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Previous research emphasises the importance of a counsellor’s ‘way of being’ in determining therapeutic effectiveness and outcome. The capacity to tolerate uncertainty is regarded as an important counsellor attribute. However, failing to show how counsellors learn this, limits the practical relevance of the existing literature for psychotherapy and counselling. This study questions how a counsellor can learn to bring his or her self more fully into relationship with clients and what the implications of this learning process on counselling work are. Central to this study is Levine’s (2002) conception that learning occurs through a willingness to think about experiences, which necessitates facing uncertainty. This thesis argues that the capacity to tolerate uncertainty is an individual learning process and a precondition for a counsellor developing his or her ‘way of being’ or therapeutic ‘use of self’ (Wosket, 1999). In this study, the counselling practitioner-researcher draws on her own learning process to show how reflection on personal issues triggered by experiences of uncertainty, that could obstruct a counsellor’s emotional availability necessary for ‘use of self’, may be a fundamental part of counsellor professional development. A learning process is demonstrated through reflection on five vignettes of experiences of uncertainty from life and counselling practice. Beginning with an inexplicable experience in counselling practice that the counsellor struggles to understand her response to, she wonders how her difficulty with tolerating uncertainty might relate to experiences of uncertainty and learned defences from her childhood and adolescence. Through an experience with a client’s overt uncertainty, the practitioner grasps the difference between trying to tolerate uncertainty and developing this capacity as a ‘way of being’. When creative and play work with a child client challenges use of the counsellor’s defences, her learning moves from a conceptual understanding to an embodied one. She becomes more present and vulnerable with clients allowing for connection with clients and greater depth in counselling work. The practitioner-researcher attributes this personal learning to the six phases of Sela Smith’s (2002) heuristic self-search inquiry that requires immersing in uncertainty, dwelling in the research question and accessing tacit knowledge. This study contributes to a lack of practical literature within psychotherapy and counselling on how counsellors develop their therapeutic ‘use of self’, a way of being that has been linked to effective therapeutic outcome yet only a small number of therapists possess. Although the process and findings of this subjective study cannot be generalised, it aims to stimulate each counsellors’ own reflection on therapeutic ‘use of self’. This study suggests a heuristic self-search framework for a counsellor to confront his or her own relationship to uncertainty as an integral part of professional development beyond what training can provide.

Humour can be a valuable tool for psychotherapists, if executed in a respectful manner. Laughter has myriad health benefits, and is associated with reduced depression, increased self-esteem, and lower perceived levels of stress (Eckstein et al., 2003). It can strengthen the therapeutic alliance and simplify the process of confronting clients on dysfunctional behaviours (Thomas et al., 2015). However, rigorous empirical study of humour in psychotherapy is scarce, as is clinical training in its use (Franzini, 2001). Ergo, this study queries: (1) How do counsellors and psychotherapists use humour in their therapy sessions? (2) In what contexts do counsellors and psychotherapists perceive humour use as being appropriate and beneficial in therapy? And (3) In what contexts do counsellors and psychotherapists perceive humour use as being potentially harmful? A semi-structured interview protocol was used to interview seven psychotherapists in Canada with a minimum of five years of work experience. Interviews were audio recorded, and data obtained was analyzed using Thematic Analysis (Braun & Clarke, 2012). This study examined the experiences of psychotherapists to determine how they use humour safely and effectively in therapy sessions, with the aim of gaining knowledge to inform clinical training on how best to minimize the potential for harm, and maximize the therapeutic benefits of humour in therapy. Eleven main themes, each with several subthemes, emerged in the data analysis. Implications for therapy, counsellor education and further research are discussed.

The treatment of eating disorders (EDs) presents many challenges. Therapists' reactions towards clients (countertransference) may further complicate treatment. Countertransference may be partially due to the therapist's own vulnerabilities. Due to the personal connection to the work, countertransference towards ED clients may be pronounced among therapists with eating disorder lived experience (EDLE). Previous research indicates that 25-50% of ED therapists have EDLE; yet, minimal research examines how therapists negotiate their experiences while treating ED clients. The existing literature largely operates from the assumption that EDLE is a liability. While therapists with EDLE have some distinct challenges, therapists with EDLE may also have a unique perspective to offer the ED profession. The present study sought to understand how therapists with EDLE use their EDLE as a resource in their clinical work with ED clients. The study was guided by the theoretical frameworks of social constructivism and symbolic interactionism, as well as the person-of-the-therapist clinical training philosophy. Using constructivist grounded theory methodology, semi-structured interviews (Mtime = 89 minutes) were conducted with 22 therapists with EDLE, who work with ED clients. Participants explored how they use and manage their EDLE during key tasks of treatment with their ED clients. Results revealed that therapists engaged in two, interconnected constellations of processes (systems) in order to use and manage their EDLE in clinical practice. The first system (The Central System) helps therapists transform their personal experiences into clinical guidance that they can use to inform their work. The second system (The Checks and Balances System) helps the therapist find a balance between connecting with the client, while also allowing for differences of experiences to emerge. Lastly, personal processes (personal meaning making, values surrounding authenticity, and stigma surrounding EDLE), existing outside of these systems, were also found to impact the ways in which therapists use and manage themselves. Findings have implications for the EDLE literature, by providing novel ways therapists can use their EDLE. Findings also have implications for the POTT framework by exploring how POTT can be adapted for therapists who share lived experiences with their clients. A POTT-EDLE is proposed for training therapists with EDLE. / Doctor of Philosophy / The treatment of eating disorders (EDs) presents many challenges (e.g., frequent comorbidity, high rates of relapse, and the life-threatening nature of the disorder). Therapists' reactions towards clients (countertransference) may further complicate treatment. Countertransference (e.g., worry, frustration, hopelessness) may be partially due to the therapist's own unresolved issues and vulnerabilities. Due to the personal and professional connections to the work, countertransference towards ED clients may be particularly pronounced among therapists with eating disorder lived experience (EDLE). Previous research indicates that 25-50% of ED therapists have EDLE; yet, minimal research examines how therapists use and manage their experiences while treating ED clients. The existing literature largely operates from the assumption that EDLE is a liability and therapists with EDLE are working from a deficit. While therapists with EDLE have some distinct challenges, therapists with EDLE may also have a unique perspective to offer the ED profession. The study sought to understand how therapists with EDLE use their EDLE as a resource in their clinical work with ED clients. Interviews were conducted with 22 therapists with EDLE who work with ED clients. Results revealed that therapists engaged in two systems in order to use and manage their EDLE in clinical practice. The first system (The Central System) helps therapists transform their personal experiences into clinical guidance that they can use to inform their work. The second system (The Checks and Balances System) helps the therapist find a balance between connecting with the client, while also allowing for differences of experiences to emerge. The Central System and The Checks and Balances System work in tandem in order for the therapist to both use and manage their EDLE. Results describe the multiple processes informing these systems. Lastly, personal processes (personal meaning making, values surrounding authenticity, and stigma surrounding EDLE), existing outside of these systems, were also found to impact the ways in which therapists use and manage themselves. Findings have clinical and training implications for how therapists with EDLE can use and manage their EDLE to inform their clinical work with ED clients.

This study examines how Taiwanese senior counsellors with substantial experience of ch’i-related exercise (CRE) perceived the influence of their regular CRE on their counselling practice. I am interested in the perceived influence of CRE on both self-care and professional practice. In this studyn this studyn this study n this study n this study n this study, CRE, CRE, CRE, CRE, CRE refers to any refers to any refers to any refers to any ch'i enhancing exercise that coordinates movement with breathing and inner concentration wherein ch'i is a first order concept used by practitioners and regarded by them as an embodiment of ideas related to human life and human existence and able to be experienced and refined through any ch'i related exercise. CRE is a set of practices and an intrinsic part of local culture in Taiwan which in recent years, has become popular practice in Taiwanese society. There are growing numbers of counselling professionals involved in regular CRE in recent years. Studies examining the effects of CRE indicate the benefits of CRE on practitioners' global health and personal growth. However, no previous study has investigated the influence of the long-term regular use of CRE on counsellors‟ self-care and counselling practice. The narrative research design for this study was developed from a post-structural theoretical perspective located in the domain of social constructivism. The data were co-constructed between the researcher and 12 senior Taiwanese counsellors with substantial CRE experience using a semi-structured in-depth interview approach. Interview data were analysed using the structure-based approach developed by William Labov in the field of socio-linguistics. The study reveals an overall benefit of regular involvement in CRE for practitioners' global wellbeing and personal growth counsellor' self-care. The research findings also reveals the potential of ch’i to be used as a way of expressing health and illness and a way of understanding in therapy and CRE to be lived out in therapy as an embodiment. I argue that collectively the narratives, as a whole, give evidence of an increasing integratin of the ideas and practices of ch’i into counselling practice in contemporary Taiwan. This might even make up a new form of integrated and culturally appropriate practice, what I term "a new way of healing." These are therapeutic practices which value the potential of CRE for counsellor's self-care and personal growth; recognize the integral whole of the human person; promote conscious use of the knowledge and experience of ch’i and CRE in therapy as an important aspect of the therapeutic use of self. Implications for practice such as the potential of CRE to be introduced into counsellor training programmes for counsellors' preparation or ongoing education are provided. Recommendations for future research such as the development of a new healing modality based on the research findings are offered.

Bakgrund Funktionella neurologiska symtom (FNS) innebär att en patient drabbas av dysfunktion i nervsystemet utan medicinsk bakomliggande orsak. Forskning visar att multidisciplinär rehabilitering, som inkluderar arbetsterapi, är effektiv för att hjälpa dessa patienter. Det saknas dock studier om arbetsterapeutiska behandlingar som är specifika för patienter med FNS. Syfte Syftet var att beskriva arbetsterapeuters erfarenheter av att arbeta med patienter med FNS. Metod Studien har en kvalitativ design där 14 deltagare intervjuades. En semistrukturerad intervjuguide användes. Data analyserades med kvalitativ innehållsanalys. Resultat Resultatet består av två teman: Erfarenhet och kunskap ger förutsättningar för att hjälpa en komplex patientgrupp och Arbetsterapeutens verktyg i behandling är aktivitet och terapeutisk användning av sig själv. Gemensamt för de två teman är att kunskapsbaserad och personcentrerad vård med aktivitet i fokus är viktiga i arbetsterapeutens arbete för patienter med FNS.  Slutsats Arbetsterapeuten, med tillgång till erfarenhet och kunskap i sin egen yrkesroll samt kollegor i vården, har förutsättningar att hjälpa den komplexa patientgrupp som de med FNS uppfattas som. Arbetsterapeuten använder aktivitet som medel under hela behandlingen och sig själv terapeutiskt i sitt bemötande och i det samspel som uppstår i den gemensamma dialogen med patienten med FNS. Med sitt fokus på patientens förmåga till aktivitet har arbetsterapeuten en betydande roll i det multidisciplinära omhändertagandet av patienten med FNS. / Background Functional neurological disorders (FND), means that a patient suffers from dysfunction in the nervous system without an underlying medical cause. Research shows that there is evidence that multidisciplinary rehabilitation, which includes occupational therapists, is effective in helping these patients. There is a lack of evidence for occupational therapy treatments that are specific to patients with FND. Aim The aim of the study was to describe occupational therapists' experiences of working with patients with FND. Method The study had a qualitative design. Semi-structured interviews were performed with 14 participants. Data was analyzed with qualitative content analysis. Results The result are presented by two themes: Experience and knowledge provide the conditions for helping a complex patient group and The occupational therapist`s tool in treatment is activity and therapeutic use of self. Common the two themes are that knowledgebased and person-centered care with activity in focus are important in the occupational therapists work for patients with FND. Conclusion The occupational therapist, with access to experience and knowledge in her own professional role as well as through colleagues in care, has the conditions to help the complex patient group that patients with FND are perceived as. The occupational therapist uses activity as a means throughout the treatment and herself therapeutically in her treatment and in the interaction that arises in the joint dialogue with the patient with FND. With focus on the patient´s abilities related to activity, the occupational therapist has a significant role in the multidisciplinary care of the patient with FND.

This paper discusses how I have made an original contribution to the field of family therapy and systemic practice in relation to three themes: the therapeutic relationship; working with emotions in therapy, and self-reflexivity in practice. I track how these three themes have developed in the course of my research and clinical practice between 1983 and 2008 and then go on to show how I have developed these themes into an original 'practical theory' that has broader application to the field of family therapy and systemic consultation. I put forward eight publications, focusing on my two books, 'Death Talk: Conversations with Children and Families' (Fredman, 1997) and 'Transforming Emotion: Conversations in Counselling and Psychotherapy' (Fredman, 2004). I show how my original contributions to the field of family therapy theory and systemic practice take forward the following issues debated in the field in the past ten years: systemic therapy's theorising of the therapeutic relationship; -the use of cybernetics, psychoanalysis and social constructionism in systemic family therapy; -the relationship between modern and postmodern approaches in the field of family therapy; -the relationship between theory and practice.

Bakgrund: Öppenhet om psykisk ohälsa är något som har fått allt mer medial uppmärksamhet. Konceptet öppenhet är brett och innefattar flertal definitioner såsom transparens, som i att vara ärlig och inte gömma information, samt ett förhållningssätt som präglas av bland annat tolerans och förmågan att acceptera nya perspektiv och idéer. Öppenhet avhandlas i denna studie från perspektivet av sjuksköterskor med egen erfarenhet av psykisk ohälsa. Syfte: Denna studie syftar till att utforska sjuksköterskors upplevelser och erfarenheter av öppenhet gällande psykisk ohälsa samt att avtäcka öppenhetens meningsbärande enheter utifrån ett omvårdnadsperspektiv. Metod: Studien har en kvalitativ studiedesign med en fenomenologisk hermeneutisk forskningsansats. Information samlades in via semistrukturerade intervjuer. Resultat: Analysen resulterade i 3 övergripande teman: öppenhet som transparens, öppenhet som förhållningssätt och öppenhetens kraft och fundamentala växelverkan. Helhetstolkningen  visade att öppenhet är en förutsättning för all typ av medmänsklig interaktion och kommunikation. Att dela med sig av erfarenheter av psykisk ohälsa är transparens med intentionalitet kopplat till både strävan efter en bättre värld och ett sätt att visa omsorg. Helhetstolkningen mynnade ut i att sjuksköterskors öppenhet gällande egen erfarenhet av psykisk ohälsa i hög grad påverkades av upplevd stigma. Slutsats: Öppenhet har en inre självförstärkande kraft: öppenhet leder till öppenhet. Att dela med sig av egna erfarenheter av psykisk ohälsa ter sig har en stor potential i att skapa relationer präglade av ömsesidighet och medmänsklighet. Att bemöta med öppenhet är nyckeln till att ge transparensen en möjlighet att skapa en mer humanistisk och rättvis vård. / Background: Openness around mental health issues has gained increased media attention. The concept of openness is vast and includes multiple definition like transparency, as in to be honest and not hiding information, and also an approach characterized by, among others, tolerance and the ability to accept new perspectives and ideas. In this study openness is presented from the perspective of nurses with own experience of mental health issues. Aim: This study aims to explore nurses’ experiences and knowledge of openness regarding mental health issues and also uncover the meaning entities within the concept of openness from a nursing perspective. Method: The study uses a phenomenological hermeneutical method. Information was gained through semi-structured interviews. Findings: The analysis resulted in 3 main themes: openness as transparency, openness as an approach and the power and fundamental interactions of openness. The comprehensive understanding exposed openness as a postulate to all human interaction and communication. To share own experiences of mental health issues is transparency with intentionality including striving for a better world and mediate caring. The comprehensive understanding also indicated that nurses’ openness in sharing own experiences of mental health issues was impacted negatively by stigma experiences. Conclusion: Openness has an inner amplifying power: openness leads to openness. To share experiences regarding mental health issues appears to possess a great potential in creating relationships characterized by mutuality and compassion. To approach with openness is the key to give transparency the ability to create a more humane and just health care.

The overarching aim of this paper is to study the professional encounter in its complexity. The requirements for receiving welfare is set by the professional and it's the professionals decision if they are met in the proper manner. This makes the assessment of the clients conditions and the correctness of the assessment hence important. There are several levels which is necessary for the social worker to take into consideration. We have therefore made a socio-analysis by using a theoretical model of Johansson (2006) where he uses the Social Psychology of the encounter to create a model with four levels, which is always present in the professional encounter: structural, positional, relational, and experience level.  Our base was that the one responsible for handling these levels was the professional which led us to search for literature concerning the professional approach. Our study is formed as a qualitative case-study. Our empirical data consist of qualitative interviews with four social workers handling social allowance.The results shows that the complexity of the professional encounter requires a professional approach. Furthermore it shows a need for more reflection of all factors of the meeting in its context.  But these abilities are by no means obvious.

Bakalauro baigiamajame darbe nagrinėjama savitarna lyginant ją su tradicine paslauga prekybos centruose Lietuvoje bei naujos paslaugos įtaka jos vartotojams. Teorinėje dalyje pateikta savitarnos esmė ir bendrosios jos savybės, savitarnos valdymo veiksnių analizė (naudojimosi savitarna lemiami veiksniai, savitarnos priėmino veiksniai), aptarti savitarnos technologijos tinkamumo kriterijai bei savitarnos reikšmė aptarnaujant klientus. Darbo problema. Stiprėjanti konkurencija paslaugų sektoriuje skatina paslaugų įmones ieškoti naujų verslo technologinių sprendimų, kurti naujas paslaugų technologijas, kurias taikant paslaugos teikiamos efektyviau. Savitarnos technologijos taikymas aptarnaujant vartotojus yra efektyvesnis negu individualizuotas, tačiau nevisos savitarnos paslaugos prigyja. Savitarnos pripažinimas iš vartotojų pusės yra susijęs su pasitikėjimu paslaugos teikėju, todėl yra svarbu nustatyti veiksnius darančius įtaką vartotojų suvokimui apie pačią paslaugą ir nustatyti savitarnos mašinų reikalingumą Lietuvos prekybos centruose. / This bachelor final paper analyses self-service comparison to traditional service of shopping centers in Lithuania and the input of self-service technology on service users. Theoretic chapter provides the analysis of the essence and general properties of self-service as well as analysis of the self-service operate factors (the use of self-service determinant factors and self-service adoption factors), discussion of the eligibility criteria for self-service technology and self-service importance for customer needs. Work problem. Increasing competition in the services sector encourages service companies of finding new technological solutions for their business and create new technology based services for more efficiency. Self-service technology for customer servicing is more effective than individualized but not all self-service naturalize. Self-service recognition from the consumer side is related to the trust of the service provider, so it is important to identify the factors influencing consumer’s perceptions of service and the need for self-checkout alternative in shopping centers of Lithuania.