“I just can’t, I am frightened for my safety, I don’t know how to work with her” Practitioners’ experiences of client violence and recommendations for future practice

To what extent is the therapist-client relationship damaged following client perpetuated violence and what steps can we take to diminish its impact? Much of the information we have on client violence comes from multiple mental health disciplines in the US and the UK over the last 20-30 years and has formed a useful, though sometimes dated and sporadic, quantitative baseline to delineate a range of issues. However, there is limited systematic research on how practitioner psychologists process the violence in the course of their everyday practice and how this impacts the therapist-client dynamic. Using Interpretative Phenomenological Analysis (IPA), we explored seven therapists’ experiences of client violence across a range of work sites – acute psychiatric hospital wards, forensic hospital wards and community mental health teams. Three main themes were documented: processing the moment-to-moment experience of client violence; professional vulnerabilities and needs as a result of client violence; and the ruptured therapeutic relationship. Strategies for supporting practicing psychologists and providing continuing professional care for clients include challenging self-doubt and re-energizing professional competencies as well as repairing ourselves and repairing the therapeutic relationship. Recommendations for credentialing and regulatory bodies in relation to client violence are also highlighted.

Projective Identification and the Fear of Failing: Making Sense of Practice Educators' Experiences of Failing Social Work Students in Practice Learning Settings

The paper focuses on emotions and processes that may arise for practice educators when working with a struggling or failing student in a practice learning setting.1 The paper firstly documents a previously undertaken thematic review of the literature, which explored why practice educators appeared to find it difficult to fail students in practice learning settings. Secondly, the paper draws on two UK qualitative studies that highlighted the emotional distress experienced by practice educators when working with a marginal or failing student. The paper documents key findings using a case study approach from both studies. We argue that the concept of projective identification offers a plausible and illuminating account of the states of mind experienced by practice educators and in making explicit, unconscious states of mind, our aim is that practice educators will feel confident to make appropriate assessment decisions when required.