes that the education of psychologists regarding the mental health needs of people with intellectual disabilities is insufficient. The authors document the need for incorporating research and treatment advances related to intellectual disabilities and mental health into to the professional training of psychologists. The paper also describe the potential this training holds for improving both the lives of people with intellectual disabilities and the overall competence of psychologists. Practical implications - This paper provides a literature-based rationale for the need to include education in the mental health needs of people with intellectual disabilities into the general training of mental health professionals. In addition, it provides specific recommendations for how such training can be incorporated into graduate psychology programs. Originality/value - This paper provides mental health professionals with a review of the growth in understanding of the enormous, unmet mental health needs of people intellectual disabilities, and of the critical role of ID in development of mental health problems. Moreover, this paper builds the case for an important revision in the training of psychologists to include competence in understanding and treating mental health problems across the full spectrum of intellectual functioning. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to present outcomes of mixed practices including use of ideas from narrative therapy (NT) in a case of mild intellectual disability (ID) and personality disorder. The formulation, therapy adaptation and outcomes are presented.Design/methodology/approach The study is a single case report describing patient presentation, assessments, psychological formulation and the mixed interventions approaches used, including ideas from NT. Adaptations to meet the needs of patients with ID were described, and therapy outcome measured using Health of the Nation Outcome scale and Psychiatric Assessment Schedule for Adults with Developmental Disorders was presented.Findings The ideas used from NT suggest this is potentially a useful approach in practice for people with intellectual disabilities and personality disorder. However, adaptation is needed for it to be used successfully in practice as a therapeutic intervention.Research limitations/implications A single case study has its limitations, and further work on using ideas from NT, its adaptation and use in this population will be needed.Originality/value There is no previous case of use of NT among patients with ID and personality disorder. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to highlight the provision of therapy for witnesses who have a learning disability prior to and following a criminal trial. Authors will reflect on clinical practice whilst stressing that this area of work is in its infancy and both continue to learn through continued reflection and each new experience. Design/methodology/approach – The paper broadly describes the nature of pre-trial therapy followed by reflection by a Counsellor and Supervisor on their clinical practice. Findings – Authors describe some of the common themes that arise whilst providing pre-trial therapy. Social implications – The authors hope that the paper will encourage professionals involved in Safeguarding cases to fully consider the emotional needs of victims and to seek timely therapeutic support where the need presents. They also hope that it will encourage practitioners from various professions to consider providing this specialist and delicate type of therapy whilst highlighting the need for good supervision. Originality/value – There is a paucity of written information about this specific subject area. Although safeguarding of vulnerable adults has grown considerably over the last decade and investigations are now more likely to lead to legal action, the availability of emotional support for victims who have learning disabilities needs to be addressed. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this paper is to describe the attempts by one youth homelessness service to implement the conceptual ideas of the psychologically informed environment (PIE) into a practical and beneficial service for very challenging young people who have been homeless, are leaving care or have left custody. Design/methodology/approach -- The approach of the paper is descriptive, outlining the thinking behind a PIE with young people and the operationalising of this understanding in the day-to-day practice of the service. Findings -- Although homelessness and housing support staff are not therapists, the nature of the work entails a need for understanding and sensitivity, and the activities of the service are designed to create positive opportunities and relationships. Reflective practice, supervision and evaluation are then essential tools in developing a "learning organisation", where the collective dynamics at an organisational level support the psychological work of the PIE. Research limitations/implications -- The implications for homelessness work that can be drawn from the outcome of this project is to better understand how the PIE linked to the concept of a learning organisation can provide a truly robust framework for providing a service that can evolve harmoniously, tying in disparate funding streams to offer very challenging young people an outstanding service that addresses their homelessness and its underlying causes. Practical implications -- The practical implications shown are the psychological skills that can be developed in housing workers; the limits of those skills and how they are complemented by partnership work with other voluntary sector organisations and mainstream health providers; how the ideas of the learning organisation can naturally underpin the work of the PIE. Originality/value -- The combination of the concept of the learning organisation, reflective practice and the PIE provides a highly original and truly robust framework for providing housing workers with the psychological tools to make a transformative difference in the lives of especially vulnerable young homeless people. [ABSTRACT FROM AUTHOR]

Purpose – This paper is a commentary on "The effectiveness of psychodynamic interventions for people with learning disabilities: a systematic review" by Chris James and James Stacey. The purpose of this paper is to illustrate the thesis that standardised ways of evaluating health care interventions may have the inadvertent effect of undermining the case that people with intellectual disabilities should be offered the same opportunities to address their emotional and mental health difficulties as other citizens. Design/methodology/approach – The commentary argues that while the evidence base focuses on the outcomes of orthodox one-to-one interventions, sometimes broader "contextual reformulation" and systemic interventions are called for. However, family- or service-based interventions tend not to feature in studies. Findings – The commentary illustrates these issues by discussing two case studies, which demonstrate how relational issues tend to be unhelpfully focused on the person with intellectual disabilities to the detriment of family members or direct care staff, who may be struggling to make sense of the person's behaviour or distress. Originality/value – The commentary supports the argument put forward in the longer paper and also argues for mental health services to be offered on a non-discriminatory basis to people with intellectual disabilities and to their family members. But it also suggests that one of the additional impacts of service level psychotherapeutic interventions is to re-establish respect for the work of direct care staff whose work is often presented as if it is little more than domestic drudgery when in fact it involves negotiating and responding to people and their issues with great sensitivity and balance. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to appraise “transference” and “countertransference” when working with people with intellectual disabilities (PWID).Design/methodology/approach A review of the literature was conducted, followed by a discussion.Findings No research articles were found. Potential reasons for this are discussed. Historical influence, complexity of the topic and resistance among professionals may be contributing factors. Despite this, these phenomena are important for several reasons. These include the high levels of trauma these clients experience; the manner in which they have been marginalised by mainstream society; the strong likelihood of PWID evoking difficult countertransference from therapists; and the myriad of coping mechanisms and defences that these clients may employ.Research limitations/implications Research is needed to further current understanding of these issues.Practical implications An awareness of these issues amongst practitioners and other key members of a PWID’s system is important.Originality/value This is the first review and commentary on these issues. [ABSTRACT FROM AUTHOR]

Purpose Many homeless people have significant levels of early adverse experiences and consequent mental health difficulties. The purpose of this paper is to examine the experiences of residents and staff living and working in a psychologically informed environment (PIE), a new model of hostel for homeless people which aims to update and make more flexible the principles of the therapeutic community, thereby meeting the psychological and emotional needs of residents.Design/methodology/approach Semi-structured interviews were carried out with nine residents, ten staff and five psychotherapists at two PIE hostels in London. The data were analysed using thematic analysis with a phenomenological epistemological approach.Findings Analysis generated 18 themes for residents and staff combined, organised into five domains: what makes a home, resident needs, managing relationships, reflective practice and theory vs practice of PIEs. The study suggests that PIEs broadly meet their aim in providing a different type of environment from standard hostels. Efforts to build relationships with residents are particularly prioritised. This work can be challenging for staff and reflective practice groups provide a supportive forum. There are limits to the extent to which the theoretical PIE can be put into practice in the current political and economic climate.Originality/value This is one of the first qualitative studies of PIEs. It provides perspectives on their theoretical background as well as how they operate and are experienced in practice. It may be informative to services intending to establish a PIE and to commissioners in assessing appropriate resources. [ABSTRACT FROM AUTHOR]

Purpose - There are many treatments and interventions available to families and carers of children with autism, many without any solid evidence base. This paper aims to present and discuss the literature on some of the commonly used and better researched interventions.Design/methodology/approach - Research literature drawing on systematic reviews in particular, where available, was collated and summarised under the subheadings of psycho-educational, psycho-pharmacological, and complementary interventions or therapies.Findings - There are very few interventions that have a solid research base. Even those with the strongest evidence base, such as early intensive behavioural intervention, have not necessarily been found to have a universally positive impact. Recent studies have been methodologically stronger, but there are still many weaknesses in the research to date.Originality/value - This paper attempts to provide a balanced and independent view of the literature on different interventions for autism. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to provide an update on the effectiveness of psychotherapy with persons with intellectual disabilities.Design/methodology/approach - This paper focused on summarizing the conclusions of other reviews published in the last ten years, including a recent review by the authors.Findings - The paper concludes that there is evidence that psychotherapy with persons with intellectual disabilities is at least moderately effective. Further, there is evidence of effectiveness of psychotherapy for both child and adolescent, and adult populations. There is also evidence that a range of therapeutic interventions are effective and that a spectrum of problems can be addressed via psychotherapy.Research limitations/implications - This area has received relatively little attention in the research literature and the area lacks a large base of methodologically sound and rigorous studies. There is a need for well-designed studies, particularly randomized controlled trials (RCTs), and a need for better specification of treatments (e.g. manualized), better outcome measures, and clearer specification of diagnostic categories within the intellectual disability population.Practical implications - This review provides continued support for the use of psychotherapy with persons with intellectual disabilities.Originality/value - This review appears to represent the most current overview of research in this area. [ABSTRACT FROM AUTHOR]