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Respect for the journey: a survivor-led investigation of undergoing psychotherapy assessment

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Alison Faulkner, Katie Kelly, Sarah Gibson, Steve Gillard, Lana Samuels, Angie Sweeney

Original languageEnglish
JournalSocial Psychiatry and Psychiatric Epidemiology
DOIs
E-pub ahead of print1 Feb 2021

Bibliographical note

Funding Information: Angela Sweeney is funded by a National Institute for Health Research Post-Doctoral Fellowship. This paper presents independent research partially funded by the National Institute for Health Research (NIHR). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. Dr Sweeney would like to thank the Advisory Groups for their contribution to the APTT research programme (understanding and improving Assessment Processes for Talking Therapies) which this paper is a part of: Vanessa Anenden, Katie Bogart (co-author), Dr Sarah Carr, Dr Jocelyn Catty, Professor David Clark, Dr Sarah Clement, Alison Faulkner (lead author), Sarah Gibson (co-author), Mary Ion, Steve Keeble, Dr Angela Kennedy, Dr Gemma Kothari and Lana Samuels (co-author). Funding Information: This work was funded by a National Institute for Health Research Post-Doctoral Fellowship award, Grant no. PDF-2013-06-045. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

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Abstract

Purpose
Psychotherapy assessments are key decision points for both clients and services, carrying considerable weight on both sides. Limited research indicates that assessments have immediate and long-term impacts on clients, particularly where trauma has been experienced, affecting engagement with therapy. Understanding assessments from clients’ perspectives can inform service development and improve client experience.

Methods
This is a survivor-led exploration of clients’ experiences of undergoing assessment for talking therapies. Interviews were conducted with seven people who had undergone assessment for psychological therapies in third sector and NHS services. Interviews were recorded, transcribed and analysed thematically.

Results
The core theme was ‘respect for the journey’ reflecting the need expressed by participants for their life experiences prior to the assessment to be given full respect and consideration. Six sub-themes were identified: trauma and desperation, fear of judgement, search for trust and safety, sharing and withholding (a balancing act), feeling deconstructed, and finding hope.

Conclusions
The findings highlight the heightened emotional power surrounding psychotherapy assessments, reflecting the journey participants had undertaken to reach this point. The dilemma facing clients at the heart of an assessment—how much to share and how much to withhold—demonstrates the importance for services and assessors of treating the journey a client has made to the assessment with care and respect. Findings indicate the value of services and practitioners undertaking a trauma-informed approach to assessment encounters.

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