Counsellors' perspectives on self-harm and the role of the therapeutic relationship for working with clients who self-harm

Aims: To gain insight into counsellors' experiences of and ideas about self-harm, and to develop understanding of relational depth when working with clients who self-harm. Method: A qualitative exploration of counsellors' perspectives on working with people who self-harm. The research proposal gained approval from the University Ethics Committee. Data were collected from a sample of counsellors who have experience of working with people who self-harm (n = 8) using tape-recorded interviews. Grounded Theory was used for analysis. Findings: Two major categories emerged from the findings: (i) the activity of self-harm; (ii) the therapeutic relationship with people who self-harm. These categories and sub-categories were integrated to form the core category. Implications: Counsellors have a valuable role to play in the lives of people who self-harm, by embodying confidentiality and so facilitating a sense of trust, by opening minds through acceptance, and by expanding knowledge through participation in research. Conclusions: In order to effectively accompany clients from a life of self-harm to a life of self-healing, counsellors must be aware of and responsive to the many concepts underpinning the emergent categories of the research.     

Toward the science‐informed practice of clinical supervision: The Australian context

Although supervision of clinical practice is mandatory for trainee psychologists, surprisingly little is known about the key ingredients of effective supervision and the relationship between supervision and patient outcomes. The purpose of this paper was to review current regulations that shape supervision in Australia and explore the links between these regulations and the components of effective supervision. Although recent developments including supervisor training and other quality control programs are an indication of progress, there are several empirical and conceptual issues in the supervision literature that require resolution. The second part of this paper identifies the gaps in the supervision literature and suggests steps to advance the development of a mature science of clinical supervision. The main areas requiring attention include the identification of the mechanisms by which supervision produces change in supervisees and their patients, the refinement of measurement methods and instrumentation, and the need to pursue collaborative research that maximises the generalisability of research findings.     

Freestanding Psychology: The Only Way in Academic Health Centers

Psychology must assure that its programs, faculty and staff, clinical services, research enterprises, and training programs must be freestanding in Academic Health Science Centers and not organized within any other department except a freestanding Department of Psychology. Without this autonomy, it is argued, Psychology can never reach its full potential as a health care science and profession in hospital and academic health care center settings. This thesis is argued on the basis of issues of finances, credentialing and privileging, role modeling for psychologist trainees, the importance of Psychology's persona within the health science center and in the eyes of the public, and finally, academic freedom.     

A Decade of Clinical Psychology in Medical Settings: The Short Longer View

The progress and accomplishments of psychology in medical settings over the past decade since the publication of the Handbook of Clinical Psychology in Medical Settings (J. J. Sweet, R. H. Rozensky, & S. M. Tovian, 1991) and the subsequent founding of the Journal of Clinical Psychology in Medical Settings (JCPMS) in 1994 are highlighted. Areas of progress and accomplishments reviewed include professional developments with our field, roles and services provided by psychologists, education, training and research issues, and program administration in medical settings. The current status of, and possible changes in, medical settings is identified. Future challenges and opportunities for the profession are discussed.     

Those Were the Best of Times,and Then…

ABSTRACT

Rachel T. Hare-Mustin describes a career of feminist activism in academic life, the professions, and clinical practice in the 1970s and 1980s. She has been an advocate for changes in professional ethics and improving conditions for women. Her primary areas of influence have involved applying feminist theory to the study of gender and pointing out that the sex role model of gender differences has an inherent bias that overlooks the gender hierarchy. Women’s voices are silenced, not only in the process of therapy, but in the wider society as well.     

How beginning counselors learn: The interaction of personal and professional experiences in counselors with an experiential orientation

Research suggests that the way counselors work is influenced not only by training and practice but also by their personal experiences and qualities. In this study, we aimed to explore how beginning counselors with an experiential orientation integrate the experiences from different sources (e.g. training, supervision, individual therapy, practice, and their personal life) and how they utilize them in practice. Seven in-depth interviews with beginning Gestalt-oriented counselors were conducted and grounded theory method was used for analysis. The results show that personal experiences and qualities play an important role in shaping the way beginning Gestalt counselors work. We conceptualized two main components of counselors’ working style – Personal Core and Professional Extension, and 10 specific types of interaction between these components which were subsumed into two broad categories: (1) cultivation of personal qualities and (2) adoption of new competencies. These findings challenge earlier assumptions that beginning counselors simply imitate their trainers, supervisors, and senior colleagues. Implications for further research and use in practice are discussed.     

Personal factors and career adaptability in a call centre work environment: The mediating effects of professional efficacy

The study sought to assess the extent to which professional efficacy mediates the relationship between personal factors and career adaptability in a call centre work setting. The sample consisted of 409 early-career South African call centre workers (black females = 66%; age range 25 to 40). They completed measures of professional efficacy, career adaptability, sense of meaningfulness, and emotional intelligence. The results of the mediational analyses revealed that professional efficacy significantly mediate the personal meaningfulness (sense of coherence) and career adaptability relationship, but not the emotional intelligence-career adaptability relationship. Emotional intelligence independently predicted career adaptability. Call centre agents with professional efficacy are likely to be more work engaged as a result of their sense of meaningfulness and emotional intelligence.     

On (not) listening for theory: the trainee’s use of theory as defence against the stress of beginning psychodynamic practice

This paper offers reflections on the trainee’s relationship with, and use of, theory in the early stages of psychodynamic practice. It addresses the issues of ‘listening for theory’ in the face of the unsettling, yet inevitable, stress and insecurity of beginning psychodynamic practice and the daunting awareness of the work being assessed by the training institution. While theory makes psychodynamic work possible and applying theory is explicitly welcomed in psychodynamic training, the paper argues that the unexamined use of theory is problematic as it, albeit unconsciously, is used by the trainee as a defensive retreat into a private mental sanctuary from the intimate, relational space of the consulting room and from the felt incompetence and inexperience aroused in the immediate encounter with the client. Exemplified through accounts of working with a particular client during my training, the paper examines the trainee’s evolving relationship with theory, in the light of what impedes and promotes therapeutic progress, as a significant marker of the trainee’s development to work psychodynamically.     

Reasonable Partiality in Professional Relationships

First, two aspects of the partiality issue are identified: (1) Is it right/reasonable for professionals to favour their clients’ interests over either those of other individuals or those of society in general? (2) Are special non-universalisable obligations attached to certain professional roles? Second, some comments are made on the notions of partiality and reasonableness. On partiality, the assumption that only two positions are possible – a detached universalism or a partialist egoism – is challenged and it is suggested that partiality, e.g. to family members, lies between these two positions, being neither a form of egoism, nor of impersonal detachment. On reasonableness, it is pointed out that ‘reasonable’ is an ambiguous concept, eliding the notions of the ‘morally right’ and the ‘rational.’ Third, a series of practical examples are taken from counselling, medicine, law, education and religious practice and some common principles are abstracted from the cases and discussed. These include truth-telling, confidentiality, conflicts of interest between clients and particular others and between clients and society. It is concluded that while partiality can be justified as a useful tool in standard cases, particular circumstances can affect the final verdict.     

师生关系对研究生自我效能感的影响:有调节的中介模型

为探讨师生关系与自我效能感的关系,并着力考察专业认同和导师负面评价恐惧在其中所起的作用,采用一般自我效能感量表、研究生师生关系感知问卷、专业认同量表、害怕导师负面评价量表对458名研究生进行调查,结果发现：（1）师生关系可正向预测研究生自我效能感;专业认同在两者间起中介作用;（2）导师负面评价恐惧在师生关系通过专业认同影响自我效能感的中介模型后半段起调节作用,即对于导师负面评价恐惧较高的研究生来说,专业认同对其自我效能感的影响更大。研究结果揭示了师生关系对自我效能感的作用机制。