Positive experiences of doctoral-level supervisors-in-training conducting group-format supervision: a qualitative investigation

Experiential learning opportunities are powerful in shaping positive supervisor behaviours. We were interested in examining the positive experiences of supervisors-in-training during their first practice experience as supervisors. Our study was guided by two research questions: (a) what are the experiences that supervisors-in-training viewed as positive during the course of providing clinical supervision to master's-level counselling trainees? and (b) how did these positive experiences contribute to their professional development? We employed a variation of the consensual qualitative research method developed by Hill, Thompson, and Nutt-Williams (1997) and interviewed 10 supervisors-in-training regarding their positive experiences in supervising master's-level counselling trainees. The results included five major categories of positive experiences: (a) the positive value of feedback; (b) enhanced confidence in using a wider variety of supervision tasks and procedures; (c) the impact of the experience on other aspects of professional practice; (d) increased familiarity with the multiple roles of the supervisor; and (e) for some, increased comfort navigating co-supervision dynamics. Each of these categories included subcategories. We discuss our findings within the context of supervision training in graduate education.     

Exploring the experience of adhering to a prescribed pre-surgical exercise program for patients with advanced rectal cancer: A phenomenological study

ObjectivesThe aim of this study was to explore the lived experience of patients with advanced rectal cancer as they attempted to adhere to a prescribed, hospital-based pre-surgical exercise program.Design/MethodsTen patients took part in three semi-structured in-depth interviews prior to (week 0), midway (week 3), and at completion (week 6) of the exercise program. Data were analysed using a phenomenological approach.ResultsMain themes that were deemed important for remaining enrolled in the program included: (1) building camaraderie and peer support, (2) experiencing a sense of structure and control, and (3) feeling safe and encouraged. Patients also reported engaging in further exercise outside the program and feeling motivated to continue exercising in the future.ConclusionsThis study shows the potential to integrate exercise prior to surgery as it was viewed as acceptable and feasible by patients with advanced rectal cancer. Moreover, it provides much needed information into the possible mechanisms that underpin patient's continued participation in exercise programs during treatment for advanced rectal cancer. Prescribed, hospital-based program should be implemented to promote opportunities for exercise and provide on-going supportive care options for patients awaiting surgery.     

Approaching countertransference in psychoanalytical supervision: A qualitative investigation1

A recent examination of the literature concerning countertransference and its developments reveals its clinical usefulness in different psychoanalytical cultures. Nevertheless, a shortage of publications is apparent with respect to its approach in supervision. The authors aim in this study was to examine the concepts of transference and countertransference and how countertransference is approached in supervision, in the training of candidates, at an institute of psychoanalysis belonging to a society affiliated to the International Psychoanalytical Association (IPA). Qualitative research was carried out, interviewing supervisors and supervisees. Through analysis of the material acquired, the authors classifi ed the data into initial, intermediate and fi nal categories. The principal fi ndings were subdivided into three categories: the concepts of transference and countertransference, psychoanalytical listening and the complementarity of the phenomena, and the approach to countertransference. The concepts of transference and countertransference predominantly used by those interviewed are based on the totalistic outlook. Countertransference in supervision has been approached in a more direct and objective way when compared with the previous period, although great care is taken to delimit the boundaries between supervision and personal analysis. The main aim of supervision is to broaden comprehension and to deepen the interpretations directed towards the patient. These fi ndings suggest that the evolution of the concept of countertransference in different psychoanalytical cultures and developments in the analytical fi eld are contributing to this change.     

Disconnections of African American Public Housing Residents: Connections to Physical Activity, Dietary Habits and Obesity

African American (AA) and low SES populations report poor health behaviors and outcomes. This study aimed to increase understanding of barriers to participating in healthful behaviors and programs in AA residents of public housing. Twenty two apparently healthy, AA residents (50% female, M = 43.9 years) completed in depth interviews, which were taped, transcribed and analyzed using a constant comparison approach. Residents demonstrated some awareness of health recommendations, but described limited adherence. Physical activity for recreation was reported as primarily for youth, with adults engaging in limited physical activity (primarily incidental to other activities). Barriers reported by residents were both personal and environmental. Few residents were aware of local neighborhood opportunities for physical activity or healthful eating. Future efforts should focus on increasing understanding of health promoting behaviors and awareness and efficacy of residents to connect with the resources of their surrounding communities.     

A qualitative evaluation of a mental health literacy intervention for parents delivered through community sport clubs

Intervention studies have rarely targeted parent mental health literacy despite its importance for adolescent mental health. This qualitative study evaluated the experiences of parents (n = 352) who participated in the Ahead of the Game mental health literacy workshop delivered through community sport clubs. Moreover, the study aimed to investigate the relevance, retention and use of intervention content by parents, assess the acceptability and feasibility of delivering mental health education through community sport clubs, and identify strategies for increased engagement. In total, 17 parents (13 mothers, four fathers) participated in semi-structured interviews up to one month after the workshop. Reflexive thematic analysis revealed that parents perceived mental health education as important and valuable, and believed the community sport club was an appropriate setting to discuss adolescent mental health. Parents reported increased awareness and knowledge of mental health disorders and help-seeking options, and increased confidence and preparedness to communicate and assist someone experiencing a mental health issue. The workshop stimulated conversation about mental health between parents and their children, and between parents within and outside the sport club community. Parents used information and resources provided in the workshop to help those in their networks and reflected back on the workshop when noticing changes in their adolescent’s behavior. Potential additions to the workshop (as suggested by parents) included increased discussion among parents as well as opportunities for further information sessions or tailored online material. Future research might look to engage more fathers, actively encourage parents to aid in the recruitment of others, and investigate long-term adolescent mental health outcomes.     

A qualitative study of client experiences of working with novice counsellors

Aims: This paper reports on a qualitative analysis of written accounts by clients who participated in a counselling relationship with beginning-level trainees. The purpose of the study was to explore how clients experience the process of counselling with novice practitioners. Method: Consensual qualitative research was used for data analysis. Findings: Three general thematic categories were identified – client perceptions of self in counselling; client perceptions of the counsellor; and client perception of the counselling process. Conclusions: Overall, the findings suggest that these clients saw the interpersonal qualities and skills of the counsellor as major contributors to their experience. Implications: Clinical training of novices should start by developing the interpersonal and collaborative skills of trainees.     

Four types of fare evasion: A qualitative study from Melbourne,Australia

Fare evasion on public transport can reduce revenue by millions of dollars, undermining the financial viability of transit. However little research examines how public transport users think about fare evasion or attempts to understand why people fare evade. This paper presents the results of a program of qualitative research conducted in Melbourne, Australia to understand the attitudes toward and motivations behind fare evasion. A total of 67 people participated in face-to-face or online focus groups.Results established a spectrum of perceived circumstances where someone might travel without a valid ticket. ‘Fare evasion’ was considered to be at only one end of that spectrum. The degree of intent to evade was a critical factor explaining the severity of fare evasion from user perspectives. People’s attitudes toward fare evasion differed significantly; four key attitude segments were uncovered based on the attitudes and behaviours that group members tended to share. These included 1. ‘Fare evasion is wrong – the accidental evader’ who held strong views against fare evasion, 2. The ‘it’s not my fault’ evader who meant to pay but sometimes find themselves fare evading due to barriers to payment, 3. The ‘calculated risk-taker’ evader who deliberately fare evade if they think the reward outweighs risk and 4. ‘Career evaders’ who always fare evade. Attitudes, feelings and motivations for these segments are described and implications for revenue protection policy are discussed.     

A qualitative study of citizens' experience of participating in health counseling

Individual health counseling is a form of intervention designed to minimize the effects of chronic health disease and to offer a path towards good health practices. The aim of the present study was to explore the experiences of those persons who participated in health counseling in order to assess the psychosocial significance of the counseling upon their health behavior. In addition the study was concerned with the factors which underlay peoples' decision to sign up for health counseling. The research involved 11 semi‐structured interviews with individuals who had participated in a municipality based health counseling program. Data was analyzed using Malterud's systemic text condensation and a theoretical framework around Bandura's social cognitive theory. Analysis revealed that an approach tailored to each individual with minor short‐term goals accompanied by feeling supported by the counselor produced the greatest impact on behavior. Receiving feedback from the counselor and feeling positive about the relationship were seen as essential. These aspects were also crucial in the decision to undertake health counseling. The study indicates that whether individual's sign up on their own initiative or conversely are invited to join the program has no influence upon their motivation to change their behavior. Overall the respondents demonstrated improvement in their behavior and attitudes towards their health. However, the study also indicates that this form of intervention is less or even ineffective without the support of the individual's immediate family.     

Training needs among nonmental health professionals working with service members: A qualitative investigation

Though many service members will not directly seek mental health care due to stigma and other factors, they may interact with the healthcare system in other ways including contact with first responders, nurses, and allied health care professionals. However, little attention has been spent in this regard on the educational needs of these professionals whose contact with service members and Veterans may provide the opportunity to assist Veterans in need with overcoming barriers to accessing mental health care. This qualitative study investigates the educational training needs of first responders and health care professionals in contact with military families and trauma survivors to determine whether, and what type, of additional training is needed. A sample of 42 first responders and health care professionals including emergency medical technicians, police officers, fire fighters, speech language pathologists, occupational therapists, physical therapists, and nurses were recruited to participate in 1 of 6 focus groups. Sessions were audiotaped and transcribed verbatim. Data analysis was guided by a thematic analysis approach. Thematic analyses suggest there is a significant knowledge gap with unmet educational needs of these professionals such as information on the invisible wounds of war, military culture, and screening and referring patients who present symptoms falling outside professionals’ scope of practice. Findings point to a need and desire for more robust education for first responders and health care providers around mental health concerns of military populations, including topics such as trauma, military culture, and screening tools. Efforts to develop curricula addressing these concerns are warranted.     

Person‐centred counsellors' experiences of working with clients in crisis: A qualitative interview study

Aims: This study aims to explore and understand person‐centred therapists’ experiences and work with clients at the pivotal point of crisis. Specifically: how do person‐centred therapists experience working with clients in crisis? Do they identify differences in crisis intervention compared to non‐crisis work? What do they perceive as helpful to crisis clients? How relevant are therapists' own experiences of crisis? Method: Participants were all experienced person‐centred therapists. Qualitative, semi‐structured interviews were conducted and the data were analysed qualitatively using person‐centred/phenomenological methodology. Results: Respondents identified differences in their experiences. Typically, therapists described polarity in their experience of danger and opportunity, also heightened energy levels within themselves, perceived higher levels of engagement, faster pace of work, experiences of reaching ‘relational depth’ earlier, and the importance of assisting symbolisation of clients' experience in awareness. Clients were experienced as vulnerable, unable to access previous coping mechanisms, in a state of breakdown and disintegration, but also as wide open, having dropped their usual defences, and more available to engage in therapy and enter the process of change and potential post‐crisis growth. Discussion: The findings are discussed in relation to prevailing models of crisis intervention, person‐centred theory and theoretical developments in post‐traumatic growth in the aftermath of crisis.     

Peer support critical elements and experiences in supporting the homeless: A qualitative study

Peer supporters are individuals with lived experience and are an integral part of health care systems, providing support to those affected by various phenomena such as homelessness and addictions. However, little is known about the critical elements that underpin peer support interventions. This qualitative study sought to understand the critical elements of intentional peer support with a homeless population, voiced by those who provide and/or receive this support. Twenty‐nine participants from 4 different homeless charities in England were interviewed about their experiences of providing/receiving peer support and what they felt were critical factors to its success. Participants defined peer support as an experience‐based relationship, built upon mutual understanding, empathy, and support. Thematic analysis was utilised to in developing 6 themes. Results identified peers' persistence in developing unique experience‐based relationships, providing social support, role modelling recovery, and peers' motivations were perceived as important factors involved in peer support. It was also found that peers described benefitting from helping, such as, undergoing transformative identity developments that helped them to escape homelessness. Through the retelling of their stories, they create meaning and restructure their autobiography, attributing experiences of homelessness as a catalyst for positive changes in their lives. Limitations and future research are discussed.     

Primary care counsellors’ experiences of working with treatment resistant depression: A qualitative pilot study

Treatment resistant depression (TRD) is a severe and enduring form of depression that does not respond fully to medication. Although the evidence base for effective psychological treatments is not yet established, it is inevitable that counsellors working in primary care will encounter patients with this presentation. This pilot study explores the experience of four primary care counsellors with this patient group using Interpretative Phenomenological Analysis (IPA) and considers the implications for training and practice.     

School psychology: a public health framework: III. Managing disruptive behavior in schools: the value of a public health and evidence-based perspective

Schools typically adopt individualistic approaches to address disruptive behavior and meet the needs of students with disruptive behavior disorders (DBD) [i.e., Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD)]. These approaches are often not the most effective and have a limited impact on overall school climate. This article emphasizes the value of an evidence-based and public health perspective in managing disruptive behavior. Information about comprehensive school-based programs and classroom management techniques for disruptive behavior disorders is presented and the important role school psychologists can play in implementing these programs discussed.     

Sharing the road with autonomous vehicles: A qualitative analysis of the perceptions of pedestrians and bicyclists

Public perception assessment is important for gaining a better understanding of the acceptance of autonomous vehicles (AVs) and identifying potential ways to resolve public concerns. This study investigated how pedestrians and bicyclists perceived AVs based on their knowledge and road sharing experiences, applying a combined inductive and deductive data analysis approach. Survey responses of pedestrians and bicyclists in Pittsburgh, Pennsylvania, USA collected by Bike Pittsburgh (BikePGH) in 2019, were analyzed in this research. AVs following traffic rules appropriately and AVs driving safer than the human drivers were the most notable positive perceptions towards AVs. Pedestrians and bicyclists showed comparatively fewer negative perceptions towards AVs than positive perceptions. Negative perceptions mostly included a lack of perceived safety and comfort around AVs and trust in the AV technology. Respondents also concerned about AV technology issues (e.g., slow and defensive driving, disruptive maneuver), while sharing the road with AVs. Perceptions of the respondents were significantly influenced by their views on AV safety, familiarity with the technology, the extent respondents followed AV on the news, and household automobile ownership. Regulating AV movement on roadways, developing safety assessment guidelines, and controlling oversights of improper practices by AV companies were the major suggestions from the survey participants. Findings of this study might help AV companies to identify potential improvement needed in AV technology to increase pedestrians and bicyclists acceptance, and policymakers to develop policy guidelines to ensure safe road sharing among pedestrians, bicyclists, and AVs.     

Integrating models of self-regulation and optimal experiences: A qualitative study into flow and clutch states in recreational distance running

ObjectiveIn this study, we aimed to understand the self-regulatory processes facilitating optimal experiences in running by integrating models of self-regulation with flow and clutch states.MethodUsing an event-focused approach, we interviewed 16 runners less than one day on average after recreational running activities (M = 22.17 hours later, range = 3–46) they described as positive, rewarding experiences. Our analysis drew on principles for thematic and connecting analyses.ResultsWe structured our analysis of the self-regulatory processes facilitating flow and clutch states into three overarching themes: forethought; monitoring; and control. Flow was facilitated by intrinsic experiential motives and non-specific goals, whereas clutch states involved an intrinsic motive to accomplish specific goals. The perceived ease and pleasure during flow motivated runners to continue this experience, which appeared to be aided by active and involuntary distraction. Conversely, clutch states were described as more effortful and less pleasant during the run, with active self-regulation strategies used to exert control over cognition and manage feelings of difficulty. Attending to specific outward or internal sensory stimuli appeared to initiate changes that contributed to the disruption of flow, although many runners described transitioning into a clutch state after flow disruption. No runner reported transitioning from a clutch state into flow.ConclusionsOur study offers novel insights into optimal experiences in running by integrating models of self-regulation with flow and clutch states. We discuss how these insights can inform research and applied practice seeking to develop interventions for promoting optimal experiences during running.     

The affective interval: An investigation of the peaks and valleys during high- and moderate-intensity interval exercise in regular exercisers

Evidence supports the notion that people generally feel worse during high(er) intensity exercise but experience an affective rebound immediately following cessation that often exceeds pre-exercise feeling states. Considering rest/recovery is an integral part of interval exercise, it is of interest to determine the degree of affective reactivity and recovery that may occur during interval exercise of different intensities. The purpose of the present study was to examine affective reactivity to and recovery from an acute bout of moderate-intensity (MIIE) and high-intensity interval exercise (HIIE). Participants (N = 25, 13 females, 23.3 ± 4.0 yrs, BMI = 25.7 ± 4.1 kg m⁻²) completed 4 sessions at the same time of day with at least 24-h between each session: a baseline session to record resting affect, a graded exercise test on a stationary bike (cycle ramp protocol 25 W·min-1) to volitional exhaustion, and then completed a high- (HIIE) and moderate-intensity interval exercise (MIIE) session where affect was recorded prior to, during, and up to 30-min post exercise. Participants reported more negative feeling states during the HIIE session compared to the MIIE session, but these states recovered similarly as early as 5-min post-exercise. In addition, while affective change (reactivity and rebounds) were relatively equal during the MIIE, declines in affect during the HIIE outweighed the affective rebounds associated with rest, resulting in a large decline in affective state from pre-exercise.