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Borderline personality disorder (BPD) is a severe mental health disorder that is subject to significant stigmatisation. With language being a key reinforcer of stigma, this co‐produced study aims to explore the language use regarding BPD and its effect on those with BPD and carers. Recommendations to reduce stigmatisation are provided for both clinicians and researchers. Participants with BPD (consumer n = 33) and those supporting someone with BPD (carer n = 30) discussed their experience of hurtful and helpful language. Reflexive thematic analysis was used to analyse written and verbal responses into core conflictual relationship themes (CCRT) reflecting how different words were heard and experienced. All consumers and carers in the study reported experiences with stigmatising language. Feelings of inadequacy and frustration were common amongst consumers, specifically when they perceived others as trivialising their needs or not seeing them as a unique individual. Carers often reported feelings of frustration when they perceived others as blaming them or not acknowledging their needs. Both consumers and carers reported helpful language as being connecting, validating and accepting. Unhelpful communication patterns have negative consequences for the person's self‐understanding (i.e., self‐stigma) and their relationships with others, including the therapeutic alliance. A consideration of these communication patterns may foster the use of reflective positive language that is compassionate and hopeful. [ABSTRACT FROM AUTHOR]

Clinical social work practice in organisational settings is complex and challenging. Effective practice is contingent on knowledge and skills that are particular for systems-based work involving multiple interprofessional mental health practitioners and clients interacting in a relational matrix. Yet, not all social work theories and constructs that were developed for application in individual, group, and family modalities are directly transferable to the practice environment of a treatment system. This paper offers a conceptual framework that synthesises contemporary psychodynamic theory with systems theory – referred to as a psychodynamic systems approach – to inform and advance knowledge of systems-based social work practice. This approach considers the interplay of dynamic processes among the four levels of the socially co-constructed system which constitute the system as a whole. It examines how five key clinical phenomena – transference, countertransference, splitting, projective identification and enactment – are actualised in systems. Definitions of these phenomena formulated from a dyadic perspective and a contemporary psychodynamic systems approach are offered, and their similarities and differences are discussed. A composite case example is provided to illustrate how several of these phenomena manifest in clinical practice. [ABSTRACT FROM AUTHOR]

Collusion is a specific and potentially harmful transference-countertransference interaction. At its core is an unconscious, unresolved issue shared by two or more participants, who are interlocked in a defensive maneuver. The issue at stake, which is avoided at the intrapsychic level, externalized, and circulating in the interpersonal space, may pertain to control, intimacy, loss, or domination, among other possibilities. Collusion occurs not only in psychoanalysis, psychotherapy, psychiatry, and medicine but also in couples and both within and between groups. This critical narrative review is based on a comprehensive consultation of the literature and our experiences as psychotherapists, supervisors, and researchers. We situate and delineate collusion, engage in a critical dialog with the literature and question some conceptual aspects of collusion. The aim of this review is to stimulate the interest of clinicians, supervisors, and researchers in this somewhat neglected phenomenon and to demonstrate and illustrate the challenges and pitfalls that clinicians face in collusive encounters. Finally, we provide clues to identify and ways of working through collusion in the context of psychotherapy and supervision. [ABSTRACT FROM AUTHOR]

Countertransference, the analyst's main instrument for detecting the patient's projective identification, is a central preoccupation, and O'Shaughnessy uses it with particular confidence and freedom of movement. Graph Edna O'Shaughnessy, who has died aged 97, was a leading British psychoanalyst of both children and adults. As suggested earlier, O'Shaughnessy finds that an image or dream used by a patient can crystallize, for both the patient and the analyst, many elements in the internal reality of each of them, and in their interaction. O'Shaughnessy thought that Bion's emphasis on how contact between analyst and patient is won and lost in the course of a session had changed the way analysts work. [Extracted from the article]

Purpose: Many referrals to our mental health of learning disability service focus on concerns about behaviours that present risks to the referred person and to those around them, including support workers. If the referred person has good verbal ability, psychological therapy may be requested and offered, but the person may find it too difficult to engage for a number of reasons. Even when they do engage in therapy, the authors recognise the importance of helping staff better understand their attachment needs. This paper aims to demonstrate an innovative approach to helping staff provide Trauma-Informed Care (TIC). Design/methodology/approach: The authors developed a training programme for support workers using psychodynamic concepts, such as splitting, transference and counter-transference, to help them develop insight into the processes that get enacted during their work. In this paper the authors have generally used the term "care staff", recognising that an important aspect of the role of those staff is to provide care within an attachment framework; as well as support to maximise independence. Findings: The feedback from staff who have attended has been very positive, both at the time and later. Staff who have attended have talked to multidisciplinary colleagues about the impact their learning has had on their ability to work with service users who present great challenges, in the context of their trauma histories. Originality/value: The importance of providing TIC is gaining traction across varied settings. The authors are in the process of developing both qualitative and quantitative research programmes to evaluate this approach to increasing TIC for adults with learning disabilities, reducing staff burn out and placement breakdown. [ABSTRACT FROM AUTHOR]

Introduction: What does the analytical music therapy (AMT) approach have to offer the field of music therapy in terms of listening to manifestations of the unconscious, in both music and speech? Since Freud, dreams have been thought of as the royal road to our unconscious. Mary Priestley, the founder of AMT, integrated concepts from Freud, Klein and Jung in her work with her client's dreams. Method: This paper will explore the AMT techniques Priestley developed to work with dreams and situate them in Freudian theory, drawing on literature of AMT, other psychodynamic music therapy approaches, as well as the author's own training in AMT. The author will also examine what an analytical perspective on musical events during improvisation can teach us about how the unconscious may manifest in music. Results: Musical events such as sudden rhythmic shifts, polyrhythmic moments and rhythmic ruptures in a musical improvisation can indicate noteworthy moments in which the client encounters his or her unconscious. By recognizing and working with these moments, the music therapist may facilitate further exploration of unconscious content. Discussion: The implications of these shifts on how meaning can be generated within the frame of AMT will be discussed. The author argues that it is clinically useful to distinguish an understanding of the Freudian dynamic unconscious from a more general sense of the unconscious. [ABSTRACT FROM AUTHOR]

Background: There is increasing evidence that cognitive behavioural therapy (CBT) can be effective for people with intellectual disabilities. The aim of this review was to report the nature and frequency of adaptations reported in studies of CBT for people with intellectual disabilities. Method: This review updated and extended a previous review by (Whitehouse et al. 2006, J Appl Res Intellect Disabil, 19, 55), which used a framework of adaptations developed by (Hurley et al., 1998, J Dev Phys Disabil, 10, 365). Adaptations included simplification, language, activities, developmental level, use of directive style, flexible methods, involve caregivers, transference/countertransference and disability/rehabilitation approaches. A search identified peer‐reviewed papers that reported individual CBT informed psychological interventions for people with an Intellectual Disability. Results: The search identified 23 studies which met the inclusion criteria for review. Studies reported the majority of the categories of adaptation described by (Hurley et al., 1998, J Dev Phys Disabil, 10, 365). Conclusions: The results suggest that the framework of adaptations needs further development to increase sensitivity in identifying and categorizing adaptations of CBT. Increased, systematic reporting of adaptations to studies of CBT with people with intellectual disabilities is recommended. [ABSTRACT FROM AUTHOR]

While the construct of countertransference has been established in psychodynamic theory since its inception, it has received relatively little attention from cognitive-behavioral theorists. However, it is generally agreed that therapists’ reactions to patients powerfully influence treatment, for better or worse. Suicidal patients in particular are likely to evoke negative reactions in therapists. In this paper, we briefly review the theoretical literature on countertransference, with particular attention to suicidal patients, from standpoints of psychodynamic and cognitive-behavioral theory and research. We argue that the cognitive-behavioral perspective, together with the RAIN model proposed by mindfulness authors (Recognition, Acceptance, Investigation, and Non-Identification), opens avenues to assess, distance from, and perhaps modify cognitions that could lead to counter-therapeutic emotions and behaviors in working with suicidal patients. We conclude that, while work with suicidal patients can be challenging, cognitive-behavioral therapists can potentially improve effectiveness and enhance their own well-being by managing their reactions in a manner consistent with their theoretical orientation. [ABSTRACT FROM AUTHOR]

The therapeutic movement relationship (TMR) is central to the work of dance/movement therapists; yet, a definition of this core concept remains absent. This phenomenological study explored the meaning and essence of the TMR, as experienced by eight co-researchers who are board certified dance/movement therapists, in order to arrive at a definition. Data analysis of semi-structured interviews resulted in five textural themes that describe the essence of the TMR: (a) fundamental, foundational, and integral, (b) powerful, dimensional, and full, (c) shared presence and connection through movement, (d) creative collaboration, and (e) evidence of the TMR. In addition, three structural themes emerged that describe how the TMR is experienced: (a) presence, (b) space and time, and (c) creativity. These themes informed the creation of a definition of the TMR, which can support the teaching, learning, practice, supervision, and research of this critical component of dance/movement therapy. [ABSTRACT FROM AUTHOR]

The aim of the study was to explore the coping strategy and the effects of self-efficacy of Chinese undergraduate nursing students when they face the stress in clinical practice. Convenience sampling was used to recruit undergraduate nursing students in Mainland China who have practiced 3 months in hospitals in their final college year. Self-report questionnaires including demographics, Perceived Stress Scale, coping behaviour inventory and Generalized Self- Efficacy Scale were collected. The results showed that during clinical practice, assignments and workload were the most common stress to students; transference was the most frequently used coping strategy by students. Self-efficacy not only had a positive main effect in predicting the frequency of use of staying optimistic and problem solving strategies but also moderated the effects of stress from taking care of patients on transference strategy, as well as stress from assignments and workload on problem solving strategy. It is essential to bolster the students' self-efficacy to reduce stress and adopt positively the coping strategies during clinical practice. [ABSTRACT FROM AUTHOR]

The concept of vicarious resilience captures the therapist's emotional growth occurring as a direct result of therapeutic engagement with traumatized clients. Three chronological case scenarios are presented for exploration of vicarious resilience in relation to attachment trauma. The purpose is to increase awareness and appreciation of the positive functions it serves for client mentalization, therapist skill and resilience factors for both parties. The reflective methodology considers the intrapsychic worlds of the client and the therapist and details how the therapist comes to experience the client's distressing projections. The potential for vicarious resilience begins from the outset of the therapist's actions of containment upon these projections. Advancing early ideas, it is advocated that vicarious resilience requires the therapist to have both the capacity and willingness to maintain a constant reflective stance. [ABSTRACT FROM AUTHOR]

The different pathways chosen to efficiently and effectively provide relief to those struggling with mental health challenges reflect different assumptions about the human condition and have led to disagreements over which intervention strategies are best suited to particular individuals or populations. Evidence-based practice and culturally competent services, as discussed within the United States, have been characterized as opposites. However, neither approach captures all of the elements that embody the full treatment experience. This article offers a framework that includes the personal identity of the practitioner and the organizational context as two elements that serve as active agents in the helping relationship, although they have rarely been included in the discourse about evidence-based practice or cultural competence. Suggestions for practice, education, and research are included based on this analysis. [ABSTRACT FROM PUBLISHER]

Psychoanalytic theory offers a varied conceptual system for considering psychosis by providing a coherent representation of the anxieties and processes at work in adult patients. But at the practical clinical level, it is not enough simply to ‘think about psychosis’ and have a theoretical system in place. The therapist must also ‘have psychosis in mind’, that is, get to grips with its forms of logic, gain familiarity with its workings, and learn to understand and accept the effects it has on the therapeutic relationship and on their own expectations. Clinicians engaged in this type of work must be able to tolerate getting back in touch with processes deemed archaic at the core of their own psychological functioning, which will impact their ability to listen and think. These chaotic processes demand a change of approach since they cause a ‘desymbolisation’ that perturbs the internal mental structure of the therapist. This ‘desymbolisation’ is therefore the locus of the therapeutic work, which must attempt to render it comprehensible and represent it. A case study illustrates these processes. [ABSTRACT FROM PUBLISHER]

Three-quarters of the world come from collectivistic group-oriented cultures. As the world becomes more globalized it is inevitable that group counseling will be a major choice of healing and psychological intervention internationally. However, a review of scholarly articles from The Journal for Specialists in Group Work and Group Dynamics during the past 10 years reveals that there are few articles that address international group work. To better prepare group counselors to do group counseling across international boundaries this article discusses 9 critical cross-cultural themes in international group work and the importance of having an international group counseling training curriculum. [ABSTRACT FROM AUTHOR]

This study employed a qualitative research design utilizing intensive interviews and written case accounts to examine the therapist’s internal experience when a patient with an early-life trauma history dissociates in session. Findings support emerging theory and research from the intersecting fields of relational psychoanalysis and interpersonal neurobiology that frame the internal experience of the therapist as a pathway for empathy and understanding. The findings suggest that the therapist’s willingness to enter into a patient’s dissociation in session and observe one’s own internal experience during the dissociation can promote states of resonance, attunement, and implicit knowing in the therapy dyad. [ABSTRACT FROM AUTHOR]

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This article discusses major concepts of developmental theory in terms of their concurrence with neurobiological information. Regulation theory is used to summarize the development and functions of the right hemisphere, the workings of two distinct memory systems, and right-brain involvement in attachment functions. The clinical relevance of interpersonal neurobiology to transference and countertransference is illustrated with a clinical case example. [ABSTRACT FROM PUBLISHER]

Aim: This study explored therapists’ understanding and experiences of erotic transference within therapeutic relationships. Method: A small-scale qualitative research project was undertaken with six therapists working within different counselling contexts. Data was collected through semi-structured face-to-face interviews, and an Interpretative Phenomenological Analysis used for analysis of individual perception and experience. Findings: All participants had experienced what they understood to be erotic transference and/or sexual and loving feelings within therapy. There was little differentiation between the two phenomena, and both were often referred to interchangeably. There were contradictory views as to whether using the phenomena would be beneficial to client work, but there was a strong motivation to learn more about it. Therapists who encountered sexual attraction within therapy experienced feelings including shame and embarrassment. Supervisory support was seen to be beneficial. Implications/conclusion: The importance for therapists to acknowledge a lack of clarity that exists around the understanding of erotic transference and its relationship to sexual attraction within therapy is noted. Also, a recognition that better access to training regarding erotic transference and sexual responsibility within client relationships might be helpful to therapists in their work. [ABSTRACT FROM AUTHOR]

Purpose. Supervision is an expanding area of clinical practice, and despite the threadbare evidence base, the demand for supervision provided by trained clinical supervisors is growing. This demand accompanies the injection of large numbers of psychological therapists into the UK National Health Service (NHS), and the increased expectations of good clinical governance. Therapeutically appropriate approaches that can help supervisors work with psychological therapists are needed. Methods. Key processes in supervision are explored in the light of the clinical application of cognitive-analytic concepts, such as reciprocal roles, the zone of proximal personality development (ZPPD), and the super-addressee. Results. Cognitive-analytic ideas allow for a reframing of traditional psychoanalytic concepts in supervision, such as parallel process. They offer a readily accessible model with which to think about the construction of interacting supervisory processes at the level of the individual self, the supervisory dyad or group, through to the organizational and cultural context. They provide a way to think about the supervisor's development in the context of the evolving supervisory relationship. Conclusion. A cognitive-analytic approach to supervision that includes both cognitive and relational dimensions of the work can help to broaden therapeutic thinking and navigate complexity, not only for cognitive-analytic therapists, but also for therapists using other cognitively oriented and integrative models. [ABSTRACT FROM AUTHOR]

Background: The concepts of transference and countertransference developed within psychodynamic paradigms. While there is an increasing interest by cognitive therapists in the therapeutic relationship, there is less discussion of the relevance of transference and countertransference. Understanding these concepts may be useful to cognitive therapists as part of reflective practice, especially in regard to understanding and managing countertransference responses. Methods: This article briefly examines the concepts of transference from a number of different perspectives, including social-cognitive, attachment, cognitive analytic therapy, and schema perspectives. Two aspects of countertransference that are sometimes termed 'subjective' and 'objective' are also examined. A case example is given to illustrate a cognitive conceptualisation of countertransference. Results: There is some evidence that therapists' countertransference responses can provide insight into clients' experiences and patterns of relating to others. Cognitive therapists may therefore benefit from applying psychodynamic perspectives of countertransference in reflective practice. Conclusions: Transference and countertransference can be understood using cognitive perspectives. These concepts may be helpful for cognitive therapists to consider during reflective practice in self-supervision and in clinical supervision. It seems important that cognitive therapists do not dismiss these concepts because of their origins but rather investigate the potential applications of these concepts within cognitive frameworks. [ABSTRACT FROM AUTHOR]

This article reports on a qualitative, multi-case study of child welfare professionals who discussed the changes they experienced because of the work they do. It was concluded that vicarious trauma was the cause. This study was grounded in the constructive self-development theory, a developmental and interpersonal theory with a trauma focus that explains the impact of trauma on an individual's psychological development, identity, and adaptation. [ABSTRACT FROM AUTHOR]