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Objective: In-session processing of emotions is important in facilitating psychotherapeutic change. This study explores how clients in active treatment experience inner changes when sharing emotions in psychotherapy sessions. The aim was to retrieve in-depth knowledge about clients' moment-by-moment experiences of change in a naturalistic psychotherapy context. Method: Two psychotherapy sessions (session 3 or 4 and session 7 or 8) were videotaped and immediately followed by semi-structured interviews with clients (n = 11) in the format of Interpersonal Process Recall (IPR). Interviews were analysed using thematic analysis. Results: Four themes resulted from analysis: (1) reaching a new clarity about inner struggles; (2) a shift in how I approach and experience my feelings; (3) grieving losses and gaining a more positive understanding of myself; (4) feeling relief and liberation when allowing difficult emotions. Conclusion: The resulting themes took into account the importance of the felt quality of change experiences within sessions, which appears to be important in making micro-processes of change salient. Across themes, we found accounts of shifts in awareness and self-compassion, which we discuss as micro-outcomes that clients can ideally be guided to dwell with. [ABSTRACT FROM AUTHOR]

Under what life conditions do individuals turn to perfectionistic striving and ideals as a solution? The present paper examines how people with perfectionism narrate their relationship to our shared existential vulnerability; that we are vulnerable as human beings, and that the ways we relate to this vulnerability have consequences for psychological health. In the present qualitative study, we explored the life narratives told by nine students with perfectionism, drawing on semi-structured life-story interviews. We conducted an explorativereflexive thematic analysis and identified five themes: 1) Outside--Feeling Alienated, 2) Relating to Chaos, 3) Trying to Control the Painful and Uncontrollable, 4) Islands of Just Being and Positive Contact, and 5) Heading Toward a Balance Between Doing and Being. Their perfectionism can be seen as a way of handling existential vulnerability at a point in their lives where relational resources needed to stay firm in a vulnerable state are lacking. Perfectionistic themes influence their personal identity in the domain of narrative constructions, values, belongingness, and embodiment. Accomplishments were dominant themes in the plots of their narrative self-constructions and values. They felt their "self-made" identities kept others at a distance. However, we also found strivings for a more fulfilling life with broader self-definitions. [ABSTRACT FROM AUTHOR]

Mindfulness based stress reduction (MBSR) for academic evaluation anxiety and self-confidence in 70 help-seeking bachelor's and master's students was examined. A repeated measures analysis of covariance on the 46 students who completed pretreatment and posttreatment measures (median age = 24 years, 83% women) showed that evaluation anxiety and self-confidence improved. A growth curve analysis with all 70 original participants showed reductions in both cognitive and emotional components of evaluation anxiety, and that reduction continued postintervention. Although more research is needed, this study indicates that MBSR may reduce evaluation anxiety.

The purpose of this study was to explore moments during psychotherapy sessions in which clients experience that they have an opportunity to approach and engage with difficult topics and emotional experiences, with the aim of describing therapists' acts that support clients' in-session engagement. Two treatment sessions of 11 participants were videotaped and immediately followed by an in-depth semi-structured interview, using the interpersonal process recall (IPR) interview method. A follow-up interview was conducted 3 months after the final IPR interview. Participants' accounts were analyzed using thematic analyses. Five themes of engagement-supportive acts resulted from our analyses: 1. inviting the client by showing acceptance; 2. recognizing the clients' hints and try-out signs; 3. providing information on the process and evaluating clients' expectations; 4. actively helping the clients to notice and stay with difficult experience and 5. showing sensitivity to the client's needs for micropauses. We discuss these themes as acts of recognition. Clients found it was engagement-supportive when therapists implicitly and explicitly recognized the challenges of being in psychotherapy. This recognition could be achieved through the engagement-supportive acts described in the five themes. Therapists should continually make space for and seek a balance between different engagement-supportive acts. [ABSTRACT FROM AUTHOR]

Does working with suicidal patients become easier with time? A representative national survey of 375 psychologists (72% women, Mean age 44 years) showed that years of experience (r = −.13, p =.01) and frequency of contact with suicidal patients (r = −.15, p =.004) correlated only weakly with perceived difficulty. Thematic analysis of respondents' descriptions of difficult suicide-related situations on an open survey-question yielded four themes: Unreachable patients, choosing between therapy and security, therapist's boundaries and empathy with death-wishes. We conclude that improved confidence in coping with suicidality may require specific training rather than simply years of work. [ABSTRACT FROM AUTHOR]

Background: The literature on antipsychotic medication in psychosis lack systematization of the empirical knowledge base on patients' subjective experiences of using antipsychotic drugs. Such investigations are pivotal to inform large-scale trials with clinically relevant hypotheses and to illuminate clinical implications for different sub-groups of individuals. Aims: To re-analyze and summarize existing qualitative research literature on patient perspectives of using antipsychotic medication. Method: A systematic literature search was performed in September 2018 (Protocol registration no. CRD42017074394). Using an existing framework of meta-analyzing qualitative research, full text evaluation was conducted for 41 articles. Thirty-two articles were included for the final synthesis. Results: Four meta-themes were identified: (1) short-term benefits; (2) adverse effects and coping processes; (3) surrender and autonomy; (4) long-term compromise of functional recovery. Conclusions: While largely positive about acute and short-term use, patients are more skeptical about using antipsychotic drugs in the longer term. The latter specifically relates to processes of functional and social recovery. The clinical conversations about antipsychotic medication need to include evaluations of contexts of patient experience level, patient autonomy processes, patient values and risk preferences, and patient knowledge and knowledge needs in addition to assessing the severity of symptoms of psychosis. [ABSTRACT FROM AUTHOR]

In this article we draw on literature from philosophy, history, and psychology to argue that empathy supports qualitative analysis of transcripts in several ways. We discuss examples of these processes both with data that we have co-created with our participants and data where we have not interacted with participants during data collection. What we suggest is not a new approach to analysis. Rather, we argue that the deliberate use of empathy bears potential to strengthen analysis across various analytical approaches. We explore five examples of how to access and harness our capacity for empathy as a resource in qualitative analysis: 1) Make time and room for prolonged engagement with data; 2) Use details and context actively when developing your understanding; 3) Practice decentering by actively seeking the perspective of the participants; 4) Attend to your own visceral experiences and body sensations; and 5) Utilize your capacity for imagination and creativity. [ABSTRACT FROM AUTHOR]

Background: Clinical trials indicate that mindfulness‐based stress reduction (MBSR) may be effective for social anxiety disorder (SAD), but little is known about how young adults with SAD experience this intervention. Aim: The purpose of this study was to explore how improved participants experience the process of change in MBSR for SAD. Method: We used a two‐staged mixed methods design to identify participants with reliable and clinically significant improvement on primary outcome measures after an eight‐week MBSR programme (n = 11), and analyse qualitative interviews to explore how they experienced their own process of change. The interviews were analysed using a hermeneutic‐phenomenological thematic analysis. Results: Thematic analysis revealed five main themes: (1) Using awareness of the body to sense that you are actually here right now, (2) Establishing a space that enables you to see negative thoughts for what they are, (3) Allowing fear and shyness through sustained awareness of physical sensations, (4) Transforming an experience of being inferior with kindness and self‐acceptance, and (5) Discovering new ways of engaging with other people. Conclusions: Participants described increased awareness and acceptance of sensations, thoughts and feelings, as well as greater self‐acceptance and improved interpersonal relationships during the MBSR programme. Future studies are needed to understand how and why individuals change in mindfulness‐based interventions for SAD. [ABSTRACT FROM AUTHOR]

Objective: What works for whom in mindfulness-based group interventions for social anxiety disorder (SAD)? The present article compared the experiences of 14 participants in a clinical study of mindfulness-based stress reduction (MBSR) for young adults with SAD.Methods: A two-staged mixed methods design was used to identify the participants who reported the highest (n = 7) and lowest (n = 7) levels of symptomatic change on outcome measures after treatment, and analyze qualitative in-depth interviews to explore what they experienced as helpful and unhelpful during the MBSR program. The qualitative interviews were analyzed using a thematic analysis methodology.Results: We identified the global theme of (i) Discovering agency to change or not feeling empowered through the MBSR program, and four sub-themes: (ii) Forming an active commitment or feeling ambivalence toward learning mindfulness, (iii) Engaging with others or avoiding contact with the group, (iv) Using the mindfulness exercises to approach or resigning when facing unpleasant experiences, and (v) Using the course to break interpersonal patterns or remaining stuck in everyday life.Conclusions: MBSR may be helpful for young adults with SAD, although it may be important to match clients to their preferred form of treatment. [ABSTRACT FROM AUTHOR]

The present study investigated mindfulness-based stress reduction ( MBSR) for young adults with a social anxiety disorder ( SAD) in an open trial. Fifty-three young adults in a higher education setting underwent a standard eight-week MBSR program. Eight participants (15%) did not complete the program. Participants reported significant reductions in SAD symptoms and global psychological distress, as well as increases in mindfulness, self-compassion, and self-esteem. Using intention-to-treat ( ITT) analyses, effect sizes ranged from large to moderate for SAD symptoms (Cohen's d = 0.80) and global psychological distress ( d = 0.61). Completer analyses yielded large effect sizes for SAD symptoms ( d = 0.96) and global psychological distress ( d = 0.81). The largest effect sizes were found for self-compassion ( d = 1.49) and mindfulness ( d = 1.35). Two thirds of the participants who were in the clinical range at pretreatment reported either clinically significant change (37%) or reliable improvement (31%) on SAD symptoms after completing the MBSR program, and almost two thirds reported either clinically significant change (37%) or reliable improvement (26%) on global psychological distress. MBSR may be a beneficial intervention for young adults in higher education with SAD, and there is a need for more research on mindfulness and acceptance-based interventions for SAD. [ABSTRACT FROM AUTHOR]