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This paper presents the findings of a research project that explored the experiences of psychoanalytic psychotherapists based in the UK during the first period of lockdown in the COVID 19 pandemic. Groups of therapists met regularly to share and reflect on the impact of the sudden changes to their practice, and this paper pulls together the key themes which emerged from these discussions. The overarching preoccupations of the psychotherapists were those of loss and survival, with sub‐themes of difficulty holding the frame; reduced security and safety; challenged analytic technique; and altered relationship dynamics. The groups were highly valued by participants as offering support during times of unprecedented stress, while also providing a forum to learn from and make creative use of the challenges presented by working remotely. [ABSTRACT FROM AUTHOR]

Background: Counselling psychology training courses in the UK are required to focus upon at least two therapeutic approaches. Such a stipulation means that trainees need to become competent at navigating the complexities associated with therapeutic integration (e.g. tolerating its ambiguous nature), a factor that proves commensurate with the pluralistic stance often advocated in the theoretical writings of counselling psychologists. This study intends to explore such challenges and engage with the philosophical nature of 'being and becoming' a pluralistic therapist. Method: A case study design has been adopted to reflect in depth upon one counselling psychology trainee's understanding of their developing therapeutic practice. The trainee in question kept a detailed reflexive journal whilst undertaking a training activity which involved working as a therapist over a six-week period with a colleague on the same training programme. Cooper and McLeod's (2011) pluralistic framework for counselling and psychotherapy was actively utilised to harness the therapeutic work. The journal was analysed using thematic analysis with a view to eliciting the major themes associated to the trainee's experience of 'becoming a pluralistic therapist'. Findings: Analysis of the data would indicate that the trainee was becoming a pluralistic therapist through the interaction between four selves: the Reflective Self, Thoughtful Self, Relational Self, and Skilled Self. Each of these is briefly introduced and discussed. Discussion and Conclusion: The paper ends by reflecting upon the complexities inherent in using pluralist philosophy to underpin therapeutic work. Incorporated within this, it reflects upon some of the challenges associated with using the pluralistic framework in practice. Finally, the paper provides recommendations for those training in programmes that advocate pluralistic practice. In particular the importance of understanding pluralistic philosophy, the positive role of ambiguity, the personal nature of training, and the need for further research in this area are outlined. [ABSTRACT FROM AUTHOR]

This paper explores the dilemma faced by many current analytic practitioners, particularly in the National Health Service. With the elevation of the idea of 'evidence-based practice' as the increasingly dominant mode of discourse, is it better to try to preserve one's analytic identity and practice by keeping to the psychodynamic model, or is there a case for seeking accommodation with other therapies, even if they are non-analytic? This paper describes the author's experience in pursuing the latter course, in learning a form of therapy called Interpersonal Psychotherapy. The author describes a piece of work using Interpersonal Psychotherapy, and then attempts to give a psychoanalytically informed reading of the same material. The aim is to suggest that although a perfectly adequate account can be given of this clinical work in terms of Interpersonal Psychotherapy, the therapeutic process can also be understood in terms of movements in the transference and in the patient's intra-psychic world. It is finally suggested that adding a psychoanalytic dimension to such a non-analytic therapy may enrich one's practice not only of these other therapies but also of analytic therapy itself. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Psychotherapy & Counselling is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper seeks to facilitate a discussion across schools of psychotherapy and UK professional registration bodies around the controversial and misunderstood subject of being a dual‐trained/training psychotherapist and sex worker. Despite its importance to a minority of practitioners and clients, the potential overlap between sex work and psychotherapy remains an understudied and underreported area. We aim to open up conversation regarding the potential of sexuality work to therapeutically benefit clients for whom talking therapy alone is insufficient. We illustrate how medical theories of pathology are linked to gender diversity and then applied by "therapeutic" communities to marginalise and suppress competing ways to provide therapeutic contact. Our dialogue highlights the practice and philosophical inconsistencies of mainstream psychotherapies' codes of ethics and conduct, which underpin how dual‐trained sex worker–therapists are deemed to bring the profession into disrepute. Rather than protecting the public, perhaps some sections of the public are left at greater risk of harm because such codes of ethics are unable to respect perceived transgressive sexualities, yet are comfortable with how practitioners are paid for intimate (albeit psychological) contact. We look into psychotherapy's shadow, and show that dual‐trained sex‐worker–therapists have something to offer. We also suggest ways to express sexual rights and reclaim sexuality bodywork from those who can be said to seek to exert power and control over the minds and bodies of others. [ABSTRACT FROM AUTHOR]

Purpose In Scotland, individuals referred for NHS psychological therapies are expected to commence “treatment” within 18 weeks of receipt of referral. With high demand, high non-attendance rates and limited capacity, this can be a challenging goal. The service discussed here was keen to develop a way of seeing individuals referred sooner and improving the efficiency of the assessment process. The purpose of this paper is to look at the impact of introducing assessment (“Signpost”) appointments on waiting times, attendance, and treatment planning.Design/methodology/approach Signpost appointments were offered to all existing, and any new referrals, to an adult psychological therapies team (PTT) in NHS Lanarkshire. Clinicians kept a record of the outcomes of these appointments over a six month period. Waiting times and attendance figures were compared before and after the introduction of the Signpost system.Findings Following the introduction of Signpost appointments, individuals were seen sooner for both assessment and therapy. Attendance at first appointments improved and Signpost appointments helped inform treatment planning. Although alternatives were discussed, the majority of clients were still offered individual therapy. Service user and staff satisfaction was high.Practical implications The results from this study led to assessment (“Signpost”) appointments being rolled out across other adult PTTs in NHS Lanarkshire.Originality/value There is little research looking at the impact of assessment/signpost appointments on adult mental health services in the UK. In the current climate of public service cuts, this study provides an innovative way of reducing waiting times and maintaining service user satisfaction, without requiring more resources. [ABSTRACT FROM AUTHOR]

Much as it is the prevailing paradigm within the NHS and the ideology underpinning the outcome measurement agenda, psychotherapy continues to question whether the evidence-based model represents a suitable methodology for complex psychological processes. Outcome measurement is antithesis to the psychotherapeutic project - or at least many within the discipline continue to argue this position. However, if providers of psychotherapy services are to survive in the 'real' world of evidence-based medicine, then the onus is upon them to side-step the 'paradigm wars' and find new ways of engaging with the mandate to measure. This paper proposes that psychotherapists can engage meaningfully with outcome measurement by asking two important questions of the time they spend with their patients: 'Is this treatment working for this individual presentation?' and, if not: 'What immediate action can be taken in order to remedy the situation?' The paper goes on to illustrate how the patient-reported outcome measure ( PROM), when incorporated into routine clinical practice can act as the mediator of this important self-evaluative process. [ABSTRACT FROM AUTHOR]

Poor outcomes for young people in and leaving care have been well documented and research has indicated that the expectations of professionals working with children and young people looked after is a significant influence, particularly in relation to education. An evaluation of an independent children's residential school in Scotland provided a rare opportunity to analyse and compare the views of different kinds of staff about desirable outcomes and how successful outcomes could be achieved. Care workers, teachers and specialist support staff shared some views, but also held contrasting expectations, which appeared to be linked to differing emphases in their models for working with young people. This paper offers tentative explanations for such differences and concludes with suggestions on how to help align service staffs' expectations of young people leaving their care. [ABSTRACT FROM AUTHOR]

Many psychotherapists across a range of modalities remain unaware that, from the late nineteenth and twentieth century on, lesbians and gay men were pathologized in classical psychoanalytic theories. For decades lesbians and gay men had been deemed 'unfit' to train as psychoanalytic practitioners due to failures in their early sexual development. In this article I describe the history of the challenges for lesbian and gay clients, applicants to training, trainees, and qualified psychotherapists in the UK from 1986. As emphasised by the French philosophers, Ricoeur and Doss, the work of remembering is vital if we are to prevent the repetition of failures from the past. It is important to recognise history is never linear and points of achievement are never stable; in the past four years, for example, homophobic hate crimes have trebled in the UK. I describe how lesbian and gay psychoanalytic psychotherapists, along with establishing counselling and psychotherapy services accessible to lesbians and gay men, organised conferences, spoke publicly, published, and demonstrated. Our challenges to heteronormative psychoanalytic theorising included an engagement with other disciplines such as fiction, biography, and poetry written by lesbians and gay men, post-colonial theorising, queer theory, and philosophical texts. Challenging universalising interpretations of the 'causes' of 'homosexuality' we emphasised the critical importance of attending to differences in individuals' experiences of their sexualities and identities. In 2015 the crucial Memorandum of Understanding which protects the public through a commitment to end the practice of 'conversion therapy' was signed by twenty organisations (amended in 2017 to include gender), including psychoanalytic training organisations, and released at the Department of Health. This was widely welcomed after nearly thirty years of fighting for recognition of the effects of the pathologizing of lesbian and gay sexualities on people' lives, including those of people who identify as heterosexual. [ABSTRACT FROM AUTHOR]

Minoritised individuals (people identifying as belonging to groups experiencing socially constructed power inequalities) frequently experience mental health inequalities. Mental health services have often, intentionally or inadvertently, perpetuated these inequalities due to historic and ongoing systemic discrimination. To reduce inequalities, mental health services must address ongoing systemic discrimination and improve cultural-sensitivity of clinical staff. One method of improving clinician cultural-sensitivity is through reflective practice groups. This project evaluates a staff Equality Diversity and Inclusion (EDI) reflective space within a community psychological therapies team. A mixed methods approach of survey feedback and semi-structured interviews was used. Staff found the reflective space beneficial for improving their clinical skills relating to issues of EDI and helpful for their own wellbeing. Staff also found the EDI reflective space both acceptable and feasible and were keen to attend future sessions. However, some clinicians highlighted challenges relating to fear of judgment and evaluation from others. Findings are discussed in relation to the growing body of evidence of the usefulness of staff reflective spaces in healthcare generally, and provide specific support for the implementation of EDI reflective spaces. Guidance for developing an EDI staff reflective space for healthcare staff are discussed, alongside limitations and possible future research directions. [ABSTRACT FROM AUTHOR]

An NHS Mental Health Trust Medical Psychotherapy Consultation Service using psychoanalytic psychiatry to help the patient and professional is described. The Consultation Service established in 2000 is offered to secondary acute and community mental health teams and primary care. The service was evaluated as a basis for regional and national development. Between 2006 and 2013, 87 consultations from 210 were sampled to ascertain demographic and diagnostic profiles and outcomes of the consultation process. We conducted an online survey of local consultant psychiatrists' views about the service, and undertook a thematic analysis of the free text comments. We also conducted a survey of members of the Royal College of Psychiatrists' Medical Psychotherapy Faculty to ascertain whether similar consultation services existed elsewhere in the UK and had been evaluated. The Leeds model of psychoanalytic consultation – a 'consultation sandwich' – is described. From a psychoanalytic perspective, the work of consultation is seen as an extension of the dynamic field of the analytic situation. This paper develops the concept of a bastion – an omnipotent reserve in and between the patient and professional derived from adhesive identifications leading to stuck relationships. The adhesive identification in the patient and professional acts like a 'grievance glue' – a mutual manifestation in a last bastion of painful limitations not faced, losses not grieved. [ABSTRACT FROM AUTHOR]

Arts therapies practice in the UK, due to its complexity, is rarely adequately described and what constitutes main features of the professions often remains unclear. A nationwide Arts Therapies Survey was conducted in 2011 with the aim to offer a description of clinical practice with particular emphasis on work with depression. The survey received responses from 395 arts therapists, among whom 36 were dance movement therapists. While complete data from the survey is available elsewhere, this paper presents results particularly relevant to dance movement practitioners and highlights key areas of their practice, including usual work settings, client groups and preferred theoretical approaches. Both quantitative and qualitative data are used to illustrate the points discussed. Additionally, dance movement psychotherapists' responses concerning their work with depression are presented against other arts therapies professions' practice with this condition in the UK. Finally, areas for further research are recommended. [ABSTRACT FROM AUTHOR]

This paper is a brief phenomenological description of the polarities and paradoxes emerging in people's day-to-day lives, within the context of the COVID-19 pandemic. It uses a collection of vignettes to explore the ways that people in the UK are making sense of the early stages of the COVID-19 public health measures. It concludes by suggesting there is an existential importance of working with paradox and polarities, both personally and professionally, as psychotherapists at this time. [ABSTRACT FROM AUTHOR]

Evidence-based and person-centred care requires the measurement of treatment outcomes that matter to youth and mental health practitioners. Priorities, however, may vary not just between but also within stakeholder groups. This study used Q-methodology to explore differences in outcome priorities among mental health practitioners from two countries in relation to youth depression. Practitioners from the United Kingdom (UK) (n = 27) and Chile (n = 15) sorted 35 outcome descriptions by importance and completed brief semi-structured interviews about their sorting rationale. By-person principal component analysis (PCA) served to identify distinct priority profiles within each country sample; second-order PCA examined whether these profiles could be further reduced into cross-cultural "super profiles". We identified three UK outcome priority profiles (Reduced symptoms and enhanced well-being; improved individual coping and self-management; improved family coping and support), and two Chilean profiles (Strengthened identity and enhanced insight; symptom reduction and self-management). These could be further reduced into two cross-cultural super profiles: one prioritized outcomes related to reduced depressive symptoms and enhanced well-being; the other prioritized outcomes related to improved resilience resources within youth and families. A practitioner focus on symptom reduction aligns with a long-standing focus on symptomatic change in youth depression treatment studies, and with recent measurement recommendations. Less data and guidance are available to those practitioners who prioritize resilience outcomes. To raise the chances that such practitioners will engage in evidence-based practice and measurement-based care, measurement guidance for a broader set of outcomes may be needed. [ABSTRACT FROM AUTHOR]

Research on individual therapy suggests that the ability to build effective therapeutic alliances with clients is related to the therapist's adult attachment style. This paper reports an on-line survey of the attachment styles of registered family therapists in the UK which investigated associations between therapist's attachment style, prior profession, gender and preference for a model of therapy. All 443 UK registered family therapists were surveyed and 82 (19 percent) replied. The survey included two standardised self-report measures: the Relationship Questionnaire (RQ) (Bartholomew and Horowitz in Pers Soc Psychol 61:226-244, ) and the Experiences in Close Relationships Questionnaire (ECR) (Brennan et al. in Attachment theory and close relationship. The Guilford Press, New York, ). The RQ invites respondents to rate the extent to which descriptions of secure, preoccupied, dismissing and fearful attachment styles applied to themselves. The ECR is a more conventional measure similar to a personality inventory. Responses to the two measures were discrepant. On the RQ 61 self-reported as having a 'secure' attachment style, nine 'preoccupied', six 'dismissing' and six were 'fearful'. Responses to the ECR indicated that 24 were 'secure', 16 'preoccupied', 15 'dismissing' and 27 'fearful'. Attachment style, as measured by the ECR, was not associated with therapists' prior profession, gender and preference for a model of therapy. The discrepancy between measures may be attributable to the more transparent RQ measure. Participants' responses may have been based on how they wanted others to view them or how they viewed themselves. These responses are challenged by the findings from the ECR which revealed apparently less desirable adult attachment styles in this sample. [ABSTRACT FROM AUTHOR]

Background: Two current trends are making it increasingly important for counsellors and psychotherapists to be more engaged with research. Evidence of effectiveness is being increasingly demanded by those who fund our therapies and also by our clients. Meanwhile therapy research is offering practicable ways for therapists to improve their practice. Therapy organisations have an opportunity, perhaps even a duty, to meet the research needs of their members. Methods: This paper reports on a survey conducted by the UK Council for Psychotherapy (UKCP) to help it plan the activities of its Research Faculty. Findings: Key findings from the survey were that the most common ways of UKCP practitioners engaging with research were through reading, discussions with colleagues and doing research. Engaging with research collaboratively with other therapists, having more time, and access to user‐friendly web‐based research resources and updates, were the factors most commonly cited as supporting practitioner engagement with research. Conversely, lack of time, difficulties accessing resources and materials and feeling not competent were the major barriers to practitioner engagement with research. Discussion: Implications for therapists, for training, and for therapy organisations are considered. [ABSTRACT FROM AUTHOR]

Aims: This paper proposes that ethnography and auto‐ethnography can make important contributions to counselling and psychotherapy research. Auto‐ethnography is a recent methodological approach that focuses on the subjective experiences of the researcher. It is informed by anthropology, which encourages the researcher to journey alongside the persons being observed and to make meaning of complex symbolic systems in their lives. Method: Examples from a study of therapeutic processes in a mental health setting for women are examined. Discussion: If auto‐ethnography situates the researcher with the insider's perspective and ethnography is from the outsider's perspective, the researcher is caught 'in‐between' these two approaches. Acknowledging the concept of 'in‐between‐ness' can both cause discomfort and transform the experience of all who engage in the process and enhance the quality of the research. [ABSTRACT FROM AUTHOR]

Throughout most of the twentieth century psychoanalysis regarded same-sex desire as a pathological or arrested condition. As people became less hostile to homosexuality in the late twentieth century, so did the psychoanalysts, only more slowly. In this paper the author briefly traces the evolution of psychoanalytic ideas on homosexuality, before examining how today's psychoanalytical practitioners and their patients regard treatment of same-sex desire, focusing mainly on research conducted over the past 15 years. [ABSTRACT FROM AUTHOR]

Alongside concerted political action, the survival of psychoanalytic psychotherapy in the NHS will require adaptation within the psychoanalytic community. This paper looks at the difficulties facing the profession, provides an example of the important role the profession can play in the NHS, and then outlines three areas for examination and adaptation in order to enable survival and development: professional narcissism of minor difference, the use of language, and a broader understanding of 'risk' in mental health services. [ABSTRACT FROM AUTHOR]

This paper argues that there is a gap between intention and delivery when it comes to strategic decisions and that this is in part a consequence of the ambiguity associated with membership. Psychoanalytic organizations are rightly expected to support the standards and integrity of clinical practice but far less attention is given to the 'needs' of the organization. In times of scarcity such a split can endanger the future robustness of the psychoanalytic community. The lack of sustained discussion or real anxiety about the fertility of our community is a constant surprise. Perhaps this has something to do with the status and influence that psychoanalytic ideas have enjoyed. Perhaps it is also a product of our age, status, and our real concerns about our own mortality. One characteristic of ageing is a concern to leave something of value to one's children. I do wonder sometimes whether there is not some disavowed guilt about the robustness of the organizational, intellectual and clinical property that we are passing on, and specifically its capacity to sustain itself, in difficult times, another generation. [ABSTRACT FROM AUTHOR]

The workforce providing psychological therapies in the UK has traditionally been divided according to where they work, sharp boundaries between professional associations and adherents of different treatment models, and allegiances to other professions. There are signs of a more unified (and larger) psychotherapy profession emerging as a result of government initiatives that, directly or indirectly, have the potential to reduce each of these divisions. The paper summarises recent initiatives in service delivery, training standards, evidence-based practice and professional regulation that are working to reshape the workforce responsible for providing psychological therapies in the UK, especially within publicly funded services. [ABSTRACT FROM AUTHOR]

The United Kingdom Council for Psychotherapy (UKCP) was formed to provide a professional body for all psychotherapists in the UK. It maintains a register of trained practitioners who abide by the ethical standards ratified by UKCP, which includes psychotherapists working in all the modalities recognized by UKCP irrespective of their primary professional training. In the absence of statutory registration, there is no fully representative list of UK psychotherapists, but the UKCP register is probably the nearest thing to it. The UKCP board recognized that a survey of registrants would provide a snapshot of the state of UK psychotherapy, which would be valuable in understanding the contribution of psychotherapists to health services in the UK. A questionnaire was designed, and sent out to all 4005 practitioners registered by UKCP in December 1997. One thousand three hundred and thirty-one questionnaires were returned, a response rate of 34 per cent. The respondents were representative of all registered psychotherapists in 1998 in those characteristics that are published in the paper register, or that can be inferred from it. The respondents were aged 51 years on average, predominantly white (97 per cent described themselves this way) women (69 per cent) practising in London and the South East of England (55 per cent). All the respondents described themselves as being influenced by psychotherapeutic approaches rooted in psycho-analysis. Ninety-five per cent of respondents had another profession previous to psychotherapy. This was most commonly teaching (27 per cent), social work (22 per cent) or counselling (21 per cent). Only 11 per cent of respondents were psychologists. The contribution of UKCP registrants to the National Health Service has never previously been estimated. A breakdown of the diaries provided by respondents in this survey suggests that UKCP registrants may contribute as many as 44,760 hours of psychotherapy per week to the British National Health Service and other health sectors. Assuming that a whole-time-equivalent psychotherapist works 37 hours per week, this means that UKCP registrants may provide the equivalent work to health service organizations, both public and private, of more than 1,311 full-time psychotherapists. [ABSTRACT FROM AUTHOR]

Although research into family therapy training is increasing it has so far mostly focused on the process of the teaching and acquisition of certain concepts and skills. In contrast, the experience of training as family therapists has rarely been investigated. This paper reports on the impact of family therapy training at one training institution in the UK on the personal, relational and professional identities of trainees. Six family therapy trainees were interviewed using semi-structured interviews at regular intervals over a period of approximately twenty months. Interpretive phenomenological analysis (IPA) was employed to analyse the interviews. The results suggest that participants often found the experience of training as a family therapist overwhelming and de-skilling, but that it nevertheless provoked a re-evaluation of some of their established personal, relational and professional identities. In many cases these re-evaluations seemed to have preceded a process of individuation, of assuming a different or more complex identity. [ABSTRACT FROM AUTHOR]

Since the 1940s art therapists have often worked with marginalised people and marginalised imaginations. The expressions of this can be strikingly original, yet fit uneasily with any genre. Artists becoming therapists were presented with radical opportunities to witness, support and possibly befriend those possessing, or possessed by, ways of seeing, feeling and thinking contradicting conventional consciousness. This was particularly true in the large populations inhabiting psychiatric institutions in Britain until the 1980s. This paper describes the work and ‘performances’ of five people; three of whom it was possible to know well, and the unusual ways of being of the others could only be experienced. The approach is not ‘scientifically’ clinical but more like anthropological reportage and stories about ‘characters’. Change is of course aim of psychotherapy, but so is witnessed. No matter what traumas lay in their past, over time they had become who they most memorably were. [ABSTRACT FROM AUTHOR]

This paper briefly describes narrative and open dialogue approaches before exploring their shared values, ways of working, their differences and the possibilities for integration. Both authors have extensive experience in using a narrative therapy approach, while Val Jackson, a family and systemic psychotherapist, also uses an open dialogue approach in her work in an early intervention in psychosis service in Yorkshire, UK. [ABSTRACT FROM AUTHOR]

Background: In addition to having a negative impact on the physical and emotional health of the population, the global Covid–19 pandemic has necessitated psychotherapists moving their practice to online environments. This service evaluation examines the efficacy of Eye Movement Desensitization and Reprocessing (EMDR) Therapy delivered via the internet. Methods: A real–world service evaluation was conducted from a self–selecting group of EMDR therapists that subscribe to either a JISCMail discussion list or either the UK or All Ireland National EMDR Associations. Author designed questionnaires were used to gather information on the efficacy of EMDR delivered online as well as client and therapist characteristics. Results: Thirty-three therapists provided efficacy data on a total of 93 patients. Statistically significant and clinically meaningful reductions were found in all four-psychometrics used both in adult and children and young people populations. Client outcome was not related to therapist experience. Conclusions: EMDR delivered via the internet can be an effective treatment for clients experiencing mental health issues. [ABSTRACT FROM AUTHOR]

Focuses on the changes of the working environment of child psychotherapists in the public sector in Great Britain. Provision of general service to a local community; Kinds of dual citizenship; Importance of district child psychotherapy.

Objective: The aim of this study was to explore the impact social class biases may have on the diagnosis and treatment of clients by psychological and psychotherapeutic professionals working in the National Health Service (NHS) in Britain. Methods: Psychological and psychotherapeutic professionals working in the NHS were randomised to one of two video vignettes representing a psychological assessment session with either a 'lower' or 'upper' class client. The accent and dress of the client were varied to elicit class stereotypes. The video and study measures were accessed online via a link to a webpage. Participants completed measures of clinical reasoning, namely diagnosis, risk assessment and treatment, as well as measures of class self‐awareness. Results: Among the 156 practitioners who completed the measures there was little difference between the two groups for the clinical reasoning measures. The expectation was that participants believed a 'lower class' client was more likely to receive an 'alcohol or substance misuse' diagnosis (p =.002; d = 0.40). Unexpectedly, seeing a 'lower class' client led to significantly increased class self‐awareness scores, particularly those measures indicating reflection on personal conflicts relating to practitioners' own social class and the impact such biases may have on their work. Conclusions: There was little difference in clinical reasoning between the two class conditions. This may be due to client class cues priming the psychologist to reflect on their own potential class biases. Practitioners may benefit from further reflection and training on biases related to substance use and social class. [ABSTRACT FROM AUTHOR]

Family therapy in Britain must develop to encompass the external reality of family life. Living in a racist society dominates the lives of all black families. Family therapists need to acknowledge and address this before intervening in the family system. This paper offers personal and professional experiences, confrontaion, structured exercises and general and specific principles for work with black families. Minimal and positive goals are advocated so that practitioners do not feel paralysed by the enormity of the task. [ABSTRACT FROM AUTHOR]

The integration of spirituality into counselling and psychotherapy poses complex challenges. Personal spirituality, professional competency and ethical considerations may impact on trainees' experiences of integrating spirituality into therapy. This study adopted an inductive, qualitative approach to explore trainee counsellor/psychotherapists' experiences and perceptions of integrating spirituality into therapy. Six trainee counsellors and psychotherapists were recruited using purposive sampling from a professional counsellor and psychotherapist training institution in the UK. In‐depth, semi‐structured interviews were conducted, audio‐recorded and transcribed verbatim. Thematic analysis of the interviews revealed two overarching themes: spirituality provides support but needs a warning; and spirituality is relevant but undervalued. These themes encompass a wide range of trainee concerns associated with integrating spirituality into therapy. Participants reported that they felt unprepared to work therapeutically with clients' spiritual beliefs. However, the value of spirituality in providing support to both the trainee and their clients was highlighted by several participants. Some participants described integrating clients' spirituality as having a positive impact on the therapeutic relationship, but often felt threatening to the trainee. This research has implications that are important for counselling and psychotherapy training and developing enhanced consideration of client spirituality and the interpersonal environment in which therapy is delivered. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Family Therapy is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This case study describes work undertaken within an NHS early intervention mental health service in the UK, focusing on the therapeutic use of “freestyle” and original rap. In particular, it uses material and analysis pertaining to one individual who formed part of an open group for clients in the community. The specific role of this form of therapy is detailed, addressing the aims of the work relating to the setting and background of the client, and outlines the rationale for the use of an empowerment-based model of working. The clinical material is analyzed from a psychodynamic perspective, with a particular emphasis on the development of the therapeutic relationship and the use of rap as a therapeutic intervention, taking into consideration stylistic and cultural connotations of the genre and Hip Hop culture. [ABSTRACT FROM AUTHOR]

A multidisciplinary guideline on religion, spirituality (R/S), and psychiatry aims to address: (1) organising R/S consultation in mental health care, (2) categorising research findings, and (3) professionalism and education with respect to R/S. Contents are derived from brainstorm sessions with key participants in the field of R/S and psychiatry in the Netherlands, and from the position statements on R/S and psychiatry in the UK and by the World Psychiatric Association. The following chapters are proposed: (1) ethical and existential themes and R/S, (2) R/S in stages of mental health care practice, (3) R/S counselling, (4) collaboration, and (5) relationship to other guidelines. The core themes need verification by specialists in the field, nurses, therapists, counsellors, patient-practitioners, and psychiatrists. The author recommends to approach R/S in an easy way, to listen to matters of personal meaning, and to leave the task to others in case of a lack of affinity. [ABSTRACT FROM PUBLISHER]

The article presents short biographies of British psychotherapists whose papers are published within the issue. Monika Flakowicz, who graduated with a master of arts degree in clinical psychology, is working as a trainee child and adolescent psychotherapist. Wendy Hollway works as a professor in psychology at the Open University. Cathy Urwin is the consultant child psychotherapist and research fellow at the Tavistock Centre.

The research aimed to investigate the national Improving Access to Psychological Therapies (IAPT) programme, from the perspective of ‘non-IAPT’ counsellors and psychotherapists working within IAPT services. Semi-structured interviews were carried out with therapists who were currently working within IAPT services, but had no formal ‘IAPT-compliant’ or ‘IAPT-accredited’ training. Foucauldian discourse analysis was used to analyse interview transcriptions and the study examined the various discourses used by participants to speak about IAPT. Findings indicated that participants drew upon dominant discourses in attempts to fit in or belong, yet paradoxically, the way in which the discourses were used seemed to create subject positions that were outside to, or excluded from, the IAPT services they worked at. IAPT and non-IAPT discourses emerged simultaneously – a possible indication of the discursive junction where different ideologies were in conflict with one another. Implications of the power relations that may be operating within this setting are discussed and suggestions made for further research. [ABSTRACT FROM PUBLISHER]

Background: A large body of research has identified that many therapists do not use research to inform their practice, but few studies investigate the reasons behind this. Aims: The current study seeks to understand what sources therapists use to inform their practice and why they are chosen. Method: Thirty-three interviews with psychological therapists in the UK were undertaken. These were transcribed and analysed using Interpretative Phenomenological Analysis. Results: Two superordinate themes emerged. The former focused on the nature of evidence and the latter described why certain sources were used to make clinical decisions. When discussing evidence, participants felt that research studies, specifically Randomized Controlled Trials (RCTs), used unrepresentative samples. Therapists felt that research other than RCTs, particularly qualitative research, was important. Therapist specific factors were felt to be as, or more, important than the technique used to treat patients. When discussing the sources they used, therapists preferred to use their clinical experience or their patients’ experience to make clinical decisions. Theoretical or practical information was preferred to empirical research. The presentation of information was felt to be important to encourage the implementation of research, and therapists also felt tools such as outcome measures and manuals were too rigid to be useful. Finally, patients’ choice of treatment was felt to be important in treatment decisions. Conclusions: The views of therapists were heterogeneous, but this study highlighted some of the barriers to closing the gap between science and practice. This knowledge can be used to increase the translation of science into practice. [ABSTRACT FROM AUTHOR]

Copyright of Family Process is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In sketching the position of couples and family therapy and systemic practice in the United Kingdom of Great Britain and Northern Ireland (the UK) we have provided what we can of the development of the contexts of training and practice; the content of some of the theories and their applications; and the external realities within which we currently operate. The UK has a well developed structure for training and practice in systemic couples and family therapy. The history is of enthusiastic adoption of therapies from international sources which are generally then incorporated into an overarching systemic framework. Family therapy in the UK is currently subjected to a variety of pressures but is well regulated and is in a strong position to continue making its contribution to the welfare of families. [ABSTRACT FROM AUTHOR]

In spite of policies advocating the involvement of families in the care of mental health service users in the UK, there are few examples of initiatives to develop staff confidence and skills in partnership working. This article describes a whole team training initiative and family liaison service to promote family inclusive working on in-patient wards for older people in Somerset, UK. A three-day staff-training programme is described and training outcomes are reported. Staff report a substantial increase in confidence and family meetings held. A pre-and post- training case note audit shows increased consideration of the needs of families. To further increase face to face meetings with families a family liaison service has been established, whereby a staff member with systemic family therapy training joins ward staff to hold family meetings as part of the assessment/admission process. Evaluation of this service has shown it to be effective with positive feedback from families and staff. [ABSTRACT FROM AUTHOR]

This study describes how a sample of six psychosexual therapists regard the use of sexual fantasy in their work with couples presenting with sexual dysfunctions. The study used a qualitative approach, adopting a thematic analysis to explore the common threads in the therapists’ experiences. Five themes emerged from analysis: The importance of fantasizing, Help with fantasizing, Accepting fantasies, Assessing disclosure of fantasies and Partner replacement fantasies as necessary. The research highlights the importance of an informal attachment assessment of the partners before the introduction of fantasy. It also briefly considers the possibilities of an approach to “fantasy training” that takes into account how Schnarch’s concept of “differentiation” might help to promote personal growth and couple intimacy. [ABSTRACT FROM PUBLISHER]

Primary objective: This is the first qualitative study that elicited the perceptions of both psychological therapists and their clients in the use of Clinical Outcomes in Routine Evaluation with computer software (CORE‐Net), where instant visual feedback for session tracking was given on a computer screen in the therapy room at each therapy session. The study also examined how therapists viewed its potential value in supervision and provides suggestions for improving training. Research design: The study adopted a convenience sample of four therapists in a primary care counselling setting (PCC – General Practitioner referrals) who were experienced in using CORE‐Net, and five therapists in an NHS employee/occupational support counselling service (OH) who had just begun to use CORE‐Net for session tracking with 10 of their clients. Method: A qualitative methodology was used and interview data were collected from the therapists via focus groups; the clients were interviewed individually face to face. All data was analysed inductively. Findings: The study identified six overarching themes: (i) therapists were initially anxious and resistant; (ii) therapists adapt 'creatively'; (iii) outcome measures help the client/therapist relationship; (iv) clients perceive visual measures as helpful; (v) CORE scores inform supervision; and (vi) proper and ongoing training/support of therapists is necessary. The main limitations are comparability of data and the generalisabilty of results. Conclusions: The implementation of routine outcome measurement (ROM) is a challenge but can be made easier with proper training and supervision. Clients appear happier than their therapists when routine outcome measurement is used. [ABSTRACT FROM AUTHOR]

Objective. 'What is narrative therapy and how do you do it?' is a question that is repeatedly asked of narrative therapy, with little consistent response. This study aimed to explore and distil out the 'common themes' of practitioner definitions of White and Epston's approach to narrative therapy. Design. This was an Internet-based study involving current UK practitioners of this type of narrative therapy using a unique combination of a Delphi Panel and Q methodology. Method. A group of experienced practitioners were recruited into the Delphi Poll and were asked two questions about what narrative therapy is and is not, and what techniques are and are not employed. These data combined with other information formed the statements of a Q-sort that was then administered to a wider range of narrative practitioners. Findings. The Delphi Panel agreed on a number of key points relating to the theory, politics and practice of narrative therapy. The Q-sort produced eight distinct accounts of narrative therapy and a number of dimensions along which these different positions could be distinguished. These included narrative therapy as a political stance and integration with other approaches. Conclusions. For any therapeutic model to demonstrate its efficacy and attract proponents, an accepted definition of its components and practice should preferably be established. This study has provided some data for the UK application of White and Epston's narrative therapy, which may then assist in forming a firmer base for further research and practice. Copyright © 2010 John Wiley & Sons, Ltd. Key Practitioner Message: • Narrative therapy and how it is carried out remain unclearly defined, which limits studies of the efficacy of this approach. • Experienced practitioners of narrative therapy were able to identify a set of core concepts, values and techniques over which there was some consensus. • This study also identified the different 'positionings' of narrative therapy that have contributed to its opacity and have highlighted the diversity in therapist practice. [ABSTRACT FROM AUTHOR]

Aim: This study explores dilemmas facing psychodynamic therapists who provide personal therapy to therapists in training. Method: Eight experienced psychodynamic psychotherapists were interviewed using a semi-structured interview format during which they were asked about the importance of personal therapy, if they encountered any dilemmas and, if so, how they resolved those dilemmas. Their responses were analysed using a qualitative form of content analysis. Findings: Two categories of dilemma emerged: clinical and personal. Clinical dilemmas arose out of the mandatory requirement for therapy, boundaries, fitness to practice and the suitability of trainees. Personal dilemmas included pressure to model, sense of responsibility, therapeutic narcissism, countertransference reactions, over-use of self and stressful involvement. The therapists' strategies for resolving the dilemmas are described. Conclusion: The results show participants considered personal therapy to be essential for trainees and thought it should be mandatory even though it led to difficulties in the therapy. Questions arose about the suitability of some trainees, the person of the therapist and stressful involvement. Further research into these important areas is recommended. [ABSTRACT FROM AUTHOR]

Background: Psychoeducational family approaches are effective in improving the quality of life for both those with mental health problems and their families, but implementation of these approaches within health services has been limited. The Meriden Family Programme has provided training and support for over 3,900 therapists and 242 trainers in Behavioural Family Therapy (BFT) to encourage widespread delivery of effective services for families with a member who has psychosis or other serious mental health problems. Aims: This article synthesises healthcare professionals' and carers' views on the implementation of family work and ways of increasing family involvement in services. Methods: During the Meriden Programme's 10th anniversary year, three Masterclass groups ( n == 27) were conducted with healthcare professionals and carers involved with the programme over the past 10 years. Results: A collaborative approach between management, commissioners, BFT trainers, therapists, carers and service users encourages and ensures the delivery of family work. The most effective types of support, methods of training and organisational factors in supporting family work implementation are illustrated. Conclusions: Best practices in implementing family work are identified to support and better inform those responsible for providing family work within their services. [ABSTRACT FROM AUTHOR]

Background and aim: There have been several calls for adopting an empirical approach investigating public opinion concerning the differentiation between the professional titles 'counsellor' and 'psychotherapist'. The present research makes a first step to addressing this issue. Method: Sixteen interviewers, recruited across the UK, interviewed 450 members of the public in 57 UK district codes. Age, gender and education were monitored for sampling purposes. Results: The findings indicated that around two thirds of the public perceive the professional title 'counsellor' to be distinct from the professional titles 'psychotherapist' and 'psychological therapist' and for these latter two titles to be almost identical. About one third of the public perceive the opposite trend, and one tenth is undecided whether these professional titles are distinct or indistinct. Conclusion: These results have implications for the debate concerning the structure of the Health Professions Council (HPC) Register in the regulation of counsellors and psychotherapists. [ABSTRACT FROM AUTHOR]

Arising out of a perceived contradiction in the implementation of a second order perspective, this article suggests a practice framework for inclusion in the training of systemic supervisors. Brief feedback from trainees is also presented. [ABSTRACT FROM AUTHOR]

This article, updated in June 2008, explores issues related to ethical governance as an integral part of the increasing professionalization of the mental health field as psychotherapists and counsellors move towards statutory regulation in the United Kingdom (UK). The Health Professions Council (HPC) continues to meet with the numerous interested parties who are working to achieve regulation by 2011. It is important to note that this is a rapidly evolving process so that some of the information related to it may have changed by the time the article is published. The author suggests that the points made in the article may be relevant not only to the UK but to the mental health field worldwide. Legal issues are looked at that pertain to judicial review, data protection, anti-discriminatory legislation, human rights, and confidentiality with regard to patient material. Transparency and accountability are the twin pillars of ethical governance not only in the mental health field but in the socio-political-economic life of much of today's world. [ABSTRACT FROM AUTHOR]

The article offers information about the fourth Chiron Association for Body Psychotherapists conference held at Robinson College in Cambridge, England. The event was attended by about 150 experts from a number of different countries and orientations. Among the speakers in the said event include Joe Schwartz, Shoshi Asheri, and Roz Carroll.

Focuses on the British Confederation of Psychotherapists Working Group on Confidentiality. Role of the American Psychoanalytic Association in the case of Jaffee v. Redmond; Application of the case in Great Britain; Cases involving a psychotherapy and psychotherapists given to the Working Group.

Background This pilot study examined the feasibility of conducting a randomized controlled trial of brief psychodynamic interpersonal (PI) therapy, carried out by inexperienced psychiatry trainees, in a secondary care psychotherapy setting with NHS psychotherapy patients waiting for a brief therapy intervention. Method Patients were randomized to receive twelve weeks' PI therapy immediately or to remain as waiting-list controls for that period, following which they received twelve weeks' PI therapy. Results Fifty-four patients entered the study, of whom thirty-three completed therapy. The data were analysed in two ways. First, significant improvement was demonstrated in those patients who completed therapy. Second, the comparison between twenty-four patients randomized to treatment and twenty-two waiting-list controls showed a non-significant trend towards greater improvement in the immediate treatment group. Conclusions The study implementation was feasible in a service setting. This study provides preliminary evidence that treatment by inexperienced therapists may be effective and that the majority of patients can be engaged in therapy. However, high attrition rates were found between waiting list and completion of therapy, and patients with a history of abuse in childhood were particularly difficult for trainees to engage in brief therapy. A definitive study with adequate power confidently to detect differences of this magnitude would require sample sizes of approximately 121 in each comparison group. [ABSTRACT FROM AUTHOR]