Objectives The study aimed to explore which discourses staff in crisis services draw on when discussing people in crisis. Further questions were; how those with borderline personality disorder diagnosis are positioned by these discourses and what the subsequent consequences are for people in crisis. Design This study utilised a qualitative design. Individual interviews were conducted with participants to generate personal and reflective accounts. Method Twelve staff members from home treatment, day treatment or acute ward teams were interviewed. Questions related to their experiences of people in crisis. Foucauldian Discourse Analysis was used to highlight the discourses used when talking about those in crisis. Results Four main discourses were present in language used; ‘medical legal’, ‘personal responsibility’, ‘limited resources for the problem’, and ‘human experience and emotions’. People with a diagnosis of borderline personality disorder (BPD) were positioned differently to those with other diagnosis. Staff are positioned as experts needing to diagnose and cure distress. The discourse of human experience and emotions highlighted the emotional aspect of working with people in crisis, especially those with a BPD diagnosis. Conclusion The prevailing discourses within NHS crisis services remain those of the medical model, legitimising ideas of classic mental illness and practices of medication and control. This impacts the position of people with a BPD diagnosis. Further reflective spaces are required to highlight the flexibility of these discourses, practice, and the importance of emotions raised by those in distress.

Introduction: Immigration detention leads to poor mental health outcomes. Little qualitative research has been conducted focusing on immigrants’ experiences of detention centres or the mechanisms of the particular psychosocial processes involved in harm and resilience, particularly for women in the UK. Method: A social constructionist grounded theory methodology was used. Ten adults (seven females), previously detained in UK immigration detention, were interviewed. Transcribed interview data was analysed to develop categories. Results: An initial model of the psychosocial processes of immigration detention was developed, which included the means by which individuals’ adaptation, resistance, and survival is navigated. Life as a liminal refugee and imposed criminality through institutionalisation and an unjust system was described. Detainees were not believed and felt uncared for. Detainees internalised persecution, injustice, and threat. They responded with physical and emotional. Detainees also responded with agency and defiance. They supported each other and made use of advocates. Recovery after release from detention involved processing and re-establishing oneself, despite on-going challenges. Discussion: Immigration detention has enduring effects that reflect internalisation of institutional processes. Disempowerment and resilience are discussed. Treatment may be similar to that used for complex therapy. Professionals should consider ethics and actions in relation to immigration detention.

Over the last twenty years there have been several investigations exploring theory of mind (ToM) abilities within populations with acquired brain injury, including stroke survivors. Most neuropsychology studies involving people with acquired brain injury have assessed the cognitively-demanding, social-cognitive component of ToM, whereas the literature concerned with exploring social-perceptual ToM is limited by its reliance on measures that are not representative of ToM processes within real-world situations. The current study aimed to examine the use and utility of an ecologically-valid (verisimilitudinous) social-perceptual ToM task within stroke survivors, known as the Cambridge Mindreading Face-Voice Battery (CAM; Golan, Baron-Cohen, & Hill, 2006). Group comparisons of CAM performance between 22 stroke survivors and 20 age- and education-matched healthy control participants showed no significant differences. In addition, the CAM was unable to accurately distinguish between the groups. An exploratory cluster analysis revealed differential patterns of ToM impairment and preservation within the sample of stroke survivors. These findings suggest studies that have attempted to tap social-perceptual ToM through artificial tasks and/or static stimuli may be overestimating the deficits observed within stroke samples, and tentatively points towards functional fractionation of social-perceptual ToM abilities dependent on modality. Some recommendations for future research combining neuropsychology and neuroimaging methodology are discussed.

Mindfulness meditation (MM) is an ancient Buddhist spiritual practice that has been secularised into popular and effective therapeutic interventions. This is the first empirical study to investigate the spiritual and secular context of mindfulness-based interventions through the prism of Common Factors theory, specifically focusing on the work of Frank (1973) and the concept of a healing ‘myth’ or story. The hypotheses predicted that a philosophically integrated role-induction to MM, would be more effective at improving credibility and expectations, state mindfulness and affect outcomes compared to philosophically narrower spiritual or secular presentations. Participants were randomly allocated to a role-induction group (integrated / spiritual / secular) and all received the same MM-intervention. Additionally, congruency effects between participants’ dispositional spirituality / secularity and induction group were tested. 165 participants (82 % female, mean age 25 years, SD=11.15) completed the online study. While all groups showed improvements on measures of credibility and expectations, state mindfulness and negative affect across timepoints, contrary to hypotheses the integrated induction group did not improve more than the secular or spiritual groups, nor were strong congruency effects found. Results are discussed in the context of a possible primary ‘myth’ of MM that overrides secondary divisions between secularity / spirituality; the ‘myth’ of finding peace in a frantic world.

Burnout in human services has become a widely researched psychological concept over the last 40 years (Shaufeli, Leiter & Maslach, 2009). Negative outcomes of clinician burnout in mental health services is well documented, however less research has focused on the specific burnout subsection of depersonalisation (Maslach, 1998). A mixed methodology was used which aimed to examine predictors of depersonalisation among qualified clinicians employed in NHS mental health services, as well as an exploration of experiences of resilience and burnout. A total of 261 Mental Health Nurses, Clinical Psychologists and Social Workers employed in NHS mental health services completed an online survey and open-ended qualitative questions. Multiple regression analysis suggested five significant predictors of depersonalisation; clinicians’ specialties, years of experience post-qualification, exposure to physical abuse, emotional exhaustion and low ratings of personal achievement. No significant differences of depersonalisation were reported among different professions. Thematic Analysis of responses to open-ended questions suggested that a ‘love of the job’ or desire to ‘help service users’ supported resilience. Job stressors such as exposure to physical abuse or bullying were reported as detrimental to resilience. Implications of maintaining compassionate and effective client care were discussed as well as limitations and areas of future research.

Previous research suggests that human trafficking (HT) can have multiple adverse effects, which can then interact with post-trafficking environmental factors to further impact wellbeing. A version of participatory action research (PAR) was employed to explore how a community arts project was experienced and ways it supported psychological wellbeing post-trafficking. A total of eleven participants took part including ten women who had experienced HT and one project organiser. Data collection involved six participants. Data was analysed using thematic analysis. Five themes were developed, exploring challenges and restorative influences to wellbeing including: disconnection and connection to others; disorientation and becoming orientated to the local community; feelings of worthlessness and developing self-worth; fear and the development of trust; and low mood and the helpfulness of engaging in activities. Findings suggested that the project helped individuals experience belonging, build trust and use the group as a "secure base", which supported post-trafficking wellbeing. The role of art as metaphor and a vehicle for agency is also discussed. Clinical and research implications and limitations are also considered.

Evidence indicates that a sub-group of trainees experience high levels of stress and anxiety during training. These difficulties are influenced by factors such as cognitive appraisal, coping strategy, and course structure. However, to date there does not appear to be any study investigating the role of self-compassion in trainee stress and anxiety. Based on the literature it was hypothesised that self-compassion would be related to stress, anxiety, and coping strategy but also it would mediate the relationship between appraisal, stress, and anxiety. Using a qualitative cross-sectional study a sample of 188 trainees recruited from 29 Universities completed an online survey measuring stress, anxiety, appraisal, coping, and self-compassion. The results were consistent with previous findings, indicating a sub-group of trainees with high levels of stress and anxiety. Self-compassion was found to be correlated with all measures and partially mediated the relationship with appraisal, stress, and anxiety.

Purpose: To understand how clinical psychologists identify ethical issues. The specific aims were to describe the process of ethical sensitivity and examine how clinical psychologists identify a need to engage in ethical decision-making. Design: A qualitative design was adopted using Grounded Theory method. Findings: Twelve clinical psychologists participated in semi-structured interviews. A model of how participants identified ethical issues was developed. The three core categories were discomfort, conscious realisation of an ethical problem and the impact of context on the assessment of the situation. The service context, specifically the balance of service demands to resources resulted in either thinking space or restricted thinking. Thinking space enabled participants to attend to their discomfort, understand its cause and identify a clash with their values. This process of ethical sensitivity being facilitated led to a restored sense of coherence with participants' values. When the context restricted thinking this resulted in an ongoing emotional burden. Participants described this as unsustainable long-term and it had led several to changing jobs, reducing their hours or leaving the national healthcare service altogether to work for private providers or in independent private practice. Value: The paper details an empirically developed theory of clinical psychologists' ethical sensitivity. It describes the process experienced by practicing clinical psychologists when noticing potential ethical issues in their work practice. Limitations are discussed and practical recommendations made for mental health services, clinical psychologists and supervisors.

Introduction: Moving house later in life can be a major transition. Some studies have identified valued objects may be important to this process however the significance of objects is not well understood and related psychological theory is limited. As such, the present study aimed to build an explanatory model for the significance of valued objects to older adults in the context of a residential transition. Method: 11 older adults, and 1 care home manager were interviewed about the meanings and roles of valued material objects following a residential transition. Older adult participants lived in either their own home, or a care home. Grounded theory method was used to build a theory of the value of objects for older adults following a residential transition. Results: The theory proposes valued objects are associated with at least one of five key constructs; properties of objects, emotions, memory, connection, and legacy. The model also depicts the process of residential transition which is characterised by making decisions about objects. Conclusion: Valued objects have important meanings and roles for older adults following a residential transition. Losing objects can result in emotional pain and potentially separate people from making use of objects to adjust and reflect on their move. Clinical recommendations include providing information to support people with making decisions about objects when moving house, and exploring the topic of valued objects with older adults when working therapeutically.

Stress and anxiety are among the most significant reasons for staff sickness absence in the NHS. The provision of psychological support for healthcare staff may have the potential to improve staff job satisfaction and reduce staff stress and burnout. Mindfulness-based interventions (MBIs) are one type of psychological approach that has gained particular research interest in recent years. MBIs may have the potential to reduce stress and improve staff wellbeing. A fully powered randomised control, followed on from a pilot study, aimed to look at the effects of the effectiveness of a mindfulness-based self-help intervention for healthcare staff and the factors that may mediate any effects found. A total of 133 participants were recruited for the study. The results showed that participants in the intervention arm of the study reported a decrease in stress, anxiety and depression and an increase in wellbeing compared to controls. Further to this it was found that mindfulness is a mediator for self-compassion which increased wellbeing.