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Objective: This paper presents the findings of a study evaluating the effectiveness, accessibility, sustainability and patient satisfaction of the Assessment PLUS model. This model aimed to reduce patients' symptomology, improve their functioning and alleviate the demand on Psychological Therapies Team (PTT) staff, particularly in response to the challenges posed by the COVID‐19 pandemic. Methods: The intervention was offered to 55 patients with mild‐to‐moderate mental health conditions across three localities in Lanarkshire, UK, of whom only 25 completed the sessions. Clinical outcome measure scores, patients' feedback, wait times, discharge, returning patients and re‐referral rates were analysed using a mixed methods approach. Results: The results of the statistical analysis highlight a statistically significant improvement (p < 0.001) in patients' presentations and results of the thematic analysis reveal that almost all patients found the intervention helpful and returned overall positive feedback. On completing the intervention, less than a third of patients returned to the waiting list, while more than half were discharged completely. At the 6‐month follow‐up, those returning to the PTT waitlists (n = 12) had between 6 and 8 sessions on average, while over the 80% of those discharged from A+ did not require further psychological input. The average wait time across the full sample was 6 weeks. Conclusions: In summary, the results of the mixed methods analysis demonstrate a significant improvement in patients' presentations after completing the A+ intervention. The majority of patients found the intervention helpful and provided positive feedback. Moreover, a significant proportion of patients were discharged completely, and those who returned to the PTT waitlists required fewer sessions on average. The average wait time for the full sample was just over 6 weeks. [ABSTRACT FROM AUTHOR]

Aim: Counsellors who work with young people in a range of contexts know that they are not engaging with ‘mini‐adults’. The issues young people bring to counselling are often complex, challenging and wide‐ranging, as adolescents are experiencing times of turbulence and change in their physical, emotional, social and psychological development. This paper focuses on a research project undertaken with five counsellors who work with young people, and asks the question: ‘What works?’ Method: The research project is an in‐depth qualitative study into the counsellor's experience of counselling young people, using a narrative approach. Findings: Four key shared themes emerged: the significance of ‘safety’ in the relationship; building the therapeutic alliance; flexibility and integration relating to theoretical orientation; and the use of creativity. Outcomes: This paper offers counsellors the opportunity to reflect on ‘what works’ and consider the professional knowledge, which underpins their own counselling practice with young people. [ABSTRACT FROM AUTHOR]

Aims: The aim of this paper is to present an attempt to collate the results of the client‐completed Goal Attainment Form (GAF) and to explore the usefulness of analysing the data in this way. The GAF is used primarily to add qualitative idiosyncratic data to the quantitative data collected by the CORE‐OM (Clinical Outcomes for Routine Evaluation Outcome Measure) questionnaire. Method: A sample of 477 completed GAF were used during short‐term therapy through primary care mental health services to investigate potential correlations in various different aspects between the GAF and the CORE outcome measure (CORE‐OM). The themes from these forms were qualitatively analysed to compare how clients describe their experience of therapy with clinical perspectives. Results: The results reveal several significant correlations. Themes used by clients to describe their problems and benefits of therapy were different from clinicians' perspectives. Discussion and recommendations: Several suggestions and recommendations are offered regarding evaluation, therapy and primary care short‐term therapy services. [ABSTRACT FROM AUTHOR]

Background: There is a need for a generic, short, and easy‐to‐use assessment measure for common presentations of psychological distress in UK primary care mental health settings. This paper sets out the development of the CORE‐10 in response to this need. Method: Items were drawn from the CORE‐OM and 10 items were selected according to a combination of usefulness, coverage of item clusters, and statistical procedures. Three CORE‐OM datasets were employed in the development phase: (1) a primary care sample, (2) a sample from an MRC platform trial of enhanced collaborative care of depression in primary care, and (3) a general population sample derived from the Office of National Statistics Psychiatric Morbidity Follow‐up survey. A fourth dataset comprising a sample from an occupational health setting was used to evaluate the CORE‐10 in its standalone format. Results: The internal reliability (alpha) of the CORE‐10 was.90 and the score for the CORE‐10 correlated with the CORE‐OM at.94 in a clinical sample and.92 in a non‐clinical sample. The clinical cut‐off score for general psychological distress was 11.0 with a reliable change index (90% CI) of 6. For depression, the cut‐off score for the CORE‐10 was 13 and yielded sensitivity and specificity values of.92 (CI=.83–1.0) and 0.72 (CI=.60–.83) respectively. Conclusion: The CORE‐10 is an acceptable and feasible instrument that has good psychometric properties and is practical to use with people presenting with common mental health problems in primary care settings. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to address current gaps in knowledge regarding the appropriateness and quality of counselling provided to egg donors in the UK. Methods: The present study used a cross‐sectional, qualitative design. Semi‐structured interviews were carried out with 29 UK egg donors to explore their experiences of egg donation and the counselling received. Results: Of the 29 participants, 24 had received counselling. The remaining five did not receive counselling because they were either not accepted as a donor (n = 4) or were offered, but chose not to take up the session (n = 1). The findings are presented in relation to five themes: feeling supported via counselling; feeling well‐informed; welcoming an individualised approach; the counselling setting; and thinking about the future. Conclusion: Egg donors in this study had varying experiences of counselling offered to them as part of the egg donation process in the UK. Implications: The findings indicate that there are some aspects of counselling in the UK that could be improved, including the routine offering of counselling throughout the egg donation process and the tailoring of counselling to meet egg donors' individual needs. [ABSTRACT FROM AUTHOR]

This research aims to gain new insight by exploring the thoughts, feelings and experiences of therapists working with clients who have autism. Three professional talking therapists participated in the study. Unstructured interviews were conducted and analysed using interpretive phenomenological analysis. Six main themes and 13 sub‐themes were found which include therapists' validation of autism, how therapists integrated autism when addressing mental health problems, how their personal experiences of autism impacted on their work and how they experienced the situation in which autism emerges during the therapy. Helpful suggestions are made for clinicians, namely, to zoom‐in and zoom‐out of autism, hold the knowledge that people with autism process information differently, incorporate working with trauma, consider disclosing a personal connection to autism and consider carefully whether, or not, to tell a client that they may have autism. [ABSTRACT FROM AUTHOR]

Many people experience estrangement from a family member, which is broadly understood to refer to negative relationships that are characterised by little or no contact. However, little is known about how people cope with family estrangement. To address this gap, interviews were conducted with 46 participants who identified as being estranged from a parent/sibling and/or child and having sought therapeutic support for this experience. The participants were recruited from a UK‐based charity that supports individuals experiencing family estrangement. The participants had a range of experiences of therapeutic support, with most (N = 31, 67%) having paid for private therapy. The data were analysed using thematic analysis, and three themes were generated: (1) finding the missing qualities in estranged family relationships: warmth, validation and safety; (2) speaking the unspoken: addressing the causes and consequences of estrangement; and (3) learning relational skills: improving the relationship with oneself and with others. When the causes of estrangement were addressed in the context of a safe therapeutic relationship, participants learned strategies to improve the relationships they had both with themselves and with others. When participants experienced a cold or unresponsive therapeutic relationship, and the causes and consequences of estrangement were not adequately addressed or understood, counselling was experienced as unhelpful. Individuals who seek therapeutic support for family estrangement have specific needs. Training around these needs and the causes and consequences of estrangement could be beneficial to helping professionals and the clients with whom they work. [ABSTRACT FROM AUTHOR]

Background: The use of "walk and talk" counselling has recently increased due to the COVID‐19 pandemic, concurrent with an increased awareness of the benefits of the outdoors, nature and exercise on mental health. Walk and talk counselling is relatively new and seemingly easy to incorporate for everyday counsellors. However, there is limited previous research on this form of counselling. Aim: This study aimed to investigate how the client experiences walk and talk counselling in a natural outdoor environment. Method: To evaluate the client's lived experience of walk and talk counselling, online semi‐structured interviews with five adult participants in the United Kingdom (UK) were analysed using the interpretative phenomenological analysis (IPA) method. Findings: The general outlook on walk and talk was positive. There was a feeling of informality, and a relational equalising element, but these aspects did not appear to detract from the professional relationship. There was an appreciation of nature, although there was an element of not noticing it. Timing was more fluid, and there were positive and negative aspects of the outdoor walking. Limitations: A small sample size limits the wider application of these findings. Implications: Further research is required to support further guidelines and training for practitioners. Implications for practice include the consideration of client preferences and a more fluid approach to contracting, a need for increased awareness of physical and psychological safety and a consideration of the relational dynamic when walking outdoors. Conclusion: Walk and talk is a viable alternative to indoor counselling. It proved useful in a pandemic and for clients who would not consider indoor counselling. [ABSTRACT FROM AUTHOR]

Objectives: Research suggests therapists may be lacking the skills and experience to work with the trans population and may hold a range of personal and professional views about trans people, in line with wider society. The aim of this study is to understand attitudes that qualified cisgender UK therapists have towards this client group, how equipped they feel to work with them and to identify gaps in training and experience. Design: A mixed‐methods, concurrent nested design was used. Methods: Data were generated via an online survey. Quantitative data were analysed alongside a reflexive thematic analysis. Results: The politicisation of trans identities has created a toxic debate that has left therapists confused about their professional and personal stance, but there is an earnest attempt to understand this. Therapists are generally supportive of trans people and a majority have worked with this community, but a significant minority of these therapists could be said to hold transphobic views or working practices. Therapists feel ill‐equipped to work with the trans community and are fearful of getting things wrong. Younger, more recently trained therapists are more comfortable working with gender identity, with older, "gender critical" and psychoanalytic therapists struggling the most. Conclusions: The politicisation of trans identities has created a split in UK therapists, and work is necessary to ensure adequate training and ongoing reflexivity regarding personal biases. Clarity and reassurance are needed on the implications of the proposed conversion therapy ban, particularly on exploratory therapeutic work within an affirmative stance. [ABSTRACT FROM AUTHOR]

The transition to remote learning in response to the COVID‐19 pandemic was unprecedented and unanticipated, resulting in professional courses delivering content and conducting skills‐based practice online. For counselling students, placements also transitioned to online, meaning previous skills acquired through face‐to‐face learning required adapting for remote working. This project sought to evaluate UK‐based counselling students' experiences of participating in online role‐play activities. Through purposive sampling, individual semi‐structured interviews were conducted and analysed applying thematic analysis. The findings indicated participants identified fundamental differences between planned online content compared to the unanticipated transition they experienced due to the pandemic. Whilst varying attitudes were shared, all participants recognised the value of skill acquisition for future employability and all recommended an element of online practice should be embedded in future course delivery. Whilst limited to a specific sample, key recommendations were identified, including the importance of involving students in course development, recognising the importance of diversifying role‐play practices for skill development and the application of a transitions model to facilitate understanding of the student experience. Though making some progress towards understanding this unique experience, further evaluations conducted with students from different counselling fields and institutions are required to further strengthen the recommendations made. [ABSTRACT FROM AUTHOR]

Background and aims: Self‐mutilation (self‐harm) is a phenomenon that is increasingly being seen in patients presenting in mental health services in the United Kingdom. This present study aimed to explore the lived experience of South Asian women raised in the United Kingdom and their perspective of 'Izzat', which refers to honour. Method: Semi‐structured interviews were conducted with 12 women of 'South Asian' heritage. Their accounts were analysed using interpretative phenomenological analysis (IPA). Findings and discussion: The findings suggest that the concept of Izzat and Asian cultural identity permeated the narratives of all the participants. The results position Izzat as central to cultural discord felt by the women and as a base for some of the discontent that led to self‐mutilating. The analysis revealed five over‐arching themes as the most common factors to self‐harm among South Asian women, which include: (1) The struggle to maintain cultural identity, (2) Experience of loss of control and trauma, (3) Focus on self‐mutilation as a distraction process, (4) Psychological angst as metacommunication of pain, and (5) Enactment of perceived deserved punishment. Our conclusions argue for the importance of understanding the complexity of cultural diversity, introjected cultural expectations, and its impact on the development of trauma and implications for clinical practice. Future research and practice should focus on exploring trauma‐informed methodologies and culturally sensitive approaches in working with those impacted by Izzat and the cultural responsibility of maintaining family honour. [ABSTRACT FROM AUTHOR]

Test anxiety can have a deleterious impact on academic achievement and adversely affect adolescent well‐being, both concurrently and in later life. The current study explored the use of compassionate mind training (CMT) as a school‐based intervention for test anxiety among adolescents. Participants were 47 adolescents, aged 16–17 years, attending a post‐primary school in the UK and enrolled to take qualifications beyond compulsory education. Participants were quasi‐randomly allocated on the basis of timetable availability into an intervention group that received eight sessions of CMT (n = 22) or a control group (n = 25). Participants in both groups completed pre‐ and post‐intervention measures of test anxiety, general anxiety and self‐compassion. Attendance and retention rates were used as an index of intervention feasibility. The findings indicated that CMT was a feasible and effective intervention. Adolescents receiving CMT showed significant reductions in test anxiety and general anxiety, as well as a significant improvement in self‐compassion following the intervention compared with the control group. The findings highlight the potential value of CMT in supporting young people suffering from test anxiety in schools. The implications for counselling practice are discussed. [ABSTRACT FROM AUTHOR]

The broad area of psychotherapy research is sometimes subdivided into that which focuses on outcome and that which focuses on process. Research into the active processes of psychotherapy can sometimes be occupied with debates around common versus specific factors. At the same time, within the process literature there has been increasing focus on the qualitative accounts of the service user in therapy and what they found to be significant or useful to them. The aim of this mixed methods study was twofold: first, to identify what elements of a relatively brief CBT intervention contributed to a successful outcome from the point of view of the service user. Participants were recruited at a low‐intensity Improving Access to Psychological Therapy (IAPT) service in the UK; and second, to attempt to frame those results within the common versus specific factor framework. Eight participants (5 males and 3 females) took part in this mixed methods research, which used semi‐structured interviews analysed using thematic analysis and brief quantitative questionnaire completion. Five overarching qualitative themes were identified in the data: three relating to common factors ('Insight', 'Talking' and 'Therapist qualities'); and two relating to specific factors ('Responding differently to thoughts and feelings' and 'Tasks/activities'). Importantly, all participants spoke about the importance of both common and specific factors. The discussion relates the findings back to existing research, highlighting the relative importance of insight within the data set and the participant led focus on talking. Future directions are discussed. [ABSTRACT FROM AUTHOR]

Aims: The therapeutic alliance is a concept that has received a great deal of attention within face‐to‐face counselling. Furthermore, links have been made between the creation of strong alliances and successful therapeutic outcomes. This study examines the therapeutic alliance when counselling services are offered online to young people. Method: Fifteen young people took part in online interviews (utilising synchronous and asynchronous methods), and Grounded Theory techniques were utilised to analyse the data. Findings: A core category of 'Client‐Service Match' and three subcategories pertinent to the individuals' experiences of creating good quality relationships with the counsellors were identified: (1) initial engagement, (2) developing rapport, and (3) establishing control. Discussion: The themes elicited are all relevant to the matching process and viewed as a chronological process similar to face‐to‐face counselling. However, unlike face‐to‐face work, specific nuances related to the online work arise that counsellors should be mindful of, including the rationale behind each individual's choice to approach services online, their own computer‐mediated communication skills, technical hurdles, and the perceived 'power' of the counsellor. [ABSTRACT FROM AUTHOR]

Although much attention has been paid in recent years to culture and diversity, cross‐lingual issues in the counselling room have not been given the consideration they deserve. This field is under‐researched in the UK, particularly from the monolingual counsellor's perspective, and often focuses on working with interpreters or addressing communication barriers. This brief study sets out to explore the experiences of monolingual therapists in the UK when working with proficient multilingual clients, trying to find out whether interventions such as 'language switching' are used therapeutically by monolinguals, and what their views are regarding supervision and training. A qualitative approach was taken, with a semi‐structured questionnaire collecting data from 50 participants. Thematic analysis was used to interpret their answers. The findings revealed that the majority of monolingual therapists had not reflected on the psychological and socio‐political implications of using English exclusively, the diverse roles of language and the specific needs of multilingual clients. The highest awareness was found among the most experienced counsellors, who perceived working with multilingual clients as an opportunity for personal and professional development and who showed as much linguistic empathy as multilingual counsellors. However, most participants placed a strong emphasis on communication barriers, which may indicate that, as counsellors, we could be overlooking the opportunities that cross‐lingual exchanges present therapeutically and, as a result, we may be failing to address the needs of multilinguals in our diverse community. The study concluded that there is a need to include this topic in counselling training and do further research. [ABSTRACT FROM AUTHOR]

The integration of spirituality into counselling and psychotherapy poses complex challenges. Personal spirituality, professional competency and ethical considerations may impact on trainees' experiences of integrating spirituality into therapy. This study adopted an inductive, qualitative approach to explore trainee counsellor/psychotherapists' experiences and perceptions of integrating spirituality into therapy. Six trainee counsellors and psychotherapists were recruited using purposive sampling from a professional counsellor and psychotherapist training institution in the UK. In‐depth, semi‐structured interviews were conducted, audio‐recorded and transcribed verbatim. Thematic analysis of the interviews revealed two overarching themes: spirituality provides support but needs a warning; and spirituality is relevant but undervalued. These themes encompass a wide range of trainee concerns associated with integrating spirituality into therapy. Participants reported that they felt unprepared to work therapeutically with clients' spiritual beliefs. However, the value of spirituality in providing support to both the trainee and their clients was highlighted by several participants. Some participants described integrating clients' spirituality as having a positive impact on the therapeutic relationship, but often felt threatening to the trainee. This research has implications that are important for counselling and psychotherapy training and developing enhanced consideration of client spirituality and the interpersonal environment in which therapy is delivered. [ABSTRACT FROM AUTHOR]

Background: References are frequently made to a strained relationship between therapeutic practice and research. This study has developed in response this critique. Aims: This study aims to explore therapists' views on the relationship between research and clinical practice, guided by some of the following questions; What sort of relationship do therapists feel that they have with research? What amount of formal research training do therapists have? To what extent do therapists feel that their own research is valued? To what extent does research inform therapists' clinical practice? Methodology: The study is anchored in mixed‐methods framework (Hesse‐Biber, 2010; Priest, 2013) drawing from a survey (n = 92) distributed within and outside the UK and coupled with interviews (n = 9) approached within a narrative thematic framework. Findings: Both the survey and interviews suggested a sense of "homelessness" for researchers in the field of therapy. Obstacles were referred to within and outside the therapeutic community. Some referred to little training, and many felt unsupported among colleagues and employers when pursuing research. One therapist said "The scientists and researchers I work with; they know they have a career in research – you get rewarded and promoted. That kind of recognition doesn't exist in therapy." Implications: To meet the increased requirements of research‐supported practice, the study suggests that more systematic efforts are required to support psychotherapists' engagement in research activities. [ABSTRACT FROM AUTHOR]

Abstract: Background: This study is a qualitative analysis of clients’ experiences of a new avatar based counselling intervention, based on the ‘ProReal’ software ( www.proreal.world). The intervention was piloted in eight secondary schools in the UK in 2016. Aims: Twenty‐nine participants (53% of the full sample) were interviewed about their use of the software, experience of the intervention, process of change and views about its helpfulness. Materials and Methods: Interviews were semi‐structured and were analysed using thematic analysis. Results: The analysis shows that the intervention was potentially attractive to these clients, particularly those enthusiastic about digital software and clients who found visual communication helpful. The software provided additional opportunities for clients to communicate their inner worlds to the counsellor and supported the development of insight. Male clients, in particular, commented on its helpfulness. Discussion: There is an indication that digital imagery supported the process of change in counselling and the development of meaning bridges: both internally and with the counsellor (Stiles, 2011; Stiles et al., 1990). However, the software could be experienced as an obstacle when clients wanted to talk about specific problems or ‘vent’ their feelings. All clients who reported that they did not find the software helpful were female. There were a number of suggestions about developing the software to increase opportunities for expression as well as appropriateness for clients from different minority ethnic backgrounds. Conclusion: Use of digital software in counselling has a potential to enhance communication and support a process of change, particularly with male clients, those who find visual communication helpful, and clients enthusiastic about digital technology. Further research is needed to develop the intervention and compare it to the use of other creative media in counselling. [ABSTRACT FROM AUTHOR]

Abstract: Aim: Counselling for Depression (CfD) is a person‐centred experiential therapy developed for implementation in the Improving Access to Psychological Therapies (IAPT) programme. Training in this model has been available across England since 2011. This study aims to investigate counselling practitioners’ experiences of learning the CfD model and implementing CfD in practice settings. Method: Participants were recruited by an email sent to the British Association for Counselling and Psychotherapy's (BACP) CfD Practice Research Network (PRN). Of the 53 CfD practitioners belonging to BACP's CfD PRN, 18 participated in this mixed‐methods piece of research. All 18 participants completed an online questionnaire, and one hour follow‐up semi‐structured interviews were conducted with six of the participants. Results: Descriptive analyses from the online questionnaire indicated a positive experience of CfD training, with practitioners indicating a positive impact on sense of self, practice and skill set. Although a degree of challenge was encountered when training in the CfD model, thematic analysis from the six semi‐structured interviews revealed factors contributing to the positives and challenges experienced on the course. Themes also revealed a predominately negative experience of CfD in practice and service settings, although this was service dependent. Conclusions and implications for practice: The findings can inform future recruitment of trainees to CfD training programmes and the training programme itself. They can also be used to achieve greater congruence between training in CfD and the delivery of the model. Future research may need to focus on the service level factors influencing practitioners’ experiences, and whether this experience is specific to the CfD modality in IAPT. [ABSTRACT FROM AUTHOR]

Background: In the UK, only one in four people with a diagnosis of depression receive any form of treatment. To address this, the Improving Access to Psychological Therapies (IAPT) programme was established with the main therapeutic approach being cognitive behavioural therapy (CBT). This raised concern regarding client choice, prompting the development of a new evidence‐based manualised therapy, namely ‘Counselling for Depression’ [CfD]. To date, the client's view of the effectiveness of CfD has not been researched. Aims: The aims of this study were twofold: (1) to explore and evaluate CfD from the perspective of the client and (2) to inform the counselling profession of the client's perception of what is occurring within this therapeutic approach. Methodology: This qualitative study used Interpretative Phenomenological Analysis, the ideographic aspect valuing each individual narrative and the contribution it makes towards a larger account of the phenomenon from a small group of people. Twelve participants receiving CfD completed a Helpful Aspects of Therapy questionnaire after each counselling session, with ten participating in a semi‐structured interview post counselling. Findings: Four superordinate themes were identified: A helpful process, Client's view of a counsellor, Gains and Negative aspects. Participants perceived this model of therapy as helpful, feeling understood by their counsellors and able to work through issues in a safe therapeutic relationship. Negative findings related to counselling being ‘hard work’ and a dislike of the time limitation that curtailed the work. Implications: Participants believed this type of counselling met their needs, reassuring practitioners that CfD is helpful to their clients. [ABSTRACT FROM AUTHOR]

Aims: This study sought to understand: (1) UK school counsellors' use of computer technology to communicate with pupils as of March 2014; (2) perceived barriers to its further implementation; and (3) practitioners' expectations regarding future use of online therapy, to extend understanding of these issues in UK secondary schools. It is the first study of its kind to be carried out in the United Kingdom. Method: A pluralist, mixed ‐ methods approach utilised quantitative and thematic qualitative analysis of an Internet survey of UK secondary schools. Results: Of 3753 schools approached, 246 responded, and of these, 45% had no online communication with their clients and 52% were using various forms of online communication; 43% used online communication (mostly email) for administrative purposes; and 9% offered therapy via email, Skype and Face Time (3% did not respond). The three main motivators for developing therapeutic contact online were as follows: evidence of reaching pupils with psychological barriers to accessing face ‐ to ‐ face help, evidence of demand from pupils and access to appropriate training. The main perceived deterrents were as follows: impact on the quality of the relationship, issues around confidentiality, and impact of lack of visual and auditory cues. Conclusion: This mixed landscape in terms of current and planned future use of technology by school counsellors revealed perceived practical and ethical challenges. However, it is notable that all of these can be addressed using currently available resources, for example through exposure to existing literature and research, and through specialist training. [ABSTRACT FROM AUTHOR]

Background: There are no published empirical research studies exploring transgender people's experiences of seeking and receiving counselling or psychotherapy outside of gender identity clinics within the UK. As a result, counsellors know little about why transgender people seek counselling, who they seek counselling from, and what their experiences are of receiving counselling. Aim: To address this gap in the literature, this study investigated transgender people's experiences of seeking and receiving counselling or psychotherapy outside of gender identity clinics within the UK. Funding for this study was provided by a BACP Seedcorn grant. Method: A mixed method small‐scale qualitative research design was employed, comprising an online survey and five semi‐structured interviews. Findings: Participants tended to seek counselling on two or more occasions and received between 2 and 12 sessions. Participants sought counselling for common psychological concerns as well as gender identity and coming out issues. A fear of being discriminated against and exploring gender for the first time were significant barriers in seeking help. Participants reported mixed experiences of counselling but valued a therapeutic relationship in which they felt affirmed, listened to and understood. Discussion: The findings from this study mirror aspects of previous research conducted in the USA concerning transgender clients' experiences of counselling. However, these findings point to the importance of recognising the potential vulnerability transgender clients experience when seeking counselling and the need for therapists to develop greater awareness, knowledge and competence regarding working with transgender clients. [ABSTRACT FROM AUTHOR]

Aims: This qualitative pilot study explored the perceptions of four female domestic violence clients regarding counselling they had concluded in order to identify a preliminary client‐preferred domestic violence counselling approach. Method: Semi‐structured interviews asking about significant events during counselling were held. An adapted grounded theory and narrative methodology was used. Results from the analysis were reviewed with two of the participants. Participants were offered additional counselling support if required after the research interview. Results/Findings: Domestic violence clients found starting counselling particularly difficult after years of keeping the abuse to themselves. Participants actively withheld and managed information for several sessions and needed to know they had time to explore their experiences. The counsellor being consistent and non‐judgemental, and understanding domestic violence and its effects was helpful. Having a clear ending was appreciated by the participants. Discussion: The initial development of the therapeutic relationship benefited from active discussion of how domestic violence could affect behaviour and emotions. Good early therapeutic relationships showed elements of the three main psychological schools. Participants benefited from a pro‐active discussion of endings. A key limitation of this research is the small sample size. Implications for practice: The research suggests that counsellors would benefit from knowledge and skills from different psychological schools and specific training in domestic violence. Allowing flexibility on the number of sessions available to clients may be helpful. Conclusions: Further work is required to explore these preliminary findings. However, early indications suggest that domestic abuse clients may benefit from non‐time‐limited specialist counselling services. [ABSTRACT FROM AUTHOR]

Background: Representatives of counselling and person‐centred organisations indicate many of their members feel their profession and orientation is under threat, with counselling services being decommissioned in NHS settings. Aims: To understand the views of key figures in the psychological therapies field (policy makers, researchers and representatives of the counselling community) towards randomised controlled trials (RCTs), and their present and future role in developing the evidence‐base for counselling and psychotherapy. Method: Interviews (phone, Skype or face‐to‐face) were conducted with 24 authorities in the field. Relevant practitioner and academic networks were also contacted and key documents in the field were reviewed. Results: Key figures believe that RCTs will continue to play a decisive role in determining which psychological interventions are recommended and commissioned within the NHS for the foreseeable future. Other methods are seen as having some validity, but are generally considered supplementary to RCTs and not a replacement for them. Discussion: Although many members of the counselling community are critical of RCTs, they are likely to remain the mainstay of commissioning policy for some years to come. This means, in the coming years, members of the counselling community may face difficult choices in how to promote their work, while maintaining their core principles and values. [ABSTRACT FROM AUTHOR]

Introduction: Much literature is devoted to the gap between clinical practice and research, particularly outcome research in the form of the randomised controlled trial (RCT). However, the RCT's central role in health services policy has increasingly led to calls for psychotherapists of all theoretical backgrounds to participate in RCT research. Aims: This study explored how actual participation in outcome research may change clinicians’ attitudes towards this type of research. The specific focus is on psychoanalytic child psychotherapists’ experiences of participation in a large-scale RCT in the UK studying the effectiveness of treatments for adolescent depression. Method: Five child psychotherapists were interviewed towards the end of the planning stage of the trial, and transcripts were analysed using Interpretative Phenomenological Analysis. Findings: Many child psychotherapists found their experience of participation in outcome research transformative, and the study identified six key ‘stages’ in the story of their evolving attitudes to outcome research. Discussion: The contribution of this study to ongoing debates about the relationship between psychotherapy research and practice is discussed. [ABSTRACT FROM PUBLISHER]

Background: Adolescent reluctance to engage in help‐seeking for psychological and emotional problems is well documented. Despite a significant expansion in counselling provision in UK secondary schools, young people's experience of accessing counselling remains under‐researched. Aim: The present study aimed to elucidate the key features and stages of the help‐seeking process as defined by young people accessing school counselling. Method: Semi‐structured interviews were conducted with young people who had successfully completed a course of counselling at school. Thematic narrative analysis focusing on help‐seeking was then applied to the interview transcripts. Results: The analysis proposes a multi‐staged socially‐mediated process of disclosure and engagement, from initial acknowledgement of a problem through to full disclosure to the counsellor. Discussion: Analysis of young people's narratives highlights: the complex process of negotiation and evaluation which they undertake to engage fully in school counselling; the careful management of stigmatisation concerns both through practical access arrangements and the language in which school counselling is framed; the significant balanced position of the counsellor as both integrated and separate within the school community; and the key role of facilitators in enabling young people to access counselling, both practically and psychologically. [ABSTRACT FROM AUTHOR]

Aim: To investigate young people's views on the effects of school‐based counselling, and what they found helpful and unhelpful. Method: Eleven semi‐structured interviews were conducted and thematically analysed. Findings: Participants expressed predominantly positive views of school‐based counselling with changes in three main domains: emotional, interpersonal and behavioural. Participants viewed these changes as having had an important effect on their lives. The most commonly cited helpful aspects of counselling were related to talking or getting things out, and counsellor qualities. Conclusions: School‐based counselling is viewed positively by those who have experienced it, and appears to be an appropriate and valuable intervention for young people. [ABSTRACT FROM AUTHOR]

Primary objective: This is the first qualitative study that elicited the perceptions of both psychological therapists and their clients in the use of Clinical Outcomes in Routine Evaluation with computer software (CORE‐Net), where instant visual feedback for session tracking was given on a computer screen in the therapy room at each therapy session. The study also examined how therapists viewed its potential value in supervision and provides suggestions for improving training. Research design: The study adopted a convenience sample of four therapists in a primary care counselling setting (PCC – General Practitioner referrals) who were experienced in using CORE‐Net, and five therapists in an NHS employee/occupational support counselling service (OH) who had just begun to use CORE‐Net for session tracking with 10 of their clients. Method: A qualitative methodology was used and interview data were collected from the therapists via focus groups; the clients were interviewed individually face to face. All data was analysed inductively. Findings: The study identified six overarching themes: (i) therapists were initially anxious and resistant; (ii) therapists adapt 'creatively'; (iii) outcome measures help the client/therapist relationship; (iv) clients perceive visual measures as helpful; (v) CORE scores inform supervision; and (vi) proper and ongoing training/support of therapists is necessary. The main limitations are comparability of data and the generalisabilty of results. Conclusions: The implementation of routine outcome measurement (ROM) is a challenge but can be made easier with proper training and supervision. Clients appear happier than their therapists when routine outcome measurement is used. [ABSTRACT FROM AUTHOR]

Aim: This study explores dilemmas facing psychodynamic therapists who provide personal therapy to therapists in training. Method: Eight experienced psychodynamic psychotherapists were interviewed using a semi-structured interview format during which they were asked about the importance of personal therapy, if they encountered any dilemmas and, if so, how they resolved those dilemmas. Their responses were analysed using a qualitative form of content analysis. Findings: Two categories of dilemma emerged: clinical and personal. Clinical dilemmas arose out of the mandatory requirement for therapy, boundaries, fitness to practice and the suitability of trainees. Personal dilemmas included pressure to model, sense of responsibility, therapeutic narcissism, countertransference reactions, over-use of self and stressful involvement. The therapists' strategies for resolving the dilemmas are described. Conclusion: The results show participants considered personal therapy to be essential for trainees and thought it should be mandatory even though it led to difficulties in the therapy. Questions arose about the suitability of some trainees, the person of the therapist and stressful involvement. Further research into these important areas is recommended. [ABSTRACT FROM AUTHOR]