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Therapeutic activities and psychological interventions by cognitive behavioural and psychodynamic therapists working with medically unexplained symptoms: a qualitative study
- Author:
- LUCA Maria
- Journal article citation:
- Counselling and Psychotherapy Research, 12(2), 2012, pp.118-127.
- Publisher:
- Wiley
Medically unexplained symptoms (MUS), or signs of physical malfunction that cannot be accounted for by a physical disorder, weighs heavily on NHS resources and are difficult for psychological therapists to work with. The belief of some MUS clients that their symptoms are purely physical perpetuates this difficulty. The aim of this paper is to report on therapeutic activities and psychological interventions used to treat MUS clients by experienced cognitive behavioural and psychodynamic therapists. Twelve in-depth, semi-structured, qualitative interviews with psychotherapists, recruited from 2 NHS Departments, were conducted. Interview transcripts were analysed using grounded theory. The findings showed that therapists from 2 modalities share the following activities and interventions: working together with clients; sensitive, empathic responding and building trust; being flexible with techniques; keeping an open mind; and multi-disciplinary cooperation. They also use a number of modality specific interventions which differentiate them from their colleagues. While the therapists spoke of the difficulty that experienced in engaging MUS clients psychologically, they also felt that working together with clients produced more positive outcomes.
A qualitative study of psychodynamic and cognitive behavioural therapists’ conceptualisations of medically unexplained symptoms in their clients
- Author:
- LUCA Maria
- Journal article citation:
- Counselling and Psychotherapy Research, 11(4), December 2011, pp.291-299.
- Publisher:
- Wiley
An increase in the awareness of the prevalence of medically unexplained symptoms in recent years has led to recognition of how unexpressed emotional distress is significant in these cases. This qualitative study investigated therapists’ conceptualisations of their psychodynamic and cognitive behavioural therapies with clients with medically unexplained symptoms. Interviews were conducted with twelve experienced psychotherapists, recruited from two National Health Service departments. Interview transcripts were analysed using grounded theory. Conceptualisations fell into two categories. Firstly, informal, bottom-up practice driven where therapists from both modalities shared experiential conceptualisations, and secondly, formal, top-down theory driven where therapists shared some conceptualisations while retaining others from their theoretical training. The author concluded that therapists conceptualised using theoretical concepts from their respective professional trainings, by developing experiential concepts of their own, and by integrating theoretical concepts from other theoretical orientations. Implications for practice are discussed.
Childlessness and upward intergenerational support: cross-national evidence from 11 European countries
- Author:
- PESANDO Luca Maria
- Journal article citation:
- Ageing and Society, 39(6), 2019, pp.1219-1254.
- Publisher:
- Cambridge University Press
Childless individuals are often depicted as ‘selfish’ as they opt out of raising children in favour of investing resources in themselves. Yet no research has investigated whether this claim holds in domains of social life such as intergenerational family support. Using data from the Generations and Gender Survey for 11 European countries, this article examines differences between childless and non-childless individuals in the provision of financial, practical and emotional transfers to their elderly parents. Results support the idea that the childless are more prone to provide upward support than individuals with children. Specifically, estimates from multivariate logistic regression and propensity score specifications suggest that, ceteris paribus, childless adults are about 20–40 per cent more likely to provide support to their parents, with the association driven by transfers to elderly mothers. These findings enrich the literature on childlessness and ageing, and support the view that researchers and policy makers should take into more consideration not only what childless people receive or need in old age, but also what they provide as middle-aged adults. (Edited publisher abstract)