Counselling & Psychotherapy Research最新文献

{"title":"University Students' Post-Traumatic Symptoms in the Aftermath of COVID-19: The Mediating Role of Attachment and Epistemic Trust","authors":"Panoraia Andriopoulou,&nbsp;Evangelia Karagiannopoulou,&nbsp;Panayiotis Lianos,&nbsp;Peter Fonagy","doi":"10.1002/capr.70122","DOIUrl":"10.1002/capr.70122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study investigated how attachment patterns and epistemic trust mediate the development of post-traumatic stress disorder (PTSD) symptoms among university students in the aftermath of the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The sample consisted of 225 university students, a population shown to be particularly vulnerable to the long-term psychological impact of experiencing the COVID-19 pandemic. Data were collected via validated instruments measuring attachment anxiety and avoidance, epistemic trust, perceived psychosocial pandemic-related impact, and post-traumatic stress symptoms reported in relation to the COVID-19 illness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Structural equation modelling revealed that perceived COVID-19 impact was directly associated with PTSD symptoms and attachment anxiety. Attachment anxiety—unlike avoidance—did not directly predict PTSD, but significantly predicted epistemic mistrust and credulity, which, in turn, were associated with increased PTSD symptoms, indicating a significant indirect effect. Although avoidant attachment significantly predicted lower epistemic trust, it did not significantly influence PTSD, suggesting that deactivating strategies might offer temporary protection during crises.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings underscore the importance of considering individual differences in attachment and social learning capacities when addressing trauma responses in young adults. The clinical relevance of targeting epistemic trust in interventions, particularly for anxiously attached individuals, and call for further longitudinal research to clarify causality and long-term outcomes are discussed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"26 2","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/capr.70122","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147668507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural and Methodological Adaptations in Eye Movement Desensitisation and Reprocessing Therapy Across Diverse Cultural Contexts: A Narrative Review","authors":"Anwar Khan,&nbsp;Amalia bt Madihie","doi":"10.1002/capr.70120","DOIUrl":"10.1002/capr.70120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Eye movement desensitization and reprocessing (EMDR) therapy is an established intervention for trauma and stress-related disorders. As its use expands across diverse sociocultural contexts, questions arise regarding how its structured protocol can be adapted without compromising therapeutic integrity. This narrative review synthesizes published evidence on cultural and methodological adaptations of EMDR therapy across Western and non-Western settings to inform the development of a systematic framework for cultural and methodological adaptation of EMDR therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using narrative review methodology, relevant studies were searched in selected online databases. Reported adaptations were analysed and synthesized thematically into two clusters: cultural modifications (e.g., language translation, integration of spiritual or communal meanings, adaptation of therapeutic setting and social roles) and methodological adjustments (e.g., phase restructuring, modified distress scaling and alternative forms of bilateral stimulation).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The findings indicate that adaptations frequently extend beyond surface-level translation and reflect deeper shifts in explanatory models of trauma, communication norms and relational structures of care. However, reporting remains fragmented, theoretical grounding is inconsistently articulated, and consensus is lacking regarding which procedural elements may be modified while preserving core EMDR processes. In response, a structured three-stage framework is proposed to guide culturally and methodologically informed adaptation while maintaining functional fidelity. Ongoing challenges include limited longitudinal outcome data and the need for systematic fidelity monitoring and culturally informed training models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>EMDR therapy can be effectively adapted across diverse sociocultural contexts. The proposed framework of this review supports cultural and methodological adaptations while preserving core principles of EMDR. Further research is needed to validate adaptations and establish implementation consensus.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"26 2","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/capr.70120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147668425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Group Narrative Therapy Based on a Postmodern Psychotherapeutic Approach for Reducing Test Anxiety in Secondary School Students","authors":"Adem Peker,&nbsp;Serkan Cengiz,&nbsp;Carlos Laranjeira,&nbsp;Murat Yıldırım","doi":"10.1002/capr.70123","DOIUrl":"10.1002/capr.70123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate the effectiveness of a narrative therapy (NT)–based psychoeducation programme in reducing test anxiety among eighth-grade students in Türkiye.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a quasi-experimental design and purposive sampling, 22 students (63.6% female) were assigned to either an experimental or control group (11 each). Participants completed the Turkish version of The Test Anxiety Scale (EXS). The six-week NT-based programme was applied to the experimental group. Data were analysed using single-factor ANCOVA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The results showed that the test anxiety levels of the students in the experimental group were significantly lower than those in the control group (<i>F</i> = 6.23; <i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Research findings have shown that NT training programmes are effective in reducing test anxiety. These results suggest that incorporating NT principles and strategies can serve as an effective approach to addressing and alleviating test anxiety in students.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"26 2","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/capr.70123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147668327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Transactional Analysis Training on Self-Knowledge and Its Constituent Ego States in School Counsellors","authors":"Mehravar Javid,&nbsp;Fatemeh Talebi,&nbsp;James Sexton,&nbsp;Shima Tondar,&nbsp;Negar Tabibian","doi":"10.1002/capr.70109","DOIUrl":"10.1002/capr.70109","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Developing self-knowledge and ego state regulation is essential for counsellors' professional growth and therapeutic effectiveness. Transactional Analysis (TA) training offers a structured approach to fostering self-knowledge, yet empirical evidence among practicing school counsellors remains limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study examined the effectiveness of TA-based group training in enhancing overall self-knowledge and its dimensions—Adult, Parent and Child ego states—among school counsellors in Iran.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>From a pool of 68 volunteers, 30 eligible counsellors were randomly assigned to an experimental group (<i>n</i> = 15) or a control group (<i>n</i> = 15). A pre-test/post-test randomised controlled design was employed using a 29-item Self-Knowledge Questionnaire. The intervention consisted of 10 weekly 2-h TA sessions focusing on ego state awareness and self-reflection. The control group received no intervention during the study period but was offered the training afterward. Data were analysed using MANCOVA, controlling for pre-test scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The TA group showed statistically significant improvements in total self-knowledge and across all ego state dimensions (Adult, Parent, Child) compared with the control group (Hotelling's Trace = 1.04, <i>F</i> (3, 23) = 10.00, <i>p</i> = 0.001, η² = 0.51). Univariate follow-up analyses confirmed large effect sizes, particularly for the Child ego state (η² = 0.48) and total self-knowledge (η² = 0.47).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings suggest that TA training effectively enhances counsellors' self-knowledge and awareness of ego states, which may contribute to improved emotional regulation and counselling competence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"26 2","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147668198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Provision of Counselling and Psychotherapy for Boarders and Ex-Boarders From Elite Boarding Schools: A Scoping Review","authors":"Virginia Sherborne","doi":"10.1002/capr.70116","DOIUrl":"10.1002/capr.70116","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The psychological impact of attending elite boarding schools is of increasing interest to counsellors and psychotherapists. However, little academic research has explored the provision of interventions for supporting current and ex-boarders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This scoping review aimed to capture the existing evidence by identifying studies investigating the provision and effectiveness of therapeutic interventions for this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Included items had to be journal articles in English, from any date, peer-reviewed, presenting empirical studies conducted in the context of elite boarding schools. Types of studies included were qualitative, quantitative, mixed methods and structured case studies. Included studies had to focus on the provision/experience of delivering or receiving counselling or psychotherapy for current or ex-boarders. Searches of ProQuest, PsycINFO and EBSCO databases happened on 25 October 2024. Data charted from included studies were citation, aim, methodology, participant population and key findings. Narrative synthesis was used for data analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most excluded items did not focus on counselling and psychotherapy (CAP). Of those eligible for inclusion, five related to the provision and effectiveness of CAP and three to the experience of receiving or providing CAP. Included studies came from the USA (4), the UK (2), Malaysia (1) and Indonesia (1), with most presenting cognitive-behavioural or psychoanalytic approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Future research is recommended into how and by whom counselling and psychotherapy are provided to children, young people and staff in elite boarding schools, as scant evidence is available. To inform best practice, research is also needed into the efficacy and accessibility of different interventions for adult ex-boarders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"26 2","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147668110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Quest for Cultural Neutrality Within Psychodynamic Therapy: British Born South Asians' Lived Experiences","authors":"Rooksana Patel,&nbsp;Holly Bradley","doi":"10.1002/capr.70102","DOIUrl":"10.1002/capr.70102","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study aimed to review the clinical experiences of British-born South Asian individuals in psychodynamic therapy, with a particular focus on cultural adaptation and integration. The goal was to develop recommendations for integrating clients' cultural frames of reference into therapeutic work in order to enhance its effectiveness. British-born South Asians often experience conflicting British and South Asian values, which can lead to feelings of alienation, confusion, and intergenerational conflict. The study therefore explored acculturation, the tension between individualism and collectivism, and the psychodynamic implications of holding two contrasting cultural value systems within the self.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Method&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Semi-structured, one-on-one interviews were conducted via Zoom, allowing participants to reflect on their experiences in a familiar and accessible environment. Data were analysed using interpretative phenomenological analysis (IPA), which enabled a detailed exploration of participants' subjective experiences and the meanings they attributed to their cultural and therapeutic journeys.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Findings&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Two major themes emerged: (1) culture, and (2) the process of change. Participants described an ongoing struggle to form a cohesive cultural identity and to renegotiate the blend of Indian and British values in ways that felt authentic. Psychodynamic therapy supported participants in gaining autonomy and exploring aspects of the “self” within a non-judgmental and containing space. The therapeutic relationship played a central role in facilitating this process, with participants emphasising the importance of a culturally attuned therapist who could hold the complexities of dual identity, without imposing assumptions or judgement.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Participants' upbringing significantly influenced their relationships, identity, and capacity for autonomy. Although autonomy was eventually achieved, the tension between the contrasting cultural expectations of British and Indian heritage persisted throughout their lives. These findings highlight the importance of understanding this dual-cultural pressure within psychodynamic therapy, particularly in relation to internal conflict, guilt, and the negotiation of selfhood across differing cultural value systems.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Recommendations&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Clinicians shoul","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"26 2","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/capr.70102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147668144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Use of Transactional Analysis in Group Counselling: A Systematic Literature Review in the Indonesian Educational Context","authors":"Galuh Prawitasari,&nbsp;Anita Dewi Astuti,&nbsp;Mulawarman Mulawarman,&nbsp;Muslikah Muslikah","doi":"10.1002/capr.70108","DOIUrl":"10.1002/capr.70108","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study examines the range of psychological issues addressed through transactional analysis (TA)–based group counselling within educational contexts in Indonesia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A systematic literature review was conducted in accordance with PRISMA guidelines, drawing on major academic databases commonly used by Indonesian scholars. Fifteen studies met the predefined inclusion and exclusion criteria and were included in the final synthesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The findings suggest that TA-based group counselling has been utilised to address a broad spectrum of interpersonal and intrapersonal concerns in educational settings, yielding generally positive yet heterogeneous outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>By focusing on an under-represented non-Western context, this review responds directly to limitations identified in previous reviews, including the dominance of English-language literature and the limited empirical attention to school-based applications of TA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"26 2","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147668146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Power of the Mind's Eye: Mental Imagery and Its Role in Social Anxiety","authors":"Ghada A. AlKhodair","doi":"10.1002/capr.70118","DOIUrl":"10.1002/capr.70118","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Using a convergent mixed-methods design, this study aimed to investigate the relationship between mental imagery and symptoms of social anxiety within the context of Saudi Arabian culture.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy-three undergraduate students were assessed using self-report questionnaires and semi-structured interviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The integrated mixed-methods results provide evidence for the fact that mental imagery in social situations can elicit anxiety levels comparable to those in non-social contexts, with no significant differences observed between social and non-social situations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The conclusions underscore the pressing need for further exploration of mental imagery concerning mental health within specific cultures. This research has sought to explore these findings as dynamic ideas that evolve over time, rather than static structures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"26 2","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147668212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“My World Is Gone”: Understanding and Addressing the Needs of Caregivers of First Episode Psychosis Patients","authors":"Oscar Modesto,&nbsp;Lachlan Beaton,&nbsp;Morgan Nicholson,&nbsp;Caroline Brown,&nbsp;Brooke Short","doi":"10.1002/capr.70114","DOIUrl":"10.1002/capr.70114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Caregivers of those who have suffered a first episode psychosis (FEP) carry a significant burden, and report high levels of psychological distress, burnout and other emotional and financial difficulties because of the role they play. However, the role caregivers play is crucial to the recovery prospects of someone who has experienced an FEP, and thus, their needs and how they can be supported is of particular importance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This paper sought to understand the caregiver experience, and the needs that they expressed having had that experience. In addition, we explored how these needs might be met, by way of supports and potential structures for delivery of them. To address the aim of this study, a qualitative study of 15 caregivers was conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Two key overarching themes emerged within the data. Firstly, caregivers felt that they did not prepare for the caring role and that it had been life changing. Secondly, they reported that they would like more support by way of feeling like they matter, by being upskilled and by being provisioned their own, ongoing support. The study highlights key policy and practice implications for FEP services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our results emphasise caregiver recognition and inclusion in the medical team. Ongoing structured psychoeducation, early and ongoing communication with the clinical team, and access to emotional and practical supports for carers, as well as flexible delivery models of these support services, are essential to improve caregiver well-being and optimise recovery outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"26 2","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/capr.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147668181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can You Stay With Me? Existential Skills and Attitudes in Relating to Persons With a Persistent Death Wish Related to Psychiatric Suffering: A Qualitative Study","authors":"Sofie Verdegem,&nbsp;Zara Gelders,&nbsp;Jitske Naessens,&nbsp;Elisabeth Vandenberghe,&nbsp;Marie Jaenen,&nbsp;Joris Vandenberghe,&nbsp;Jessie Dezutter,&nbsp;Thijs Vanhie,&nbsp;Siebrecht Vanhooren","doi":"10.1002/capr.70106","DOIUrl":"10.1002/capr.70106","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study explored the therapeutic skills and attitudes mental health care (MHC) workers draw on when engaging with existential concerns in working with individuals with a persistent death wish related to unbearable psychiatric suffering (DWUPS) and examined whether sustained exposure to specialised existential care settings shapes existential responsiveness and relational presence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A qualitative design was employed, following Elliott and Timulak's descriptive-interpretative methodology. Eighteen in-depth interviews were conducted with two samples: non-specialised (Sample A) and specialised MHC-workers affiliated with Reakiro, a care centre for persons with DWUPS which operates from an existentially grounded, presence-based palliative and recovery-oriented framework (Sample B). Interview transcripts were organised into thematic categories through inductive analysis. Comparative frequency analysis identified specific patterns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Four core domains characterised MCH-workers' engagement with persons with DWUPS: existential, relational and palliative skills and attitudes, alongside the importance of self-care. Across both samples, participants described personal existential processing, presence, and existentially oriented interventions, relational engagement within the therapeutic space, facilitating connection with significant others and openness to the death wish as central to their work. Differences between samples were secondary and context-related. Specialised MHC-workers showed less hesitation in addressing the death wish, whereas non-specialised MHC-workers more strongly emphasised life-affirming interventions and reported greater ethical and emotional burden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Working with individuals with DWUPS requires an existentially grounded therapeutic stance that integrates openness to both life and death. The findings highlight the need for clinical training, peer support, and reflective supervision focused on existential presence, relational engagement and dual-track care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":46997,"journal":{"name":"Counselling & Psychotherapy Research","volume":"26 2","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147668145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}