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The first-person experiences of people diagnosed with borderline personality disorder (BPD) is an important area of research. It can support clinical and ethical practice, and nuance and expand on insights offered by diagnostic and treatment-oriented research approaches. In this study, we aimed to develop knowledge about how persons who were recently diagnosed with BPD experience being in relationships with themselves and others.We conducted in-depth life-world interviews with 12 women recently diagnosed with BPD. The interviews focused on their lived experiences of relationships to self and others. All participants gave their informed consents to participate. We analysed the data with a structured approach to reflexive thematic analysis, conducted as a team-based approach.We extracted an overarching theme, "Reaching for firm holdings", that is the most abstract interpretation of participants' experiences. The five subordinate themes ("Captive of emotions", "Keeping undeservedness at bay", "Distrusting oneself", "Dependence as stability" and "The uncertainty of reaching out") are specific constituents of the overarching theme, and provide detail and variations across individual accounts.The results suggest that the experience of relationship to self and others of people recently diagnosed with BPD entails feeling insecure, unsafe and frightened. We report five themes that describe ways participants seek to cope with this situation. The results indicate that their experiences encompass turning to others, or to objects, for feelings of safety. As such, the experience of relationship to self and others in the context of receiving a BPD diagnosis seemed to entail finding and evolving strategies to protect a vulnerable self. Self-harm, suicide attempts and addiction all seemed to be ways of handling and tolerating chaotic and frightful emotions. One major limitation of our study is that only people who identified as female were recruited to participate in the study.

The growing scope and influence of qualitative research methodologies has generated an interest in the use of art-informed approaches to disseminating research findings. In the present article, our aim is to present a methodological case study of the development of a theatre play based on a qualitative study of senior therapists' life and work. Lessons learned from this project are presented in relation to ethical issues, the process through which qualitative data are transformed into a theatre performance, and the distinctive perspective afforded by a dramaturgical approach. Implications for research practice are discussed.

The practice of routine outcome monitoring and providing clinical feedback has been widely studied within psychotherapy. Nevertheless, there are many outstanding questions regarding this practice. Is it an evidence-based adjunct to ongoing psychotherapies, or an ineffective complication of treatment? If it is effective, through what mechanism(s) does it act? Is it effective with all patient populations, treatment types, and service delivery mechanisms, or does its impact vary across context? What choices in the implementation process affect the utility of patient-reported data feedback on psychotherapy outcomes? The studies in this special section explore these questions using a wide variety of methods and significantly expand the reach of studies on feedback. Together, these studies represent a snapshot of a maturing field of study: Initial discoveries are developed into more robust theories and applied in a wider range of contexts, while the limits of that theory are tested. They also signal directions for future clinical and research work that may improve patient care in psychosocial interventions into the future.

Clinical feedback (CF) systems are considered to be effective tools for supporting therapy. However, their implementation can be challenging. In this article, we question whether the Norse Feedback...

The aim of the present study was to investigate the use and attitudes toward standardized assessment tools among clinicians in a public mental health service in Norway. A total of 606 clinicians provided feedback on their use and attitudes regarding psychometric qualities of such tools, their practicality, and their benefit over clinical judgment alone using the Attitudes toward Standardized Assessment (ASA) Scales. Clinicians working in the adult mental health field scored significantly higher on use of diagnostic interviews, pre-post evaluations, and ongoing evaluations, whereas clinicians working in the child/adolescent mental health field scored significantly higher on use of screening instruments and held more positive attitudes towards using standardized assessment tools. Attitudes toward standardized assessment tools predicted use of such tools, and results were found to be similar to a study on US clinicians. Whereas the US study only found attitudes regarding the practicality of using such instrument as an independent predictor of assessment use, the current study found that attitudes regarding psychometric qualities of such tools, their practicality, and their benefit over clinical judgment alone were independent predictors of use.

Routine outcome monitoring (ROM) and clinical feedback (CF) systems have become important tools for psychological therapies, but there are challenges for their successful implementation.To overcome these challenges, a greater understanding is needed about how patients experience the use of ROM/CF.We conducted a systematic literature search of qualitative studies on patient experiences with the use of ROM/CF in mental health services.The findings from 16 studies were synthesized, resulting in four meta-themes: (1) Suspicion towards service providers, (2) Flexibility and support to capture complexity, (3) Empowering patients, and (4) Developing collaborative practice.We discuss the implications of these meta-themes for further development and implementation of ROM/CF into clinical practice, acknowledging the limitations of our review and suggesting avenues for further research. Clinical or methodological significance of this article: This article provides useful and actionable knowledge about the patient perspective on ROM/CF, an important discussion on the current state of research in this area, and useful and concrete suggestions for further avenues of research.

To evaluate the factor structure and clinical validity of a Norwegian translation of the treatment outcome package (TOP). Exploratory factor analysis was used to confirm the factor structure of the TOP (n = 334). Samples collected from university students (n = 137) were used to evaluate 1-week test–retest reliability. Concurrent validity was examined using data collected from a hospital sample (n = 197), who completed several referent measures. Logistic regression (n = 293) was applied to determine the translated TOP's ability to differentiate between clinical and non-clinical samples. A 12-factor solution was the best-fit for the data, largely supporting the US TOP structure. One-week test–retest reliability ranged from ICC = 0.56 to ICC = 1.00. Internal validity ranged from α = 0.49 to α = 0.93. The TOP subscales correlated most highly with referent measures or appropriate subscales. Logistic regressions correctly identified 77% of subjects as clinical or non-clinical. Conclusions: While larger and more...

Qualitative research has the potential to explore patient and therapist experiences of psychotherapeutic processes, as well as the challenges and opportunities inherent in relational and technical aspects of therapy. This paper examines explorative and reflexive ways of doing qualitative research on psychotherapy, based on the ontological and epistemological premises of hermeneutic phenomenology. An explorative–reflective thematic analysis is presented as a team-based approach, with a firm and transparent structure to the process of finding and interpreting experiential commonalities and differences in empirical material from semi-structured interviews. We use two examples of the interplay between phenomenological exploration and reflexivity from the interviews of two adolescent psychotherapy patients in a research project examining experiences of useful ways to establish a productive therapeutic relationship. A systematic way of conducting explorative–reflexive thematic analysis in a research team and wi...

Interviews were conducted to explore the recall of impasse experiences of 12 highly skilled and experienced therapists. Participants were interviewed in depth individually about a specific impasse from their experience that resolved successfully. The transcribed interviews were analysed using qualitative methodology. The authors found that participants understood their reported impasse experiences as important for their professional development. The category of “helpful subjective presence” describes the mode of being with patients that the participants found therapeutic. The categories of “losing hope” and “difficult feelings in the therapist in the here and now” are processes that threaten the helpful presence. The participants' inner work on the two latter categories is identified as a key to the successful resolution of impasses.