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Undergraduate student mental health and wellbeing is becoming an increasingly important topic. In particular, students from backgrounds that have been traditionally underrepresented in higher education may have increased difficulties during the transition to university. Therefore, 'Mind Your Mind', a pilot, three-part programme of workshops facilitated by doctoral clinical psychology students to support first year undergraduate psychology students was developed. The workshops were formulation-based and explored 'social media', 'anxiety' and 'belonging'. Students generally found the workshops useful and easy to understand, and felt that attending the workshops increased their wellbeing. The programme also provided an opportunity for the clinical psychology students to develop their skills and give something back. Reflections on the development, facilitation and sustainability of the programme are discussed.

This paper describes the development and delivery of an innovative approach to teaching qualitative research methods in psychology. The teaching incorporated a range of "active" pedagogical practices that it shares with other teaching in this area, but was designed in such a way as to follow the arc of a qualitative research project in its entirety over several sessions, whilst episodically dealing with distinct methodological approaches along the way. In line with this design, and the mutuality of the learning, it was called a "qualitative learning series". Following Mason (2002), the paper also considers the challenge of qualitative teaching in the context of academic psychology, and touches upon whether developments in the years since have made for much difference. These strands of the paper come together in how the teaching met these challenges.

AbstractThis paper is the first to systematically review qualitative research on adopted adults’ motivations and experiences of birth family searching. A line of argument synthesis developed four overarching themes: ‘missing pieces’, ‘different and othered’, ‘the circumscribed position in the adoption triad’ and ‘internal and external challenges.’ The main findings illustrated that searching is complex, inherently linked to identity. Also implicated in the process are relational dynamics and internal and external challenges. Practice implications include recommending contact services that provide psychological support for the searching process. Also recommended for mental health practitioners is specialized training in contemporary adoption issues. [ABSTRACT FROM AUTHOR]

The intermediate psychological therapies service is provided for individuals referred with common mental health problems within the primary care psychological therapies service, but whose difficulties are longstanding and/or complex. The prevalence of borderline personality disorder (BPD) in intermediate psychological therapy services has not been researched to-date. The current study aimed to measure the prevalence of BPD amongst patients attending intermediate psychological therapies (n = 63). The prevalence of BPD was established by identifying the number of patients who met DSM-IV criteria. BPD prevalence amongst patients attending an intermediate psychological therapy service was 37%. The high proportion of patients presenting with BPD indicates the potential need for staff training and supervision in how to manage such high levels of need at this service level. This is the first study to report prevalence rates of BPD specifically in an intermediate care psychological therapy service.

Background: Self-injurious behaviour (SIB) is among the most serious problems faced by intellectual disability services. It is very difficult to treat and can become a chronic problem. Method: Information on a number of variables was collected through a survey of service-users identified as displaying SIBs. Clinical opinion and a literature review guided the selection of potential predictors of continued SIB. Univariate statistical analyses were used to investigate associations between continued SIB and each of the variables identified. Variables shown to have a significant association with continued SIB were subjected to a multivariate analysis to isolate those variables that still predicted continued SIB once the influence of the others had been accounted for. Results: Two factors, self-biting and verbal ability, were found to independently predict continued SIB. Conclusion: The results have implications for intellectual disability services, in terms of the importance of multidisciplinary team working, training and guidelines for problem management.

Background: Shame can be a powerfully aversive emotion that is associated with a wide variety of mental health difficulties including non‐suicidal self‐injury (NSSI). This study used a novel mixed‐methods design (Qualitative Experiential Sequence Tracking; QUEST) to investigate the experiences of shame in a sample of individuals who self‐injure. Methods: Six participants received prompts to complete brief online diaries three times per day over a period of 2 weeks. These diaries captured information about the experience of negative emotions, especially shame. Participants then underwent an individualised qualitative interview about their experiences over the previous 2 weeks. Results: Thematic analysis suggested that participants experienced shame as a social and relational emotion. Further themes included shame being associated with feelings of failure, being trapped, dangerous or contaminated, and hidden or exposed. The phenomenology of shame, and coping with shame, were also themes. NSSI could occur as a response to shame, but often shame was triggered or exacerbated by the responses of others to NSSI. Conclusions: Consistent with previous research, shame was described as an aversive emotion occurring within interpersonal and broader societal contexts and involving a negative self‐focus. A lack of compassion or understanding in response to NSSI, or anticipation of negative responses from others often triggered more intense shame than the NSSI itself. Future studies could use QUEST methodology with more diverse samples or different populations to further investigate experiences of shame. [ABSTRACT FROM AUTHOR]

Background: Nonsuicidal self‐injury (NSSI) is associated with high levels of distress, co‐morbid mental health issues, and elevated risk of suicide. Previous literature indicates that emotion regulation is the most endorsed function of NSSI. Experience Sampling Methodology (ESM) provides a powerful tool for investigating the moment‐to‐moment associations between emotional states and NSSI thoughts and behaviours. The aim of the current study was to systematically review and evaluate ESM research concerning the relationship between momentary emotional states and NSSI. Methods: A systematic search of electronic databases from date of inception to 16th April 2021 was conducted. This was supplemented through backwards citation tracking. A risk of bias assessment was completed prior to data synthesis. Results: Nineteen eligible studies were identified for inclusion in the review. Heightened negative affect was found to typically precede instances of NSSIT thoughts and behaviour. Results were less consistent for positive affect. Limitations: Sample sizes across studies were often small, meaningful effect sizes were not always reported, and non‐validated measures of NSSI thoughts and behaviour were used during ESM assessments. Conclusions: The results support affect regulation models of NSSI, and demonstrate the value of ESM studies, specifically those sampling more than once per day, in plotting the temporal, "in‐the‐moment" characteristics of these processes. [ABSTRACT FROM AUTHOR]

Objective: The aim of this research was to examine relationships between attachment insecurity and suicidal ideation and behaviour. Secondary aims were to explore the mediating role of emotion dysregulation and the moderating role of betrayal trauma in explaining hypothesised relationships. Method: Sixty‐five participants with experience of suicidal ideation completed questionnaire measures assessing attachment security, suicide ideation, emotion regulation, betrayal trauma, depressive symptoms and hopelessness. Results: A direct relationship was found between avoidant attachment and suicide ideation after controlling for age and gender. Multiple suicide attempters had higher anxious attachment. Anxious and avoidant attachment, suicide ideation and betrayal trauma were associated with emotion dysregulation. The relationship between attachment insecurity and suicide ideation was not mediated by emotion dysregulation. In the mediation model, only anxious attachment remained a significant predictor of emotion regulation and there was no significant effect of emotion regulation nor betrayal trauma, on suicide ideation. Conclusion: Suicidal individuals may benefit from therapeutic intervention that explores attachment‐related difficulties and therapies such as dialectical behavioural therapy, which support skills in emotional regulation. Future longitudinal research should identify other important mediators of the association between attachment and suicidality to develop more targeted psychological interventions for suicidality. [ABSTRACT FROM AUTHOR]

ABSTRACT Child and adolescent mental health services (CAMHS) inpatient units provide multi-disciplinary treatment for young people with a wide range of complex needs, many of whom have co-morbid presentations. There [...]

Abstract Aim: A dependency measure (the CAMHS AID) was developed in Birmingham and Manchester to support more accurate decisions about whether a young person can be accommodated on a child [...]

Insecure attachment is widely accepted to be a risk factor for suicidal thoughts and behaviour. To increase our understanding of this distal association, the current systematic review aimed to evaluate empirical evidence that has investigated the role of psychosocial mechanisms within this relationship. Sixteen original research articles were identified, with the majority carrying out mediational analyses to test their hypotheses. Substantial heterogeneity was found across studies with regards to their theoretical approach to assessing attachment, suicide‐related outcomes, sample population, statistical analyses, and the psychological factors under investigation. Nevertheless, this emergent evidence base indicates that a range of predisposing, precipitating, and crisis‐state factors may mediate the association between attachment security and suicidality. Studies that investigated moderating factors did not report significant findings, and the mediating role for psychiatric diagnoses remains unclear. Furthermore, this emerging research base is limited by an over‐reliance on cross‐sectional designs and self‐reported data. Longitudinal and experimental designs are required to verify causal pathways and to investigate whether trait vulnerabilities interact with acute stressors to increase suicide risk. Finally, disorganized attachment has been overlooked so far and should be given greater consideration going forward. [ABSTRACT FROM AUTHOR]

Summary: Background: Clinical environments can be so stressful to medical students as to be detrimental to their learning and well‐being. Our intervention, Clinical Debrief, integrates learning through clinical experience with the development of positive coping strategies. Students shared cases and experiences during weekly small group classroom discussions, facilitated by general practitioners (from outside their current hospital placement), throughout two consecutive 12‐week blocks of their first clinical year. Alongside enquiry‐based and clinical reasoning learning, we gave students a safe space to reflect on their affect. Our aim was to critically examine students' views in Clinical Debrief. Method: Anonymised quantitative and qualitative evaluation data were collected over 3 years using online questionnaires on completion of each 12‐week block. The data relating to psychological supervision were analysed independently and in parallel, using thematic analysis for qualitative data. We aim to help students develop positive coping mechanisms, promoting empathy,self‐awarenessand wellbeing Results: A total of 1857 evaluations were extracted (response rate 67%). The median (interquartile range) overall rating for Clinical Debrief sessions was 9 (8–10), where 10 indicates 'excellent' and 1 indicates 'significant improvement needed'. The rating for the supervisory aspects of the sessions and free‐text comments were positive. Students appreciated safe environments, the session structure, facilitator role modelling, transitional support and processing of emotional experiences. Discussion: Mandatory integrated longitudinal supervision, using trained clinician facilitators, was positively received by students in transition to clinical placements. Normalising the emotional impact of medical work destigmatises distress. Linking clinical reasoning with affective state awareness to contextualise case management, following Mezirow's transformative learning theory, brings added benefit to learning and well‐being. Student demand for the expansion of Clinical Debrief is evidence of success. [ABSTRACT FROM AUTHOR]

Story stem measures are an increasingly popular method for assessing the attachment representations of young children, but little is known of their cross-cultural applicability. This study aimed to characterise the attachment representations in 73 five- to eight-year-old children in urban Ghana, West Africa, using the Manchester Child Attachment Story Task (MCAST) to test its feasibility, psychometric characteristics and concurrent associations with caregiver- and teacher-rated child behaviour, and to conduct a qualitative thematic analysis of methodological observations. Among the classifiable cases (92 percent), all attachment classifications were observed, yielding a higher rate of secure attachment than in European samples. Inter-rater reliability, internal consistency, and internal structure were reasonable and largely similar to European studies, although one structural difference was the separation of 'child assuagement of distress' from other secure-related items. MCAST narratives were associated with teacher- and caregiver-rated hyperactivity, but internal consistency was low in most Strengths and Difficulties Questionnaire scales. Possible culturally-sensitive explanations for our psychometric and qualitative findings are discussed. Overall, story stems are a promising tool for accessing attachment representations in non-Western samples, although modifications are likely to improve cross-cultural equivalence when applied to non-Western cultures. Further investigation is needed to link MCAST outcomes to parenting and socio-emotional development. [ABSTRACT FROM AUTHOR]

There is a growing interest into how attachment theory can inform psychotherapeutic practice with adults. This study aimed to explore how a group of therapists with an interest in attachment theory use it in their work with adult clients. A cross-sectional qualitative design was adopted. Sampling, data collection and analysis procedures were guided by grounded theory principles. Semi-structured telephone interviews were conducted with 12 therapists from a variety of training backgrounds. Data were coded and developed into thematic categories. Six primary themes were identified to describe how attachment theory influenced the clinical practice of the sample through the following: (i) complementing other therapeutic models; (ii) providing a framework to understand the development of clients' mental health problems; (iii) working with different attachment styles; (iv) thinking about the therapeutic relationship as an attachment relationship; (iv) influencing the different stages of the therapeutic process; and (vi) influencing clinical service design and delivery. It is concluded that attachment theory can play a significant role in influencing the practice of therapists and can be usefully adopted to complement therapeutic processes irrespective of the therapist's dominant clinical orientation. Further research is needed to explore the views of clinicians from different theoretical orientations and to investigate the security of the client-therapist attachment within the context of therapeutic change processes. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message Attachment theory may have implications for practice across a range of different types of therapy and may help therapists to bridge apparent differences between modality-specific formulation and techniques., Attachment theory can be used to understand the development of mental health problems. Therapists should assess and formulate clients' attachment styles, and these formulations should guide therapeutic approaches., Attachment theory provides a comprehensive framework for facilitating the therapist's attentiveness to relational issues and use of the therapeutic relationship as a fulcrum for change., The principles of attachment theory can be used to inform all stages of the therapeutic process, as well as the design and delivery of mental health services. [ABSTRACT FROM AUTHOR]

Objectives: This review systematically examines research that investigates changes in adult attachment representations during psychological therapy. Method: Studies from two adult attachment approaches are reviewed (interview and self-report) with the aim of concluding whether psychotherapy can improve attachment representations. To guide the interpretation of findings, the methodological quality of studies is assessed. Results: The results suggest that attachment security increases following therapy, whereas attachment anxiety decreases following therapy. Findings are unclear with regard to attachment avoidance. Improvements are observed across different methodologies, patient groups, therapeutic approaches, and therapy settings. Findings also appear to be consistent across different levels of study quality. Conclusions: Overall, research supports the suggestion that attachment styles may alter during the course of psychotherapy, but further controlled trials are required to confirm this conclusion. [ABSTRACT FROM AUTHOR]

We investigated associations between attachment, psychopathology, quality of life, service utilisation and costs. Twenty-five people with psychosis completed self-report measures and service use was assessed from case note review. Insecure attachment was associated with greater psychopathology and higher service utilisation and costs. Insecure anxious attachment was related to higher service utilisation independent of symptoms. [ABSTRACT FROM PUBLISHER]

Within the context of child and adolescent mental health inpatient services, a literature review was undertaken to understand the concept of inpatient dependency and how it can be measured. Articles and books relating to patient dependency and its measurement in various contexts were retrieved, and other published measures were identified. It was found that dependency has been defined in many different ways, and various techniques have aimed to quantify or categorize patients' dependencies. This article focuses particularly on measures used in adult psychiatry and paediatric services. At present, there is no available established measure of patient dependency in child and adolescent inpatients. This article identifies the need to develop a measure of inpatient dependency that is specifically designed for these services, and outlines a tool that the authors have recently designed. [ABSTRACT FROM AUTHOR]

Abstract Phenomenon : There is a paucity of research reporting the experiences of general practitioner clinical educators. Providing education for students could lead to better clinical skills and greater job satisfaction for the educator. However, it could also result in increased stress and mental fatigue, adding to what is an already pressured situation in the current primary care climate. Clinical Debrief is a model of case-based learning with integrated supervision developed to prepare medical students for clinical practice. This study aimed to explore the experiences of general practitioners who facilitate Clinical Debrief. Approach : Eight general practitioner educators with experience of facilitating Clinical Debrief participated in semi-structured qualitative interviews. Results were analyzed using Reflexive Thematic Analysis, and four main themes were developed. Findings : Themes included: Personal enrichment: psychological "respite" and wellbeing; Professional enrichment: Clinical Debrief as a "two-way" door; Becoming a facilitator: a journey; and, Relationships in teaching: blurred boundaries and multiple roles. Insights : Being a Clinical Debrief facilitator had a transformative impact on the personal and professional lives of the GPs who participated in this study. The implications of these findings for individual GPs, their patients, and the wider healthcare system, are discussed. [ABSTRACT FROM AUTHOR]