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Aims Traditionally in person‐centred therapy (PCT), clients are counselled for as long as required. It is a nondirective process. Recently, financial constraints have introduced time limits for therapy in health care, so it seemed appropriate to revisit the practice of PCT in the current UK context. The aim was to explore the concepts of learning and change within PCT and to consider whether learning is facilitated. Method Five experienced person‐centred therapists, who were involved in educating therapists, participated in semi‐structured interviews. Questions explored their views on learning and change in therapy, whether learning processes can be facilitated in PCT—both philosophically and practically—and the outcomes of PCT. Therapists were not specifically asked about time pressure, but rather it was left to see if it emerged as an issue. Results Ten major themes emerged: learning and change, goals, learning process, PCT process, issues on nondirectivity/directivity, questioning, outcomes, assessment and diagnosis, and other methods used. The issue of time pressure permeated many of these themes. Views were often contradictory reflecting the inconclusive views in the literature, particularly in relation to how clients learn and the relationship between change and learning. Discussion The issue of directivity seemed to cause cognitive dissonance, with participants wanting to be directive to deal with time pressures, but not wanting to be disloyal to Rogers' PCT principles. Processes of learning and change were acknowledged as important, but little clarity was obtained on their current application.

Background Thailand has a higher global non-communicable disease (NCD) mortality rate in comparison to the rest of the world, accounting for 75% and 71% of all deaths. WHO focused increasingly on health literacy (HL) in order to decrease NCDs. This study aimed to assess the effectiveness of an HL intervention utilizing transformative learning and positive psychology with mindfulness training in terms of changing levels of HL, health behavior (HB), and health outcomes. Design and methods The study was a randomized control trial from May to September 2019. The participants were a rural Thai population with low levels of HL, living in an area with high levels of NCDs. The 200 participants were cluster randomly allocated to an eight-week intervention, and the control group. The data were collected by Likert questionnaires and physical exams, and analyzed via ANOVA. Results The intervention group mean scores for HL, psychological capital, HB, and family well-being increased from baseline to post-intervention, but decreased during the follow-up but were still significantly higher than the control group and baseline scores. The increases in HL and HB were matched by improvements in physiological measurement. The BMI scores of the intervention group decreased in each phase, while the control group scores remained largely unchanged. An intervention group had significantly lower fasting blood sugar than the controls at the intervention and in the follow-up. There was no interaction between social support and any other variables. Conclusions This program demonstrated improvements in HL, HB and the well- being of Thai families at risk of NCDs in rural communities.

The advanced nurse practitioner (ANP) role was established in Ireland in 2001 and represents an important nursing role development within Irish healthcare. Currently there are 336 ANPs registered with the Nursing and Midwifery Board of Ireland, working across 40 specialties. This number is increasing exponentially in response to emerging and anticipated future service needs and population demand projecting to a critical mass of 750 by 2021. Health service provision is enhanced by advanced practice performance outcomes. This article explores nurse to advanced nurse practitioner transitional journeys, a concept that has not previously been researched in depth from an Irish perspective. The theories of Benner, Woods, and Bourdieu are reviewed to explore whether an advance practice career trajectory results in unique nurse-to-ANP role transitioning. Contextualising possible personal, professional and educational transitions may enable the promotion of effective career ‘scaffolding’ to enhance a smooth transition for aspiring ANPs into advanced nursing practice roles.

Purpose Mindfulness based interventions (MBIs) are an emerging area of empirical study, not only in positive psychology, but also in clinical health care. This research aims to synthesize the evidence about whether MBIs reduce blood pressure (BP) in patients with non-communicable diseases (NCDs). Methods Relevant studies were identified via PubMed, the Cochrane Library, Embase and the CINAHL database between 2009 and 2019. The papers selected focused on mindfulness and the effect of these on the BP of patients with NCDs. The change in SBP and DBP were meta-analyzed, stratified by type of intervention (Breathing awareness meditation (BAM), Mindfulness Meditation (MM), and Mindfulness-based Stress Reduction (MBSR). Results Fourteen articles met eligibility criteria and were included in the final review. Among the studies using the type and duration of intervention, systolic BP was reduced after the mindfulness-based stress reduction for 8 weeks (-6.90 mmHg [95% CI: -10.82, -2.97], p < .050), followed by the breathing awareness meditation for 12 weeks (-4.10 mmHg [95% CI: -7.54, -0.66], p < .050) and the mindfulness-based intervention for 8 weeks (-2.69 mmHg [95% CI: -3.90, -1.49], p < .050) whereas diastolic BP was reduced after the mindfulness-based stress reduction for 8 weeks (-2.45 mmHg [95% CI: -3.74, -1.17], p < .050) and the mindfulness-based intervention for 8 weeks (-2.24 mmHg [95% CI: -3.22, -1.26], p < .050). Conclusion MBIs can provide effective alternative therapies to assist in blood pressure reduction for patients with NCDs., Public health; Health profession; Nursing; Blood pressure; Meta-analysis; Non-communicable diseases; Mindfulness; Systematic review.

Life expectancy is increasing globally, which makes understanding what contributes to well-being in older adults crucial for social and economic reasons. This is the first study to categorize positive life events in community dwelling older adults, to explore their fit with psychological well-being models. Volunteers self-defined as well (N = 88), completed diaries identifying three positive events daily for 14 days. Diary entries combated negative stereotypes of ageing by describing older adults with active lives contributing to society. Of nine themes identified through thematic analysis of over 3500 events; seven supported existing well-being models, being activities delivering positive affect and life satisfaction (hedonic model) and demonstrating competence, autonomy, relatedness, self-acceptance, purpose in life, and personal growth (eudemonic models). However, two well-supported new dimensions were also identified within the themes ‘interaction with the physical environment’ and ‘personal well-being’. These new dimensions were labelled ‘life-affirmation and ‘mindfulness’. This suggests the existence of additional considerations related to well-being specifically for older populations, which may indicate a need to broaden the existing models.

Student engagement is an important predictor of success, retention and perseverance in higher education. This study used structural equation modelling to evaluate a gain cycle of future time perspective (FTP), positive emotion and student engagement derived from the broaden-andbuild theory (BBT). A second objective was to examine changes within study variables over time. Participants were 217 UK undergraduates sampled at two time points. Mean levels of\ud positive emotion and engagement decreased over time, whereas FTP increased. At both time points, FTP predicted higher engagement, and engagement predicted greater positive emotion levels. Positive emotion at Time 1 predicted increased levels of FTP, engagement and positive\ud emotion at Time 2. This was consistent with the ‘build’ hypothesis of BBT suggesting that positive emotions facilitate approach behaviour and the development of psychological resources. Findings indicate that interventions designed to enhance FTP and positive emotion\ud can facilitate student engagement and retention in higher education.

Autonomous learning is a commonly occurring learning outcome from university study, and it is argued that students require confidence in their own abilities to achieve this. Using approaches from positive psychology, this study aimed to develop confidence in first‐year university students to facilitate autonomous learning. Psychological character strengths were assessed in 214 students on day one at university. Two weeks later their top three strengths were given to them in study skills modules as part of a psycho‐educational intervention designed to increase their self‐efficacy and self‐esteem. The impact of the intervention was assessed against a control group of 40 students who had not received the intervention. The results suggested that students were more confident after the intervention, and that levels of autonomous learning increased significantly compared to the controls. Character strengths were found to be associated with self‐efficacy, self‐esteem and autonomous learning in ways that were theoretically meaningful.

This review examines the application of positive psychology concepts in physical health care contexts. Positive psychology aims to promote well-being in the general population. Studies identifying character strengths associated with well-being in healthy populations are numerous. Such strengths have been classified and Positive Psychology Interventions (PPIs) created to develop these strengths further in individuals. Positive psychology research is increasingly being undertaken in health care contexts. The review identified that most of this research involves measuring character strengths and their association with health outcomes in patients with a range of different conditions, similar to the position in positive psychology research on non-clinical populations. More recently, PPIs are beginning to be applied to clinical populations with physical health problems and this research although relatively scare is reviewed here for cancer, coronary heart disease, and diabetes. In common with PPIs being evaluated in the general population, high quality studies are scarce. Applying PPIs to patients with serious health conditions presents significant challenges to health psychologists. They must ensure that patients are dealt with appropriately and ethically, given that exaggerated claims for PPIs are made on the internet quite frequently. This is discussed along with the need for more high quality research. \ud Keywords; positive psychology interventions; cardiovascular disease; cancer; diabetes; character strengths; health assets; review

The literature demonstrates that stress in the working life of academics has increased over recent years (Kinman, 2014). However, qualitative research on how academics cope with changes in working life and associated stress is limited. This paper examines how a sample of 31 academics in a post-92 predominantly teaching-focused UK university cope with teaching, research/scholarship and administration, what they perceive to be positive about work, what is less valued and what is stressful. Online interviews were used to maximise participation. Data were analysed using thematic analysis. Six themes emerged from the data. These were administrative loads, coping with stress at work, task preferences in the academic role, features of the academic role, positive and negative feelings around research/scholarship, and thoughts around leaving the academic environment. The factors that contributed to stress included the increasing the number of students, heavy workloads, increasing administration, poor management, funding cuts, and government initiatives threatening the future of education. Academics reported as negatives that they had less time to interact with students because of increasing administration, difficulties obtaining sufficient funding for research in particular, and feeling that academic posts were less secure. All of this led to greater job dissatisfaction. However, support from colleagues and taking steps to manage their time more effectively were identified as factors that can moderate some of the negative consequences of work stress. Academics overall reported being happy at work because of the satisfactions gained from teaching, their relationships with students, the levels of work autonomy, and support from colleagues.

A case is made for a skilled, independent counselling service to be made available to children with cancer, and their families. Evidence is presented from a selected review of recent literature, and the stated needs and views of a small group of parents obtained by counsellors' in-depth interviews. This evidence shows the stresses imposed, and the inability of the medical team fully to address these needs concurrently with treating the illness. Skilled, long-term counselling for patient and family is seen to be an important aspect of a comprehensive childhood cancer service.

The lack of any consensual definition of forgiveness is a serious weakness in the research literature (McCullough, Pargament & Thoresen, 2000). As forgiveness is at the core of Christianity, this study returns to the Christian source of the concept to explore the meaning of forgiveness for practicing Christian clergy. Comparisons are made with a general population sample and social science definitions of forgiveness to ensure that a shared meaning of forgiveness is articulated. Anglican and Roman Catholic clergy (N = 209) and a general population sample (N = 159) completed a postal questionnaire about forgiveness. There is agreement on the existence of individual differences in forgiveness. Clergy and the general population perceive reconciliation as necessary for forgiveness while there is no consensus within psychology. The clergy suggests that forgiveness is limitless and that repentance is unnecessary while the general population suggests that there are limits and that repentance is necessary. Psychological definitions do not conceptualize repentance as necessary for forgiveness and the question of limits has not been addressed although within therapy the implicit assumption is that forgiveness is limitless.

SUMMARY This article reports the findings of a questionnaire survey of 118 local authority socialworkers' attitudes towards parental participation in child protection case conferences.Arguments from the professional literature both in favour of and against parentalparticipation were presented. Overall social workers were found to be largely support-ive of parental participation although aware of the potential problems. Other profes-sional groups involved in case conferences were perceived as being less enthusiasticabout parental participation. The implications of these findings are discussed and sometraining needs identified. INTRODUCTIONThe ethos of child protection case conferences has changed somewhatwith the recommendation that parents should have the right to partici-pate in the proceedings. This recommendation appeared in the OfficialGuideline Document from the Cleveland Enquiry and was reiteratedin the 1989 Children Act and the 1991 Working Together document.This has opened up a new area of debate within social work.Proponents of increased civil liberties have focused on the parentalright to attend case conferences where decisions are being made abouttheir child. Opponents on the other hand have been concerned aboutthe inhibitory effect on the frank exchange of information betweenprofessionals that parental presence may engender. The guiding prin

SummaryOne hundred and sixty Scottish psychiatrists complete a questionnaire eliciting the extent of their use of the term ‘borderline patient’ and the factors affecting this. The term was used by 27.5 per cent, the majority of whom felt that it ought to be included in current diagnostic classification systems. There was, however, general dissatisfaction with the vagueness of current definitions of the term and a confusing use of numerous diagnostic labels.Use of the term was not related to status, geographical location, or familiarity with American psychiatric literature. The practice of psychodynamically-oriented psychotherapy and extended working contact with psychiatry in North America were found significantly to increase its use.