Self-harm is a prevalent phenomenon regularly faced by doctors and nurses working in accident and emergency (A&E) departments. We argue that the treatment decisions A&E doctors make are fundamental to decreasing the high risk of suicide among this group. In this article we present a qualitative study exploring how doctors working in A&E respond to treating people who self-harm. In total, five A&E doctors were interviewed and the data were analyzed using interpretative phenomenological analysis. Three main themes were extracted: treating the body, silencing the self, and mirroring cultural and societal responses to self-harm. Within these themes, we identified both facilitative and unhelpful aspects of the relationships between people who self-harm and A&E doctors. We consider the clinical implications of these findings within the context of A&E doctors having limited opportunities to address the relational nature of the care they offer to this group.
Participants' ability to work in a recovery-oriented manner seemed to be limited by the way in which services perceived and responded to risk. Participants did not discuss risks arising from stigma, social exclusion, racism, sexism, or iatrogenic effects of psychiatric treatment. Narrow conceptualizations of risk as related to harm and danger seen in this study contribute to a sense of needing to be risk averse. However, the implications for practice included ideas about what might increase the possibilities for adopting recovery approaches across disciplines.
The construct of Borderline Personality Disorder (BPD) as an explanation of an individual's experience is generally accepted in the literature but has recently been called into question. This study adopted a qualitative stance to offer an alternative to this accepted view. Six individuals undergoing Mentalization Based Treatment (MBT) participated and their data was analyzed using Interpretative Phenomenological Analysis (IPA). Themes interpreted from the data provided a sense that although MBT helped participants, they did not feel cured.
This study investigated the experiences of people who received a contemporary form of cognitive therapy for distressing voices. Eighteen people who heard distressing voices participated in an 8-session person-based cognitive therapy (PBCT) group and were then interviewed to elicit their experiences from the group. Data were gathered during a series of five posttherapy focus groups based on a semistructured interview schedule. A grounded theory approach was used to generate, work with, and understand the data. Four categories emerged: two representing the context for reflection and change and two representing the acceptance of voices and self and the changing sense of self. The conceptual and clinical implications of the findings are discussed.
This paper reports a qualitative, idiographic study employing Interpretative Phenomenological Analysis to explore the experiences of therapists who have a mindfulness practice, looking at how this is brought into their individual therapeutic work. Findings focus on mindfulness, conceptualised as a way of being, which emerges as a central theme in all accounts. Three "way of being" related themes are used to illustrate therapists' experiences of mindfulness as part of their personal life and how this is brought into the therapy room both implicitly and explicitly.The application of mindfulness in therapy is discussed while drawing links with the mindfulness literature.
High levels of mental health problems have been identified in young people who have offended (committed/been convicted of a criminal offence). However, as with many young people, they tend not to seek support for their difficulties. This research aimed to explore support-seeking in this population by asking 'What are the perceptions of support-seeking in young people attending a Youth Offending Team?' Semi-structured interviews were carried out with six males (aged 13-18) and the transcripts were analysed using interpretative phenomenological analysis. Four master themes were revealed: Youth Offending Team attendance prompting reflection, Damaged self, Complexity of relationships and Internal conflicts. Generally participants perceived support-seeking as beneficial, but various barriers meant that they did not tend to view it as a viable coping strategy for themselves. Interventions aimed at addressing these barriers may help young people who have offended to seek support.
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