Reflecting on self-care practices during clinical psychology training and beyond

In this paper, I will discuss the concept of self-care and its importance for clinical psychologists, both during training and post-qualification. I will review the pertinent literature in this area covering the concept of self-care and its meaning, the personal and professional impact of a lack of self-care for clinical psychologists, and discuss some of the barriers to implementing self-care practices. Throughout the discussion of barriers to self-care, I will intersperse three reflective pieces on my own experiences throughout clinical psychology training, which will allow for a more in-depth exploration of the issues. My conclusion will highlight the personal, professional and systemic barriers to self-care in clinical psychologists, and in other helping professionals, and suggest possible ways of tackling these barriers and promoting greater utilisation of self-care during clinical training and beyond and across different professional groups.     

Mentalization in children and mothers in the context of trauma: An initial study of the validity of the Child Reflective Functioning Scale

This study examined the validity of the Child Reflective Functioning Scale (CRFS: Ensink, Target, & Oandason, 2013, Child reflective functioning scale scoring manual: for application to the Child Attachment Interview. London, UK: Anna Freud Centre – University College London), a measure designed to assess reflective functioning (RF) or mentalization during middle childhood. Participants were 94 mother–child dyads divided into two subgroups; 46 dyads where children had histories of intrafamilial (n = 22 dyads) or extrafamilial (n = 24 dyads) sexual abuse, and a community control group composed of 48 mother–child dyads. RF of children and their mothers was assessed using videotaped and transcribed data gathered using the Child Attachment Interview and the Parent Development Interview (PDI: Slade, Aber, Bresi, Berger, & Kaplan, 2004, The parent development interview‐Revised. New York, NY: The City University of New York). The findings indicate that the CRFS proved reliable, with excellent intraclass correlation coefficients for general RF, as well as RF regarding self and others. Significant differences in RF were found between sexually abused children and the control group, and also between children who had experienced intrafamilial and extrafamilial sexual abuse. This provides support for the discriminant validity of the CRFS. Furthermore, maternal RF was associated with child RF. Both abuse and maternal RF made significant contributions to predicting children's RF regarding themselves, but child sexual abuse was the only variable that made a significant contribution to explaining variance in children's RF regarding others.     

Qualitative tools and experimental philosophy

Experimental philosophy brings empirical methods to philosophy. These methods are used to probe how people think about philosophically interesting things such as knowledge, morality, and freedom. This paper explores the contribution that qualitative methods have to make in this enterprise. I argue that qualitative methods have the potential to make a much greater contribution than they have so far. Along the way, I acknowledge a few types of resistance that proponents of qualitative methods in experimental philosophy might encounter, and provide reasons to think they are ill-founded.     

The case of Peter: reflections on applied ethics in a neonatal intensive care unit

The case of Peter is reflected upon in order to highlight some of the moral theorising that could be brought to bear in the process of providing palliative care for sick neonates. The situation will be discussed using the theoretical lenses of deontological and virtue ethics. Nursing practice is considered as engaged moral reasoning where the nurse brings his/her beliefs, knowledge and experience into the situation and engages in reflexivity to provide appropriate ongoing patient care. The care should be provided in culturally sensitive manner and tailored to the needs of the newborn and their family. Nurses should initiate early consultations with colleagues, medical staff and families to address concerns about patient well-being in order to enhance the well-being of patients and families and to improve the work environment making it more conducive to care.     

Experiences of Countertransference: Reports of Clinical Psychology Students

While historically linked with psychoanalysis, countertransference is recognised as an important component of the experience of therapists, regardless of the therapeutic modality. This study considers the implications of this for the training of psychologists. Fifty‐five clinical psychology trainees from four university training programmes completed an anonymous questionnaire that collected written reports of countertransference experiences, ratings of confidence in managing these responses, and supervision in this regard. The reports were analysed using a process of thematic analysis. Several themes emerged including a desire to protect or rescue clients, feeling criticised or controlled by clients, feeling helpless, and feeling disengaged. Trainees varied in their reports of awareness of countertransference and the regularity of supervision in this regard. The majority reported a lack of confidence in managing their responses, and all reported interest in learning about countertransference. The implications for reflective practice in postgraduate psychology training are discussed.     

Development of the reflective practice questionnaire: preliminary findings

This study introduces a new reflective practice questionnaire (RPQ) that can be used to assess self-reported measures for investigating the experiences, benefits, and potential pitfalls of reflective practice and reflective supervision. This questionnaire sets itself apart from previous self-report measures of reflective practice by the ability to administer to individuals working in any service industry (e.g. psychology, nursing, education, and others). This will allow for future investigations that can compare and contrast across different contexts and professions. This will further the understanding of how reflective practice impacts those engaged with the process. The present study provides preliminary evaluation of the questionnaire with samples from the general public (Study 1), and mental health practitioners (Study 2). The questionnaire includes a number of short four-item sub-scales for evaluating reflective practice including: reflective-inaction; reflective-on-action; reflective with others self-appraisal; desire for improvement; confidence (general); confidence (communication); uncertainty; stress interacting with clients; and job satisfaction. A six-item attitude towards reflective supervision scale is also included in the research. Results suggest that reflective practice can foster confidence and further a desire for self-improvement. However, results also indicate how reflective practice might increase uncertainty and stress in some individuals. Study 2 reveals that a more positive appraisal of reflective supervision is associated with greater selfreported reflection, desire for improvement, and confidence.     

Curiosity as an Agent of Conscience

Public outcry against social outrages in our nation in the past few years have called for solutions that suggest that we as a nation believe that by strengthening the observational and punishing components of the superego of the American Psyche we can successfully overthrow our moral failings. By using data in regard to Adolph Eichman and other Nazis as clinical examples, it is suggested that the problem of our moral failings resides not in a deficient superego (a refluent moral agent) but in the insufficient development of conscience (a reflective consciousness). The roles that curiosity and impeded curiosity take in the development of morality are shown to be central to an understanding of how conscience differs from superego.     

The analyst and analysand as citizens in the world

Beginning with Jung's reflections on individuation as a starting point, this article examines the analytic relationship in the context of our current reality. The latter exerts pressures of all sorts that do not favour individuation. Indeed, geopolitical commentators see present‐day society as marked globally by excessive self‐love that seeks to dominate, at the expense of the other. Given that such forms of dominance are now also very prevalent in the workplace, this article examines how to help the increasing number of individuals with highly successful professional careers who suffer from this pressure and who then seek analysis. ‘Progressive movement’, an indicator of and incentive to change, is examined by studying the narrative processes emerging from dream activity ‐ including dreaming with the hands in the sand tray ‐ in the co‐transference. The article highlights how ‘progressive movement’, founded on narrative Competence and on the reflective function, may generate experiences of ‘realistic hope’. The latter signals the start of an individuation process in the analytic couple and, simultaneously, the transformation of both the analyst and the analysand into good enough ‘citizens in the world’.     

Fostering collaborative mind-sets among customers: a transformative learning approach

To succeed and grow, companies must win new customers. However, selling innovative solutions to prospective business customers remains challenging. We seek to explore how salespeople create, early in the sales process, collaborative customer mind-sets to accommodate learning and adoption of new solutions. By applying transformative learning theory and analyzing authentic video-recorded business-to-business (B2B) initial sales meetings, we are able to determine the microlevel processes and mechanisms taking place in transformative sales dialogue. In this article, we outline seven interactional activities occurring in reflective dialogue cycles, a key means by which salespeople create new customer mind-sets. Reflective dialogue cycles form a spiral-shaped process requiring completion to achieve a shared new understanding favorable to adopting new approaches. Through our analysis, we demonstrate the value of transformative learning theory in better understanding sales interactions. Along with theoretical contributions, our results may help managers and salespeople better develop new business customers.