Service user experiences of clinical psychology within an adult mental health service: an IPA study
| Date | 29 August 2019 |
| Published date | 29 August 2019 |
| DOI | https://doi.org/10.1108/MHRJ-02-2018-0005 |
| Pages | 171-182 |
| Author | Diane Beattie,Síle Murphy,John Burke,Hester O’Connor,Sarah Jamieson |
| Subject Matter | Health & social care,Mental health |
Service user experiences of clinical
psychology within an adult mental health
service: an IPA study
Diane Beattie, Síle Murphy, John Burke, Hester O’Connor and Sarah Jamieson
Abstract
Purpose –The purpose of this paper, a qualitative study, is to explore service users’experiences of
attending clinical psychology within a public community adult mental health service.
Design/methodology/approac h –Six individuals who had complete d at least 16 sessions of
psychotherapy participated in semi-structured interviews. Data were transcribed and analysed using
interpretative phenomenological analysis.
Findings –The results showed the following overarching domains: the relationship and its impacts, structure
and focus, and participant factors –timing/readiness. The importance of the use of language was also
identified. Participants appeared to value a sense of humanity within the relationship. Interestingly, the
personal impact of therapy as perceived by the participants was not focussed on symptom reduction, but on
broader changes. The results are discussed in relation to the relevant literature.
Practical implications –Suggested principles for practice include maintaining attentiveness to relational
factors, to client factors such as readiness for change and to the use of structure and flexibility. The use of
recovery focussed and alliance measures are recommended.
Originality/value –For clinical psychologists providing psychotherapy within the public system, there are
valuable lessons we can learn from asking the service users directly about their experiences, in terms of focussing
on the human element of the relationship, and striking a balance between professionalism and humanity.
Keywords Qualitative, Clinical psychology, Mental health service, Service user experience,
Therapy relationship
Paper type Research paper
Introduction
Decades of research have indicated that psychotherapy is effective in the treatment of various
psychological difficulties (Carr, 2009; Hubble et al., 1999; Lambert and Harmon, 2015; Valkonen
et al., 2011). Many researchers have concluded that equivalent beneficial outcomes are
demonstrated regardless of the therapeutic orientation, in that there is little clinically meaningful
difference between the efficacy of therapies when compared through randomized controlled
trials (RCTs) and outcome studies (e.g. Barkham and Saxon, 2018; Cuijpers, 2017; Lambert,
2013; Miller et al., 2007) –the controversial “Dodo bird verdict”(Budd and Hughes, 2009). Some
argue this represents the significant commonalities across models (Luborsky et al., 2002),
factors such as therapeutic alliance, therapist empathy, congruence and positive regard, hope
for recovery, theoretical understanding of the problem and client expression of emotions
(Stamoulos et al., 2016). Others contend that the use of RCT methodology has contributed to
the finding of similar results across therapy models (Budd and Hughes, 2009), and that statistical
power and therapist bias would need to be addressed to properly examine comparative
effectiveness of treatments (Barkham et al., 2017).
Diverging from traditional approaches to outcome research in favour of focussing on the service
users’own views is a key method of advancing understanding of the psychotherapy process
Received 19 February 2018
Revised 30 November 2018
Accepted 17 June 2019
Diane Beattie and Síle Murphy
are both based at Department
of Clinical Psychology, HSE
Kildare/West Wicklow,
Naas, Ireland.
John Burke is based at the
University of Limerick,
Limerick, Ireland.
Hester O’Connor and Sarah
Jamieson are both based at
Department of Clinical
Psychology, HSE Kildare/West
Wicklow, Naas, Ireland.
DOI 10.1108/MHRJ-02-2018-0005 VOL. 24 NO. 3 2019, pp. 171-182, © Emerald Publishing Limited, ISSN 1361-9322
j
MENTALHEALTH REVIEW JOURNAL
j
PAG E 17 1
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