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Overemphasis on appearance and strong appearance stereotypes to date are expected to contribute to the challenges and distress of people who live with skin conditions and those with appearance distress. Skin conditions are highly prevalent and are often associated with high levels of distress and disruption in the life and well-being of patients. On the other hand, demand for cosmetic procedures and elective plastic surgery has been increasing. Psychological interventions in the field of skin and appearance rarely feature person-centred approaches. We intend to fill this gap by: Juxtaposing symptom-based and person-centred conceptualisations; Presenting person-centred ways of working therapeutically of skin and appearance related concerns and Discussing potential challenges in application of the approach in this field.

Survivors of adversity and trauma experience high levels of distress, interpersonal challenges and poor physical health. We investigated the role of trust in trauma-related psychological and physiological responses. Serum concentrations of C-reactive protein, cortisol, tumour necrosis factor-alpha and interleukin-8 from 25 participants in Scotland were measured. Trauma history and experience were assessed using the Childhood Trauma Questionnaire and Life Events Checklist. Trauma symptomatology was measured by the Impact of Event Scale. Interpersonal trust was measured using the Trust Scale. Trauma history and inflammatory biomarker concentrations were significant predictors of trauma symptomatology with trust as a covariate. Psychological and physiological responses after trauma seem strongly linked. Trust can mediate distress and physiology in adversity.

We investigated the lived experience of therapeutic trust and its ruptures in working with clients with complex trauma presentations, a vulnerable and under-researched client group. A total of 13 clinicians and key informants, working in the field of complex trauma, were interviewed. Transcripts were analysed using Interpretative Phenomenological Analysis (IPA) to identify recurrent themes. The Nature, Function, Components, Process, and Challenges of building and maintaining therapeutic trust were identified. Therapeutic trust was experienced as a mechanism for reducing threat, processing vulnerability, and enabling accurately symbolisation. Focusing on trust and its ruptures seems key in working with clients presenting with complex traumas and potentially other severe and/or complex presentations. The importance of trust-focused person-centred approaches for addressing key psychological challenges, increasing engagement, and addressing experiences of disengagement in complex trauma is stressed. The central role of trust in the therapeutic relationship as a catalyst of change brings person- centred models to the fore of psychotherapy for complex trauma, as well as severe and/or complex presentations. In a traumatogenic world, therapists will be increasingly called to work with more clients presenting with traumas. A person-centred understanding seems to hold a lot of promise. Strategies for actively facilitating trust – focused, practice are proposed. [ABSTRACT FROM AUTHOR]

Survivors of adversity and trauma experience high levels of distress, interpersonal challenges and poor physical health. We investigated the role of trust in trauma-related psychological and physiological responses. Serum concentrations of C-reactive protein, cortisol, tumour necrosis factor-alpha and interleukin-8 from 25 participants in Scotland were measured. Trauma history and experience were assessed using the Childhood Trauma Questionnaire and Life Events Checklist. Trauma symptomatology was measured by the Impact of Event Scale. Interpersonal trust was measured using the Trust Scale. Trauma history and inflammatory biomarker concentrations were significant predictors of trauma symptomatology with trust as a covariate. Psychological and physiological responses after trauma seem strongly linked. Trust can mediate distress and physiology in adversity. [ABSTRACT FROM AUTHOR]

Overemphasis on appearance and strong appearance stereotypes to date are expected to contribute to the challenges and distress of people who live with skin conditions and those with appearance distress. Skin conditions are highly prevalent and are often associated with high levels of distress and disruption in the life and well-being of patients. On the other hand, demand for cosmetic procedures and elective plastic surgery has been increasing. Psychological interventions in the field of skin and appearance rarely feature person centred approaches. We intend to fill this gap by: Juxtaposing symptom-based and person centred conceptualisations; Presenting person centred ways of working therapeutically of skin and appearance related concerns and Discussing potential challenges in application of the approach in this field. [ABSTRACT FROM AUTHOR]

The aim of this article is to explore the positive and negative impacts of working therapeutically in complex psychological trauma (CPT), particularly the field of gender-based violence (GBV) and childhood sexual abuse (CSA), from the clinicians' perspective. The focus was on the prospect of positive gains and growth for therapists. Twenty-one clinicians (n = 21; counselors/psychotherapists and psychologists) from National Health Service (NHS) specialist trauma services, a community mental health team, and specialist sexual assault counseling organization participated. Interpretative phenomenological analysis (IPA) was utilized to conduct single one-off interviews and analysis. Six themes were identified: Called to the work; Connection, Separation, and Oneness; Into and out of the darkness; Chaos into meaning; Reparation not repetition; and Expansion and growth. The first "Therapist Led Framework of Growth in Trauma Work" is presented. Vicarious posttraumatic growth (VPTG) was a key finding, with CPT therapists experiencing a "challenge/benefit/change" growth process. Adoption of actively relational strategies to enhance clinicians' growth process through trauma work is being proposed. The benefits of conceptualizing both the positive and negative impacts of such work for supervision, training, shaping the formal curricula, service management, and continuing professional development (CPD) are being discussed. The need for good practice guidelines on self-care internationally is highlighted. [ABSTRACT FROM AUTHOR]

Our understanding of therapeutic change processes in group therapy for complex interpersonal trauma has been limited. The present study aimed at addressing this gap by developing a framework of therapeutic change in this field from a survivor and therapist perspective. This is a qualitative study, which utilized semistructured individual interviews. Transcripts were analyzed using interpretative phenomenological analysis (IPA) to identify recurrent themes. A final sample of n = 16 patients and n = 5 facilitators completed the interview. Main change processes identified by survivors were as follows: self versus others, trust versus threat, confrontation versus avoidance, and "patching up" versus true healing. Therapeutic processes identified by therapist facilitators included managing group dynamics, unpredictability and uncertainty, and process versus content. The proposed framework explains therapeutic change in group therapy in relational terms, that is, therapeutic dissonance, the dynamic interaction of self and experience as well as building empathic trusting relations. The importance of managing dissonance to aid personally meaningful recovery was highlighted. These findings have implications for the usefulness of relational and person-centered approaches to clinical practice in the area of interpersonal and complex trauma, especially in the early identification, prevention, and management of dropouts. [ABSTRACT FROM AUTHOR]

As the COVID-19 pandemic continues to challenge our human, financial and psychosocial resources on a national and global level, dermatology is faced with unique challenges. The impact of the pandemic on the physical and mental health of the population is undeniable. This impact will be felt more intensely by the most vulnerable, such as those with co-morbidities and those living in poverty. Patients with skin conditions presented with high levels of psychosocial challenges even before the pandemic. Such challenges are expected to intensify. Psychological input in dermatology is already limited and dermatology professionals will be called to respond to increasing psychosocial needs of their patients, as much as - if not more than - to their increasing medical needs. To do this efficiently and safely they will have to look after themselves and their colleagues. In this paper we will summarise the biopsychosocial challenges encountered in dermatology by professionals, patients, and the general population in the pandemic. We will suggest strategies for maximising capacity and facilitating person-centred care in these challenging times and the aftermath. This paper will also discuss a way forward through the pandemic. Suggestions are made for supporting each other, as well as providing the best possible care for our patients in these challenging times. Potential physical challenges, including flare ups and skin integrity; as well as psychosocial challenges, including mental health impact and changes in health behaviour are highlighted. Consultative support, mental health input for professionals and patients, as well as training needs are highlighted as means for preventing further morbidity and mortality. [ABSTRACT FROM AUTHOR]

Suicide is a global public health problem, and with recent economic and societal changes, there may be emerging risk factors unrecognized by health care professionals. The aim of this systematic review was to update existing suicide risk factor literature applicable to emergency health care settings. A total of 35 articles identified from PsycINFO, CINAHL, and Medline met the inclusion criteria. Results supported the significance of existing suicide risk factors and identified emerging risk factors. The review provides a high-quality update of risk factor literature that could be applied to emergency health care settings; however, further research is needed to confirm emerging risk factors. [ABSTRACT FROM AUTHOR]