Client perceptions of hindering experiences in counselling

The purpose of this study was to increase understanding of what clients perceive as hindering experiences in counselling. In‐depth interviews combined with concept mapping were used to gather, organize, and understand clients' perceptions of hindering aspects of therapy. In the initial data gathering stage, 8 adult client participants, aged 18 or older (average of 14.1 sessions) were asked to respond to the following open‐ended questions:

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A journey through languages: A systematic literature review on the multilingual experience in counselling and psychotherapy with children and adolescents

The purpose of this research was to address the gap in the existing literature on the multilingual aspect of language in psychotherapy with children and adolescents. This research aimed at interpreting possible meanings for clients of being multilingual in the therapeutic process as well as reflect on the influence of clients’ multilingualism in the therapeutic relationship. The researcher used a systematic literature review (PRISMA guidelines, 2009) to select articles based on empirical qualitative/mixed studies with participants up to 25 years old or adults referring to childhood/adolescence. The researcher used thematic synthesis (Thomas & Harden, 2008) to extract, analyse and interpret data. The rigour of this study was enhanced by the use of auto-ethnography as a source of evidence (McLeod, 2015). The auto-etnography documents self-reflections on personal experience of being multilingual contributing to deeper contextualised knowledge. The findings confirm previous research on the existence of a link between multilingualism and “identity” (Costa, 2020, p. 5). This research suggests that the meaning a client gives to bilingualism can be co-constructed within an attuned therapeutic relationship. In this co-construction journey, there is a significant opportunity for children and young people in finding their way through languages, hence reaching emancipation and affirmation in the world. The main limitation of this research relates to the fact that there are not many studies with children/young people. This led the researcher to also include studies based on a mixed sample and with adults referring to childhood/adolescence, which might have influenced the interpretation of findings.     

Do perceived autonomy-supportive and controlling teaching relate to physical education students' motivational experiences through unique pathways? Distinguishing between the bright and dark side of motivation

ObjectivesGrounded in Self-Determination Theory (SDT), this study examined the mediating role of students' experiences of need satisfaction and need frustration in associations between perceived teaching style and students' motivation and oppositional defiance in the context of physical education. Specifically, we tested an integrated model including both a ‘bright’ path from perceived autonomy-supportive teaching through need satisfaction toward autonomous motivation and a ‘dark’ pathway from perceived controlling teaching through need frustration toward controlled motivation, amotivation, and oppositional defiance.DesignCross-sectional study.MethodsTo investigate the proposed paths structural equation modeling was used in a sample of 499 secondary school students (44% boys, M_age = 15.77 ± 1.16).ResultsWe found that perceived autonomy-supportive and controlling teaching, as well as need satisfaction and need frustration, constitute different constructs relating distinctively to motivational outcomes. Consistent with the notion of a bright and dark path, perceived autonomy support was related primarily to autonomous motivation, with need satisfaction mediating this association, whereas perceived controlling teaching was related primarily to controlled motivation and amotivation, through need frustration. Perceived controlling teaching also displayed a direct and unique relationship with oppositional defiance.ConclusionsTo more accurately capture the detrimental effects of controlling teaching, this teaching dimension along with its consequences in terms of need frustration and motivational outcomes needs to be studied in its own right. It is also discussed that effective teacher training may raise awareness among teachers about the motivational risks associated with controlling practices.     

Early attrition among suicidal clients

The study aimed to identify the level of suicidal ideation in early attrition clients and their reasons for the early termination of their therapy. The cross-sectional design involved early attrition clients (C_A) who withdrew from therapy before their second session (n?=?61), and continuing clients who (C_C) progressed beyond their second session (n?=?73). All completed the Suicidal Behaviours Questionnaire-Revised scale, and the C_A group also completed the Reasons for Terminating Therapy Scale. Clients were significantly more likely to disengage if they were self-referred, had no health-care support or had lower suicidal ideation. The study identifies the significant role of suicidal ideation and referral source in therapy retention and the implications this has for therapists and counsellors.     

The Suffocation of Marriage: Climbing Mount Maslow Without Enough Oxygen

This article distills insights from historical, sociological, and psychological perspectives on marriage to develop the suffocation model of marriage in America. According to this model, contemporary Americans are asking their marriage to help them fulfill different sets of goals than in the past. Whereas they ask their marriage to help them fulfill their physiological and safety needs much less than in the past, they ask it to help them fulfill their esteem and self-actualization needs much more than in the past. Asking the marriage to help them fulfill the latter, higher level needs typically requires sufficient investment of time and psychological resources to ensure that the two spouses develop a deep bond and profound insight into each other's essential qualities. Although some spouses are investing sufficient resources—and reaping the marital and psychological benefits of doing so—most are not. Indeed, they are, on average, investing less than in the past. As a result, mean levels of marital quality and personal well-being are declining over time. According to the suffocation model, spouses who are struggling with an imbalance between what they are asking from their marriage and what they are investing in it have several promising options for corrective action: intervening to optimize their available resources, increasing their investment of resources in the marriage, and asking less of the marriage in terms of facilitating the fulfillment of spouses’ higher needs. Discussion explores the implications of the suffocation model for understanding dating and courtship, sociodemographic variation, and marriage beyond American's borders.     

Young clients' narratives of the purpose and outcome of counselling

This study explores how adolescent clients construct the purpose and outcome of counselling. A narrative analysis was performed on interviews with 22 clients (aged 16–18) who had used a school-based counselling service. The aim was to identify the purpose and outcomes that participants attributed to their counselling experience. The analysis identified four narrative forms that young clients used to describe counselling. These included ‘transformative’, ‘supportive’, ‘pragmatic’ and ‘disappointed’ narratives. Each narrative form constructed a different purpose and outcome for counselling. Engaging with clients' narratives about the purpose and intended outcome of counselling may allow counsellors to better match their expectations and approach to fit with their young client or to work with them to co-construct more flexible narratives that support helpful outcomes.     

Coming to terms: Client subjective experience of ending psychotherapy

How do clients consider their own contribution and that of their therapist in the last phase of therapy when they are moving toward the end? Thirty-seven clients who had received therapy from highly experienced clinicians were interviewed. Since the time for ending had not been decided at the onset, clients in both short- and long-term therapies were included. Thematic case-by-case analyses were carried out. Clients actively engaged in looking back and looking ahead, as means of reflecting on their capability to handle issues on their own. The majority of clients were satisfied with what they perceived as a reciprocal engagement that enabled them to come to terms with emotionally charged issues in life and in therapy. For some clients unresolved issues remained: wondering whether a therapist with another approach could have helped more; feeling pushed away by the therapist; having to take the lead in ending therapy; the fear of being an “unworthy” client; or wanting to end without the therapist’s approval. Coming to terms with the ending of therapy was highly personally meaningful and loaded with affective tensions, in ways that were not always shared with their therapist.     

La « préparation magistrale » en droit français : un lot exclusif par patient ?

Outpatient pharmaceutical needs are not always met by industrial products and do not necessarily justify hospitals activation. Preparing in advance and storing a batch of compounded drugs for one or more patients with identical/recurrent needs – as part of compound outsourcing in ambulatory sector – raises issues. While the french law does not expressly provide (and according to prevailing interpretations excludes) this hypothesis, it seems to us to be possible – in contrast to the prominent french judicial and administrative courts, as well as to the European Court of justice. We here propose to reset the debate within both the existing laws and a systemic perspective, and call for a normative clarification.