On the Right Track: Client Experience of Narrative Therapy

This article presents an ethnographic research on eight families' experience of narrative therapy and discusses six major themes found in the interviews including externalizing conversation, developing the alternate story, personal agency, reflecting/consulting teams, building a wider audience, and the helpful and unhelpful aspects of the therapy. The findings and the notation that families found the therapy to be very effective are also included.     

Clients Helping Therapists Find Solutions to their Therapy

This paper is offered as a beginning toward including client perspectives on treatment and client participation in supervision. Rather than see therapists as technical experts who do things to people, many of us now see therapists as nonexperts who create conversations with people (Goolishian & Anderson, 1992). This new shift challenges the traditional training positions of supervisor and supervisee, respectively. Including clients' voices the supervisor participate from a nonexpert position.     

Remembering successes and failures: rehearsal characteristics influence recollection and distancing

We investigated the relationship between components of rumination, brooding and reflection, and autobiographical remembering by testing whether voluntary and involuntary rehearsal mediated rumination-related variation in the sensory-affective and metacognitive features of memory experience. We focused on achievement and failure memories as both are goal-related events, yet they represent distinct experiences in terms of valence and functionality. For failure memories, brooding was associated with intense recollection and reduced psychological distance. Brooding was related to enhanced distance of achievements, indicating the disruptive effects of brooding on remembering. Although reflection attenuated the recollective experience for both achievement and failure memories, it brought achievement memories to a subjective closer past. Structural equation modelling demonstrated the mediating role of involuntary remembering on the pattern of remembering experience.     

“The Parallel Dialogue”: Parental experience of their role in the relationship with their child's counsellor/psychotherapist

The parent–therapist relationship is a central consideration in child counselling and psychotherapy, particularly in private practice where parents are typically financially, emotionally and practically invested in the process. The relationship, which can be ambiguous and anxiety-laden on both sides, has historically received scant attention in therapeutic discourse, leading to gaps in practitioner confidence and training. In this context, and seeking to centre parent voices, this study provides an interpretative phenomenological analysis of four mothers' experiences of their role in the relationship with their child's therapist. Key identified themes encompass parental expectation of involvement; the destabilising, disorienting nature of the relationship; the centrality of trust; and critical evaluations of value. Findings are discussed in relation to attachment theory and cultural expectations of parental responsibility. The study concludes that the relationship is a live and potent property with potential to impact the course of the intervention, and recommends that practitioners thoughtfully consider the potential benefits and drawbacks of meeting or frustrating parental involvement expectations.     

Parent Satisfaction with Case Managed Systems of Care for Children and Youth with Severe Emotional Disturbance

Case management has emerged as an integral component of current efforts to reform the delivery of mental health services to children and youth with Severe Emotional Disturbance (SED). We examined parental satisfaction with one program's case management system for SED children. In order to validly address parental satisfaction, the program first turned to a group of its parents to develop a satisfaction measure, the Family Satisfaction Survey (FSS). Of the 51 parents who returned an FSS, 74% of the parents were generally satisfied while 26% indicated that they were dissatisfied with their families' case management services. Multivariate regression analyses were employed to examine the role played by client, service, and outcome variables in predicting parental satisfaction. After controlling for child diagnoses, severity of impairment, and levels of psychosocial stress, parent satisfaction with case management services was best predicted by the frequency of monthly contact and fewer days is a psychiatric hospital proportional to length of service. Our results suggest that parent satisfaction is based not only on what case managers do but on how this service impacts SED children's ability to remain at home and in their communities.     

Ethical Considerations in Psychotherapeutic Systems

Theoretical Medicine and Bioethics - In the process of individual psychotherapy, the client and the therapist work together towards clarifying the client's problems, unlocking vicious circles,...     

A Longitudinal Analysis of Family Empowerment and Client Outcomes

We examined the relationship between family empowerment, parent satisfaction, and mental health outcome across time. Based on the Vanderbilt Family Empowerment Project Model, increased empowerment should lead to positive changes in client outcomes. Data consisted of the Family Empowerment Scale (FES), which was used to assess the caregiver's perception of empowerment, Child and Adolescent Functional Assessment Scale (CAFAS), which measures the degree of disruption in the youth's current functioning, Client Satisfaction Questionnaire (CSQ), and demographic information gathered from families receiving services from a county mental health service system at intake and discharge. The results showed that the CAFAS and CSQ were related to empowerment at intake and discharge. Results also indicated significant increases in the knowledge subscale of the FES and the CAFAS and moderate increases in the advocacy subscale of the FES and the CSQ. We discuss the implications of these findings for systems of care, such as stronger parent-professional relationships.     

Clients' experiences of online therapy in the early stages of a COVID-19 world: A scoping review

The emergence of the COVID-19 pandemic in 2019 forced an abrupt shift in the modality through which psychotherapy was delivered and online therapy became the only viable option for clients. Research regarding experiences of online therapy during the early stages of the COVID-19 pandemic is minimal, however, and has largely focussed on therapists' experiences of delivering online treatment, as opposed to clients' experiences of receiving it. A scoping review was undertaken to establish what is known from the existing literature about clients' experiences of online therapy during the initial stages of the COVID-19 pandemic and identify gaps in the current knowledge. Searches were conducted across four academic databases: Scopus, EBSCO CINAHL Complete, EBSCO MEDLINE and OVID PsycInfo; the literature was excluded based on established PICOS criteria. Data were summarised through data charting and synthesised by way of inductive content analysis. A total of five articles were identified. All articles focussed on online therapy using video or audio conferencing, and four of the five studies examined clients with eating disorders. Inductive content analysis identified seven categories, as follows: preference for face-to-face therapy; appreciation of accessibility and convenience; online format hindered connection; positive experience of online therapy; individual client differences impacted experience; strong therapeutic alliance indicative of positive experience; and gratitude for continuation of treatment. Future research could explore clients' experiences of online therapy in a “post-pandemic” world and include a broader range of client populations and online therapy approaches in the COVID-19 context.     

Psychotherapy for lesbians: The influence of therapist sexuality

This study explored the influence of therapist sexuality upon lesbian experiences of therapy, and particularly the influence of marginal and dominant discourses within the process. It is argued that explorations of discourses of sexuality should be a necessary feature of a psychotherapist's training. A postmodern feminist methodology — Bungay and Keddy's adaptation of Reinharz's experiential analysis — was used in the study. This method involved triangulation of interview, literature analysis and reflective diary methods, with analysis drawing upon a discourse analytic perspective. Two sites of contradiction were explored, indicating the possible emergence of resistant lesbian discourses against the dominant patriarchal, heterosexist and homophobic discourses. The study illustrates the discursive and contextual nature of psychotherapy with lesbians.