Centre for Ageing Research and Development in Ireland

Introduction: Autistic psychotherapists hold a unique and underexplored position within the mental health field. While research on autistic clients is growing, there remains a significant gap in understanding the experiences of autistic clinicians. This study adds to the emerging literature on neurodiversity-affirming care by centering the voices of licensed autistic psychotherapists. Methods: Using a qualitative approach informed by interpretative phenomenological analysis, this study explored the professional identities, challenges, and contributions of eight licensed autistic therapists in the United States. We recruited participants through targeted outreach in online communities and took part in in-depth, semi-structured interviews. Results: Analysis revealed six superordinate themes: (1) Integration of autistic identity into therapeutic practice, (2) challenges in navigating professional environments, (3) adapting therapy for autistic clients, (4) autistic therapist well-being, (5) unique contributions of autistic therapists, and (6) advocacy and systemic change. Participants highlighted the value of authenticity in their clinical work, the therapeutic benefits of shared identity with autistic clients, and the importance of peer support within autistic communities. They also described systemic challenges, including stigma, limited accommodations, and workplace environments built around neurotypical norms. Discussion: Findings underscore the need for more inclusive training, supervision, and workplace practices to support and retain autistic clinicians. Participants challenged deficit-based assumptions about autism and demonstrated how autistic therapists bring essential insight, innovation, and empathy to their work. This study contributes to the growing field of neurodiversity scholarship and offers practical implications for building more affirming, equitable mental health systems.

ABSTRACTBackgroundIn clinical practice, there is considerable variance in involving parents in their child's therapy.AimThis research aimed to explore therapists' experiences of including parents in their young person's therapy sessions.MethodThis phenomenological, qualitative study used semi‐structured interviews to collect data from 10 therapists about their experiences of involving parents. Thematic analysis was used to analyse data as it tallied with the study's interpretive paradigm.FindingsSeven themes emerged: ‘The session structure’ based on workplace standards, policies and procedures; ‘Young person's voice’, whereby therapists seek the young person's consent before involving parents; ‘Ethical considerations’ that demand parental involvement, such as risk management; ‘Systemic issues and broader context’ as resources for young people; ‘Therapists' skills and strategies’ influence the level and duration of involving parents; ‘Therapists role’ in helping parental involvement and ‘Cultural awareness and sensitivity’ of the therapist, where sessions are tailored according to the young person's cultural needs.ConclusionThe parental role in young people's therapy sessions is complicated, multifactorial and influenced by several factors. Further research should consider (i) benefits to young people's mental health when therapists employ cultural knowledge and sensitivity in sessions and (ii) evaluate the views of parental involvement as part of the triadic relationship and the mental health outcomes of young people.

Infinite scrolling, a feature designed for seamless digital engagement, has evolved into a compulsive behaviour that many struggle to control. While existing research frequently frames scrolling within biological and behavioural models, these approaches fail to capture its deeper psychological function. This study proposes a psychodynamic model of scrolling, arguing that it serves as a neurotic-level defence mechanism that simulates a soothing, infantile phenomenal world – what object relations theorists term the paranoid-schizoid position. Drawing on defence mechanism theory, neuropsychoanalysis, and object relations theory, this study elaborates Herdi’s (2023) flowing construct and situates it within an extended mind framework. Through reflexive thematic analysis of psychodynamically oriented interviews with eight participants, the findings suggest that scrolling functions as a technologically scaffolded defence against the depressive position, where one must confront finitude, loss, and responsibility. While scrolling, the algorithmic systems engage the user in a process termed black mirroring by generating an impinging phenomenal world characterised by splitting, semantic levelling, and part-object perception, termed the paranoid-schizoid simulacrum. The guilt and demoralisation experienced by participants post-scrolling is proposed to reflect an oscillation back into the depressive position. These findings have implications for how we conceptualise digital engagement, arguing that scrolling constitutes the ontological antithesis of psychodynamic psychotherapy by precluding the emergence of spontaneous thought and emotional insight.

ABSTRACT This Special Issue of the European Journal of Psychotherapy and Counselling on Qualitative Research and Mental Health comprises a collection of papers that show how qualitative inquiry can be used to explore aspects of social experience that are relevant to counselling, psychotherapy and mental health, alongside other pieces that addresses methodological issues associated with this type of research. The present paper discusses these articles in relation to the question of how counsellors and psychotherapists can make use of routinely reading published research reports to support and enhance their work with clients. In particular, reading strategies are described that promote the development of therapeutic imagination.

Abstract Training and accreditation standards play a critical role in the development of a research‐informed agenda. This commentary on Barkham et al. (Counselling and Psychotherapy Research, 2024) discusses obstacles to fully integrating research into the training and standard agendas, and the potential role that the British Association for Counselling and Psychotherapy (BACP) can play in helping to overcome such obstacles. Knowledge of research evidence is currently limited in training and accreditation standards for counselling and psychotherapy, and course tutors are often not familiar—or engaged—with research findings. In the development of professional standards (for instance, within SCoPEd), the BACP should work to ensure that research competencies are comprehensive, contemporary and explained in a granular manner. Further helpful developments might include an annual research‐oriented conference for trainers and clinical supervisors, a journal dedicated to disseminating research and good practice in training and clinical supervision and/or a training/clinical supervision research network to coordinate activities in these area. BACP events—across all elements of the profession—should strive to address issues of research awareness and participation, and the use of research to inform practice. Critically, across all of these possibilities, BACP's Research Department, alone, cannot be left to support moves to a research‐informed profession. Rather, an organisation‐wide initiative is needed in which appreciation of the research evidence is at the heart of all aspects of the Association's work.

BackgroundIn both routine practice contexts and research studies, evidence from standardized self-report symptom measures, administered pre- and post-treatment, is predominantly used to determine whether psychotherapy has been successful. Understanding the nature of unsuccessful psychotherapy requires an ability to evaluate the credibility of outcome data generated by such techniques. An important body of research has identified discrepancies between outcomes assessed through symptom measures and those obtained from other sources. However, not enough is known about the extent to which such paradoxical outcomes exist.ObjectiveThis study analyzes the relationship between outcomes, as assessed by a standardized self-report measure, and as assessed by ratings of young people’s descriptions of change at post-counseling interviews.MethodsParticipants were 50 young people (13–16 years old) who had taken part in a trial of up to 10 weeks of school-based humanistic counseling. Our primary standardized measure was the Young Person’s CORE (YP-CORE). To assess young people’s experiences of counseling change, three independent raters scrutinized transcripts of post-counseling interviews, and scored levels of helpfulness on a 1 (Not at all helpful) to 10 (Extremely helpful) scale. Inter-rater reliabilities were 0.94 (Cronbach’s Alpha) and 0.96 (McDonald’s Omega). Sensitivity analyses were conducted to explore relationships between helpfulness ratings and other outcome measures, i.e., satisfaction with counseling (ESQ) and the Goal-Based-Outcome Tool (GBO), and process measures, i.e., the Working Alliance Inventory (WAI-S) and the Barret Lennard Relationship Inventory (BLRI).ResultsMultilevel analysis indicated that helpfulness ratings were not significantly associated with changes in YP-CORE scores. Analyzed categorically, 38% of those showing reliable improvement on the standardized measure were below the median for self-described helpfulness, and 47% of those not showing reliable change were at or above the median for self-described helpfulness. Sensitivity analyses demonstrated closer correlations between helpfulness ratings and other outcome measures (ESQ and GBO), and between helpfulness ratings and process measures (WAI-S and BLRI).DiscussionOur results raise questions about reliance on symptom change outcome measures for defining treatment success and failure, given their disparity with clients’ own descriptions of the helpfulness of therapy. Implications for practice and research are discussed.

At the outset, Cheryl Hunt, a retired academic in the field of community education, clarifies that her purpose in writing this exceptional book was to show how reflections on everyday practice, par...

Abstract ObjectivesTo date, there has been no research exploring the use of a pluralistic framework when working with neurodivergent (ND) clients. This research addresses the gap between theory and practice and explores therapist perspectives and experiences using the pluralistic framework as an ND therapist and/or when working with ND clients.MethodsEight pluralistic therapists were interviewed using semi‐structured interviews. This study employed interpretative phenomenological analysis (IPA) to capture lived experiences and sense‐making of the participants. The therapists had a range of experiences—some were ND themselves and working with ND clients.ResultsSix key themes emerged from the results: the importance of language; client strengths and cultural resources; collaboration and shared decision‐making; demystifying therapy; learning events within therapy; and flexibility. These results were synthesised into two overarching themes: ND justice and the pluralistic model as a supportive framework for ND affirmative practice. The approaches within the participants' therapeutic interactions modelled a neurodiversity justice approach. There was a belief that the pluralistic framework could have been designed for neurological difference. There was a deep respect for client experience along with hearing the client, giving voice, and respecting choice embedded in the approach. The participants were able to use the model to facilitate client autonomy and normalise them being part of their own processes both in therapy and in life.ConclusionThis study provides insights into the experience of ND, which can be used to improve practice and increase knowledge in the field.

This essay arises from research carried out between the summer of 2018 and the spring of 2020 among pilgrims who had participated in the Camino de Santiago in north-western Spain and St Patrick’s Purgatory, on Lough Derg in the northwest of Ireland. Research focused on embodied experience in relation to pilgrim motivation, groundedness and the enduring power of sacred travel as ritual. Convergent considerations about psychology, theology and pilgrimage studies clarified perspective on descriptions and definitions of pilgrimage in contemporary literature. Long-standing questions about journey vs. destination are subsumed into a description of pilgrimage which emphasizes larger process. Interconnected elements of this process are a most significant part of the enduring appeal of contemporary Western pilgrimage.