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This paper argues that the process of modeling in science and the process of encountering and working with a client in clinical psychotherapy overlap. In briefer terms: what makes a good therapist is much like what makes a good scientific modeler. Both modeling and psychotherapy are iterative processes, requiring careful observation, generation and testing of hypotheses. Both processes also face similar epistemic and pragmatic trade-offs. Heuristics and biases can shape both practices, for better and worse. Implications are considered for both training in clinical psychotherapy, and for larger debates concerning evidence-based methods in assessment of mental health care, and categorical v. dimensional approaches to diagnosis. [ABSTRACT FROM AUTHOR]

The principles of CBT emphasize the interactions among cognition, emotion, and behavior. CBT's origins lie in Stoicism philosophy and share similarities with the ideas of Confucianism, Taoism, and Traditional Chinese Medicine (TCM) in China. The idea of mind–body regulation in traditional Chinese culture has laid a cultural foundation for the promotion of CBT in China. This paper analyzes the applicability and challenges of CBT in China based on the current development of CBT in mainland China and the learning and practice of CBT therapists. It also explores the potential further development of CBT in China and the integration of CBT with the Chinese culture. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic caused concern regarding suicide risk mitigation while requiring many clinicians to transition to telehealth. We hypothesized that this transition would increase suicide intent, suicide desire, and depressive symptom ratings from pre-COVID-19 to peri-COVID-19. Patients at a southeastern US outpatient psychotherapy training clinic reported on suicide risk and depressive symptoms before and after the transition to telehealth treatment. Additionally, the effect of continuation of treatment on suicide risk was also analyzed. Suicide risk levels (n=39) and depressive symptoms (n=25) did not increase following the transition to telehealth. Self-reported suicide desire ratings significantly decreased from pre- to peri-pandemic assessments. Findings suggest that telehealth, among other sociocultural factors, became somewhat of a "port in a storm," such that it may have provided protections from exacerbations of mental health concerns and further vulnerabilities towards increased suicide risk. This paper concludes with relevant implications and suggestions for community health clinics. [ABSTRACT FROM AUTHOR]

Objective: Although Ireland has one of the highest levels of well‐being in Europe, having a health condition has been found to have a direct negative impact. The aim of this study is to evaluate the current situation and the experiences of patients with epidermolysis bullosa (EB), a rare genetic skin disease, and their relatives living in Ireland, with a focus on burdens and helpful practices. Methods and Measures: In a mixed‐methods design, a series of standardised questionnaires were combined with open‐ended questions. Via an online survey, data from n = 59 EB patients and relatives of EB patients living in Ireland were collected. Results: EB affects both the patients and their relatives. Burdens were found in relation to the visibility of EB, the degree of severity, the current health status, reduced mobility, the financial impact of EB, the psychosocial impact and personal and social resources. The paper also analyses existing resources and highlights opportunities for support and needs of improvement. Conclusion: Quality of life with EB is influenced by somatic symptoms and the psychosocial burden. Individual helpful practices in dealing with this rare disease can be considered as mediators, but they need to be supported by structural and healthcare improvements. Patient or Public Contribution: The perspective of EB patients, their relatives and EB experts were taken into account in the development of the study design via two feedback loops with the EB patient organisations DEBRA Ireland and DEBRA Austria. The design was adapted accordingly. Additionally, by including open‐ended questions, patients and relatives could contribute their individual perspectives and add insights into their lives with EB that might not have been captured with the structured online survey alone. [ABSTRACT FROM AUTHOR]

Background: Adolescence is a critical period for social emotional development. The need to focus on social emotional competencies is exacerbated by the COVID 19 pandemic. Objective: This systematic review paper provides a collective account of mindfulness interventions conducted exclusively with adolescent students in an educational setting (mean age 11 to 18) with the sole focus on social emotional and behavioral competencies primarily as outlined by the Collaborative for Academic, Social, and Emotional Learning (Safe and sound: an educational leader's guide to evidence-based social and emotional learning programs, Author, Chicago, IL, 2003, 2011). Method: Mindfulness literature in the past 15 years, i.e., Jan 2008–Feb 2023 was reviewed. Additionally, the type of intervention implemented, dosage, delivery, measures used, and targets of intervention were examined. All the articles were also assessed for their methodological quality using the EPHPP quality assessment tool for quantitative studies (Effective Public Health Practice Project in Quality assessment tool for quantitative studies, Effective Public Health Practice Project, Hamilton, ON, 1998. https://merst.ca/ephpp/). Results: With less than one third of the 30 included studies rated as strong, there appears to be moderate evidence for the effectiveness of MBIs on adolescent social emotional competencies. Overall, there appears to be mixed evidence for the effectiveness of MBIs on adolescents' self-awareness, social awareness, social skills, with relatively more consistent evidence that MBIs positively impact their self-management (e.g., emotional regulation). We classify broader characteristics of the MBIs that could help explain some of the differences in effectiveness into three categories: intervention implementation related (e.g., dosage), method related (e.g., psychometric properties), and participant related (e.g., age and gender). Conclusion: Future work on MBIs in schools needs to consider the quality of and factors known to impact effective implementation and resultant social emotional outcomes. [ABSTRACT FROM AUTHOR]

Meta-analytic research has suggested that, although there are two forms of power that can be problematic in a psychotherapy context, they are rarely considered in interaction. One form, cultural power, influences the ways clients, therapists, and systems interact in relation to social identities, communities, and ascribed cultural statuses, and the other, professional power, is held by therapists by virtue of their training and the authority ascribed to them. Both formsmay limit clients' ability to be empowered in therapy. As many feminist multicultural researchers and task forces have thoughtfully explicated strategies for responding to cultural power, this paper focuses predominantly on processes for addressing professional power, which have been less well explicated. Although there is a rich body of humanistic therapy literature on maximizing clients' agency, these core processes have rarely been framed in relation to concepts of power. This reframing contributes to prior work by feminist multicultural-humanistic therapy (FMHT) scholars by examining central humanistic principles to identify specific strategies that attenuate the misuse of this form of power. For instance, therapists teach clients to symbolize inchoate experiences (often resulting from cultural or interpersonal oppression eroding trust in oneself or one's community), to confidently self-reference (developing resistance to stigma), and to maximize their agency within the change process (empowering them to guide their own development). Integrating these humanistic therapy principles into FMHT enhances ethical practice and holds relevance across therapies, supporting therapists' competence, clients' agency, and a multidimensional understanding of power in therapy. [ABSTRACT FROM AUTHOR]

Aim: Routine outcome monitoring (ROM), including the use of feedback, has become a much vaunted method in psychological therapies but is little used in university/college counselling and mental health services, perhaps because its adoption raises questions for many practitioners and service leaders. There is a need for both clinical‐ and research‐based statements to clarify the reasoning and rationale for ROM. This paper aims to present and respond to common challenges of and reservations about using ROM in student counselling and/or mental health services. Method: The article poses 15 questions and issues about the adoption of ROM drawn from the literature on this topic and further refined by practitioner‐ and researcher‐members of a consortium comprising service leads, practitioners, and researchers working in the field of student counselling in the UK. The questions address nine themes: (1) the purpose and yield of ROM; (2) the burden of measurement; (3) the impact on clients and process of therapy; (4) consistency with therapeutic theory; (5) client groups and settings; (6) concern from practitioners; (7) equality, diversity, and inclusion; (8) implementation; and (9) relationship with the paradigm of practice‐based evidence. Findings: Responses to each of the 15 questions are provided from a methodological, evidence‐based, and clinical perspective. Conclusions: The responses provide practitioners with the necessary information to enable them to make informed decisions as to the value, or otherwise, of adopting ROM, including feedback, in the delivery of counselling interventions, and generating evidence created from clinical practice. [ABSTRACT FROM AUTHOR]

Background: The use of artificial intelligence (AI) is increasing in many areas of healthcare, including mental healthcare. The automated nature of such technologies has the potential to be developed to work with large numbers of people. This paper examines the way that student therapists experience using an interactive text‐based machine client as a training tool. Methodology: Chatbot technology has been used to develop an emotionally responsive interactive client (ERIC). This introduces individuals to concepts of person‐centred therapy (empathy, congruence and unconditional positive regard) by using a series of pre‐programmed scenarios. Twenty‐eight student therapists evaluated ERIC's potential as a learning tool. Individuals were recruited from one university from a postgraduate and an undergraduate counselling programme. Findings: Feedback was generally positive, with all reporting that they enjoyed engaging with ERIC as a learning method. ERIC helped individuals consider their understanding of counselling skills in a non‐judgemental environment. Participants felt the scenarios were realistic and engaging, with many reporting that they felt they were engaging with a real client/person due to ERIC's ability to express emotions. Discussion: ERIC is at the proof‐of‐concept phase. From the feedback presented here, it is evident that it can be a useful learning tool. Further development of ERIC with feedback from a larger sample is, however, required. ERIC is currently a text‐based client, and further development would like to see the intervention be voice‐activated to enhance the experience. ERIC can be further enhanced and adapted to be a useful learning platform for student therapists, as well as for students in other (healthcare‐related) disciplines, whereby a client or patient is required. [ABSTRACT FROM AUTHOR]

Film therapy, the therapeutic use of movies in psychological therapies, is a growing area of interest to therapists and researchers. This paper discusses the benefits of film therapy and presents a method, the MOVIE model of film therapy, a widely applicable, trauma‐informed framework for individual or group therapy, counsellor education and self‐help. Film or cinema therapy is a highly accessible and relatable method for many diverse groups. The benefits identified include emotional processing, greater ease of dialogue, increased empathy, interpersonal learning, new perspectives and learning skills. Following the model's reflective steps, clients mindfully observe and voice their emotional and psychological responses to movie‐watching; identify how the imagery, characters, themes and story symbolise personal experience; and consider any new possibilities that emerged for their own lives. The model is informed by a practice‐focussed review of literature and draws on methods from mindfulness and experiential and narrative therapies. The steps are widely applicable in a range of settings and can be adapted across counselling modalities. Further research to consider the outcomes of using the model, alongside qualitative research on clients' experiences of working this way with film, is recommended. [ABSTRACT FROM AUTHOR]

Tic disorders in children often co-occur with other disorders that can significantly impact functioning. Screening for quality of life (QoL) can help identify optimal treatment paths. This quality improvement (QI) study describes implementation of a QoL measure in a busy neurology clinic to help guide psychological intervention for patients with tics. Using QI methodology outlined by the Institute for Healthcare Improvement, this study implemented the PedsQL Generic Core (4.0) in an outpatient medical clinic specializing in the diagnosis and treatment of tic disorders. Assembling a research team to design process maps and key driver diagrams helped identify gaps in the screening process. Conducting several plan-do-study-act cycles refined identification of patients appropriate to receive the measure. Over the three-year study, electronic health record notification tools and data collection were increasingly utilized to capture patients' information during their visit. Over 350 unique patients were screened during the assessment period. Electronic means replaced paper measures as time progressed. The percentage of patients completing the measure increased from 0% to 51.9% after the initial implementation of process improvement, advancing to 91.6% after the introduction of electronic measures. This average completion rate was sustained for 15 months. Using QI methodology helped identify the pragmatics of implementing a QoL assessment to enhance screening practices in a busy medical clinic. Assessment review at the time of appointment helped inform treatment and referral decisions. [ABSTRACT FROM AUTHOR]

Aim: In this paper we review the current literature on the clinical problem that some patients do not achieve response after adequately conducted psychotherapy. We explicate our understanding of nonresponse and treatment resistance including the operational definitions, summarize the theoretical explanations and empirical studies and put forward possible study designs and treatment options. Methods: Literature search using PubMed and Web of Science. Results: For the domain of psychotherapy, the term treatment resistance does not seem appropriate; instead, we use the more descriptive terms nonresponse and recurrent nonresponse. Generally, this topic is far less represented in psychotherapy than in pharmacotherapy. Controlled switching studies with a switch from pharmacotherapy to psychotherapy are rare and those switching from one psychotherapeutic approach to another are nearly nonexistent. Building on clinical considerations, we propose a flow-chart for clinical decision making after nonresponse in psychotherapy. Discussion: Learning from errors is highly beneficial. This principle should be more consistently followed up in psychotherapy research as well as in supervision and training. Guidelines should include consensual and evidence-based advice on how to deal with nonresponse and recurring nonresponse. [ABSTRACT FROM AUTHOR]

The transition to parenthood, or the addition of another child to the family system is a life altering event for both mothers and fathers that can affect both parents individually and their relationship. For some parents, this includes perinatal suicidal ideation. Despite the prevalence of perinatal mood disorders, there are no systemic models designed specifically for couples who are at risk for suicide. This paper reviews the literature on the prevalence of perinatal suicidal ideation and proposes an integrative treatment model using aspects of Collaborative Assessment of Suicidality (CAMS), Attachment based family therapy (ABFT), and Emotionally Focused Therapy (EFT). [ABSTRACT FROM AUTHOR]

Aimed at understanding and improving psychological therapies as they are conducted in clinical routine, practice-oriented research (POR) is now a well-established approach to the scientific foundations of mental health care services. Resting on the accumulation of a wide range of practice-based evidence related to treatment outcome and process, as well as factors associated with the participants of psychotherapy and its context, POR is ripe for new developments – regarding what to investigate and how to investigate it. This paper is the introduction of a series devoted to recent advances and future directions of POR as their pertained to routine outcome monitoring, technologies and artificial intelligence, the integration of constructs and methods from program evaluation and implementation science, and the investigation of populations with limited financial resources across various regions of the world. The series also includes commentaries from two leaders of POR. [ABSTRACT FROM AUTHOR]

Background: Youth violence and knife crime is increasing dramatically, so much so it has been described as a global epidemic. The social, economic and political forces fuelling this rise mean that minority groups are particularly affected. Aim: This paper reviews the literature primarily from a UK perspective, and illustrates the disparate factors that are influencing the rise in youth violence and knife crime and illustrates the complexities of integrating the perspectives of different disciplines into coherent intervention strategies. Method: We conducted a systematic review of the literature that explores both the causes of increasing youth violence and knife crime as well as some of the interventions that have attempted to deal with the problem. Results: A complex interplay of social, economic, mental health and political factors underpin the increase in youth violence and knife crime. An uneasy tension exists between a traditional criminal justice system-based approach based upon deterrence and punishment, and a more liberal preventative model focusing on adolescent mental health. None of the interventions thus far have been particularly effective. Conclusion: Youth violence and knife crime is a global social issue that causes untold suffering to individuals, families and communities as well as fear that reverberates through society. Interventions have often been devised through the lens of particular disciplines or ideologies. Integrating these perspectives into a coherent approach that is actually effective demands greater co-operation, dialogue and mutual understanding between disciplines and agencies, as well as a robust framework for the evidence-based assessment of outcomes. [ABSTRACT FROM AUTHOR]

The benefits of expressive writing have been explored since at least the 1980s. The effect of expressive bereavement-related writing has been studied primarily in college students, yielding inconclusive results. Nonetheless, recent effective, integrated psychotherapy protocols, targeting complicated and prolonged grief, include writing assignments, typically in the form of letters. The present paper explores how and why letter writing might be effective and meaningful as a therapeutic tool in the context of grief psychotherapy. It describes how working with letters, addressed to the deceased, might help facilitate self-disclosure, promote exposure to what is avoided, confront unfinished business, encourage continuing bonds, and help achieve a coherent narrative around experiences with the loss. As a therapeutic tool, letter writing has the potential to be helpful to many bereaved people, as it is a simple, effective, and meaningful way to access and work with relevant clinical material in the context of psychotherapy. [ABSTRACT FROM AUTHOR]

This paper aims to advance a theoretical and clinical perspective on the developmental origin and role of omnipotence in early object relations, and a differentiation of the adult sequelae of these maturational dynamics. The focus is on negative omnipotence as inherent in the constitution and impact of the psychotic part of the personality. The case history of the psychoanalytic psychotherapy of a man with a psychiatric diagnosis of obsessive–compulsive disorder illustrates the self and treatment defeating impact of negative omnipotence. Diplomatic therapeutic engagement, based on the understanding that these negative therapeutic dynamics represent unfinished maturational processes, is presented as enabling treatment to progress and facilitate gradual beneficial modification in the use of omnipotence intra‐psychically and inter‐personally. [ABSTRACT FROM AUTHOR]

This book review discusses "Transforming Infantile Trauma in Analytic Work with Children and Adults: The Clinical Writings of Alessandra Cavalli," a collection of papers by Alessandra Cavalli, a Jungian-trained analyst. The book explores Cavalli's work with severely traumatized children and adults, focusing on the impact of early infantile trauma on the developing self. The review highlights Cavalli's dedication to establishing meaningful emotional connections with her patients and her persistence in trying to communicate with highly defended children. It also mentions Cavalli's exploration of intergenerational trauma and her consultancy work with a staff team at a home for street children in Mexico. The reviewer recommends the book to child and adult psychotherapists. [Extracted from the article]

Adopted children are often at a risk of experiencing several neurobiological and psychosocial difficulties. Adoptive parents must support these difficulties whilst managing their own idiosyncratic challenges. Family-based psychotherapeutic interventions which promote adoptive family functioning, environments and relationships can mediate these difficulties for adopted families. This review synthesises evidence exploring family-based psychological interventions for adoptive families, appraises the literature's strengths and weaknesses, and reports characteristics of promising interventions. Included studies recruited domestically adoptive families receiving psychotherapeutic interventions delivered to at least one adoptive parent and child. The authors searched seven electronic information databases, four grey literature databases, two journals and five relevant websites up to 12.12.2022. The quantitative Risk of Bias in Non-Randomised Studies of Interventions tool and the qualitative Critical Skills Appraisal Programme checklist assessed risk of bias. The narrative synthesis presents 20 papers detailing 18 studies involving at least 729 adopted children and 829 adoptive parents. Findings provide preliminary support for integrative interventions which include aspects of sensory activities, attachment-based play, Dyadic Developmental Psychotherapy and Eye Movement Desensitisation and Reprocessing with Therapeutic Input provided to adopted children and adoptive parents separately, alongside the adoptive family. However, risk of bias was high, limiting the conclusions. Future research should examine the feasibility, acceptability and efficacy of integrative therapeutic approaches for adoptive families to further direct clinical practice. [ABSTRACT FROM AUTHOR]

Introductions: Psychosis is a condition of severe mental disorder characterised by the presence of disability in assessing reality. Schizophrenia is the most common psychotic disorder. It is also associated with long-term disability. ACT is one of the newest psychological interventions for psychotic patients. This paper aims to describe ACT as the newest psychotherapy intervention and its advantages for psychotic patients. Review: The management of psychosis is a combination of the use of antipsychotics, psychotherapy, and psychosocial therapy. ACT is one of the newest psychological interventions for psychotic patients that aims to increase the patient’s psychological flexibility through six core processes of therapy: acceptance, cognitive defusion, being present, self as context, value, and committed action. ACT does not target symptom reduction. Therapists help patients recognise and reduce unnecessary struggles with psychological content so that patients can develop an accepting attitude and be able to move towards the values they hold. Conclusions: The use of third-wave behavioural therapy based on mindfulness and acceptance showed good results in patients with psychotic disorders. ACT aims to help individuals accept things that are beyond their control and commit to actions that can improve their lives. Research on the clinical adaptation of ACT for psychosis has shown good initial results in reducing distress due to psychotic symptoms, better regulation of emotions, and reducing relapsing rates. [ABSTRACT FROM AUTHOR]

A gay identity offers a perspective outside heteronormative narratives characterized by exclusion as well as a radical position of difference. Being a psychotherapist, too, holds complex implications for identity. This paper explores the lived experience of gay male psychotherapists, a group whose voice is seldom heard. Based on interviews with six White South African gay male psychotherapists, a narrative analysis explores their experience of identity and voice. This paper highlights the ways in which the journey to occupying oneself as gay and the journey of becoming a therapist are intertwined. The complex power relations evoked in this experience are explored, and the position of the gay male therapist as "outside looking in" is interrogated as a position of marginality that both excludes and provides a unique vantage point from which to challenge exclusion. [ABSTRACT FROM AUTHOR]

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]

This paper aims to explore the ethical issues which arise with the employment of the performance or viewing of drama as a therapeutic process for ‘mental illness’. Looking into two case studies, this piece concentrates on the use of drama therapy along an axis of risk which balances patient safety and potential benefits. As this is a vast area of practice, this paper chooses to focus on the performance and viewing of Greek tragedy as a ‘complementary therapy’. In the public and academic psyche, Greek tragedy has held a prominent place in artistic explorations of ‘mental ill-health’ and thus it is unsurprising that it has been a point of origin for drama therapy. Reviewing the content of the plays, the settings of their modern performances, and the ‘ideology’ behind such performances will enable this paper to highlight some of the greater issues concerning the ethical implications of these examples of drama therapy. Citing performances from the 1950s to the present day, we will explore the competing risks to individuals that come with using ancient Greek drama as a potential means of therapy. [ABSTRACT FROM AUTHOR]

This paper was developed as part of a panel for the International Psychoanalytic Association's (IPA) 53rd Congress in July 2023. In this paper I discuss treatment with students from the American University of Afghanistan as part of a team at New York University's Postdoctoral Program in Psychoanalysis and Psychotherapy. The paper reviews the themes that I identified while working with three students from the university. The themes include issues of identity and power, role confusion, and finally the question "am I doing a good thing?" Simultaneously, I discuss my own countertransferential process and disavowed material based on my own cultural background. [ABSTRACT FROM AUTHOR]

Objective: Therapeutic boundaries are limits to appropriate behaviours within a therapist–client relationship (e.g. related to accepting gifts, self‐disclosures, therapist neutrality and advocacy). Therapeutic boundary considerations are fundamental in the care of refugees and asylum seekers. Research on the experiences of therapists navigating such boundaries is sparse and warrants further exploration. The aim of this qualitative systematic review was to thematically synthesise literature regarding therapists' (psychologists, psychotherapists, counsellors) experiences of implementing flexible therapeutic boundaries with refugee and asylum seeker clients and determine how such applications have been helpful for therapeutic interventions. Method: Six databases were searched. Following full‐text screening, 21 papers were included in the analysis. Boundary theory underpinned the analysis. Results: Three major themes were developed: (i) Changes to Therapeutic Practice & Therapeutic Intervention, (ii) Re‐Conceptualisation of Therapy as 'Clinical Political' and Re‐Conceptualisation of Therapist Identity and (iii) Careful Monitoring of Personal Boundaries—Not becoming 'Hardened' or 'Haunted'. Papers described how, when used in a reflective, considerate way, flexible therapeutic boundaries can strengthen the therapist–client alliance and positively impact therapeutic interventions. Many therapists acknowledged making conscious efforts to re‐conceptualise therapeutic work with refugee and asylum seeker clients from advocacy standpoints. However, systemic constraints, and lack of guidance, made this difficult to navigate and contributed to therapist burn‐out. Conclusions: Boundary considerations manifested as interpersonal, structural and cultural changes to practice. These have implications for clinical practice and developing guidelines on boundary practices with refugees and asylum seekers. Future research should explore promoting therapist well‐being and training needs for therapists supporting this population. [ABSTRACT FROM AUTHOR]

1) Systematically review meta-analyses and systematic reviews that (a) explored health/lifestyle factors affecting sleep, and/or (b) investigated behavioral/psychological sleep interventions in young people (10–25-years); 2) Evaluate the quality of published literature, and, if an intervention; 3) Examine method and effectiveness of mode of delivery, to inform current clinical practice and research direction. A systematic search of Embase (n = 45), MEDLINE (n = 67), Web of Science (n = 375), Google Scholar (n = 138), and hand-searching was conducted. After full review, 12 papers were selected, 2 systematic reviews without, and 10 with, meta-analyses. Six examined associations between sleep and lifestyle/health, and six examined cognitive-behavioral (n = 4), or school education (n = 2), programs. Electronic media use, type of day (week/end), sex, age, culture/geographical location, substance use, family environment, and evening light exposure were negatively associated with sleep, in young people. Only cognitive and/or behavioral interventions of at least 2 × 1-hr sessions improved sleep. This paper informs sleep recommendations for young people and advises that ≥ 2 × 1-hr sessions of cognitive behavioral or behavioral therapy is the minimum to improve sleep in young people. School-based sleep interventions do not produce long-term change. [ABSTRACT FROM AUTHOR]

In Mexico, there is a lack in academic research about bisexual Health-Disease-Attention process. This paper analyzes the main problems about health-disease for bisexual people with a Social Medicine and a Collective Health approach. In order to do this analysis, this paper offers a systematization of research's discoveries related to the Health-Disease-Attention process in bisexual people. Problems on health-disease for bisexual people include worse mental health conditions in comparison to gay and lesbian people. As psychologists have few contextualized knowledge about bisexual health-disease situations, then they cannot adequately respond to bisexual people needs. Bisexual Health-Disease-Attention process is an historical and social product where the lack of visibility and the negative valuation functions as mechanisms to regulate people's sexuality, which can be reproduced in Health-Attention places, such as Mental Health ones. [ABSTRACT FROM AUTHOR]

This paper introduces the Attachment Mapping Protocol (AMP), which is an assessment and treatment tool for use in individual psychotherapy, systemic family therapy and multifaith spiritual care, using a bio-psycho-social-spiritual model of care. Attachment theory has a long and significant history in psychology, with an evolving relationship within the above clinical domains. A central aim of this paper will be to recognize and affirm the extension of attachment theory beyond the traditional parameters of nascent parental, guardianship bonds and individual, developmental psychology, to reveal a much broader spectrum of valid attachment considerations for mental health and spiritual well-being. A case study will be applied to the interviewing instrument to demonstrate its utility for broadening assessment beyond attachment figures to include surrogate attachments of other persons, places and things. A model of spiritual discernment derived from the Spiritual Exercises of Ignatius of Loyola will undergird this larger worldview of attachment considerations. [ABSTRACT FROM AUTHOR]

Background: Chronic tinnitus during childhood/adolescence can be associated with impaired quality of life. Guidelines for managing paediatric tinnitus recommend assessment and interventions are often based upon the experiences and opinions of guideline committee members. Objective: To examine patient response tools used for the assessment and management of childhood tinnitus and how interventions had been evaluated. Design: A structured scoping review (i) identifying and critically appraising patient response measures (PRMs) assessing tinnitus in children/adolescents, and (ii) critically appraising evidence supporting reported interventions. Original papers written in English, involving paediatric participants ≤19 years, reporting (i) application of established PRMs to assess the experience of chronic tinnitus or (ii) application and evaluation of tinnitus interventions were included. Study sample: Papers written in English, identifying, or assessing the experience of chronic tinnitus (>3 months) as a primary complaint during childhood/adolescence in participants ≤19 years of age using a PRM and studies evaluating the application of non-pharmaceutical interventions for tinnitus in children/adolescents. Results: Six studies involving the assessment of tinnitus during childhood/adolescence using a PRM were identified and evaluated. Three established (previously named, described, and published) PRMs were applied of which none were developed specifically for children/adolescents. Three behavioural tinnitus interventions and three combination intervention strategies (coupling of psychological intervention with sound enrichment) had been applied to and evaluated within paediatric populations. Conclusions: Although clinicians are seeing children/adolescents with tinnitus, they are evaluating and managing children’s distress without appropriate PRMs, and little evidence exists to support clinical interventions. [ABSTRACT FROM AUTHOR]

The Melbourne Study of Psychoanalytic Psychotherapy examined the implementation, lived experience, and perceived therapeutic gains of psychoanalytic psychotherapy in a low‐cost, private‐sector community clinic. A first in Australia, this 8‐year demonstration project allowed naturalistic study of the impact and process of intensive, long‐term, time‐limited psychoanalytic psychotherapy delivered to self‐referred adults by clinicians with a common theoretical frame of practice. Presented in three papers, the research employed the RE‐AIM planning and evaluation framework, using complementary quantitative and qualitative methods, to study the psychotherapy service in terms of Reach, Effectiveness, Adoption, Implementation and Maintenance. This first paper reports the Reach of the program to be 67% for those presenting for assessment for psychoanalytic psychotherapy, with Adoption of the full 2‐year treatment program being 60%. Improvements in mental health and life functioning provided quantitative evidence of Effectiveness for those completing the 2‐year treatment program, with Maintenance at 8‐month follow‐up. Patient age, gender and personality characteristics did not modify these improvements. In‐depth qualitative exploration of patient and psychotherapist perspectives regarding the psychotherapy is reported in the second paper highlighting expectations, experience and benefits of the psychotherapy. The third companion paper presents the qualitative findings concerning factors experienced as facilitating or challenging therapeutic progress. Each of the three related papers amplifies understandings of how low‐cost, long‐term but time‐limited psychoanalytic psychotherapy can be implemented in the community with adults otherwise unable to afford such treatment, and discusses lessons learned. [ABSTRACT FROM AUTHOR]

Qualitative exploration of the experience of psychoanalytic psychotherapy complemented the quantitative evaluation of mental health and life functioning improvements in the Melbourne Study of Psychoanalytic Psychotherapy. Twice‐weekly treatment was offered to adults for 2 years by the private sector Glen Nevis Clinic for Psychoanalytic Psychotherapy, established by the Victorian Association of Psychoanalytic Psychotherapists as a subsidized, low‐cost community service over 8 years. This paper is the second of two presenting the qualitative arm of the study, involving in‐depth narrative interviews with patients and psychotherapists. Analysis of 143 transcripts further contributes to evidence of the Reach, Effectiveness, Adoption, Implementation and Maintenance of psychoanalytic psychotherapy in a community setting. The first qualitative paper reports themes concerning patient expectations of psychotherapy and perspectives of both patients and psychotherapists on the experience and benefits of the treatment. This paper reports what was perceived by participants as facilitative or challenging for therapeutic progress, illuminating how experiences of the nature of psychoanalytic psychotherapy may have affected the Implementation, Effectiveness and Maintenance of the program. The most notable facilitative factors emerging were the exploratory, insight‐oriented nature of the work, elements of the patient‐psychotherapist relationship, and the frame of the treatment. Challenges were also often seen as inherent to Effectiveness; however, proposing the frame of 2‐year treatment, as both an expectation and a limit, probably inhibited program Reach, Adoption and overall Implementation. The limitations and strengths of the qualitative arm of the research, together with implications for further investigation, are discussed. [ABSTRACT FROM AUTHOR]

The naturalistic, longitudinal Melbourne Study of Psychoanalytic Psychotherapy was conducted in a subsidized community clinic established by the Victorian Association of Psychoanalytic Psychotherapists as a demonstration project operating over 8 years. It offered lower SES adults twice‐weekly psychoanalytic psychotherapy for 2 years. An independent research program used the RE‐AIM planning and evaluation framework to investigate the Reach, Effectiveness, Adoption, Implementation and Maintenance of the service. Complementary quantitative and qualitative methodologies studied mental health and general‐life functioning outcomes and underlying processes of treatment. Two papers present the qualitative arm of the research, exploring the lived experience of the psychotherapy, reported contemporaneously and retrospectively by patients and psychotherapists. This first paper details the qualitative design and methods employed. In‐depth semi‐structured narrative interviews during psychotherapy, upon completion at 2 years, and at an additional 8‐month follow‐up point for patients, were conducted. Analysis of the narrative transcripts of 143 participant interviews revealed themes regarding patient expectations of treatment and the perceptions of both patients and psychotherapists of the long‐term psychoanalytic psychotherapy experience and its benefits. Narratives thus provided evidence of the Reach, Effectiveness, Adoption, Implementation and Maintenance of the service. The findings enrich understanding of the effective processes underlying the outcomes of the quantitative arm of the study reported separately. The second qualitative paper presents the findings concerning participants' experiences of facilitative and challenging aspects of the treatment, as well as the implications of the qualitative findings overall. [ABSTRACT FROM AUTHOR]

Case study can be adopted when aiming to understand an individual's lived experience. Such experience produces rich and complex qualitative data for analysis, conducive to counselling and psychotherapy research. Furthermore, grounded theory (GT) can be adopted to produce a theory from qualitative data, fitting well with case study research that explores complex experiences regarding social, psychological and phenomenological processes. This paper aims to guide the counselling researcher to incorporate Strauss and Corbin's model into the main arena of qualitative counselling research. In addition, this paper draws on a multiple case study that adopted Strauss and Corbin's method and identified various phases in the GT process. The aim is to inform the reader how to put the iterative process and pragmatic theoretical sampling into practice to produce a robust theory from clinical case study data. [ABSTRACT FROM AUTHOR]

This paper explores the journey taken by experienced psychotherapists as they embark on doctoral research, highlighting the adjustments involved in moving from being a clinician to becoming a researcher. Having touched on the complex relationship between psychotherapy and research as a whole, including how badly this has affected the development of a robust evidence base for many approaches, the paper describes the development of a post-qualifying research programme for those grafting research skills onto their clinical roles. The paper then considers how the kind of research undertaken by psychodynamic psychotherapists has shifted from being primarily focussed on single case studies – so remaining closer to the clinical writing of the past – to including both more general social science research methodologies and more precise psychoanalytic methodologies, capable of exploring in depth the processes at work in the therapeutic encounter. The main focus of the paper is on the impact on the students of undertaking their first research project. At the beginning of this process nearly all students underestimated just how much of a shift in their thinking it would involve, and the paper captures some of the key issues and powerful moments reported after their first year. They speak of the humbling impact of conducting a structured literature review and of the complexity of finding a truly researchable question and viable design, as well as the appreciation of the difference between clinical illustration and evidence. They speak of the impact of thinking about the ethical issues involved in research, and of the need to interrogate their design in order to minimise bias. One of the interesting – and to them surprising – effects is that the shift to research-mindedness feeds back into their clinical identities, in a way that is both challenging and invigorating, overall boosting their confidence as practitioners. [ABSTRACT FROM AUTHOR]

This perspective paper explores the choice of psychotherapy for psilocybin‐assisted psychotherapy for treatment‐resistant depression. There is evidence to support the use of some psychotherapies in treating 'treatment‐resistant' depression, and emerging evidence for the efficacy of psilocybin. The next step which is the focus of this paper is to identify psychotherapies that are both effective and congruent with the psilocybin experience. The evidence for the efficacy of the psychotherapies is drawn from a Cochrane review and the analysis of their congruence with the psilocybin experience is drawn from a qualitative meta‐synthesis of the experience of psilocybin. The paper will examine whether three one‐to‐one psychotherapies identified as effective in the treatment of treatment‐resistant depression are compatible with the psilocybin experience. Each psychotherapy will be examined in relation to its congruence with the qualitative evidence that suggests the choice of psychotherapy needs to give priority to the subjective experience, facilitate emotional processing, support connectedness with others, acceptance of the self as emotional and support change based on the person's insights into their relationships with others and the world in which they live. We conclude that interpersonal psychotherapy and intensive short‐term dynamic psychotherapy align with that experience, although others are currently being trialled. [ABSTRACT FROM AUTHOR]

In this clinical paper, the focus is on the use of questionnaires in family therapy practice. Psychotherapy research has indicated that the quality of the therapeutic relationship is the most robust predictor of therapeutic change. While the therapeutic relationship is even more important in family therapy than in individual therapy, it is also more complex. As will be illustrated in this paper, questionnaires can be useful in clinical practice to deal with the complex alliances in family therapy. In this paper, we will introduce two questionnaires: the Worries Questionnaire and the Dialogical Feedback Questionnaire. As illustrated in detailed case stories, we use these questionnaires in our practice as conversational tools rather than measuring instruments. They serve as the starting point for the therapist's reflection and for dialogues with family members. [ABSTRACT FROM AUTHOR]

Abstract Objective: There is a growing interest in idiographic patient-reported outcome measures (I-PROMs) for routine outcome monitoring (ROM) and clinical feedback (CF) in psychotherapy, but to our knowledge, no systematic reviews of the empirical literature. Method: We conducted a systematic literature search for empirical papers investigating effects and experiences of I-PROMs for ROM/CF and found a total of 13 papers. There was only one experimental controlled effectiveness study. Results: We formulated a narrative summary of the data set as a whole. We conducted a secondary analysis of nine papers containing qualitative data on stakeholder experiences with I-PROMs and found three superordinate themes and eight subthemes, summarized as “I-PROMs can facilitate self-reflection for patients, assist in identifying and tracking therapeutic topics, and make patients more committed to therapy by giving them a greater sense of responsibility and empowerment. Formulating goals and problems can be difficult, and lack of progress can be demotivating. Time in therapy is precious and must be spent wisely. Effective use of I-PROMs is facilitated by flexibility and therapists’ use of clinical skills.” Conclusion: We discuss the limitations of the study and provide recommendations for future research and clinical practice. [ABSTRACT FROM AUTHOR]

Harmful sexual behaviour that occurs between siblings (HSB-S) is thought to be one of the most common forms of intrafamilial abuse. Despite an increase in academic papers, and acknowledgement of the prevalence of the problem, there is still a lack of specific assessment and intervention models. The aim of this paper is to provide an overview on the Assessment, Intervention and Moving On (AIM) HSB-S Practice Guidance. The framework draws on the literature and evidence-based models, as well as clinical practice illustrated by the four-case series summarised. Of the four-case series illustrated in the paper positive outcomes were observed. In addition, the intervention includes the practitioner guiding the family to write a structured narrative which supports them to restore family relationships and find a way of moving forward. This guidance will strengthen practitioner's skills and confidence in working with families impacted by HSB-S and provide hope for them that they can heal from this crisis. This paper provides a preview for the AIM HSB-S Practice Guidance illustrated by a case series. The framework will provide practitioners with a clear approach to assessment and intervention when working with families impacted by HSB-S. [ABSTRACT FROM AUTHOR]

Objective: The use of qualitative methods for investigating causation has been controversial ever since the "paradigm wars" of the 1980s. Quantitative and experimental researchers have largely dismissed the relevance of qualitative research for causal investigations, while many qualitative researchers have rejected the concept of causation entirely. However, a growing number of scholars, in both research methods and philosophy, have proposed an alternative perspective, one that sees quantitative and qualitative approaches as having complementary strengths and limitations in understanding causation. In this article, we consider this perspective in relation to the study of causality in psychotherapy research. Method: This paper reviews and integrates key descriptions of the mechanisms for identifying causal processes using qualitative research. Results: An overview of how qualitative methods study causation is presented, considering its implications for both identifying causality and for generalizing causal conclusions. Conclusion: The paper holds relevance for establishing outcomes caused by psychotherapy treatments and for developing clinical practice guidance for the field. [ABSTRACT FROM AUTHOR]

To treat the impact of trauma, most current evidence supports the use of trauma-focused psychotherapy as the first line approach. However, millions of individuals exposed to trauma worldwide seek Complementary and Integrative Health (CIH) therapies in hopes of achieving wellness above and beyond reducing symptoms. But what is the evidence for CIH interventions? What are potential pitfalls? Given the growing popularity of and strong interest in CIH, EJPT is featuring research on these approaches in this special issue. The papers range from common interventions such as mindfulness to the use of service dogs and scuba diving to alleviate trauma related symptoms. A featured editorial highlights the importance of defining when, where, and how placebo responses work. Nonspecific elements of treatment such as positive expectations, therapeutic rituals, healing symbols, and social interactions are identified as factors influencing treatment response and scientists looking to add to the CIH evidence base are encouraged to consider the impact and methodological challenges these elements present. CIH interventions more specifically recognize and harness some of these factors in addition to intervention-specific factors such as attention or emotion regulation along with focus on overall wellbeing. The body of work in this special issue supports the emerging evidence for meditative and relaxation-based interventions and illustrates a creative but nascent state of the field. Cross-intervention mechanisms that may play a role in achieving wellness, such as arousal reduction, emotion regulation, posttraumatic growth, and positive affect are highlighted. The trauma field would benefit from accumulation of evidence for promising CIH interventions, evaluation of potential mechanisms, and examination of health and wellbeing outcomes. With the paucity of high-quality trials, it would be premature to recommend CIH interventions as first-line treatments. However, the emerging literature on CIH continues to advance our understanding of what works and how these interventions exert their effects. Complementary and Integrative Health (CIH) interventions for trauma that target holistic wellness above and beyond symptom reduction are increasingly used in the real world, though the evidence base lags. Papers in this issue support the emerging evidence for efficacy of mindfulness or other meditative or relaxation-based interventions. This special issue illustrates creative approaches but also the need for continued research establishing efficacy, evaluating more inclusive outcomes (e.g. a sense of wellbeing or ability to pursue valued life goals), and identifying potential mechanisms. [ABSTRACT FROM AUTHOR]

This discussion of papers by Sarnat and Berman on psychoanalytic supervision explores the complex nature of the contemporary psychoanalytic supervisory relationship. It considers how developments in psychoanalytic theory and practice, reflecting relational, intersubjective, attachment, and field theory influences over the past 30 years, have changed the ways in which many analysts practice and theorize supervision. Contemporary supervisors attend not just to the patient being presented, or to the therapeutic dyad, but to the supervisory relationship itself as part of the clinical/supervisory frame of reference. Similarities and differences between therapy and supervision are considered. [ABSTRACT FROM PUBLISHER]

The February 2024 issue of the Journal of Analytical Psychology features a range of stimulating papers. Silvia Presciuttini's paper explores the impact of mask usage in the treatment setting during the COVID-19 pandemic. Wes Wallace examines Jung's paper on the psychology of transference and proposes a new translation to clarify Jung's meaning. Ginny Hill discusses the clinical application of Jung's Black Books and The Red Book in therapy for a patient experiencing feelings of being the "living dead." Gunnar Reefschläger investigates synchronicity in psychotherapy and psychoanalysis, focusing on relational and transferential aspects. Benjamin Swogger pays tribute to Anthony Stevens and his contributions to the archetype debate. Joe Cambray interviews Ann Casement, discussing her journey in depth psychology and her various roles in the field. The Clinical Commentaries section presents a vignette on unconscious-to-unconscious linkage and the challenges it poses for the analyst. The issue also includes book reviews on a variety of topics. [Extracted from the article]

Background: This commentary offers a critical reflection on the current status of evidence‐based psychological treatments for psychological distress in dementia, with a particular emphasis on acceptance and commitment therapy (ACT). Purpose: The paper hypothesises several explanations, such as ethical dilemmas with recruitment and consent, and possible preconceptions surrounding the nature, scope and likelihood of therapeutic change in this population, for a lack of interventional research on people with dementia. Implications: We highlight some recent developments in psychological therapy with people with dementia that are raising more questions and generating new outcome research. [ABSTRACT FROM AUTHOR]

Our separateness from the other is the 'basic agony', the 'original heartbreak' of the human condition, according to Frances Tustin's thinking. The ways we deal with this heartbreak form the foundation through which relationships, self-experience and wellbeing are built and developed. The following paper describes a child's journey, from omnipotent encapsulation, through the extremes of heartbreak – the child's, as well as his parents' and the therapist's – to liveliness and hope. Tustin teaches us the meaning and experience of encapsulation, the delicate balance between 'hard' and 'soft' needed in the therapeutic stance, the extremes of despair, hurt, cruelty and heartbreak that are met with along the way, as well as the possibility of hope even in dire situations. Holding on, survival and faith, as well as hope-against-hope, which is the resistance to despair in situations of hopelessness, are needed in order for this broken heart to be somewhat mended and allowed to flourish and to grow. [ABSTRACT FROM AUTHOR]

My intervention briefly addresses the long, complex debate on technical and educational issues within British psychoanalysis during the late 1930s and 1940s. I hope to show that some of the problems discussed and the resolutions proposed by the Training Committee of the British Society during the years of the Controversies which we are commemorating are still a source of food for thought today, in spite of the fact that they belong to a specific past. I stress the importance of Strachey's ideas about an open psychoanalytic forum. This would not be the solution to all our problems, as crises and dissent are an inevitable part of the development of our discipline. However, the more transparent and the more informed we are about our past, and about the whole internal history of our discipline, including the wider cultural, scientific and socio-political context within which psychoanalysis developed and is developing, the better chance we have of understanding our present. [ABSTRACT FROM AUTHOR]

This paper outlines the ways in which Karl Friston's work illuminates the everyday practice of psychotherapists. These include (a) how the strategic ambiguity of the therapist's stance brings, via 'transference', clients' priors to light; (b) how the unstructured and negative capability of the therapy session reduces the salience of priors, enabling new top-down models to be forged; (c) how fostering self-reflection provides an additional step in the free energy minimization hierarchy; and (d) how Friston and Frith's 'duets for one' can be conceptualized as a relational zone in which collaborative free energy minimization takes place without sacrificing complexity. [ABSTRACT FROM AUTHOR]

Losing a child is a traumatic event, disrupting life's natural cycle, profoundly affecting the family system, and causing enduring grief. Perinatal death, including ectopic pregnancies, miscarriages, stillbirths, and neonatal deaths, exacerbates this distress. Additionally, the COVID-19 pandemic has challenged healthcare systems and supporting services available to individuals in need. Thus, this research explores experiences of parents facing perinatal loss in 2020–2021, further focusing on the pandemic's impact. Using a mixed-methods design with self-reports and qualitative interviews, this paper presents results from the quantitative protocol, involving an update and follow-up of a previous study. It compares measurements across scales: COVID-19: The Impact of Event Scale-Revised; The Prolonged Grief-13; The Parental Assessment of Paternal/Maternal Affectivity; The Dyadic Adjustment Scale (short version); The Daily Spiritual Experiences Scale; and The Inventory of Complicated Spiritual Grief. In the baseline measurement, 45 parents participated (37 mothers and 8 fathers), with 20 (13 mothers and 7 fathers) contributing to the follow-up and 9 engaging in interviews. Baseline results showed higher scores for mothers compared to fathers, with effect sizes ranging from small to medium (ranging from −0.02 to 0.29), though statistical significance was limited due to the small sample size. Multiple regression analysis for distress measures at baseline identified two significant predictors: maternal/paternal affectivity and gestational week. Additionally, positive support from healthcare professionals emerged as a mitigating factor, particularly in relation to Avoidance. A significant reduction in stress measures and parental affectivity was observed at the 6-month follow-up. Qualitative analysis revealed three themes: Shifts in Self-Perception and Post-Loss Growth; Conflicted Relationship with One's Body; and Negative Impact of COVID-19 vs. Unexpectedly Positive Aspects. In conclusion, the findings emphasize the significance of psychological and psychosocial interventions based on meaning-making processes, along with the importance of spiritual care and empowerment for those navigating perinatal loss. [ABSTRACT FROM AUTHOR]

The term schizotypy refers to the latent personality organization that is thought to underpin the liability to develop schizophrenia and associated disorders. Metacognition, or the ability to understand and form increasingly complex and integrated ideas of oneself, others, and one's community, has been proposed to be an important transdiagnostic construct across schizophrenia spectrum disorders and a range of both clinical and non-clinical manifestations of schizotypy. In this paper, we review evidence that deficits in metacognition are present in individuals with relatively high levels of schizotypy and that these deficits are related to symptomology, function, and quality of life. We address the idea that decrements in metacognition may also contribute to the progression from schizotypy to more severe manifestations, while the amelioration of these deficits may enhance aspects of recovery, including the ability to form an integrated sense of self, others, and the wider world. We also review the following two recovery-oriented psychotherapies that target metacognition to promote recovery in individuals with clinical manifestations of schizotypy: Evolutionary Systems Therapy for Schizotypy (ESTS) and Metacognitive Reflection and Insight Therapy (MERIT). [ABSTRACT FROM AUTHOR]

Clinical High Risk for psychosis (CHR) refers to a phase of heightened risk for developing overt psychosis. CHR often emerges during adolescence or early adulthood. CHR has been identified as a group to target for intervention, with the hope that early intervention can both stave off prolonged suffering and intervene before mental health challenges become part of an individual's identity. However, there are few treatment modalities that can address some of the specific needs of CHR. Metacognitive Reflection and Insight Therapy (MERIT) is an integrative psychotherapy that can be applied to the CHR population. MERIT offers unique advantages to working with the CHR population as it aims to improve self-direction and recovery through stimulation of metacognitive capacity, a phenomenon that has been associated with recovery. This paper explores unique aspects of the CHR population and how MERIT can address barriers to recovery for individuals experiencing psychosis-like symptoms. Several case examples and a clinical vignette using MERIT to support patients with CHR are offered to exemplify this approach. MERIT offers a way to assist persons with CHR to address barriers to their personal recovery and to develop nuanced understandings of ways to master challenges. [ABSTRACT FROM AUTHOR]

This paper explains the context for secondary accreditations for clinical psychologists, with a focus on the recognised multi-professional marker for competence in CBT, BABCP accreditation. It describes what CBT accreditation is and how clinical psychologists can achieve it at any stage of their career. The meaning of secondary accreditation within our profession is explored and the debate is outlined in the hope that readers will gain greater clarity about the value and benefits of dual accreditation in CBT for clinical psychologists. The views of clinical psychologists at all stages of their career from trainees to service leads are presented. Recent learning and developments from dual accredited clinical psychology doctorates in England are shared including the voices of a recent graduate of a Level 2 accredited doctorate, to provide insights and guidance for other doctorate programmes currently developing Level 2 BABCP accreditation, their supervisors and their trainees. [ABSTRACT FROM AUTHOR]