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Objectives: Research indicates psychologists typically lack subjective understanding of voice hearing. Voice hearing simulation training has potential to improve understanding, empathy and confidence among clinicians, but psychologists have had limited input into its development. This study investigated psychologists' and a psychotherapist's clinical experience of working with people who hear voices and their views and recommendations for voice hearing simulation training. Design: This was a qualitative study. Methods: Clinical psychologists and one psychotherapist (N = 17) participated in semi‐structured interviews. Thematic analysis was used to analyse transcribed data. Results: The Clinical Experience theme comprised of subthemes Barriers to engagement, Diversity of voice hearing experiences, Lack of subjective understanding, Curiosity about voice hearing, Empathy for voice hearers, Using personal experiences to relate to voices, Clinical experience increases knowledge, Importance of supervision and colleague's support, Benefits of experiential training, Limited training in non‐psychosis settings and Clinical experience increases confidence. The Views on Voice Hearing Simulation Training theme comprised of subthemes Improves subjective understanding, Concern about distress, Discomfort as a strength of voice hearing simulations, Artificiality of simulation, Increases empathy and Over‐estimation of understanding. The Recommendations theme comprised of subthemes Discuss artificiality, Co‐production, Promote voice diversity, Support staff and Maximise inclusivity. Conclusions: Findings indicate that clinical experience improves psychologists' confidence and knowledge, yet participants reported a lack of subjective understanding of voice hearing. Co‐produced simulation training between individuals who hear voices and clinicians was anticipated to improve subjective understanding, empathy and therapeutic relationships, which could support a range of staff and improve quality of care delivered. [ABSTRACT FROM AUTHOR]

The imposition of nation-wide lockdowns and sporadic transition to remote work produced unforeseen psychological challenges likely to impact the medium of care and workload of mental health professionals. The present study explored the lived occupational experiences of clinical psychologists, counsellors, and psychotherapists working in the National Health Service (NHS) and private practice in the UK during COVID-19 pandemic. Nineteen professionals (11 employed in the NHS and 8 working in independent settings) were interviewed about their professional experiences during first and second waves of the pandemic. Data were analysed using interpretative phenomenological analysis. Three main themes emerged from the analysis: (i) transition from face to face to online therapy; (ii) novel changes and wellbeing; and (iii) uncertain professional support in uncertain times. The findings suggest that lack of experience in providing online or telephonic psychotherapeutic services from home negatively impacted professionals' physical and psychological health and wellbeing. Thus, to cope with it, they availed psychological and structural support from colleagues, co-workers, clinical supervisors, managers, organisations, and professional bodies. This study adds to the existing body of research on the impact of the pandemic on UK-based mental health professionals and from an applied perspective, it highlights the need for skill-upgradation of professionals. [ABSTRACT FROM AUTHOR]

Psychology trainees operate in high stress environments and supervisees with multiple marginalized identities, such as multiethnic women, must also navigate and/or resist discrimination. Resistance as a tool against oppression (positive resistance) is an emerging concept in psychology. Consensual qualitative research method was used to explore the ways multiethnic women engage in resistance during the supervision process. The central research question was, "How do multiethnic women engage in resistance to gender- and ethnicity-based inequities during supervision?" Participants (N = 12) identified as multiethnic women who were in, or had recently graduated from, clinical or counseling psychology programs. Participants sat for a 60–90 minute interview. Analyses of the interview transcripts yielded the primary domain, Resistance, and three subdomains: Motivation for Resistance, Capability for Engagement, and Forms of Resistance. Implications for supervision with women are discussed, including ways that supervisors may encourage and respond to positive resistance in the training of diverse future psychologists. [ABSTRACT FROM AUTHOR]

Recovery-orientated practice is crucial to mental health care services—consistently identified in policy, service delivery guidelines and national mental health action plans. An essential component to systems reform and the adoption of recovery-orientated practice is the inclusion of peer support workers as practice leaders to support shifting culture in mental health service delivery. Designated peer support roles operate as healthcare professionals who utilise their lived and living experience of mental health difficulty to support those on their recovery journey through mutual understanding of shared experience. This research sought to explore the experiences of peer support workers integrating into mental health teams and identify organisational actions to facilitate successful recognition, integration and acceptance by colleagues; therefore, promoting sustainability of the peer support role. Qualitative interviews were undertaken with 18 peer support workers employed across four Australian states within 12 different government and non-government organisations. Study findings reveal three key areas for organisational change with seven main themes to assist organisations to better facilitate the successful integration of peer support workers into mental health service teams. These included robust induction, training for existing staff, clear referral pathways into the service, consistent supervision and debriefing, leadership support, professional development pathways and involving peer workers through change processes. These themes were grouped into three key areas for change including preparation, process and structural changes, and cultural change actions for sustainability. This article makes recommendations for organisations to consider when implementing peer support roles into mental health services. [ABSTRACT FROM AUTHOR]

Introduction: Distance methods of supervision rapidly increased in use during the coronavirus disease 2019 (COVID-19) pandemic, and it is important to consider if these methods meet the needs of supervisees when deciding whether to retain these practices moving forward. Methods: An interpretative phenomenological approach was used to gain insight into the lived experience of distance supervision. Semi-structured interviews were completed with six occupational therapists who had experience receiving distance supervision as a supervisee, all of whom work in inpatient mental health units within a private healthcare company. Results: Interpretative phenomenological analysis revealed four superordinate themes of an altered interaction; the importance of a protected space; factors within the supervisory relationship and maximising the best of both worlds. Conclusion: Distance supervision methods afford increased access for supervisees and a reduction in the practical demands when supervised by an off-site supervisor. There are, however, clear differences in the nature of the experience which need to be considered to ensure that supervisee needs are met. This study provides insight into how distance supervision methods impact on the experience for supervisees and suggests areas for further consideration in moving forward with such approaches. [ABSTRACT FROM AUTHOR]

Clinical supervision plays an important role in competency development during psychology practitioner training. How the scientist-practitioner competency is operationalised, disseminated, and evaluated in supervision is unclear. This study aimed to explore supervisor and trainee attitudes, opinions, and perceptions of scientist-practitioner competence. It also sought to understand what supervisors are doing in supervision to develop and assess the scientist-practitioner competency, as well as how trainees demonstrate the competency in supervision. Three focus groups comprised 12 trainees and a total of 12 supervisor individual telephone interviews were conducted, where participants reflected on their supervision experiences, responding to questions about the scientist-practitioner competency. A thematic analysis resulted in the identification of core themes and subthemes. Core themes identified were 1) Scientist-Practitioner Model as a Foundation to Professional and Ethical Practice; 2) The Translation of Science into Real-World Practice; 3) Flexibility to Learn/Change within the Scientist-Practitioner Model; 4) Supervision as the Route to Developing Scientist Practitioner Skills and Knowledge; and 5) Barriers and Challenges to Bridging Science and Practice. Findings reveal specific ways supervisors and trainees can acquire and demonstrate scientist-practitioner competence in supervision during professional training. This may assist with self- and other evaluation of scientist-practitioner competence in supervision. Implications for training, education, and supervision are discussed. What is already known about this topic: The scientist-practitioner model underpins university postgraduate training programmes in clinical psychology. The supervision and competency literature has gained increased attention in recent decades, resulting in the identification and conceptualisation of the scientist-practitioner approach and mindset. Clinical supervision has an influential role in the development, assessment, and evaluation of the scientist-practitioner meta competency in psychology practitioner training. What this topic adds: This study is unique in that it provides an exploration of both supervisor and trainee perspectives of scientist-practitioner competence. Supervisor interviews and trainee focus groups revealed ways in which the scientist-practitioner competency is operationalised, disseminated, and evaluated in clinical supervision. Findings reveal specific and observable supervisor and trainee behaviours that demonstrate scientist-practitioner competence. This may assist supervisors in self-monitoring and evaluating scientist-practitioner competence and that of trainees during professional training. [ABSTRACT FROM AUTHOR]

Objectives: Eye Movement Desensitisation and Reprocessing (EMDR) is an evidence‐based psychological therapy that targets distress associated with trauma and affective disturbance. Few studies have examined EMDR for autistic individuals who have co‐occurring mental health conditions, but there is preliminary evidence of effectiveness. The current study explored EMDR therapists' experiences of working with autistic individuals, and adaptations incorporated into clinical practice to make this more accessible and effective. Design: A qualitative interview design was used. Data were thematically analysed. Method: Twenty‐three UK‐based EMDR therapists attended one‐off semi‐structured qualitative interviews. Results: Four main themes emerged: (1) the experience of being autistic; (2) factors around accessing EMDR; (3) adapting EMDR; and (4) supervision and support for EMDR therapists. Participants described offering a nuanced and tailored approach; one that retained the integral components of the eight phases of EMDR, while also being flexible and responsive to each client. Conclusions: Findings reinforce the importance of offering formulation‐based psychological therapy that flexes in an evidence‐informed way, according to the preferences and needs of autistic individuals. Further research should establish factors influencing accessibility and effectiveness of EMDR for autistic individuals, and the impact of autism‐relevant training on the knowledge, skills and confidence of EMDR therapists and clinical supervisors working with this client group. [ABSTRACT FROM AUTHOR]

Objective: Previous surveys examining the routine practice of cognitive behavioural therapy (CBT) supervision have consistently found that methods utilised by supervisors often drift from expert recommendations. Harmful or ineffective supervision are two potential consequences of practices which overlook one or more of the normative, formative or restorative functions. Given that most of the research to date in this area has used quantitative methods, it is important to gain a deeper understanding of the reasons why everyday supervision differs so greatly. One way of achieving this is through exploring the "lived experience" of supervisors and supervisees. Method: Semi‐structured interviews were conducted with (N = 10) supervisors and supervisees, and data were analysed using interpretative phenomenological analysis. Results: Three superordinate themes were identified: "inconsistency of approaches," "autonomy" and "the relationship." The findings revealed that supervisors are practicing very differently from one another, despite awareness of expert guidance. There were some indications of supervisory drift, characterised by supervisor resistance to hierarchical structures and supervisee avoidance due to concerns about their safety within the relationship. Conclusion: Further research is needed to better understand how supervision dyads can identify and manage dysfunctional supervision practices. [ABSTRACT FROM AUTHOR]

An integrated approach to reduce intimate partner violence and improve mental health in humanitarian settings requires coordination across health and protection services. We developed and tested the Nguvu intervention, which combined evidence-based interventions for psychological distress and intimate partner violence among Congolese refugee women in Nyarugusu refugee camp (Tanzania). We conducted 29 semi-structured interviews with Nguvu participants and stakeholders to explore the relevance, acceptability, feasibility, and impact of this intervention. Participants reported that the intervention aligned with needs and filled a gap in programming, yet further adaptations may improve the fit of the intervention. The Nguvu intervention was acceptable to participants, including group discussion of sensitive topics. Confidentiality was highly regarded among staff and participants, which improved safety and acceptability. It was feasible to train non-specialist refugee workers to deliver the intervention with adequate supervision. Facilitators noted contextual challenges that made it difficult to implement the intervention: limited infrastructure, competing priorities, and population mobility. The intervention was perceived to improve awareness of the association between violence and mental health, reduce self-blame, and build skills to improve wellbeing. Recommended adaptations reveal promising, yet challenging future directions for addressing social determinants of mental health and implementing multi-sectoral programmes in complex humanitarian settings. [ABSTRACT FROM AUTHOR]

Cognitive behavioural therapy (CBT) is an effective treatment for depression. There are established education programmes which prepare specialist mental health workers to practice CBT. CBT is a complex treatment requiring intensive preparation and clinical skill to deliver. An alternative and simpler psychological treatment, behavioural activation (BA), may be as effective as CBT. An advantage of BA over CBT is that you do not need to be a specialist mental health worker nor require lots of training to deliver it. The relative simplicity of BA and the brief education required for workers to deliver it may increase access to psychological treatments for depression. In 2020, we developed an online educational programme in BA targeting non‐specialist healthcare workers. In this paper, we wanted to understand healthcare workers' perceptions and experiences of completing a professional certificate programme which prepares them to deliver BA for people living with depression. We report the feedback from seven non‐specialist mental health workers who completed the online education programme in BA. Twelve workers were invited to enrol on the programme, of which four declined. All but one of the eight participants lived and worked in rural South Australia. A thematic analysis of the interview data identified three themes: Course was simple to follow, Ease of integration into clinical practice and Ongoing support and supervision. The overall meta‐theme was 'Easy to train and easy to apply'. Participants reported that the online training prepared them to practice BA and they were able to apply the skills in their clinical practice. Future work needs to examine if online training for healthcare workers in BA translates to clinical outcomes for people living with depression. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Community Mental Health is the property of Canadian Periodical for Community Studies Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nordic Nursing Research / Nordisk Sygeplejeforskning is the property of H. Aschehoug & Co. (W. Nygaard) AS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Person-centered care remains a high priority within community mental health services. Clinical supervision is an embedded resource for professional development and promotion of high quality care. This study examined supervisory strategies during the implementation of person-centered care planning (PCCP) across two northeastern US States. A criterion sample of supervisor-provider teams participated in qualitative interviews (N = 34) and direct observation from 2016 to 2017. Modified grounded theory analyses were conducted and three supervisory strategies were identified. Supervisory attunement to providers (knowing their audience), active collaborative engagement with providers (practicing together), and infusing reminders and opportunities for feedback (chipping away) were critical strategies to engage providers in adopting PCCP. These strategies changed providers' practice patterns by improving supervisors' calibration to dynamic contextual and individual needs during implementation and communicating supervisors' expectations of PCCP enactment. Workplace-based clinical supervision holds promise as a key intervention point to embed high quality care. [ABSTRACT FROM AUTHOR]

We investigated the experiences of clinical supervisors working with therapists who presented issues related to their use-of-self in psychotherapy. Semi-structured interviews were conducted with twelve experienced clinical supervisors. Thematic analysis of these interviews revealed five main themes: (a) supervisee use-of-self issues encountered in supervision, (b) points of tension in supervision, (c) roadblocks to resolution, (d) points of pride in supervising use-of-self, and (e) approaches taken by supervisors in response to supervisee use-of-self issues. Recommendations for clinical supervision and further research are offered. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Psychosocial interventions (PSI) are recognized and recommended internationally as they primarily focus on improving a client's mental health and preventing relapse.Limited qualitative studies focus on the similarities and differences on offering PSI in practice across many countries. What this paper adds to existing knowledge?: This manuscript provides readers with qualitative findings of mental health nurses' (MHNs) experiences of using PSI in practice and the need for regular clinical supervision to increase MHNs confidence and enhance the offering of PSI.MHNs want PSI guidelines for the offering of these skills to their client groups across practice settings.MHNs require work release from practice to attend supplementary training on PSI so that they can do their job adequately. What are the implications for practice?: This study sheds light on the similarities and differences on PSI in Irish mental health services. It also highlights what MHNs recognize as important for PSI to be implemented. Clinical supervision and the development of PSI guidelines are necessary so that MHNs feel confident delivering these skills. They also need ongoing work release from practice to attend supplementary PSI training to provide best evidence to enhancing client experiences and positive PSI recovery outcomes. Description: The paper will report on the interview data of trained MHNs' experiences of using PSI within the Irish context. This observational data will be reported elsewhere (Smyth et al. 2020—under review). Introduction: This research is conducted when the current reform of Irish mental health governance demands clarification of key psychosocial skills (PSI) required for mental health nurses (MHNs) to embrace recovery‐orientated ways of working. There is limited evidence about this important topic in Ireland and across countries. Aim: To explore PSI‐trained MHNs' experiences of using PSI within Ireland. Method: A multiple case study methodology was used and situated within an interpretive paradigm. Data were gathered using semi‐structured interviews with 40 PSI‐trained MHNs. Findings: Three overarching themes developed from the analysis. These included (a) PSI‐trained MHNs' understanding and use of PSI; (b) facilitating factors supporting the use of PSI by PSI‐trained MHNs; and (c) obstacles limiting the use of PSI by PSI‐trained MHNs. Discussion: MHNs recognize that regular clinical supervision is required to increase their confidence, along with PSI guidelines for the offering of these skills across practice settings. MHNs also need work release to attend supplementary training on PSI so that they can do their job adequately. Implications for practice: This study suggests that MHNs are often stuck between a rock and a hard place when delivering PSI in practice. MHNs need to be aware that this can affect client outcomes. Relevance statement: This research identified a gap in knowledge within the Irish context but also across the world on this important topic. MHNs need access to regular clinical supervision, PSI guidelines and ongoing PSI training to feel confident in order to keep abreast of the changes happening in mental health practice and research. [ABSTRACT FROM AUTHOR]

Mental health nursing in the forensic services is perceived as stressful as there is often a tension between therapeutic and custodial processes. Clinical supervision has been discussed as a support strategy for nurses. The aim of this paper is to explore forensic mental health nurses understanding of clinical supervision and their perception of its utility within their practice. A qualitative descriptive method was used and 10 mental health nurses were interviewed with the aid of an interview guide. Qualitative data was analysed using a thematic approach culminating in the emergence of three themes. Participants talked about the tension between caring and custodial roles within the forensic services which was stressful and created difficulties in the maintenance of a therapeutic relationship. Clinical supervision was seen as a necessary support to assist nurses working in the forensic services. The findings support the premise that there is a tension between therapeutic and custodial practices. Acknowledgement of the complexities of working within the forensic services and the provision of clinical supervision within a confidential, non-judgemental relationship may assist nurses in the provision of care and the maintenance of therapeutic relationships. [ABSTRACT FROM AUTHOR]

To date, there is sparse literature addressing analytical music therapists' experiences in analytical music therapy (AMT) training. This study incorporated transcendental phenomenological research methodology to explore the lived experiences of six analytical music therapists who underwent inter music therapy (IMT) with Benedikte Scheiby. The main research questions driving this study were as follows: (a) What is the IMT experience like for an AMT trainee? (b) How does IMT shape the clinical practice of music therapists who have experienced it? Data were collected through interviews. Data analysis was systematic and carried out in two multi-step phases. This study revealed that IMT is intense, challenging, and transformative, and shaped music therapists' clinical skills in several ways. The following themes emerged: (a) Celebrating skill development through experiencing challenging situations, (b) the experiential process as a path towards therapist self-awareness, (c) the value of music in the therapeutic process, (d) the non-hierarchical learning environment, (e) trust, and (f) the importance of recordings and log writing to integrate learning. The impacts upon music therapists' clinical skills were vast and rich, suggesting that learning through self-experience is deeply meaningful. This, coupled with the significance of the trainer's physical presence throughout the process, led to the following recommendations to music therapy training programs: programs should incorporate authentic self-experiences with music; the field should create competencies for music therapy supervisors, and provide training to supervisors; and professors/supervisors should increase opportunities for students/supervisees to have live observation of their clinical work to enhance their supervision experience. [ABSTRACT FROM AUTHOR]

This paper is a qualitative analysis of perspectives on leadership development among working peer support specialists and highlights the challenges, needs and efficacy these individuals experience in their work settings. Six participants engaged in a 2 h semi-structured focus group. Participants were guided through a series of nine questions regarding their transition to leadership, professional communication and relationships. Seven themes emerged: managing dual relationships; having difficult conversations; push and pull of leadership; taking responsibility for others; taking responsibility for self-care; addressing stigma in the workplace, and, spirituality/a calling to help. These professionals integrate their personal experiences of recovery into their direct care and leadership approaches in the workplace. This blending of recovery concepts and supervision approaches reflect some of the powerful elements that peer recovery specialists are uniquely qualified to lead in the healthcare workforce. These findings provide important implications for leadership development among this growing segment of the healthcare workforce. [ABSTRACT FROM AUTHOR]

In 2015, 81% of counties in Texas were designated as full or partial Mental Health Professional Shortage Areas. To address this problem, we worked with a community-based association of mental health practitioners, using the social theory of career selection, to explore factors that influence students to join the mental health field. Our goal was to better understand how to recruit and retain mental health-trained students. We interviewed bachelor and master-level mental health interns in social work, counseling, and psychiatric nursing and field instructors using semistructured, open-ended interviews. Five themes emerged from the interviews: 1) attraction to mental health; 2) professional experience; 3) impact capacity; 4) develop social work skills; and 5) intern preparedness. [ABSTRACT FROM AUTHOR]

Providing nursing students with appropriate clinical practice during their undergraduate programme is critical to ensuring that graduates meet the competency requirements to gain registration as a nurse. In response to the predicted nursing workforce shortage, universities have been significantly increasing the enrolment of undergraduate nurses into Bachelor of Nursing courses. This has placed a demand on the availability of clinical placements and often universities struggle to find appropriate places. In this study, a Bachelor of Nursing course incorporated an Integrated Clinical Learning Model (ICLM) for the first time during a mental health placement. The model offered students the flexibility of attending their clinical placement over a 16‐week period instead of a traditional block of 4 weeks. The aim of this study was to evaluate the student perspective of this model and whether it prepared them for the nursing workforce. Focus groups were conducted with undergraduate nursing students following their mental health clinical placement at an acute and extended care inpatient unit. Data were analysed using thematic analysis. Main themes included preparedness for practice, maintaining a work–life balance, and perceiving they were part of a team. The ICLM deepened students' knowledge and had a positive impact on their overall clinical learning. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Community Mental Health is the property of Canadian Periodical for Community Studies Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Peers are an important adjunct to the public mental health service system, and are being increasingly utilized across the country as a cost-effective solution to workforce shortages. Despite the tremendous growth of peer-delivered support over the past two decades, it has only been within the past few years that peer programs have been the subject of empirical inquiry. The purpose of this study was to examine the prevalence and characteristics of peer-delivered parenting programs across the New York State public mental health service system. We surveyed 46 family peer organizations across New York State regarding their delivery of structured peer-delivered parenting programs. Thirty-four (76%) completed the questionnaire, and of them, 18 (53%) delivered a parenting program. Subsequent interviews with seven of the 18 organizations revealed peer organizations had been delivering eight unique parenting programs for upwards of two decades. Additionally, organizations offered multiple supports to families to participate. Training, supervision, and issues around fidelity are discussed, as well as the implications of this study for states utilizing a peer workforce. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Community Mental Health is the property of Canadian Periodical for Community Studies Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose The purpose of this paper is to examine service-users’ experiences of mentoring trainee clinical psychologists as part of an involvement initiative on a doctoral training course.Design/methodology/approach Seven service-users were paired with trainee clinical psychologists. Pairs met for one hour monthly over six months. Meetings were unstructured, lacked a formal agenda and were not evaluated academically. All seven mentors were interviewed. They were asked about positive and negative experiences, as well as about the support provided. Transcripts were subject to thematic analysis and themes were reviewed by mentors in a follow-up meeting.Findings Overall, the results demonstrate that service-users can be involved in training in a way that they find meaningful and contribute to their recovery. Seven themes were identified: giving hope and optimism; making a difference; personal and professional development; the process; practicalities/logistics; support (positives); and support (areas for improvement).Practical implications The importance of designing involvement initiatives in a way which implicitly supports service-user values was highlighted. Recommendations for designing effective support structures are given. The authors were also involved in the scheme which could have introduced bias.Originality/value The research exploring service-users’ experiences of involvement in training health professionals is limited. This was the first study to explore in depth service-users’ perspectives of involvement in a scheme such as the mentoring scheme. If initiatives are to seriously embrace the values of the service-user movement then seeking service-users’ perspectives is vital. [ABSTRACT FROM AUTHOR]

Abstract: Background: Conventional wisdom links supervisor self‐confidence with experience in supervisory practice. Aims: This study explored the nature of confidence from an emic perspective. Method: Twelve experienced Canadian supervisors were interviewed, and data was analysed using Structured Thematic Analysis. Results: Aspects of the role and process produce tensions that create ambiguity that may diminish self‐confidence. Five main themes were distilled: (a) building supervisee confidence when experiencing self‐doubt as supervisor or clinician;(b) parallel process‐what disturbs therapy disturbs supervision; (c) expert vs. co‐explorer; (d) engaging in supervision while maintaining boundaries; and (e) catch 22 – inviting disclosures of difficulties and evaluation. Conclusion: The study adds nuance to the scholarly work that informs supervisor self‐confidence. [ABSTRACT FROM AUTHOR]

Background: Patient‐reported outcome measures (PROMs) are recommended by healthcare systems internationally, but there are a number of barriers to implementation. The aim of this research was to examine the impact of training supervisors in using PROMs on clinical practice, given the importance of leadership when changing behaviour. Method: Data included pre–post questionnaires from 42 supervisors, interviews after training with six supervisees and nonparticipant observations of nine video‐recorded supervision sessions. Results: After training, supervisors had more positive attitudes to administering PROMs and using feedback from PROMs and had higher levels of self‐efficacy about using PROMs in supervision. Conclusions: Findings are in line with the growing body of evidence that training child mental health staff to use PROMs may be associated with changes in attitudes, self‐efficacy and use of PROMs. [ABSTRACT FROM AUTHOR]

The concept of an 'internal supervisor' has been used in psychotherapy to describe the way in which the supervisory relationship is internalized and utilized by the supervisee. This research explores the possibility, and potential benefit, of training therapists to develop a 'compassionate internal supervisor'. A training programme was developed for trainee cognitive-behavioural therapists using adapted versions of compassion-focused therapy interventions. The training focused on guided imagery exercises and reflective practices undertaken for a 4-week period. Seven trainee cognitive-behavioural therapists were interviewed, utilizing a semi-structured format, regarding their experience of the training programme. The resulting transcriptions were analysed using Interpretative Phenomenological Analysis (IPA). The analysis identified six super-ordinate themes: (1) the varied nature of the supervisor image, (2) blocks and their overcoming, (3) increased compassion and regulation of emotion, (4) impact on cognitive processes, (5) internalization and integration, and (6) professional and personal benefit. The themes describe the varied ways in which participants created and experienced their compassionate supervisor imagery. Working with the personal blocks encountered in the process provided participants with a deeper understanding of the nature of compassion and its potential to support them in their training, practice and personal lives. The process and impact of 'internalizing' a compassionate supervisory relationship is described by participants and then discussed for potential implications for psychotherapy training and self-practice. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message Compassion-focused therapy, and related compassionate-mind imagery exercises, can be adapted specifically to develop compassion in trainee psychotherapists., Creating, and engaging with, an 'ideal compassionate supervisor' in an imaginal form can support psychotherapy trainees in their clinical practice and development, their supervision and their personal lives., The cultivation of therapist self-compassion can reduce unhelpful cognitive processes such as worry, rumination and self-criticism whilst increasing self-reflection, attentional flexibility and approach behaviour., Identifying, and working with, blocks to compassion is important when cultivating clinician self-compassion, Therapist self-practice of compassion-focused exercises can provide important insights into the nature of compassion and its cultivation in clients [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Recently, concerns have been raised about how well United Kingdom National Health Service nurses care for their patients and their level of compassion., Motivational interviewing ( MI) is an established approach to helping people make positive behaviour changes, through directive, person-centred counselling within a collaborative relationship between clinician and recipient., Based on evidence that MI may influence nursing practice positively, an investigation into the feasibility of training nurses on mental health inpatient rehabilitation wards ('rehabilitation') in MI to improve patient experience was reported., What this paper adds to existing knowledge? This pilot study demonstrates that training rehabilitation nurses in MI is feasible and provides preliminary evidence suggesting that a larger study to examine efficacy is warranted, including a calculation of sample size required to draw robust statistical conclusions., Nurses evaluated the training as highly relevant to their work., Patients responded well to interviews and focus groups with support from experts-by-experience; they were generally fairly satisfied with the rehabilitation ward and slight improvements in their experience were found following MI training for nurses but not at 6-month follow-up., What are the implications for practice? Rehabilitation nurses may face conflicting demands between ensuring patients with severe difficulties meet their basic needs and working with them to develop greater independence., Qualitative findings question whether nurse-patient interactions are fully valued as nursing interventions in inpatient rehabilitation., Learning MI might be a useful way of helping nurses think in detail about their interactions with patients and how to improve communications with their patients., The principles of MI should be incorporated into pre-registration training., Abstract Introduction There is limited research addressing the experiences of patients in inpatient rehabilitation (rehabilitation), who often spend long periods in hospital, and the nursing approaches utilized. Aim Based on evidence that motivational interviewing ( MI) may improve nursing practice, this was a pilot study evaluating the feasibility of training rehabilitation nurses in MI and measuring patient experience. Method Nurses underwent training and supervision focusing on MI spirit. Quantitative and qualitative measures were taken pretraining, 2 months post-training and 8 months post-training. Expert-by-experience research assistants facilitated patients' participation in the study. Results This study showed that training rehabilitation nurses in MI was feasible and relevant to their work. Patients participated in interviews and focus groups with support and potential improvements that require further empirical investigation in patient experience were found following the MI training. Discussion This pilot study establishes the feasibility of a larger study addressing efficacy. Tentative qualitative findings question whether interactions between nurses and patients are valued in rehabilitation and support MI as a promising skill set for rehabilitation nurses. Implications for practice Bringing MI into inpatient rehabilitation provoked reflection on nursing practice. Dilemmas for nurses about balancing safety with promoting autonomy and communicating constructively with patients emerged as important. [ABSTRACT FROM AUTHOR]

This article discusses minority-majority practice relations on the basis of a case study analysis of the dynamics and strategies reported by 32 Palestinian social workers living in Israel regarding their practice with Jewish clients. The described encounters reflect the charged political reality and are loaded with many tensions, fears, anger, and hatred. The results indi- cate five major categories, reflecting perceived mutual reactions: avoidance, power reversal, confrontation and anger, minimizing differences, and exploiting differences. The article discusses the need for a context-informed practice theory as well as training and supervision to change the emotional encounters from a potential battleground to a growth-enhancing experience within minority-majority practice relations. [ABSTRACT FROM AUTHOR]

The goal of the present study was to understand how current feminist multicultural supervisors understand and implement their feminist multicultural principles into clinical supervision. We addressed this aim by answering the following research question: How do self-identified feminist multicultural psychotherapy supervisors conceptualize and practice feminist supervision that is explicitly multicultural? The perspectives of 14 participant supervisors were obtained by using semistructured initial interviews, follow-up interviews, and feedback interviews and were investigated via a feminist constructivist grounded theory design and analysis. Most participants identified as counseling psychologists (n = 12), women (n = 11) and temporarily able-bodied (n = 11); but they identified with diverse racial/ethnic, sexual, spiritual/religious, generational, and nationality statuses. A 7-category empirical framework emerged that explained how the participants anticipated and managed power in supervision. The core category, the complexities of power in supervision, explained how participants conceptualized power in supervisory relationships. The 6 remaining categories were bringing history into the supervision room, creating trust through openness and honesty, using a collaborative process, meeting shifting developmental (a)symmetries, cultivating critical reflexivity, and looking at and counterbalancing the impact of context Limitations of the study, implications for research, and suggestions to use the theoretical framework to transform supervisory practice and training are discussed. [ABSTRACT FROM AUTHOR]

Background: Although training to be a counsellor is likely to be emotionally demanding the extent to which these demands become problematic emotional experiences and how they influence trainee development has not been investigated. Aim: To identify changes experienced by one trainee counsellor who was enrolled on a full ‐ time BACP accredited counsellor training course at a British university. Method: The assimilation model was used to track Mandy's journey from student to therapist over the course of five, semi ‐ structured interviews. Results: Mandy developed problematic emotional experiences during training, and their assimilation was associated with personal and professional growth. They provide some evidence that personal development group work may be more emotionally challenging for trainees than work with clients and reveal the positive impact of compassionate and honest supervision. Conclusions: The findings suggest that BACP courses are capable of producing reflective practitioners but raise questions about the length of time needed for students to become therapists and the role of personal therapy. This study also demonstrates how the assimilation model can be adapted to investigate change in trainee therapists and paves the way for further research in this area. [ABSTRACT FROM AUTHOR]

Background: Improving access to psychological therapies (IAPT) is a major programme in England to treat common mental health problems, mainly through cognitive behaviour therapy. In 2012, a Pathfinder scheme was launched to develop interventions for people with chronic physical health conditions or medically-unexplained symptoms. Aim: This qualitative component of the evaluation investigated feasibility and acceptability of IAPT provision for people with enduring physical health problems. Method: Qualitative interviews were conducted with project leaders in all 14 Pathfinder sites. Findings: Various therapeutic and training interventions were introduced. Most patients received low-intensity, structured therapy, with high-intensity input provided by some Pathfinders for complex cases. Whether the focus was on psychological symptoms or on broader well-being, psychiatric terminology was avoided to improve utilisation. Participants perceived high satisfaction among service-users. Training needs were indicated for IAPT workers in this specialised work. Conclusions: Cognitive behaviour interventions appeared to be acceptable for people struggling with physical health problems. Robust outcome evidence will be pursued in Phase II. [ABSTRACT FROM AUTHOR]

Sandtray supervision and solution-focused supervision (SFS) are both strengths-based approaches that may be effective in helping counselor trainees reduce their anxiety and develop clinical self-confidence. The purpose of this collective case study was to explore how a group of practicum students with a school counseling emphasis experienced a blending of sandtray and solution-focused supervision (SFS) approaches. Participants described how the blended approach fostered group cohesiveness in their supervision and promoted both personal and professional development. Participants indicated more awareness of the impact of sandtray than the influence of the solution-focused approach in their supervision. [ABSTRACT FROM PUBLISHER]

Three-quarters of the global mental health burden exists in low- and middle-income countries (LMICs), yet the lack of mental health services in resource-poor settings is striking. Task-sharing (also, task-shifting), where mental health care is provided by non-specialists, has been proposed to improve access to mental health care in LMICs. This multi-site qualitative study investigates the acceptability and feasibility of task-sharing mental health care in LMICs by examining perceptions of primary care service providers (physicians, nurses, and community health workers), community members, and service users in one district in each of the five countries participating in the PRogramme for Improving Mental health carE (PRIME): Ethiopia, India, Nepal, South Africa, and Uganda. Thirty-six focus group discussions and 164 in-depth interviews were conducted at the pre-implementation stage between February and October 2012 with the objective of developing district level plans to integrate mental health care into primary care. Perceptions of the acceptability and feasibility of task-sharing were evaluated first at the district level in each country through open-coding and then at the cross-country level through a secondary analysis of emergent themes. We found that task-sharing mental health services is perceived to be acceptable and feasible in these LMICs as long as key conditions are met: 1) increased numbers of human resources and better access to medications; 2) ongoing structured supportive supervision at the community and primary care-levels; and 3) adequate training and compensation for health workers involved in task-sharing. Taking into account the socio-cultural context is fundamental for identifying local personnel who can assist in detection of mental illness and facilitate treatment and care as well as training, supervision, and service delivery. By recognizing the systemic challenges and sociocultural nuances that may influence task-sharing mental health care, locally-situated interventions could be more easily planned to provide appropriate and acceptable mental health care in LMICs. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to identify the effects of a clinical supervision group on the practice of biofeedback therapists. Method Qualitative methods, including in-depth interviews, semi-structured interviews and non-participant observation were used to gather data to explore the experience and perceived impact of clinical supervision. Results Group supervision provided a safe environment for practitioners to share experiences and test ideas about their practice. It increased their ability to set boundaries with clients and realise the limits of their practice. Conclusion Clinical supervision in a group was found to enhance effectiveness, and professional and personal development. [ABSTRACT FROM AUTHOR]

Published studies have addressed boundary violations by clinical supervisors, but boundary crossings, particularly those deemed positive by supervisees, have not received much attention. Eleven trainees in APA-accredited doctoral programs in clinical and counseling psychology were interviewed regarding positive boundary crossings (PBCs) they experienced with clinical supervisors. Interview data were analyzed using Consensual Qualitative Research. Examples of PBCs included socializing with supervisors outside the office, sharing car rides, and supervisor self-disclosure. Typically, supervisees did not discuss the PBC with their supervisors because they were uncomfortable doing so, felt that the PBC was normal, or felt that processing such issues was not part of the supervisor’s style. Most supervisees viewed the PBCs as enhancing the supervisory relationship and their clinical training; however, some participants reported that the PBCs created role confusion. The results suggest that there are legitimate reasons for supervisors to be scrupulous about their boundaries with supervisees; however, supervisors who hold rigid boundaries can deprive supervisees of deeper mentoring relationships or a more authentic emotional relationship that can be valuable to supervisees learning how to provide psychotherapy. [ABSTRACT FROM PUBLISHER]

The aim of this qualitative study was to retrospectively examine nondisclosure in individual supervision while in training. Interviews were conducted with supervisees two years post-qualification. Specific nondisclosures were examined and reasons for these nondisclosures were explored. Six in-depth semi-structured interviews were conducted and data analysis drew on Consensual Qualitative Research. The findings revealed four categories relating to: (i) the nature of the difficulty; (ii) reasons for nondisclosure; (iii) the supervisory relationship; and (iv) facilitative factors. The quality of the supervisory relationship was a significant element in nondisclosure. A key recommendation was that role induction for supervisees should be incorporated into training programmes to assist supervisees in learning how to use supervision more effectively. Limitations of the study and further research are provided in light of current findings. [ABSTRACT FROM PUBLISHER]

Clinical supervision is a multi-functional intervention within numerous psychotherapeutic professions, including clinical psychology. It often relies on supervisees' verbal disclosures of pertinent information. There is limited research on supervisee self-disclosure in the UK, and none using clinical psychology populations. This study aimed to address the limitations in the evidence base. It used a constructivist grounded theory methodology to investigate qualified UK clinical psychologists' use of self-disclosure in supervision in order to develop a theoretical understanding of their self-disclosure processes. Ten clinical psychologists from various time points across the career span were recruited to the study. Four core conceptual categories were identified in the analysis as being integral to participants' decision-making processes: 'Setting the Scene', 'Supervisory Relationship', 'Using Self-disclosure' and 'Reviewing Outcome of Self-disclosure'. These four categories are comprised of a number of subcategories. The study's findings are compared with the current literature base, and it is argued that there are tensions with the scientist-practitioner model as it could be interpreted to encourage an expert stance, which may limit the self-disclosure of qualified supervisees. The implications of this perspective are discussed. Copyright © 2012 John Wiley & Sons, Ltd. Key Practitioner Message: Supervision is a key process in supporting qualified clinical psychologists and the use of disclosure appears to be important in facilitating useful supervision., It appears that clinical psychologists go through a number of complex processes in deciding whether to self disclose. [ABSTRACT FROM AUTHOR]

Experiential learning opportunities are powerful in shaping positive supervisor behaviours. We were interested in examining the positive experiences of supervisors-in-training during their first practice experience as supervisors. Our study was guided by two research questions: (a) what are the experiences that supervisors-in-training viewed as positive during the course of providing clinical supervision to master's-level counselling trainees? and (b) how did these positive experiences contribute to their professional development? We employed a variation of the consensual qualitative research method developed by Hill, Thompson, and Nutt-Williams (1997) and interviewed 10 supervisors-in-training regarding their positive experiences in supervising master's-level counselling trainees. The results included five major categories of positive experiences: (a) the positive value of feedback; (b) enhanced confidence in using a wider variety of supervision tasks and procedures; (c) the impact of the experience on other aspects of professional practice; (d) increased familiarity with the multiple roles of the supervisor; and (e) for some, increased comfort navigating co-supervision dynamics. Each of these categories included subcategories. We discuss our findings within the context of supervision training in graduate education. [ABSTRACT FROM PUBLISHER]

While the counseling community embraces the use of creative approaches in counseling and supervision, few researchers have attempted to empirically describe the process of including an art-based technique into counselor group supervision. A grounded theory design guided the exploration of including a case conceptualization drawing technique into six counselor supervision groups. Six doctoral-level supervisors, who were trained in an art-based technique, introduced the method to their group supervisees who were completing a practicum or internship. Data collection methods included individual and focus-group interviews, observations of visual case presentations, document reviews of visual case drawings, and journal-prompted inquiries. Results indicated that supervisor training in an art-based technique is a condition for yielding positive outcomes for counselor trainee development, client treatment, and the supervision group process. [ABSTRACT FROM PUBLISHER]

Background/aim Mental health practice can create challenging environments for occupational therapists. This study explores the dynamic processes involved in the development and maintenance of professional resilience of experienced mental health occupational therapy practitioners. It presents the PRIOrity model that summarises the dynamic relationship between professional resilience, professional identity and occupation-based practice. Methods A narrative inquiry methodology with two phases of interviews was used to collect the data from nine experienced mental health practitioners. Narrative thematic analysis was used to interpret the data. Results Professional resilience was linked to: (i) professional identity which tended to be negatively influenced in contexts dominated by biomedical models and psychological theories; (ii) expectations on occupational therapists to work outside their professional domains and use generic knowledge; and (iii) lack of validation of occupation-focussed practice. Professional resilience was sustained by strategies that maintained participants' professional identity. These strategies included seeking 'good' supervision, establishing support networks and finding a job that allowed a match between valued knowledge and opportunities to use it in practice. Conclusion For occupational therapists professional resilience is sustained and enhanced by a strong professional identity and valuing an occupational perspective of health. Strategies that encourage reflection on the theoretical knowledge underpinning practice can sustain resilience. These include supervision, in-service meetings and informal socialisation. Further research is required into the role discipline-specific theories play in sustaining professional values and identity. The development of strategies to enhance occupational therapists' professional resilience may assist in the retention of occupational therapists in the mental health workforce. [ABSTRACT FROM AUTHOR]

Using a qualitative research design, this study investigated how three supervision groups, each led by a counseling supervisor with a feminist theoretical orientation, understood process variables of feminist group supervision. Participants each completed one semi-structured individual interview and engaged in one of three respective focus groups to talk about their experiences in group supervision. Data from these interviews were analyzed using constructivist grounded theory; standards of trustworthiness were accounted for using multiple tools. A supervision model emerged from the data, representing various clusters of process variables that affected how the participants understood the process and outcome of their supervision experiences. Implications of the model on theory, research, practice, and advocacy are discussed. [ABSTRACT FROM AUTHOR]

This study investigated what helped and what hindered in cross-cultural supervision. The participants were 25 visible minority graduate students and early counseling professionals. They were individually interviewed according to an expanded version of Flanagan’s critical incident technique. The most frequently cited positive themes were subsumed in five key areas: (a) personal attributes of the supervisor, (b) supervision competencies, (c) mentoring, (d) relationship, and (e) multicultural supervision competencies. The most frequently reported negative themes were grouped into five areas: (a) personal difficulties as a visible minority, (b) negative personal attributes of the supervisor, (c) lack of a safe and trusting relationship, (d) lack of multicultural supervision competencies, and (e) lack of supervision competencies. The results support a person-centered mentoring model of effective supervision. [ABSTRACT FROM AUTHOR]

This study examined the experiences of counsellors in training working with clients who present with non-suicidal self-injury (NSSI) as a basis for understanding how trainees react to and resolve the challenges presented by difficult counselling cases. A qualitative data analysis using consensual qualitative research [Hill, C.E., Knox, S., Thompson, B.J., Nutt Williams, E., Hess, S.A., & Ladany, N. (2005). Consensual qualitative research: An update. Journal of Counseling Psychology, 52, 196–205; Hill, C.E., Thompson, B.J., & Nutt Williams, E. (1997). A guide to conducting consensual qualitative research. The Counseling Psychologist, 25, 517–572] was conducted on 12 transcribed interviews of Master's level trainees who had recently worked with at least one client who self-injured. Three general themes were reflected by the data. Specific to NSSI the findings revealed that trainees created an intuitive model of NSSI that reflected some understanding of the phenomenon despite little or no prior exposure to it. With regard to the work involved in these challenging cases, trainees reported a number of personal struggles and tasks that they needed to resolve while trying to be helpful to these clients. These tasks included managing their emotional reactivity and resolving ethical and confidentiality issues. Engaging in these two tasks heightened their feelings of uncertainty yet also focused them to be highly intentional in their work. Whereas supervision often serves novices well when they struggle, participants reported that supervision only partly alleviated the difficulties they faced. Implications and limitations of these findings are discussed. [ABSTRACT FROM PUBLISHER]

PURPOSE: The purpose of this article is to discuss the challenges and rewards of developing and nurturing an international clinical psychiatric mental health advanced nursing practice exchange between the Netherlands and the United States. Since 1997, Rotterdam University of Applied Sciences in the Netherlands has been participating in international clinical experiences for their psychiatric mental health (PMH) advanced practice nursing students. The international experience is mandatory prior to graduation and is the first of its kind in Europe to mandate such a unique experience. DESIGN: This study sample included eight Dutch PMH advanced practice nursing students enrolled in a full-time master's in advanced nursing practice program. METHODS: The descriptive study included reflective reports and one-on-one discussions over a 3-year period. FINDINGS: With proper planning, an international nursing experience provides a unique opportunity for nurses to think beyond their own culture and healthcare system. Solving problems together through different perspectives creates opportunities for creative solutions. PRACTICE IMPLICATIONS: International partnerships within PMH advanced practice nursing promotes sharing of knowledge and solutions as patients and diseases have no border. [ABSTRACT FROM AUTHOR]

Purpose - This paper seeks to explore staff experiences of working in Crisis Resolution and Home Treatment (CRHT). There is a paucity of research in the area and a particular lack of in-depth qualitative accounts of staff experiences with most research focused on output and outcomes of CRHTs, including inpatient admission and bed-occupancy rates.Design/methodology/approach - Interpretative phenomenological analysis (IPA) was used to investigate participants' experiences of working in this service context. Five CRHT workers were interviewed about their experiences, including the aspects of their work that they found enjoyable and those that they found stressful, and how they coped with challenges related to the work.Findings - Three master themes, each with corresponding subordinate themes, emerged from the analysis. These were: "motivating factors", "stressors" and "coping". These findings indicated these subjective experiences emphasised the opportunities to make a difference and help service users and build therapeutic relationships. Perceived stressors were understood in the context of a complex service context, operational issues, responsibility for service users, and supervision and training needs.Research limitations/implications - The implications of the research for CRHT staff are discussed as well as the limitations of this study.Originality/value - This study offers a timely development in understanding the experiences of staff working in CRHTs. [ABSTRACT FROM AUTHOR]