Recent research has emphasised the importance of therapeutic alliance to treatment outcomes for anorexia nervosa. This study aimed to examine the experiences of service users in developing therapeutic alliance whilst in treatment for their eating disorders. This qualitative study, using purposive sampling, recruited a sample of service users receiving treatment at a national eating disorders service. In-depth interviews were audiotaped and transcribed, with transcriptions being subject to interpretative phenomenological analysis. Participants were eight adult women receiving tertiary level eating disorder treatment in a specialist setting. The text analysis produced four dominant categories: alliance as a key experience; being active, not passive; taboo talking; and first impressions count. The development of therapeutic alliance is a core component of treatment. This study identifies important areas that contribute to the successful cultivation of positive therapeutic alliance.
Aims: Experiencing shame can be a risk factor for relapse for people recovering from alcohol dependence, but for some it may act as a necessary protective factor for preventing relapse. Knowing how best to manage shame is therefore an important issue, yet the precise nature of the relationship between shame and alcohol dependence remains largely unexplored.
Research questions: (1)In what ways do participants tell their stories of shame? (2) How is shame experienced and/or understood by those in recovery from alcohol dependence? Method: Eight participants were recruited from Alcoholic Anonymous (AA) groups and invited to tell their story of recovery. Stories were then analysed using a narrative analysis, focusing on how participants narrated their stories and made sense of their experiences of shame in particular. Findings: Participants spoke about an inherent deep-rooted negative view about themselves, which was present long before alcohol dependence developed. Alcohol served as a means of connection to others and a way of artificially relieving feelings of worthlessness. Recovery was about finding somewhere safe to talk about feelings of shame and make sense of these experiences.
Conclusions:The results indicate that management of shame is an important component of recovery programmes for alcohol dependence.
This article reflects on the past and present of the clinical psychology doctorate training programme, and looks ahead to the future in the context of the changes within the wider NHS.
This study explored trainee clinical psychologists’ experiences of unpaid assistant psychologist posts. Five semi-structured interviews were conducted with trainees and analysed using thematic analysis. Contrary to current debates, trainees described how well-supervised unpaid posts can benefit both post holders and services.
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