“Bridging the Gap”: A reflexive thematic analysis of the experiences of therapy trainees transitioning from psychodynamic counselling to cognitive behavioural therapy

There is limited empirical research and insight into the experiences of therapy trainees who are being taught more than one psychotherapeutic approach during their training. Further understanding is warranted to ensure that a dual modality approach to training (that is, where therapists are trained in two paradigmatically distinct modalities) is experienced as worthwhile and acceptable to trainees and to better understand any challenges faced when transitioning between approaches. The aim of this study was to investigate trainees' experiences of transitioning from psychodynamic counselling to cognitive behavioural therapy (CBT) on a two-year master's degree that offers a dual modality approach to training. Data were collected from a sample of 8 trainees using an online semistructured questionnaire. These data were analysed using Braun and Clarke's (2020) reflexive thematic analysis. Four main themes were identified: (1) perceived competence; (2) preparedness; (3) professional advantages; and (4) external challenges. The findings suggested considerable individual variation in the ease with which participants navigated the transition between therapeutic modalities. Those who found the transition easier used the structure of CBT to provide a framework and point of difference that allowed them to temporarily suspend their psychodynamic learning in order to embrace a new therapeutic approach. Others experienced the move to CBT as posing a threat to their developing identities as counsellors. Recommendations are made on how to prepare trainees for the transition including exploring the psychological impact of transitions, increasing opportunities for reflective practice and facilitating exploration of what it means to be a therapist trained in two distinct therapeutic modalities.     

The Added Value of Studying Embodied Responses in Couple Therapy Research: A Case Study

This article reports on the added value of embodied responses identified through sympathetic nervous system (SNS) activity in couple therapy research. It focuses on moments of change and the timing of therapeutic interventions or therapeutic moves in a couple therapy session. The data for this single‐case study comprise couple therapy process videotapes recorded in a multi‐camera setting, and measurements of participants’ SNS activity. The voluntary participants were a marital couple in their late thirties and two middle‐aged male psychotherapists. The division into topic segments showed how the key issue of seeking help, which was found to comprise three separate components, was repeatedly dealt with in the session. SNS activity showed different degrees of synchronization between the couple, between the therapists, and between the couple and therapists during the dialogue pertaining to these three components. The issue of timing emerged as a complex, even ambivalent, phenomenon. Arousal in the therapists was in line with their therapeutic activity, whereas in the clients it was more anticipatory. The approach used here rendered visible some of the intensity that therapeutic dialogue can generate when dealing with issues of relationship change in the couple context and showed how this intensity can be dialogically regulated in the therapeutic system.     

Towards an evidence‐base for student wellbeing and mental health: Definitions,developmental transitions and data sets

Against a background of huge changes in the world of university and college students since the turn of the millennium, together with a multitude of reports on student mental health/wellbeing, this article argues that the field of student mental health is hampered by the imprecise use of terms, a rush to action by universities in the absence of a robust evidence‐base, and a lack of overall coordination and collaboration in the collection and use of data. In response, we argue for clearer and more consistent use of definitions of, as well as differentiations between, student wellbeing and mental health, for a longitudinal approach to the student body that captures their developmental transitions to and through university, and a strategic and systematic approach to the use of bona fide measures in the collection of data on wellbeing and on the process of outcomes in embedded university counselling services. Such a coordinated approach will provide the necessary evidence‐base upon which to develop and deliver appropriate support and interventions to underpin and enhance the quality of students’ lives and learning while at university or college.     

Towards a multidisciplinary guideline religiousness,spirituality, and psychiatry: what do we need?

ABSTRACT

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

Validation française d’une version brève de l’Échelle de satisfaction maritale

IntroductionFew measuring instruments of couple satisfaction maximizing the individual perception of the relationship exists in French. Settings such as Liaison psychiatry of a general hospital could benefit from a questionnaire adapting to a variety of clinical profiles.ObjectiveThis article proposes a French revision and validation of the Marital Satisfaction Scale (MSS; Roach, Frazier, and Bowden, 1981), a 48-item self-reported questionnaire designed to evaluate personal satisfaction towards one's couple relationship.MethodA sample of 349 community-dwelling individuals aged 20–85 answered the MSS, the Dyadic Adjustment Scale (DAS; Spanier, 1976), and a series of inquiries related to sociodemographics. As an initial Exploratory Factor Analysis (EFA) did not validate the unidimensional structure postulated by the original authors, the item number was reduced to 14.ResultsThis brief version of the scale (MSS-14) was subsequently validated with an internal replication analysis, a strong criterion-related validity with the DAS (r_s = 0.73, P < 0.001), an excellent internal consistency (α = 0.961, IC à 95% [0.955, 0.967]), a strong test-retest reliability (r_s = 0.90, CI à 95% [0.85, 0.93], P < 0.001, Z = − 0.033, P = 0.973), and strong item-to-total correlations (> 0.69). The MSS-14 could differentiate individuals with and without marital distress (AUC = 0.97), while no sociodemographic variable seemed to have a significant influence on couple satisfaction.ConclusionThe MSS-14 appears to be a reliable instrument to assess the personal satisfaction towards a couple relationship in community-dwelling adults.     

Qualities of reflection: using Saul’s (2001) On Equilibrium to restore humanity to reflection in healthcare

Reflection features strongly in health and care work as a tool for personal and professional development and can support us as practitioners to be critical and self-aware in practice, of practice and the impact on clients and patients. Its power to transform learning and practice, however, has been watered down through recipe-following in reflective recording and through the avoidance of recording uncertainty or practice that might not measure against professional codes. Drawing on the humanist philosophy of John Ralston Saul, I suggest using Saul’s ‘six qualities’ as themes for reflective questions. I reflect on the influence of reason through codes of practice and offer suggestions for questions to restore an awareness of Self in work with clients and patients. Finally, from my experience as a counselling student and healthcare educator, I argue that we should have a greater appreciation of the power of uncertainty in reflective recording.