How did I get here? A narrative exploration of arriving at talking therapy in a neuro-rehabilitation setting, co-written by a young adult patient and her therapist

Abstract

AimsThis narrative case study explores some of the themes and process behind the referral process in a neuro-rehabilitation multidisciplinary team (MDT) outpatient setting. It aims to give a central focus to the patient experience, in this case, Jess, one of the co-authors, who at 19, experienced a life-changing spinal injury causing paralysis and pain in January 2017 while she was in her first year at university. Jess is doing well with her recovery, back at work part-time, and started back at university in September 2019.MethodologyThe data was gathered through two interviews held to reflect specifically on what life was like in the run up to coming to talking therapy services as an outpatient and the impact of that first session. The interviews were facilitated by, Helen the other co-author, a counselling psychologist and integrative psychotherapist, and the participants were Jess, and her referring physiotherapist and occupational therapist. The data was then analysed thematically by Jess and Helen.Findings & DiscussionFive themes were identified: 1) The point when ….I knew that I needed a bit of extra help, even though I didn’t really want to… 2) How this ‘different kind of conversation’ might fit in with the rest of rehabilitation, 3) Could this be the right time ‘to open the box …?’ 4) The moment when it felt like talking therapy might be OK and 5) How starting talking therapy began to change things. Jess’s experience and reflections provide a client-centred view as to the added value psychotherapy can bring within a physical healthcare MDT setting. The findings also support existing evidence that it is less the therapeutic approach or modality that is paramount, but the fit of the therapeutic relationship that counts (Norcross, 2002; Cook et al., 2017). The authors offer this piece of work for wider discussion within the context of practice-based research, promoting the voice of the client experience within talking therapy discourse. It also fits with the wider objectives of embedding co-production with the BPS Experts by Experience initiative. The authors present a summary with reflections and learning points in the conclusion.