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Background: Stress, and particularly burnout, is a major problem among healthcare workers and can lead to high staff turnover and low patient/client satisfaction. Objective: To explore the impact of 3-day compassion-focused therapy training on those delivering education to healthcare students. The underpinning premise was that the training course could potentially be replicated through the participants’ work with students embarking on a career within the helping professions. Design: Mixed-methods study, with the qualitative findings being presented in this paper. Setting: Training course was delivered in one higher education institution in England. Methods: In total, 44 healthcare lecturers attended the course, with 6 taking part in a reflective focus group. Findings: The analysis highlighted four main themes: reassurance and increased knowledge, increased compassion towards others, self-compassion and empathy, and blocks to compassion. Conclusion: Findings add to previous quantitative research findings showing that participants who undertook training were able to engage with their compassionate self and consider the importance of showing compassion towards the self and others in healthcare education.

Purpose The purpose of this paper is to examine pre and post outcome measures following a course of Compassionate Mind Training (CMT). Participants were students enrolled on a Post Graduate Diploma in Cognitive Behavioural Psychotherapy (CBP). The aim of the research was to explore whether CMT would increase self-compassion, compassion for others, dispositional empathy and reduce self-critical judgement. Design/methodology/approach In total, 21 participants who had enrolled on the CBP programme took part in the study. Data were collected using the self-compassion scale, interpersonal reactivity index, and the compassion for others scale. Findings Results reveal an overall statistically significant increase in self-compassion scores and statistically significant reduction in self-critical judgement scores post training. There was no statistically significant difference post training on the interpersonal reactivity index or the compassion for others scale. Research limitations/implications CMT training may help students develop healthy coping strategies, which they can use to balance their affect regulation systems when faced with organisational, placement, client, academic, personal and supervision demands. Further research and longitudinal studies, using larger sample sizes are needed to explore if cultivating compassion whilst on psychotherapy training helps students build resilience and provide a barrier against empathic distress fatigue, compassion fatigue, secondary traumatic stress, and burnout. Practical implications Incorporating CMT into a CBP programme may bring changes in student levels of self-compassion and self-critical judgement. Originality/value This inaugural study examines whether incorporating CMT into a CBP programme impacts on students levels of compassion, dispositional empathy and self-critical judgement. The findings from this preliminary study suggest the potential benefits of training students in compassion focused practices.

This article discusses how an integrated physical, psychological and social approach to wound care can help improve the quality of life for people who self-injure. The health professional should demonstrate compassion while teaching the person who self-injures how to provide their own wound care. Compassionate care may help the patient improve their self-compassion and reduce shame associated with this coping strategy, which may in turn avoid exacerbating self-harm when seeking healthcare.

Introduction: Literature on self-injury has recognized the impact on the relationship between clients and staff. Rationale: There is an absence of a detailed account of interpersonal processes surrounding self-injury. Aim: A Bricolage qualitative research approach was carried out in the United Kingdom that explored the interpersonal processes surrounding self-injury. Method: Three pairs of clients and staff were interviewed about an incident of self-injury. The interviews were thematically analysed and then synthesized producing a deeper exploration of the relationship between the client and staff. Findings: An interpersonal trigger followed by anger and shame, resulted in self-injury to ‘numb’ these experiences. Discussion: Self-injury is conceptualized as a safety behaviour to avoid shame and anger and then as a maintenance cycle that traps the client in a reinforcing and rejecting relationship. Staff interviewed were able to reflect with the clients and help them reframe these experiences. Implications for practice: Mental Health Nurses can work with clients to understand their own interpersonal cycles of self-injury. They can then reflect on their own roles in this process and avoid reinforcing the clients’ negative beliefs. - What the study adds to international evidence: This is the first international paper to explore the interconnection between the client and a professional helper in their lived experiences of self-injury.

Self-harm is a major challenge to public health. Emergency department (ED) nurses treat significant proportions of patients with self-harm injuries, and positive therapeutic patient-nurse interactions are imperative to the physical and psychological outcome of this vulnerable patient group. Research, both nationally and internationally, suggests that treating those with self-harm injuries is emotionally challenging, and ambivalence, powerlessness, and ineffectiveness are commonly manifested in negative attitudes towards these patients. Following the PRISMA guidelines, this systematic review with meta-analyses examined the attitudes of ED nurses towards patients who self-harm, based on currently available evidence. The following databases were searched: CINAHL complete; Medline complete; PsycARTICLES; PsycINFO; The Allied and Complementary Medicine Database; Health Source: Nursing/Academic Edition; PsycEXTRA; and Psychology and Behavioural Sciences Collection. Clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant reports to identify additional studies, were also searched. Five studies were included in the meta-analysis. The Self-Harm Antipathy Scale (SHAS) was used as an outcome in two studies appropriate for meta-analysis. The Attitudes Towards Deliberate Self-Harm Questionnaire (ADSHQ) scale was used as an outcome in three studies appropriate for meta-analysis. Results demonstrated limited empathy and negativity towards patients who self-harm, indicating a requirement for education and supervision of ED staff, where the SHAS or the ADSHQ can be used to monitor attitude change. Self-harm educational content for ED staff should include areas of knowledge building including explanations and causes of self-harm; range, forms, and functions of self-harm; staff responses to self-harm; assessment, management, and interventions; professional practice issues.

Purpose – The purpose of this paper is to outline a UK-based interdisciplinary workforce development project that had the aim of improving service delivery for children and young people who self-harm or are feeling suicidal. Design/methodology/approach – This innovative practice-higher-education partnership utilised an iterative consultation process to establish the local workforce need and then facilitated the systematic synthesis and presentation of evidence-based clinical guidelines in a practical format, for staff working directly with young people who self-harm in non-mental health settings. Findings – The development, content and structure of this contextualised resource is presented, along with emerging outcomes and learning from the team. It is anticipated that this may also be a useful strategy and resource for other teams in other areas and is intended to provide a template that can be adapted by other localities to meet the specific needs of their own workforce. Practical implications – The paper demonstrates how higher education-practice partnerships can make clinical guidelines and research evidence in a field often thought of as highly specialist, accessible to all staff. It also shows a process of liaison and enhanced understanding across universal/specialist mental health service thresholds. Originality/value – This paper demonstrates how collaborative partnerships can work to bridge the gap between evidence-based guidelines and their implementation in practice, through innovative multi-agency initiatives.

Introduction: There is a growing body of evidence within the healthcare community which suggests that developing feelings of compassion can have a profound impact on physical and psychological health. This is an important area of work, and initial research with non-professional groups has found that practicing compassion through a variety of experiential practices and meditations can lead to higher levels of compassion for others, sensitivity to suffering, motivation to help, and altruism. This study examines outcome measures following a three day introductory workshop on Compassionate Focused Therapy provided for healthcare providers and educators. The aim of the research was to explore whether the training would increase self-compassion and reduce self-criticism and self-persecution. Method: Twenty-eight participants consisting of three groups ‘nurses/midwives’, ‘counsellors/psychotherapists’ and ‘other healthcare providers’ completed the Self-Compassion Scale and Functions of Self-Criticising/Attacking Scale pre and post-training. Results: Results reveal an overall statistically significant increase in self-compassion and statistically significant reduction in self-critical judgement post-training. There was no statistically significant reduction in self-persecution or self-correction scores post-training. Discussion: Developing self-compassion and compassionately responding to our own ‘self-critic’ may lead the way forward in the development of more compassionate care amongst healthcare professionals. Practical Implications: Training people in compassion based exercises may bring changes in levels of self-compassion and self-critical judgement. The findings are exciting in that they suggest the potential benefits of training healthcare providers and educators in compassion focused practices.

Self-harm is a complex phenomena that occurs in many different settings. Multi-factorial explanations predominate in the literature and accounts of treatment reflect this diversity, ranging through psychobiological and psycho-social theories. This study aims to identify, describe and interpret some of the accounts and understandings of self-harm from a cross section of the general population and then relate this to clinical practice. Q Methodology is used to explore various competing viewpoints of lay people in understanding and treating people who self-harm. Eight different accounts were produced from the Explanation Q-sort. All but the Biological account described self-harm as a coping strategy, utilized in response to feelings of helplessness following social interaction and were therefore psycho-social in nature. There were four treatment/policy viewpoints that were all psycho-social in nature. These were influenced by humanistic and cognitive types of therapy and were united by the importance of empathy, positive regard and empowerment. These viewpoints are fully explored in this study. Common themes and factors connecting the explanations and treatment Q-sorts are discussed. These findings are then discussed in terms of their implications to current working practice and further initiatives and research projects.

Countertransference and self-injury: a cognitive behavioural cycle Aim. This paper discusses the emotional, cognitive and behavioural effects of selfinjury on nurses as helpers, and shows the usefulness of a cycle that can affect care provision for this group of people. Background. People self-injure for many different reasons, such as feeling angry, sad, guilty or frightened and these emotions are often linked to feeling helpless, powerless or out of control. Self-injury has often been reported as a coping strategy to gain control. Psychoanalytic and cognitive behavioural concepts have been used to understand why people self-injure and also inform intervention strategies. Unfortunately, negative emotional responses in professionals may interfere with the effectiveness of any therapeutic relationship. Discussion. Negative emotional responses from nurses can affect the way they think about and behave towards clients who self-injure. During clinical supervision or education, nurses’ thoughts can be challenged to become less negative, so that their resulting behaviour can also become less punitive. Non-punitive or more positive behaviour can in turn challenge some of the negative self-beliefs of clients. Conclusions. Knowledge about countertransference when working with people who self-injure may reduce nurses’ negative thoughts and behaviours, which may result in improved client care.