ABSTRACT Objective Therapist responsiveness within standardised group psychotherapy may be supported by patient feedback from routine outcome monitoring (ROM). This study examined patients' experiences of therapists approaching them outside group sessions to discuss therapy progress when prompted by ROM. Design This is a qualitative feasibility study as part of a naturalistic multiple‐case intervention. Twenty‐nine patients with depression entered group cognitive behavioural therapy (CBT) with ROM. We implemented a procedure for therapist responsiveness based on ROM data, in which therapists checked in with patients who were not making expected progress outside the group setting in what we termed a ‘What's at stake’ session (WASS). This session occurred before the next group session and was delivered by phone or in person. Method We interviewed 13 patients and applied a thematic analysis to address the research question: ‘How do patients experience a strategy for therapist responsiveness in structured group therapies, where therapists make individual contact based on the lack of progress suggested by ROM?’. Findings We generated three main themes: ‘An unexpected contact’, ‘An invitation for reflection’ and ‘The WASS actualized ROM’. Patients generally found ROM meaningful because they had experienced the feedback being applied in the WASS. Subthemes revealed variations in experiences, with some participants perceiving the intervention as caring, while others found it intrusive. Conclusion Therapists' responses prompted by ROM in group CBT were experienced as a departure from the standardised approach and were perceived as either caring recognition or intrusive monitoring. These qualitative findings show how the WASS fostered a potential for therapist responsiveness, but the realisation of the potential depended on the relational context and repeated, transparent explanation of ROM and the rationale for contact.

ABSTRACT Background The increasing presence of English‐as‐an‐additional‐language counsellor trainees (EAL CTs) in counselling programmes underscores the need for more inclusive and targeted training that addresses their unique developmental and cultural experiences. However, limited empirical research has examined how acculturation processes and mindfulness traits jointly relate to EAL CTs' professional identity development. Methods Using a quantitative mediation design, this study surveyed 168 EAL CTs to examine the relationships among professional identity development, mindfulness traits, and acculturation orientations towards both heritage and mainstream cultures. Mediation analyses were conducted to test whether mindfulness traits mediated the associations between acculturation and professional identity. Results Professional identity development was significantly associated with mindfulness traits as well as with both heritage and mainstream acculturation. Furthermore, mindfulness traits significantly mediated the relationships between each form of acculturation and professional identity development. Conclusion These findings highlight mindfulness as a key psychological mechanism linking acculturation experiences to professional identity development among EAL CTs. Implications emphasise the integration of mindfulness‐based practices into counselling curricula and the intentional affirmation of both heritage and mainstream cultural orientations in the training of EAL CTs.

ABSTRACT Objective The aim of this study was to examine whether meta‐categories of client‐experienced impacts of significant events (SEs) in psychotherapy sessions, synthesised by Ladmanová and colleagues, are suitable for categorising and analysing SEs in routine psychotherapy at a university training clinic, and how these were distributed among clients and therapists. Methods Data from 23 client‐therapist dyads at a Danish university clinic were analysed. Both clients and therapists completed the Helpful Aspects of Therapy form and the free text answers were used to categorise SEs. Descriptive statistics were used to examine the prevalence of different types of SEs. Results Most of the meta‐categories for helpful SEs were represented in our dataset. The most common type of helpful SEs, mentioned by both clients and therapists, involved clients gaining new perspectives, feeling empowered, feeling understood, and developing new coping strategies. Few meta‐categories represented most of the data. Very few unhelpful SEs were mentioned; hence, they could not be categorised with adequate reliability. Conclusion Adequate reliability in the coding of meta‐categories is promising and the distribution of SEs aligns with broader theory on common factors in psychotherapy process research. The finding that few meta‐categories represent most of the data points could alternatively point to a need for further refining of existing meta‐categories.

ABSTRACT Background This study explores the motivations and influences behind psychotherapists' choices of artwork for their practice rooms. Whilst prior research has focused on client preferences and general therapeutic environments, limited attention has been paid to the therapist's subjective experience in curating artwork within their space. Methods Using Interpretative Phenomenological Analysis (IPA), this study investigates the lived experiences of three UK‐based psychotherapists who have personally selected artwork for their rooms. Semi‐structured interviews were conducted and analysed to identify three Group Experiential Themes (GETs): artwork as implicit communication, artwork as a therapeutic resource, and artwork as personally meaningful. Results Findings suggest that therapists use artwork to subtly communicate aspects of their identity and theoretical orientation, regulate emotional states (both their own and their clients'), and evoke personal memories. Notably, participants often made these choices intuitively, with limited conscious reflection on broader influences. Conclusions These findings highlight the need for greater reflexivity in therapists' aesthetic decisions and suggests that artwork plays a dynamic role within the therapeutic frame. Implications for practice include encouraging practitioners to reflect on the subjectivity within their visual environment. Future research should explore these themes across more diverse samples to deepen understanding of this overlooked aspect of the therapeutic frame.

ABSTRACT Background This article uses suicide notes to explore the reasons individuals gave to end their life, and the links between suicide and the actualising tendency (AT). Suicide remains one of the most complex and challenging presentations in the mental health field. While much research has focused on risk factors, protective factors and epidemiological trends, relatively less attention has been paid to first‐person accounts of suicidal experience. The AT, defined by Rogers as the inherent drive within all living organisms to develop, grow, and realise their full potential, provides a provocative lens through which to explore the paradox of suicidal behaviour. Method and Findings Using stanza and narrative analysis, 31 suicide notes were analysed which identified the reasons individuals provided for ending their life. Notes were also analysed in relation to propositions of the actualising tendency. Four predominate narratives were identified: ‘Can't live with’, ‘Can't live without’, ‘The other’ and ‘No other’. In addition, it was concluded that four notes indicated that suicide was an expression of the actualising tendency. Conclusion This research sheds light on the complex and sometimes contradictory nature of the AT. It shows that behaviours that appear harmful on the surface may, in fact, be driven by a deep, often unconscious, need to protect the self from greater perceived harm.

ABSTRACT Background The population of classical Adlerian practitioners represents one theoretical branch of Adlerian psychology, but little empirical research has been conducted within this population. The classical Adlerian approach features a 12‐stage depth psychotherapy model that targets the dissolving of the style of life and fictional final goal and paves the emergence of the self, other, and task actualisation. Individuals study the classical Adlerian approach through postgraduate professional training in a one‐on‐one mentorship style in which a trainee is matched with a training analyst. Purpose This qualitative research aimed to explore how classical Adlerian practitioners navigate developing their professional identity in the context of the classical Adlerian mentorship training style. The research question of this study was: What are the lived experiences of developing professional identity through a mentorship‐style training among classical Adlerian practitioners? Method We employed purposive sampling and interviewed five classical Adlerian practitioners, each of whom took part in two semi‐structured interviews. We adopted interpretative phenomenological analysis to explore these classical Adlerian practitioners' experiences developing professional identity through mentorship‐style psychotherapy training. Findings Our analysis revealed four themes. Findings revealed that, first, all contributing participants recognised their mentors' influence on who they were as professionals. Second, the classical Adlerian practitioners who participated in this study reported that their experiences in classical Adlerian mentorship fostered a mentor spirit and a joy in mentoring. Third, the one‐on‐one mentoring relationship was underscored by participants, each presenting a unique descriptive account. Fourth, participants emphasised the value of a learning process in a mentorship‐style training and highlighted the integration of learning and application for learning theory and becoming Adlerian practitioners.

ABSTRACT Background The lived experience of clinical supervisors is under researched. To help fill this gap, the researcher completed a doctoral study into the lived experience of Relate supervisors. Relate was, at the time of the research, a UK charity which provides counselling. The article draws on this doctoral research and presents findings around one of the research questions: supervisors' lived experience of role tension. Method The research was completed from an insider researcher perspective as the researcher was a Relate supervisor when she undertook it. A mixed method qualitative/quantitative approach was taken and the research was underpinned by a phenomenological methodology. Firstly, a qualitative/quantitative survey was completed by Relate supervisors and analysed through reflexive thematic analysis. Secondly, semi‐structured interviews were undertaken with ten RIelate supervisors and analysed via interpretative phenomenological analysis. Findings Findings from the survey reveal a discrepancy in the expectations of supervisors, supervisees and managers around the supervisor role, which causes supervisors tension. Whilst delivering support comes naturally to supervisors and they believe that supervisees require support, they are uncomfortable delivering the enforcement function. Equally, they recognise that the priority for managers is the management of risk and the enforcement of policy and procedures. Interview findings similarly demonstrate this role tension. Themes include the discomfort of being the ‘policeman’, and tension caused by synthesising functions and being pulled into line management. Implications By bringing an empirical, phenomenological perspective to the supervisor role, this research expands our understanding. It has the potential to raise awareness and build knowledge, resulting in changes to the way supervision is delivered through supervisor and supervisee training.

ABSTRACT Introduction Autistic flow is a term that has been used to describe the autistic experience of being deeply immersed in an activity. Autistic flow theory proposes that autistic people may be uniquely positioned to access and manage flow states. However, more research is needed to understand the facilitative conditions that support autistic people transitioning into and out of flow states, particularly given the complex interplay of sensory needs, monotropic focus and environmental factors. Aims and Methods Semi‐structured interviews were used alongside Interpretative Phenomenological Analysis (IPA) to explore the qualitative experiences of ten autistic people transitioning in and out of flow. Results The analysis highlighted three themes: (1) Flow is enjoyable and essential for autistic well‐being, playing a regulatory role in everyday experiences across sensory, emotional and cognitive facets; (2) autistic ways of being (i.e., monotropic attention, sensory sensitivity and repetitive behaviours) can amplify experiences in and out of flow; and (3) predictability is important for feeling safe to enter flow. Discussion We discuss the wealth of expertise autistic people possess about their own flow experiences and how this can be harnessed to build enabling environments for well‐being. The findings contribute to a non‐pathologising reconceptualisation of autistic ways of being through the approach of autistic flow theory.

ABSTRACT Aim Autistic adults experience high levels of mental health conditions, such as depression and anxiety. Autism has been associated with difficulties in emotional processing, which may reflect co‐occurring alexithymia. Although other psychological approaches have been developed, emotion‐Focussed Group Therapy might also be a relevant intervention for helping autistic adults develop their emotional processing. Method Nine autistic adults were offered a nine‐week group neurodiversity‐affirming emotion‐focussed therapy (neuro‐EFGT). An observer measure was used to track change across therapy in emotional processing for affective empathy for self (emotion regulation) and other (empathy), and in cognitive empathy for self (self‐reflection) and other (mental representation). Results Significant pre‐/postoutcome differences were found, for both modality (therapy vs Interpersonal Process Recall; d = 2.20) and time ( d = 5.68), with seven of the nine participants showing significant reliable change in emotional processing by the end of therapy. Implications This is the first outcome study of neuro‐EFGT that offers an initial account of autistic adults' experiences of the intervention. Neuro‐EFGT may be a useful alternative therapy for autistic adults who report emotional processing difficulties.