“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.

Neurophysiologic, psychological, sport and health dimensions of three meditation techniques

The aim of this study was to record experiences of three meditation conditions: Ratio Breathing, Transcendental Meditation and Zazen, with special reference to sport, health, neuro-physiology and sense of coherence. The participants (N=9), seven males and two females were all British, actively competing across a range of individual and team sports, with no experience of using meditation techniques or practices in their sporting or daily lives. Their mean age was 31.56 years with an age range of 22 to 44 years. The study employed a within-subjects, repeated measures design, with each participant practising each meditation condition in a randomly counterbalanced order. Integrative findings support the value of all three meditation conditions for health and to a lesser extent for sport, especially with regard to their effect on focus. All three meditation conditions were associated with a decrease in respiration. The differential effect of the meditations was apparent. Participants valued Ratio breathing for its effect on concentration, Transcendental Meditation for its depth of meditation and Zazen for its effect on self and removal of external distractions. These qualitative findings were associated with differentially significant quantitative effects on lowered respiration rate in the Ratio Breathing group, increased physical relaxation and alpha activity in the Transcendental Meditation group, and increases in both alpha and theta activity in the Zazen group.