Failing to come to terms with things: a multi‐storied conversation about poststructuralist ideas and narrative practices in response to some of life's failures

This paper is designed to demonstrate some of the multi‐storied representational possibilities available to us as writers and practitioner‐researchers. It highlights some of the opportunities that are available to therapists and the people who consult them when they describe their conversational space as a site for co‐research. It illustrates the reciprocity present in conversations, including therapeutic conversations, by juxtaposing three stories that are interrelated retellings from different writing genres. In positioning poetic, storied and more academic/interpretative texts alongside each other, we hope to trouble the edges between academic and creative writing and also between practice and research. In placing these stories next to each other we seek to disrupt carefully contained ‘client’ and ‘therapist’ positions. We intend to question some current bereavement orthodoxies by demonstrating some less taken‐for‐granted ways in which people, living and dead, can and do continue to sustain each other's lives. We also hope to invite the readers and future writers of this journal to play alongside us in this conversation.     

Mental health and mediumship: an interpretative phenomenological analysis

There is a lack of research examining the mental health of practicing mediums, yet the nature of mediumship work inherently presents a number of challenges to the mental health of practitioners. In this study, we aimed to gain an understanding of how mediums experience their mental health in relation to their mediumistic practice and how they recognise and respond to psychological difficulties experienced by their clients. Fourteen mediums from the North West of England took part in one-to-one interviews, which were transcribed and subject to interpretative phenomenological analysis. Four themes were identified: from past traumas to mediumistic identity; spirit makes sense, mental illness is chaos; being resilient but vulnerable; and ethical mediumistic practice. The research highlights the value of not dismissing or attempting to change appraisals of valued aspects of mediums’ anomalous experiences. However, the findings do indicate that support for exposure to clients’ difficulties might be helpful.     

Playing with Fire: Countertransference and Clinical Epistemology

This article explores both theoretical and practical concepts related to the therapist's use of the self in psychotherapy. Particular emphasis is placed on the potential clinical value of countertransference. It is argued that awareness and resolution of personal issues are required for therapists to draw profitably from their own experiences in working with clients. Specific steps in translating the concept of the wounded healer into clinical practice are offered, along with examples from the author's own practice.     

Concrete Tornadoes

I present the case of a Hispanic woman whose physical illness parallels the massive destruction that she witnessed at the World Trade Center. I talk about my own feelings of terror and how I try to deal with my private ghosts as I sit afraid and wanting to help. I mention the longings we all have for powerful parents who can protect us and keep us safe.     

Therapist Self-Efficacy in Delivering Cognitive Processing Therapy in a Randomized Controlled Implementation Trial

Efforts to improve the implementation of evidence-based treatments (EBT) have recently made important strides. One such example is understanding the vital role that weekly consultation plays as therapists learn to deliver an EBT. Because mechanism-based research can further support EBT implementation, the present study sought to examine the potential relationship between therapist self-efficacy in relation to treatment fidelity and outcomes.We examined therapist self-efficacy ratings from 80 therapists working with 188 patients. These data were collected as part of a randomized controlled implementation trial testing cognitive processing therapy (CPT). Across post-workshop training conditions, we ran multilevel models to assess (1) changes in therapist self-efficacy, (2) therapist self-efficacy in relation to treatment fidelity, and (3) therapist-self-efficacy in relation to patient PTSD symptom outcomes.We found that therapist self-efficacy significantly improved over the course of 6 months of CPT training. Baseline therapist self-efficacy was differentially associated with client outcomes based on post-workshop training condition. Specifically, therapists with low self-efficacy that did not receive post-workshop consultation tended to have poorer outcomes than therapists with low self-efficacy that received consultation. In the present sample, therapist self-efficacy was not related to treatment fidelity.As this was the first study to examine therapist self-efficacy in the implementation of an evidence-based treatment, our findings suggest that self-efficacy may be an important implementation factor in treatment outcomes and worthy of ongoing research.     

Bittersweet: a qualitative exploration of mothers’ experiences of raising a single surviving twin

Loss of a child from a multiple birth pregnancy is not uncommon yet the idiographic experience of parents who have lost a single twin from a multiple birth pregnancy is underexplored. This novel study sought to explore the experiences of mothers bereaved after loss of a twin from a multiple birth pregnancy, focusing on the dual challenges of parenting and grieving. Eighteen mothers at least 12 months post loss were recruited from a private UK based Facebook page dedicated to supporting parents after loss from a multiple birth. Eligible mothers completed an independent qualitative open-ended survey to explore maternal experiences of loss. Data were analysed using Thematic Analysis. Findings represented a sense of duality for participants, with mothers experiencing conflict between roles and identities as well as the nature of their loss. Key themes identified include ‘Narrating a story of family and loss’, ‘Finding a place for the twins within the family’ and ‘A changing sense of self’. Findings fit with theoretical conceptualisations of bereavement that acknowledge retaining relationships with the deceased. Practically, suggestions for supporting mothers to identify stock answers to often asked questions about family make up were suggested.     

Identity continuity and loss after death,divorce, and job loss

This paper examined the relationship of constructs identified by identity continuity and attachment theories of grief to adjustment to loss from the framework of identity theory. Connections between loss salience, identity construal, and balance of identity construal on grief intensity via their association with post-loss identity disruption were examined across three types of self-relevant losses; death of a family member, job loss, or divorce. We hypothesized that lower salience, higher endorsement of identity attributes represented by relational and individualistic self-construals, and an overall balance across identity attributes would be related to decreased grief severity across all types of loss. Results supported hypotheses with the exception that the hypothesized ameliorative effect of increases in relational self-construal was only seen in the bereaved group.