“Sharing in people's pain is not an easy thing to do”: Cognitive Behavioural Therapists' understandings of compassion in the workplace

Objectives

Compassion is central to the aim of improving patient care and staff well-being within healthcare systems. To inform service development, explorations of experiences and meanings of compassion are needed. This study explored cognitive behavioural therapists ' understandings of compassion within their work environment.

Design

A qualitative study was conducted using semistructured interviews and interpretative phenomenological analysis (IPA).

Methods

Data were obtained from five practicing cognitive behavioural therapists.

Results

Two superordinate themes were developed, each with two subordinate themes. CBT therapists reported entering the profession with intrinsic motivation to care for others. They further developed an interest in compassion with exposure to clients and ongoing professional development in compassion-focused therapy (CFT). Compassionate work environments helped to facilitate compassionate practice; however, for many, workplaces were perceived to lack compassion. Challenges were encountered when negative workplace interactions left therapists feeling fatigued, distressed and demoralised. There was a desire for recognition and to be seen as more than a “work machine,” the experience of which was a threat to retaining therapists within the profession.

Conclusions

Current recruitment and training processes are producing staff with skills and motivation to deliver compassionate care. However, lack of compassion within workplaces can be a barrier to actioning these skills and motivations. Research needs to focus on how to effectively implement and run systems that are compassionate for both staff and clients. To provide compassionate care, staff need work environments that show compassion to them. These findings provide some insights into and practical suggestions regarding how this can be achieved.     

Freedom,foreknowledge, and betting

Certain kinds of prediction, foreknowledge, and future-oriented action appear to require settled future truths. But open futurists think that the future is metaphysically unsettled: if it is open whether p is true, then it cannot currently be settled that p is true. So, open futurists—and libertarians who adopt the position—face the objection that their view makes rational action and deliberation impossible. I defuse the epistemic concern: open futurism does not entail obviously counterintuitive epistemic consequences or prevent rational action.     

Why the other-race effect matters: Poor recognition of other-race faces impacts everyday social interactions

What happens to everyday social interactions when other-race recognition fails? Here, we provide the first formal investigation of this question. We gave East Asian international students (N = 89) a questionnaire concerning their experiences of the other-race effect (ORE) in Australia, and a laboratory test of their objective other-race face recognition deficit using the Cambridge Face Memory Test (CFMT). As a ‘perpetrator’ of the ORE, participants reported that their problems telling apart Caucasian people contributed significantly to difficulties socializing with them. Moreover, the severity of this problem correlated with their ORE on the CFMT. As a ‘victim’ of the ORE, participants reported that Caucasians' problems telling them apart also contributed to difficulties socializing. Further, 81% of participants had been confused with other Asians by a Caucasian authority figure (e.g., university tutor, workplace boss), resulting in varying levels of upset/difficulty. When compared to previously established contributors to international students' high rates of social isolation, ORE-related problems were perceived as equally important as the language barrier and only moderately less important than cultural differences. We conclude that the real-world impact of the ORE extends beyond previously identified specialized settings (eyewitness testimony, security), to common everyday situations experienced by all humans.     

EFFECTS OF WARNING STIMULI FOR REINFORCER WITHDRAWAL AND TASK ONSET ON SELF-INJURY

Results of a functional analysis of self-injurious behavior (SIB) in a child with autism showed that her SIB was maintained by access to preferred objects and escape or avoidance of task demands. Extinction and noncontingent reinforcement treatments were supplemented by presenting a statement combined with a picture cue at 30-s intervals indicating that a preferred object would be removed or a task would be presented. Warning stimuli in combination with extinction and noncontingent reinforcement reduced SIB to acceptable levels. SIB rates remained comparatively high in a control condition consisting of a 2-min delay to onset of reinforcer removal or task demands.     

Rapid Gains in Speed of Verbal Processing by Infants in the 2nd Year

Infants improve substantially in language ability during their 2nd year. Research on the early development of speech production shows that vocabulary begins to expand rapidly around the age of 18 months. During this period, infants also make impressive gains in understanding spoken language. We examined the time course of word recognition in infants from ages 15 to 24 months, tracking their eye movements as they looked at pictures in response to familiar spoken words. The speed and efficiency of verbal processing increased dramatically over the 2nd year. Although 15-month-old infants did not orient to the correct picture until after the target word was spoken, 24-month-olds were significantly faster, shifting their gaze to the correct picture before the end of the spoken word. By 2 years of age, children are progressing toward the highly efficient performance of adults, making decisions about words based on incomplete acoustic information.     

Group Size Effects on Risk Perception: A Test of Several Hypotheses

Yamaguchi (1998) found that people perceived a lower level of risk in a group than when they were alone, despite the fact that being in a group did not reduce the objective level of risk. Three experiments were conducted to examine several potential explanations for this effect. Experiment 1 replicated the group size effect in self-perception as well as the perception of the risk level of others. Results did not support the interdependence hypothesis and the affiliation hypothesis. Experiments 2 and 3 tested a hypothesis based on the availability heuristic. The group size effect was reduced or nullified when the target of risk judgment was associated with risk-seeking behavior or when an accident, in which many people died, was made salient.     

Trends in Gender Differences in Academic Achievement from 1960 to 1994: An Analysis of Differences in Mean,Variance, and Extreme Scores

Gender differences in academic achievement have been studied extensively. While it is generally agreed that females have a slight advantage on average in verbal abilities and males have a slight advantage on average in mathematics, it is unclear whether these differences have changed over time. In this paper evidence from seven surveys representative of the United States twelth grade student population and the National Assessment of Educational Progress(NAEP) long term trend data is brought to bear on the magnitude of gender differences in achievement, the level of agreement among different indices of difference, and the stability of these differences over time. These data provide the unique opportunity to not only empirically estimate mean differences, differences in variance, and differences in extreme scores, but also to estimate change over time in all three indices using both the same and different tests over time. Results show that gender differences in mean and variance are small, while differences in extreme scores are often substantial. None of these differences have changed significantly since 1960, with the possible exception of mean differences in mathematics and science. Each of the datasets reflects the racial composition of the national population when properly weighted (i.e. White = 70%, Black = 15%,Hispanic = 10%, Other = 5%).     

The relationship between masculine gender role stress and psychological adjustment: A question of construct validity?

Masculine gender role stress is a theoretical construct that describes the stress created in men when they feel they are not meeting society's expectations for masculinity, or when the situation forces men to act in feminine-typed ways. The stress produced by these feelings or actions are thought to be related to negative psychological outcomes for men, but should be unrelated to well-being for women. The present study investigated the validity of the masculine gender role stress construct, especially with regard to the assumption that masculine gender role stress is related to negative psychological outcomes for men more than for women. Participants were a group of mostly Caucasian undergraduates. Results indicated that masculine gender role stress was related to depression, hostility, and anxiety, but to the same degree for both men and women. These findings suggest that, if MGRS is a valid construct, then researchers need to explore other ways in which this type of stress can negatively affect men, but not women.     

Family of the forest: Fatal enmeshment and other systems issues in the animal world

While the observation of non-human animal behavior has been a major means of developing psychological theories, it has been rarely used by marriage and family therapists to devise or explain systemic ideas. Jane Goodall's multigenerational research on the Flo family of wild chimpanzees in Gombe, Tanzania, as presented in her own and other's writing, and especially in Hugo van Lawick's documentary film,People of the Forest, offers a clear example of how systems concepts' application to animal families may have theoretical, pedagogical, and clinical utility.My thanks to my good friend, Violet Richman, who suggested the subject for this paper.