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Sjukskrivningstalen är höga bland terapeuter och handledning ses som ett viktigt stöd i både utbildning och yrkesutövning. Trots det så har få metoder fokuserat på terapeuters egna upplevelse av handledning. Några nya metoder med syfte att öka intrapersonell och psykologisk kapacitet hos terapeuter i arbete med klienter är Deliberate Practice (DP), Feedback Informed Treatment (FIT) och Self-compassion (SC). Under 2018 användes dessa metoder av två handledare som handledde sex studentterapeuter under utbildning. Denna studie undersöker hur studentterapeuterna upplevde det nya arbetssättet. Studien bygger på semistrukturerade intervjuer som har analyserats tematiskt utifrån en induktiv ansats. Resultatet visar att ett upplevelse- och feedbackbaserat arbetssätt uppfattades som tidseffektivt, strukturerat och målinriktat. Detta skapar aktivitet och delaktighet, en stark gruppdynamik samt god allians med handledarna vilket ger gott klimat för inlärning och utveckling. Några negativa aspekter på arbetssättet är att det är tidskrävande, att fokusering på prestation och feedback upplevs som ett hinder som kan skapa stress, ångest samt en känsla av att utvärderingen inte blir rättvis. Sammantaget visar resultatet att arbetssättet uppfattas som gynnsamt för studentterapeuter i utbildningsterapi gällande utveckling av både terapeutiska färdigheter och intrapersonell kapacitet. En utmaning för arbetssättet är att handledningen är obligatorisk, hierarkisk och betygsgrundande. För att generera goda förutsättningar för arbetssättet behövs mer utrymme i utbildningen skapas, fördelarna med arbetssättet belysas och ett tillåtande klimat med fokus på allians mellan studenter och handledare upprätthållas. Därtill är det också viktigt att beakta studenternas förmåga att vara självmedkännande. / There are high rates of sick-leave among therapists and supervision is seen as an important support in both professional practice and during education. Despite this, there are few methods that focuses on therapists' experience of supervision. Some new methods with the aim to increase the intrapersonal and psychological capacity of therapists in work with clients are Deliberate Practice (DP), Feedback Informed Treatment (FIT) and Self-Compassion (SC). During 2018, these methods were used by two supervisors who supervised six student therapists during training. This study examines how the student therapists experienced the new way of working. To collect the data semi-structured interviews were conducted, to further be analyzed thematically based on an inductive approach. The result showed that an experience- and feedback-based approach was perceived as efficient, structured and goal-oriented. This created activity and participation, a strong group dynamic and a good alliance with the supervisors, which provided a good climate for learning and development. Some negative aspects of the work method were that it’s a time-consuming. Further, focusing on performance and feedback was perceived as an obstacle that could create stress, anxiety and a feeling that the evaluation was not fair. The result showed overall that the way of working was perceived as beneficial for student therapists in education therapy regarding the development of both therapeutic skills and intrapersonal capacity. A challenge is that supervision is mandatory, hierarchical and that it’s a graded task. In order to generate good conditions for the work method more available space is needed within program. The advantages of the method need to be highlighted and an open climate with focus on alliance between students and supervisors need to be maintained. It is also important to consider the students' ability to be self-compassionate.

The purpose of this thesis will be a contrast of the Buddhist and the Christian responses to this-worldly suffering. Many scholars have proposed that the best way to create a better world with less suffering is to make Christianity more like Buddhism, so that an interfaith synthesis between the two religions results. These scholars’ proposals are described in Chapter 2. However, what these scholars desire (i.e. less this-worldly suffering) will not logically result from the solution they suggest (i.e. Buddhicizing Christianity). For to make Christianity more like Buddhism in its essentials would render Christianity less potent to oppose this-worldly suffering. The thesis will thus contrast Buddhism with Christianity in five crucial areas, namely, their viewpoints on ultimate reality, ultimate attachments, ultimate aversions, ultimate example, and ultimate purpose. These five areas provide the content to accurately define Buddhist compassion and Christian love. Chapter 3 describes Buddhism’s struggle to ground love of neighbor ontologically, whether by the ontological givens of dependent co-arising or nirvana. Buddhism struggles to ground not only whether we should love our neighbors, but also whether we can do so. Christianity, on the other hand, proves entirely capable of grounding love of neighbor—whether should or can—given its theistic ontology. Chapter 4 describes the Buddhist and Christian responses to suffering when it comes to attachments. Buddhism asks us to let go of rigid attachments to persons, truth and goodness. Meanwhile, Christians are to cling to God, and as a result of loving God, they are to love people, hunger and thirst for the good, and rejoice in the truth. These ultimate attachments to persons, truth, and goodness help overcome this-worldly suffering. According to Chapter 5, Buddhism and Christianity differ sharply when it comes to aversion to and grief over sin. Buddhists cultivate equanimity toward the sin, reasoning that the problem is not actually the person’s fault and, furthermore, that the problem is not really a problem. Christians, however, are to love people enough that they hate the sin which destroys them. In hating evil and restoring people, Christianity undermines immense worldly suffering. Chapter 6 contrasts Gautama and Jesus as examples of combatting suffering. At each juncture, Jesus offered more to actually fight against suffering than did Gautama. Incredibly, the interfaith scholar who would Buddhicize Christianity’s ultimate example would mar the portrait of the paradigm who exemplifies the very qualities the interfaith scholar wants to emulate. Chapter 7 examines the Buddhist emphasis on “thusness” and the Christian emphasis on purposefulness. Insofar as the interfaith scholar would Buddhicize Christianity’s ultimate purpose, the robust purposefulness that gives one’s life meaning and motivation would erode into a purposelessness which, however emancipating, leaves one comparatively impotent in the face of this-worldly suffering. In light of these five contrasts, Christian love and Buddhist compassion are able to be defined and contrasted. The logical conclusion drawn is that to Buddhicize Christianity’s ultimacy would be to truncate Christianity’s efficacy, a result which should motivate these interfaith scholars to reconsider their proposals. / PhD, North-West University, Potchefstroom Campus, 2015

The purpose of this thesis will be a contrast of the Buddhist and the Christian responses to this-worldly suffering. Many scholars have proposed that the best way to create a better world with less suffering is to make Christianity more like Buddhism, so that an interfaith synthesis between the two religions results. These scholars’ proposals are described in Chapter 2. However, what these scholars desire (i.e. less this-worldly suffering) will not logically result from the solution they suggest (i.e. Buddhicizing Christianity). For to make Christianity more like Buddhism in its essentials would render Christianity less potent to oppose this-worldly suffering. The thesis will thus contrast Buddhism with Christianity in five crucial areas, namely, their viewpoints on ultimate reality, ultimate attachments, ultimate aversions, ultimate example, and ultimate purpose. These five areas provide the content to accurately define Buddhist compassion and Christian love. Chapter 3 describes Buddhism’s struggle to ground love of neighbor ontologically, whether by the ontological givens of dependent co-arising or nirvana. Buddhism struggles to ground not only whether we should love our neighbors, but also whether we can do so. Christianity, on the other hand, proves entirely capable of grounding love of neighbor—whether should or can—given its theistic ontology. Chapter 4 describes the Buddhist and Christian responses to suffering when it comes to attachments. Buddhism asks us to let go of rigid attachments to persons, truth and goodness. Meanwhile, Christians are to cling to God, and as a result of loving God, they are to love people, hunger and thirst for the good, and rejoice in the truth. These ultimate attachments to persons, truth, and goodness help overcome this-worldly suffering. According to Chapter 5, Buddhism and Christianity differ sharply when it comes to aversion to and grief over sin. Buddhists cultivate equanimity toward the sin, reasoning that the problem is not actually the person’s fault and, furthermore, that the problem is not really a problem. Christians, however, are to love people enough that they hate the sin which destroys them. In hating evil and restoring people, Christianity undermines immense worldly suffering. Chapter 6 contrasts Gautama and Jesus as examples of combatting suffering. At each juncture, Jesus offered more to actually fight against suffering than did Gautama. Incredibly, the interfaith scholar who would Buddhicize Christianity’s ultimate example would mar the portrait of the paradigm who exemplifies the very qualities the interfaith scholar wants to emulate. Chapter 7 examines the Buddhist emphasis on “thusness” and the Christian emphasis on purposefulness. Insofar as the interfaith scholar would Buddhicize Christianity’s ultimate purpose, the robust purposefulness that gives one’s life meaning and motivation would erode into a purposelessness which, however emancipating, leaves one comparatively impotent in the face of this-worldly suffering. In light of these five contrasts, Christian love and Buddhist compassion are able to be defined and contrasted. The logical conclusion drawn is that to Buddhicize Christianity’s ultimacy would be to truncate Christianity’s efficacy, a result which should motivate these interfaith scholars to reconsider their proposals. / PhD, North-West University, Potchefstroom Campus, 2015

South African society has been a ected either directly or indirectly by some degree of trauma. Therefore the presence of a trauma unit within a hospital created the ideal opportunity for novice trauma counsellors to have practical experience. The present research is an exploratory study, designed in accordance with ethno- graphic principles in order to understand the psychological e ects of trauma on novice trauma counsellors. It focuses on themes that reverberate throughout the participants narratives. Vicarious trauma and compassion fatigue are two such e ects that were explored in this study. Research into compassion fatigue and vi- carious trauma span over several decades and researchers have moved from merely describing the symptoms of secondary traumatic stress to explaining it in terms of models that highlight the role of various factors that contribute vicarious trauma or compassion fatigue. This study concludes with recommendations to counter the e ects of experiencing secondary trauma. / (M.A. (Clinical Psychology))

Religious Studies and Arabic / D.Litt. et Phil. (Religious Studies)

Background: Attachment styles involve perceptions of the self and others and influence how individuals relate to other people. Insecure attachment styles have been strongly associated with the life experiences, criminal behaviour and mental health presentations common to patients in forensic settings. Therefore, challenging interactions associated with patients’ insecure attachment styles and contact with traumatising material are considered common for psychologists working within these settings. However, previous research has also indicated that a significant number of psychologists may also have insecure attachment styles. Forensic settings have been associated with stress and burnout amongst health care professionals. However, no previous research has explored how psychologists’ attachment styles may impact their levels of compassion fatigue and compassion satisfaction or influence their self-care in this setting. Aims: This is an exploratory study which addresses a gap in the literature. It aims to explore the attachment styles and prevalence of compassion fatigue (burnout and secondary traumatic stress) and compassion satisfaction amongst psychologists in forensic settings. It will also qualitatively explore how psychologists manage negative feelings that arise in relation to their work and their use of self-care strategies in a range of situations. Finally, it will explore differences in the self-care strategies used by psychologists with different attachment styles. Methodology: An online survey was used to gather data from 66 psychologists currently working in forensic settings in the United Kingdom. Quantitative measures of attachment style, compassion satisfaction and compassion fatigue were combined with qualitative questions regarding psychologists’ self-care strategies. This provided data which was analysed using a mixed methodology, including correlational statistical analysis and qualitative content analysis. Attachment style groups were identified from the quantitative data and qualitative content analysis was applied to explore group similarities and differences in psychologists’ self-care strategies. Results: The results indicated that participating psychologists had a range of attachment styles. Compassion fatigue was not found to be as prevalent as suggested by previous research. Positive correlations were found between attachment related anxiety and burnout, and attachment related avoidance and burnout. Compassion satisfaction was found to be common within the present sample. A negative correlation was found between attachment related avoidance and compassion satisfaction. Similarities and differences in psychologists’ self-care were highlighted between different attachment style groups. Implications: A potential vulnerability was identified for psychologists with insecure attachment styles, in relation to burnout and reduced compassion satisfaction. Furthermore, there appeared to be a lack of knowledge and understanding of attachment theory and how this applies to clinical work. Therefore, a key implication is the development of training for psychologists in relation to this topic. Use of multiple self-care strategies was common and self-care was perceived as important to clinical practice by the majority of the present sample. However, a training need for skills to be taught early in the psychologists’ career and a need for self-care to be more widely supported at an organisational level regardless of stage of career was identified. The study concludes with a review of methodological considerations and the limitations these may present to the current findings.

Systematic Review: Healthcare professionals work in highly emotive environments and are considered to be at high risk of developing burnout due to the nature of their roles. There has been increased interest in applying mindfulness-based interventions for stress reduction in healthcare professionals. Previous reviews have tended to include a heterogeneous mix of patients, healthcare students and healthcare professionals. The inherent differences in these roles limits the conclusions that can be drawn regarding the effectiveness of mindfulness-based interventions for healthcare professionals. The current review aimed to address this gap in knowledge by reviewing mindfulness-based interventions specifically for healthcare professionals. Eight studies were included in the review. It was concluded that despite some methodological weaknesses there was promising evidence of the effectiveness of mindfulness-based interventions in reducing stress and improving well-being particularly when baseline levels of stress were high. The evidence in support of reducing burnout was less conclusive. Future studies employing larger samples using active controls and longitudinal designs will provide valuable information on the long-term efficacy of these interventions. Empirical Research Study: Several studies have identified psychological adjustment as one of the most important factors correlating with psychological distress and quality of life in people with cancer. Identifying ways to promote positive adjustment to cancer is an important goal in helping to alleviate distress and improve quality of life for this client group. This can be facilitated by identifying robust predictors of distress. Previous studies have identified a number of useful predictors, such as coping styles and psychological adjustment styles. The current study aimed to explore the predictive power of two newer constructs aligned to mindfulness-based processes: self-compassion and cognitive fusion - in determining adjustment to cancer. 114 adults with various cancer diagnoses completed the Mini Mental Adjustment to Cancer Scale, Brief COPE, the Self-Compassion Scale, Cognitive Fusion Questionnaire; and two outcome measures: the Hospital Anxiety and Depression Scale and the Functional Analysis of Cancer Therapy – General. Hierarchical multiple regression was used to explore relationships between predictor variables: mental adjustment, coping style, self-compassion and cognitive fusion, and outcome variables: distress and quality of life. Results showed that a known predictor, emotional avoidance coping and the newer construct, cognitive fusion were significant predictors of distress over and above other known predictors. Emotional avoidance coping was the only significant predictor of quality of life over and above known predictors and the newer constructs under examination. Self-compassion did not account for any significant incremental variance in distress or quality of life after controlling for other known predictors. The results of this study indicate that interventions focused on reducing cognitive fusion and emotional avoidance are warranted and potentially beneficial in reducing distress in this population.

Perfectionism has been seen to predict treatment outcome and symptom severity in clinically relevant diagnoses such as depression and anxiety disorders. It has also been suggested to be a transdiagnostic phenomenon. The aim of this study was to investigate, for the first time, predictors of change in Internet-based cognitive behaviour therapy for perfectionism. The chosen predictors were perfectionism severity, comorbid diagnosis and degree of self-compassion. The study was a part of the Devin-project; a randomized controlled trial with 150 participants that were allocated to active treatment (N=73) or a waitlist condition (N=77). Multiple linear regression analysis was used for the analyses. Variables chosen a priori did not significantly predict the treatment outcome (R2=.10, p = .099). A post hoc-analysis showed that perfectionism severity, as measured with CPQ, predicted symptom change after treatment (B = .783, β = .56 p < .001). The results indicate that perfectionism severity doesn’t impair the treatment effects and that the treatment is effective, independent of comorbid diagnoses. Self-compassion was investigated on an explorative basis but the results can indicate that the variable is not a risk factor nor a protective factor for perfectionism. As Devin is the largest randomized controlled study of internet-based cognitive behaviour therapy for perfectionism to date, this study generates important implications and suggestions for future research. / Devin

The purpose of this study was to investigate the process of forgiveness and the relationship among state forgiveness, self-compassion, and psychological well-being experienced by Buddhists in the United States. An integral feminist framework was developed for this mixed-method study. For the quantitative component of this study, a convenience sample of 112 adults completed an online survey. Multiple regression analysis was performed to examine: (a) the impact of gender, age, and the years spent in Buddhist practice on state forgiveness and self-compassion; (b) the outcome of psychological well-being in relation to state forgiveness and self-compassion; and (c) self-compassion as a mediator for the relationship between state forgiveness and psychological well-being. Quantitative results indicated: (a) state forgiveness positively predicted psychological well-being; (b) the years spent in Buddhist practice positively predicted self-compassion; (c) self-compassion positively predicted psychological well-being; and (d) self-compassion partially mediated the relationship between state forgiveness and psychological well-being. Age did not predict any of the three primary variables. Gender did not predict state forgiveness. For the qualitative component of this study, this researcher purposefully selected four adults from a local Buddhist community in central Kentucky and conducted two in-depth interviews to explore their subjective experiences of forgiveness within their own contexts. A holistic-content narrative analysis revealed unique features of each interviewee’s forgiveness process interwoven with the socio-cultural, family and relational contexts. From a phenomenological analysis, common themes and elements of the interviewees’ forgiveness processes emerged. Qualitative findings corresponded to the quantitative results concerning state forgiveness as a route to psychological well-being, the positive relationship between Buddhist practice and compassion, and the role of self-compassion in the relationship between state forgiveness and psychological well-being. Qualitative findings also suggested the following. First, two-way compassion toward self and the offender was a facilitating factor for forgiveness that may be unique to Buddhists. Second, one’s actual experience of forgiveness may encompass not only cognitive, affective, and behavioral changes, but also transformation of self and perspective on meaning and purpose in life. Third, Enright and his colleagues’ (1998) stage and process models of forgiveness were useful to understand Buddhists’ experiences and processes of forgiveness.