Valerie Fletcher

Aims/Purpose: The purpose of this research was to explore the experience of University students who have engaged voluntarily in a 12-week resilience training programme during their first year of study. Design/Methodology: Initially we conducted a scoping literature review guided by Arksey and O’Malley (2005) and (Peters et al. 2015b; Khalil et al. 2016) methodology, this helped us to formulate our research question. The pilot study involved facilitating a focus group with seven students who were all on an undergraduate degree relating to the field of mental health. The participants, drawn from 70 cohort had engaged & completed a minimum of 80% of the resilience programme which had met 12 times weekly. The focus group enabled participants to speak freely enabling the moderator of the group to ‘access participants everyday vocabularies’ (Silverman 2020: 223). The group interview was transcribed verbatim and analysed using Interpretative Phenomenological Analysis (IPA). Ethical Approval: Ethical approval was granted through the Leeds Beckett University School of Health and Community Studies Ethics Board. Results/Findings: The in-depth analysis of the group’s account captured participants’ journeys through the process of learning resilience skills and implementing them in their everyday lives. The findings suggested that most participants considered resilience skills beneficial in terms of helping them to cope with the emotional and cognitive challenges of not only their educational experience but also life in general. Research Limitations: The ‘clients’ were selected from one cohort of students on the same course; therefore the perspective is of the experience of the same programme. There was also a time limitation in that the study results are drawn from a short time of engagement with the programme rather than a longitudinal study. Conclusions/Implications: Seven themes provided in-depth information about participants’ lived experiences of attending and being in the resilience group, implicating exploration of current practice and development in resilience training/programme service provision in higher education/other organisations supporting mental health students. Recommendations from this study offer ways in which students’ resilience could be strengthened and ways their multiple needs may be met. The findings can inform students’ mental health and wellbeing policies as well as education strategies for teaching first year students many of whom are away from home for the first time.

Therapists’ Views on the Evidence-based guidelines for the Treatment of Depression in Adults. Abstract Aims The purpose of the study was to consider therapists’ opinions of working with the Evidence Based Guidelines for Depression. Method Structured interviews took place using Interpretative Phenomenological Analysis (Smith, Flowers & Larkin, 2009, p49) with a sample of four practising psychotherapists from different modalities who had worked with the Evidence Based Guidelines for Depression. Ethical Approval The research was granted ethical approval by The Leeds Beckett University Ethics Board. Findings • Positivity was revealed regarding the use of the guidelines as a reference/safety tool, however they were perceived to be too broad and restrictive. • There was an underlying anxiety, fear and frustration regarding job security in relation to the EBG, one therapist felt deskilled. • There was a variation in the extent to which the methodology and the quality of the data used in guideline formulation, was understood by therapists. • There was a consensus that the number of sessions recommended for clients, particularly when other issues presented such as trauma and bereavement were not adequate. • The therapists of differing modalities considered the other methodologies as unethical. • One therapist had experienced conflict when trying to reconcile the EBG with other guidelines. Research Limitations Although care was taken to select therapists from a range of modalities, the research required a limited number of (4) therapists, due to time restrictions and was also limited to those therapists who had experience of working with the guidelines. Conclusions A professional’s standpoint on the appropriateness of EBG may correlate with whether EBG favours the application of their methodology. Reeves (2017) expresses concern for the future of the counselling and psychotherapy and the researcher found anxiety and frustration recorded in this study alongside known concerns with the application of RCTs (exclusion criteria, publication bias, use of non-inferiority design) and systematic reviews (small studies and/or of low quality, publication bias) to this field. Recommendation The confidence of psychotherapists with the guidelines could be strengthened by a dissemination of information by professional bodies concerning the evidence upon which guidelines are based.

Relational Psychotherapy as a Successful Intervention for Complex Clients: including those diagnosed disorders. Relational Psychotherapy is an integrative, primarily humanistic force focusing on the relationship between client and therapist, whilst integrating aspects of psychodynamic, cognitive and or approaches. This approach allows the therapist to refresh and develop their practice in line with a continually changing evidence base. This is an ongoing project for the author to establish the experience relational counselling/psychotherapy students have when working with clients with personality disorder diagnoses. What are their experiences? Do they feel prepared? Does it affect emotional wellbeing? Do the complexities the client may present affect the therapist’s ability to work at relational depth?

The results of randomised controlled trials and meta-analyses of trials in medicine have led to major improvements in treatments, and thereby significant reductions in mortality and morbidity worldwide. The implications of specific aspects of trial methodology for evaluating the effectiveness of psychotherapy for depression are explored, with reference to trial size, quality, bias, eligibility criteria and the use of non-inferiority design. In contrast to the treatment of systemic disease, pill placebo control in trials of psychotherapy for depression is not ‘no treatment’, and the use of such can reduce measured treatment effect. Trials have entry criteria, and thus use a selective sample, findings may therefore not be generalizable. For example, in psychotherapy, specific trial exclusion criteria (suicidal behaviour) appear to raise a concern that a therapy may be widely adopted and include the treatment of a category of individual excluded from a practice-informing trial. A diagnosis of depression is associated with a higher mortality, notably suicide, and the inter-relationship between depression and suicidal behaviour is explored. Aside from the direct utilisation of specific psychotherapies for suicidal behaviour; the effective treatment of depression, notably major depression, by psychotherapy, may lead to a reduction in the prevalence of suicidal behaviour. Keywords: psychotherapy, depression, suicide, randomised controlled trial, meta-analysis, non-inferiority trial, subgroup analysis

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