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There is little consensus regarding what constitutes an effective therapist when working with adults with intellectual disabilities (ID) who have a mental health problem. This study aims to explore whether clusters of clinical psychologists (CPs) could be differentiated with regards to beliefs as to what defines an effective therapist for adults with ID experiencing psychological distress and seeking treatment.

Four interviews with CPs and an associated thematic analysis created the 49-item Q-set. These items were then sorted into a forced quasi-normal distribution by N = 27 CPs via an online Q-sorting task.

Three participant clusters were identified in the principal components analysis that accounted for 49% of the variance. These clusters were labelled the creative collaborator, the reflective expert and the system integrator.

Differences exist regarding beliefs as to what the psychotherapeutic approaches effective therapists working with ID and comorbid mental health problems should take. These differences approximated to preferred psychological therapy models. This study is critiqued to enable future research on this topic to progress.

To the best of the authors’ knowledge, this is the first study to explore what constitutes an effective psychological therapist for people who have ID.

This chapter investigates the ongoing process of academization within the field of educational therapy in Germany, particularly in the context of the introduction of university degrees in integrative educational therapy and the psychology of learning. The introduction of these degrees brought about transformative changes in the professional landscape. Educational therapists holding such degrees often demonstrate a more advanced understanding of their roles, which is underpinned by thorough university education and the legitimizing influence of their academic titles. Prior to the establishment of these degree programs, the field of educational therapy was notably unregulated, devoid of a protected professional title or a specific qualification. This lack of regulation resulted in a proliferation of varied providers, giving rise to what’s known as the “after-school market” phenomenon. This chapter explores the genesis and institutionalization of degree programs in educational therapy as a path toward professionalizing the field. It reveals the crucial role that professional associations along with scientific experts have played in launching these degree programs. Additionally, it discusses the impact of competition among different approaches to educational therapy within this rapidly evolving landscape.

The purpose of this paper is to explore primary care psychological therapists’ experiences of working with mid-life and older women presenting with intimate partner violence (IPV) and develop a theoretical framework using a grounded theory approach to identify the experiences of those practitioners working with this phenomenon.

Interviews with 17 practitioners were conducted. The data analysis was informed by a grounded theory approach, which requires three states of data coding: open, axial and selective. Data codes were thematically sorted into causal, contextual, strategic, intervening, interactional and consequential conditions.

A core state of therapist helplessness was uncovered. The framework demonstrates that psychological therapists can doubt their ability to work meaningfully with women over 45 years of age experiencing IPV. To avoid the core state of helplessness, therapists use strategies such as avoiding asking questions about partner violence, making assumptions of how patients interpret their own experiences, addressing symptoms rather than the root cause and going above and beyond in attempts to rescue patients. The consequence of therapists’ helplessness often results in burnout.

The framework identifies barriers in working effectively with IPV and women in the mid-to older-aged populations.

This study is the first to suggest a framework that is grounded in practitioner experience with capability to transfer to a range of professionals working with mid-to older-aged women such as forensic, medical and specialist psychologists.

Despite the emergence of NICE guidelines regarding the effectiveness and appropriateness of psychological therapies for the majority of common mental health problems, access to these services is still dramatically underdeveloped and uneven. Estimates of untreated problems such as depression and anxiety in primary care signal the extent of these problems and the scale of investment in new services, if these needs are to be adequately met in the future.The Department of Health's and the Care Services Improvement Partnership's (CSIP) Improving Access to Psychological Therapies (IAPT) programme sets out a framework and a series of co‐ordinated actions, including two national demonstration sites, to begin to address these issues in England.This paper examines the origins and policy drivers that have given rise to the IAPT programme, outlines the progress to date and specifically assesses the implications for the mental health workforce of this programme. Issues addressed include the workforce profiles of existing services, career frameworks for psychological therapists, the capacity of training providers to train new and existing staff in psychological therapies and the challenges implicit in devising a workforce delivery plan to support the IAPT programme.

A range of adaptations and therapy processes have been explored in relation to therapy with people with intellectual disabilities; however, there remain a few areas of therapy practice that have not yet been considered in depth. This study aims to report the results of an online survey of the practice of therapists working with people with intellectual disabilities in managing endings in therapy.

Thirty-one therapists working with people with intellectual disabilities responded to an online survey. The data were analysed using reflexive thematic analysis.

Three superordinate themes were identified: Theme 1 was “preparing for a therapeutic ending” with subordinate themes of “planning early”, “providing boundaries” and “validating feelings”; Theme 2 was “providing a therapeutic ending”, with subordinate themes of “a collaborative decision” and “fostering growth”; and the third theme was “post-ending issues” in which participants acknowledged a “spectrum of emotion”, and, in the case of difficult endings, a sense of “unfinished business”.

This is the first systematic exploration of therapy endings as described by therapists working with people with intellectual disabilities. The authors discuss implications for practice and further areas of research.

While there is general agreement in the literature regarding the importance of the therapeutic alliance (TA) in psychological interventions with people, the forensic context raises some unique challenges. The purpose of this paper is to discuss how these challenges are managed within a therapeutic context.

This paper consists of a literature review examining the following: the significance of the TA in interventions with forensic clients, especially men who have committed a sexual offence and the impact on treatment efficacy and change; therapist characteristics as well as some of the obstacles and challenges present in a correctional setting, which can impact on the TA and; the role of transference and countertransference in relation to these forensic clients.

Through the literature review, there is a discussion regarding how some of the common obstacles within correctional settings can be overcome, and how certain therapist qualities should be interpreted.

This paper will discuss some of the practical applications of certain recommended therapeutic factors within a correctional setting, challenging some of the common misconceptions and limitations. Furthermore, transference and countertransference, topics which are seldom discussed, will be considered in this paper.

Effective treatment of patients with severe psychopathy is very difficult to achieve. This conclusion may be drawn from an extensive examination into the usage of the term ‘psychopathy’ in scientific research literature, in theoretical development from various psychological schools of thought, in the practice of therapy and in assessment. The central issue for the authors of this article is the inability of severely psychopathic patients to commit to the patient‐therapist relationship. Attachment theory and mentalisation‐based treatment are used here to define the cause and nature of this inability, which is incurred in very early childhood. These two models can aid in the development of more dynamic definitions of psychopathy, better suited to dynamic therapy formats.The ways in which psychopathy is defined partly account for a number of problems encountered in the practice of therapy. The authors assume that the treatment of psychopathy should be interactional and should match patients' individual levels of psychological development and mentalisation; highly psychopathic patients often perceive others as objects, ie. as part of the context, not as subjects, ie. autonomous personalities.The authors propose to conduct further research in order to verify the validity of their hypothesis. They also put forward a number of suggestions for therapy formats with a view to establishing effective working relationships with psychopathic patients.

The purpose of this paper is to investigate the treatment effects of Quest cognitive hypnotherapy (QCH) on anxiety and depression, and make comparisons with published data from the Improving Access to Psychological Therapies (IAPT) project.

Adult clients of QCH therapists were invited to enrol in a Practice Research Network (PRN) and completed pre- and post-therapy measures of anxiety (GAD-7) and depression (PHQ-9).

Post-treatment scores were available for 83 of the 106 clients reaching caseness (above the clinical cut-off on either or both measures) on their pre-treatment scores. Totally, 59 clients had moved to recovery, representing 71 per cent of cases where post scores were available and 56 per cent of the intent to treat (ITT) population (106 clients). Additionally, including all cases (both above and below cut-offs) 118 clients had post-treatment measures. In total, 86 (73 per cent) clients improved reliably. The mean number of treatment sessions was between three and four. This compares favourably with 2012-2013 IAPT findings using the same measures.

This study was exploratory involving a client group paying privately for treatment. There was no randomised control group or attempt to evaluate the effectiveness of specific components of therapy.

QCH may offer a brief effective treatment for clients with clinically significant levels of anxiety and/or depression, widening client choice.

As the first study to explore the effectiveness of private QCH this study offers an example of how to use a PRN to compare with published IAPT data using the same measurement tools.

The psychological therapies are widely considered within the forensic literature as holding a useful role in the prison system, however, despite this, very little research into the psychological therapies has taken place. Further, where research is carried out, it is often associated with the need for evidence-based practice (EBP), involving quantification and randomization. The paper aims to discuss these issues.

This paper will initially introduce the importance of research into the psychological therapies in prison, followed by a consideration of EBP which can be thought of as the current movement governing research in the psychological therapies in the UK.

However, in providing a focused critique of EBP, particularly within prisons, this paper will attempt to pave the way for a consideration of alternative research methodologies and resultant methods in researching the psychological therapies in prisons in the UK.

Through this it is argued that research within the prison setting should act not to promote interventions and create an evidence-based as such, but to provide an accessible body of knowledge for the psychological therapists working in prisons in the UK.

The past decade has seen an expansion of psychological treatments available to patients in the NHS. Research into the effectiveness of psychological treatments is also increasing, but this evidence is often not known or used by practitioners. This paper describes the development of a local clinical practice guideline from the research evidence to assist local GPs and psychological practitioners in selecting the most appropriate of three commonly available psychological treatments for adult patients — brief counselling, cognitive behaviour therapy, and psychodynamic psychotherapy. The steps of the guideline development process and difficulties encountered are outlined, and the local dissemination and implementation process described. A survey of GPs and practice counsellors conducted a month following distribution of the guideline found that most recipients reported it useful with many also reporting having used it already in clinical practice. The limitations as well as strengths of this local guideline development process are discussed.