The person behind the therapist: a recall study on significant events that contribute to therapists' personal and professional development.

This study explores the interconnexion between personal and professional development in therapist growth. This research examines a self-integrated perspective on training, by looking at the equal importance of nurturing personal development alongside professional skills cultivation. The study uses the concept of Significant Events (SE) which was originally developed to understand client change processes and applies the concept to investigate the development of the person-of-the-therapist. SE is events that are experienced in the therapy process and that are experienced by the client as being helpful or hindering for therapeutic change. Similar to the process of therapy, professional development is not a linear process of acquiring skills and knowledge but a discontinuous process that is driven by SE. The goal is to explore transformative moments in therapists' development. 281 participants completed an online questionnaire, evaluating: i) ) personal events (physical and mental health, interpersonal relationships, exploring the world, losses and deaths), ii) professional events (training, clinical experiences, relationship with colleagues, challenges due to work position), and iii) hybrid events where personal and professional aspects intertwine (personal therapy and societal context inducing insecurity). Findings suggest a more integrated self in personal and professional development. The study contributes to ongoing discussions on professional development, revealing the interplay between personal and professional spheres of therapists.

"He is changing, but I'm changing too": An interpretative phenomenological analysis of spouse caregivers' identity in the context of dementia.

OBJECTIVE: This study explores the process through which informal caregivers, particularly spouses, construct their identity within the context of caregiving for individuals with dementia. Despite extensive research in psychology aimed at defining caregiving (e.g. tasks, consequences), few informal caregivers identify themselves as such. For instance, the affective bond shared between caregivers and care-recipients often imbues caregiving responsibilities with a sense of "naturalness," especially if the care-recipient is a spouse. METHODS: To investigate the nature of caregiver identity construction, eight semi-structured interviews were conducted with spouse caregivers of dementia patients. The collected data underwent interpretative phenomenological analysis (IPA). RESULTS: Three interconnected themes emerged from the analysis: (1) Perceiving changes in my partner, which involves recognising alterations in the care-receiver's characteristics due to dementia; (2) Processing changes, encompassing the experience of grieving losses and reminiscing about the past; and (3) Perceiving changes in myself, referring to the acknowledgement of personal changes due to caregiving. CONCLUSION: The study emphasises the dynamic and ongoing nature of caregiver identity construction, which begins with the early recognition of changes in the care-receiver. Interestingly, spouse caregivers oscillate between their identity as a spouse and caregiver, influenced by how they process changes undergone by their partner. Contrasting with previous theories on caregivers' identity, our results focus of caregivers' perceptions rather than their relationship with the care-recipient or caregiving tasks.

Sociographie des ritualités funéraires en temps de pandémie: des rites empêchés aux rites appropriés.

COVID-19 has led to unprecedented health and social measures in several countries, including major restrictions on funeral rituals. These restrictions concerned pre-mortem, peri-mortem and post-mortem rites. Based on a longitudinal study of 955 French-speaking Canadians bereaved of a loved one during the pandemic, this article describes the reality of these impediments. Through an analysis of the quantitative and qualitative data collected, it is possible to identify the gap between desired and realized funeral rituals during the first year of the COVID-19 pandemic. The results show important hindrances to the various desired rituals, yet some ritual and symbolic creativity by the bereaved.

La Covid-19 a entraîné dans plusieurs pays des mesures sociosanitaires inédites, notamment des restrictions majeures aux rituels funéraires. Ces empêchements ont concerné tant les rites pré-mortem, péri-mortem que post-mortem. À partir d'une étude longitudinale débutée en mars 2021 auprès de 955 personnes francophones canadiennes endeuillées d'un proche pendant la pandémie, cet article propose de décrire la réalité vécue de ces empêchements. Par une analyse des données quantitatives et qualitatives recueillies, il est possible d'identifier l'écart entre les rituels funéraires souhaités et réalisés pendant la première année de la pandémie de Covid-19. Les résultats montrent d'importantes privations des différents rites souhaités, mais également une certaine créativité rituelle et symbolique de la part des personnes endeuillées.

A Harmful Care: The Association of Informal Caregiver Burnout With Depression, Subjective Health, and Violence.

Providing informal care to a relative can lead to informal caregiver burnout, which is expected to lead to deleterious consequences. Among these consequences lie the risk of perpetrating violent behaviors against the care-recipient, the caregivers' risk of depression, and their low subjective health. To investigate these associations, a sample of 499 informal caregivers completed a questionnaire addressing informal caregiver burnout, depression, subjective health, and violence. Hierarchical regression models were used to investigate the potential association of burnout with these potential consequences, while controlling for sociodemographic variables and received violence. The results show that burnout, and especially emotional exhaustion, is significantly associated with depression, low subjective health, and perpetrated physical violence, but not with perpetrated psychological violence. For both psychological and physical violence, it appears that receiving violence is one of the best predictors of perpetrating violence. With these results, this cross-sectional study confirms the association of informal caregiver burnout with deleterious consequences-even if this observation must be pondered-and the central role of received violence in predicting perpetrated violence, suggesting the risk of violence escalation. The implications of these results suggest that the emotional state of informal caregivers is one of the indicators of potential deleterious consequences and should, as such, be considered as a warning signal by field workers.

Are caregiving appraisal and relationship quality key mediators in informal caregiving burnout? A structural equation modelling study in Belgium and France.

Informal caregivers are key players in maintaining chronically ill patients at home but often experience negative consequences such as informal caregiver burnout. The processes by which determinants related to informal care and their personal and social resources affect the caregiver's risk of burnout remains little investigated. Recent theoretical works have suggested that two mediators could play an important role in understanding how these risks and resources influence informal caregiver burnout: by deteriorating how they view their role (caregiving appraisal) and by weakening the relationship with the care-recipient (relationship quality). The present study aimed at exploring the impact of the care-recipient's dependency (WHODAS), the caregiver's emotional intelligence (TEIQue-SF), and loneliness (UCLALS) on informal caregiver burnout (MBI-ICg). This association was explored both directly and through the mediation of caregiving appraisal (measured by subjective burden, ZBI) and relationship quality. To do so, a sample of 444 French-speaking informal caregivers completed online questionnaires from November 2017 to August 2018. Structural equation modelling (SEM) was performed to test the mediation model. As a result, the caregiving appraisal appears as a key mediator between determinants and informal caregiver burnout, whereas the relationship quality had a lower predictive value. Among the determinants, emotional intelligence was the strongest protective factor and the care-recipient's dependency was the strongest risk factor. But beyond this association, the perception informal caregivers have of their role (their caregiving appraisal) is a key mediator between these determinants and informal caregiver burnout, which emphasizes the importance of subjectivity in building risk and protective profiles.

Do informal caregivers experience more burnout? A meta-analytic study.

Informal caregivers often report exhaustion when providing care, which can be related to forms of burnout. Yet, there is no systematic inventory of studies comparing caregivers and non-caregivers in terms of burnout. For the present meta-analysis, studies comparing burnout in informal caregivers and non-caregivers were screened and included. Two categories of studies were found: those on family care burnout (spousal or parental burnout) and those on professional burnout (mostly in healthcare). For family care burnout studies, informal caregivers reported more emotional exhaustion, and, to a lesser extent, depersonalization and reduced personal accomplishment than non-caregivers. For studies on professional burnout, workers providing informal care also reported more emotional exhaustion than workers not providing such a care. Overall, the results indicate that providing informal care represents a risk for role burnout. In family care burnout studies, these results confirm the assumption that providing informal care adds extra weight on the individuals' shoulders. In professional burnout, these results support the role accumulation theory, pointing that an additional weight in one's role, i.e., providing informal care, has an impact on another role, work. This work emphasizes the consideration of the multifaceted impact that the caregiving role can have on the individual.

'In the hospital there are no care guidelines': experiences and practices in perinatal loss in Spain.

BACKGROUND AND OBJECTIVES: Healthcare professionals play an important role in supporting and attending to families that experience a perinatal loss. Previous research has identified the existence of obstacles that professionals may encounter during their practices. The main objective of the current research was to identify and examine the subjective experiences and practices of experienced professionals attending to perinatal loss in the hospital context in Spain. DESIGN: Qualitative descriptive design. SETTING: Three different hospitals in Spain. PARTICIPANTS: Sixteen professionals were interviewed, including doctors, nurses, midwives, nursing assistants, a psychologist and a funeral home manager. METHODS: Individual semi-structured interviews focusing on three areas were carried out: practices with the baby-foetus, practices with parents and interaction with the team. A thematic analysis was performed using the three main focuses of the semi-structured interview (deductive approach) and the codes that emerged from the data (inductive approach). RESULTS: Regarding guideline-based care for the baby/foetus, participants made a distinction between the initial process of care for the baby and the decision-making process with parents. Where support for families was concerned, participants identified considerable variability in the practices used and lack of organisational and care guidelines, psychological support and follow-up. Finally, interactions with other team members were perceived as a source of support, although participants identified a significant lack of coordination. CONCLUSION: Participants reported variability of practices in care for the baby and parents, lack of continuity-of-care guidelines and the importance of support from a coordinated healthcare team.

Informal Caregiver Burnout? Development of a Theoretical Framework to Understand the Impact of Caregiving.

Informal caregiving is a rewarding but demanding role. The present theoretical framework proposes to adapt the tridimensional concept of burnout to informal caregiving as a way to address the potential consequences of caregiving. This adaptation reflects caregivers' reported difficulties, as well as empirical findings on emotional exhaustion, depersonalization, and personal accomplishment as caregiving outcomes. But to understand burnout in informal caregiving contexts, it is also necessary to find ways to model it. The Informal Caregiving Integrative Model (ICIM) is thus proposed. This model is based on the integration of elements from literature on both informal caregiving stress and professional burnout. The goal of the ICIM is to emphasize the importance of every category of determinants of informal caregiver burnout (i.e., relating to the caregiver, the caregiving setting, and the sociocultural context), with a key mediating role for the caregivers' appraisal of their situation and their relationship with the care-recipient. This article is a first integrative step in the consideration of a form of burnout specific to informal caregivers and supports the design of empirical and interventional studies based on the theoretical foundation that the ICIM proposes.

Does Informal Caregiving Lead to Parental Burnout? Comparing Parents Having (or Not) Children With Mental and Physical Issues.

Introduction: Parenting a child with special needs (CSN) may be an important challenge. Previous research has highlighted an increased risk of parental burnout among parents caring for their CSN. Yet, these studies only focused on children with specific issues and did not consider the wide variety of CSN. There is thus a need to take a more global approach to assessing the impact of caring for a CSN on parental burnout. In addition, the impact on parental burnout of personality and parenting (dis)agreement needs to be measured to have a better understanding of parent-caregivers' (PCgs) burnout. Method: An online survey was completed by a large sample of parents from which a subsample of PCgs was identified. Results:T-tests highlighted significantly more parental burnout among parents of CSN. However, further analyses showed that parents with only one child with one special need did not experience significantly more burnout than parents with typical children. The significant difference lay in the presence of comorbidity or the presence of multiple CSN in the family. Hierarchical regressions showed an important impact of Neuroticism for every burnout facet, along with co-parenting (dis)agreement. Subjective consequences of having to care for a CSN were also related to the burnout facets of both emotional exhaustion and emotional distancing. Discussion: The presence of comorbidity and of multiple CSN in the family were related to more PCg burnout, emphasizing the need to consider these situations in further research. The role of neuroticism in PCg burnout confirms previous research both in parental and professional contexts. Parenting (dis)agreement also highlights the importance of dyadic support among parents. Finally, the importance of subjective aspects suggests that parental perception of their situation remains a central element in understanding the consequences of caregiving.

The Effects of Psychotherapist's and Clients' Interpersonal Behaviors during a First Simulated Session: A Lab Study Investigating Client Satisfaction.

The purpose of this study was to examine the effects of psychotherapists' behaviors during a first simulated therapy session on clients' satisfaction, including their intention to pursue or drop out from therapy. The importance of psychotherapists' warmth on clients' satisfaction was examined to check previous findings stressing this determining factor. Examining the role of warm behaviors is however insufficient according to the interpersonal perspective. We therefore tested the role of the psychotherapist's agentic behaviors since only a few studies provide contradictory results about the role of this interpersonal dimension on clients' satisfaction and how it is influenced by matching up client and therapist's profiles. To test our hypotheses and control for alternative therapy-related explanatory variables, we used different videos as experimental conditions manipulating the therapist's behaviors. Seventy-five participants had to imagine themselves as potential clients arriving for a first therapy session. They successively watched a role-playing therapist behaving according to five randomized interpersonal profiles. Results confirmed that warmth was a major dimension predicting client satisfaction. They revealed that agency was also a determinant of client satisfaction and that its effects depended on the client's own interpersonal agentic profile. Dominant clients were found to be more satisfied with the dominant psychotherapist than the submissive one while submissive clients preferred only the warm psychotherapist. These findings are discussed and suggest that therapists may need to be flexible and adapt their behaviors according to their client's interpersonal profile to increase their client satisfaction and decrease drop outs.

Helpers' Self-Assessment Biases Before and after Helping Skills Training.

Several studies have shown that therapists are generally biased concerning their performed helping skills, as compared to judges' ratings. As clients' ratings of therapists' performance are better predictors of psychotherapy effectiveness than judges' ratings, this study examined the validity and effectiveness of a helping skills training program at reducing novice helpers' self-enhancement biases concerning their helping skills, in comparison to their clients' ratings. Helping skills were assessed by three objective measures (a knowledge multiple choice test, a video test and a role play), as well as by a self- and peer-reported questionnaire. In addition, some performed helping skills' correlates (relationship quality, session quality, and helpers' therapeutic attitudes) were assessed both by helpers and their simulated helpees. Seventy-two sophomores in psychology participated to this study, 37 being assigned to a 12-h helping skills training program, and 35 to a control group. Helpers were expected to assess the aforementioned performed helping skills and correlates as being better than their helpees' assessments at pretest, thus revealing a self-enhancement bias. At posttest, we expected that trained helpers would objectively exhibit better helping skills than untrained helpers while beginning to underestimate their performance, thus indexing a self-diminishment bias. In contrast, we hypothesized that untrained helpers would continue to overestimate their performance. Our hypotheses were only partly confirmed but results reflected a skilled-unaware pattern among trainees. Trained helpers went either from a pretest overestimation to a posttest equivalence (performed helping skills and performed therapeutic attitudes), or from a pretest equivalence to a posttest underestimation (performed session quality and performed therapeutic relationship), as compared to helpees' ratings. Results showed that trained helpers improved on all helping skills objective measures and that helpees' perceptions of their performance had increased at posttest. In conclusion, helping skills training leads helpers not only to improve their helping skills but also to have more doubts about their skills, two variables associated with psychotherapy outcome.

Daily life stressors and coping strategies during widowhood: A diary study after one year of bereavement.

The present study examined the frequency and types of bereavement-related stressors and coping strategies that 40 widowed people encountered and reported in a diary over the course of 1 week. The results indicated that, after 1 year of bereavement, (a) the most frequent stressors were oriented to the loss of the spouse, (b) specific coping strategies were used and found effective to deal with specific types of stressors,

Does exposure type impact differentially over time on the development of mental health disturbances after a technological disaster?

BACKGROUND: A longitudinal study was conducted in order to assess the impact of the Ghislenghien disaster (July 30th, 2004) on physical, mental and social health in the affected population. The present study explored the risk for the development of four types of mental health disturbances (MHD) due to exposure to different aspects of this technological disaster in comparison with data obtained from previous health surveys among the population of the same province. METHODS: Surveys were conducted 5 months (T1) and 14 months (T2) after the disaster. Potential adult victims (≥15 years) were included (n = 1027 and 579 at T1 and T2 respectively). The "Symptom Checklist-90-Revised" (SCL-90-R) has been used in order to compute actual prevalence rates of somatization-, depression-, anxiety- and sleeping disturbances for three defined exposure categories: direct witnesses who have seen human damage (SHD), direct witnesses who have not seen human damage (NSHD) and indirect witnesses (IW). Those prevalence rates were compared with overall rates using the inhabitants of the province of Hainaut (n = 2308) as reference population. A mental health co-morbidity index was computed. Relative risks were estimated using logistic regression models. RESULTS: Prevalence rates of the four MHD were much higher for the SHD than for the other exposure groups, at T1 and T2. Moreover, NSHD and IW had no increased risk to develop one of the 4 types of MHD compared to the reference population. The SHD had at T1 and T2 good 5-times a higher risk for somatization, about 4-times for depression and sleeping disorders, and 5- to 6-times for anxiety disorders respectively. Further, they suffered 13 times, respectively 17 times more from all mental disorders together. CONCLUSIONS: The present study calls attention to the fact that mental health problems disturbances are significantly more prevalent and long-lasting among survivors who have directly been exposed to human damage.

Degree of exposure and peritraumatic dissociation as determinants of PTSD symptoms in the aftermath of the Ghislenghien gas explosion.

BACKGROUND: This paper investigates risk factors for the development of posttraumatic stress symptoms in the different survivor groups involved in a technological disaster in Ghislenghien (Belgium). A gas explosion instantly killed five firefighters, one police officer and 18 other people. Moreover, 132 people were wounded among which many suffered severe burn injuries. METHODS: In the framework of a large health survey of people potentially involved in the disaster, data were collected from 3,448 households, of which 7,148 persons aged 15 years and older, at 5 months (T1) and at 14 months (T2) after the explosion. Hierarchical regression was used to determine the significant predictors and to assess their proportion in variance accounted for. RESULTS: The degree of exposure to the disaster was a predictor of the severity of posttraumatic stress symptoms. Peritraumatic dissociation appeared to be the most important predictor of the development of posttraumatic stress symptoms at T1. But at T2, posttraumatic stress symptoms at T1 had become the most important predictor. Dissatisfaction with social support was positively linked to development of posttraumatic stress symptoms at T1 and to the maintenance of these symptoms at T2. Survivors who received psychological help reported significant benefits. CONCLUSIONS: In harmony with the findings from studies on technological disasters, at T1 6,0% of the respondents showed sufficient symptoms to meet all criteria for a full PTSD. At T2, 6,6% still suffered from posttraumatic stress symptoms. The symptoms of the different victim categories clearly indicated the influence of the degree of exposure on the development of posttraumatic stress symptoms. Problems inherent to retrospective scientific research after a disaster are discussed.

Why Do Bereaved Partners Experience Interfering Rumination?: Evidence for Deficits in Cognitive Inhibition.

Recurring rumination is strongly associated with grief reactions severity. The authors investigated whether deficits in cognitive inhibition were related to such a dysfunctional process. Inhibition was examined among 61 low- or high-ruminating bereaved partners in a negative affective priming task with grief-related negative and positive words. Results revealed impaired inhibition for grief-related information in comparison with negative and positive information in bereaved individuals with elevated rumination. When accounting for differences in grief reactions, the present findings did not however confirm the hypothesis of a direct link between variations in inhibition performances and rumination. Implications for future research and clinical perspectives are discussed.

Attachment and severity of grief: the mediating role of negative appraisal and inflexible coping.

According to the Dual Process Model of coping with bereavement (DPM; Stroebe & Schut, 1999), adjustment to bereavement involves a flexible oscillation between two types of coping strategies: loss-oriented (LO) and restoration-oriented (RO). This model postulates that extremely anxious or avoidant attachment disturbs the oscillation process by focusing more on one type of strategy, either LO or RO. The present study examined this assumption. We recruited 321 bereaved individuals who had lost a romantic partner. Our results showed that less negative appraisal of bereavement-related stressors, as well as higher use of RO strategies, mediated the link between attachment avoidance and low severity of grief reactions. However, the DPM variables were not found to mediate the link between attachment anxiety and elevated grief reactions. We discuss how these results provide an empirical basis of the DPM.

An externally oriented style of thinking as a moderator of responses to affective films in women.

This study was conducted to test the hypothesis that differences in alexithymia would moderate coupling in physiological and subjective-experiential responses to two affective films, which were shown to induce a common negative (sad) feeling, but to provoke different hyper- or hypo-arousal physiological responses (e.g., heart rate acceleration or deceleration) associated with antipathic or empathic context, respectively (Davydov et al., 2011). Only women were studied as persons showing more reactivity to sad films than men. Reactivity was evaluated for facial behavior, physiological arousal, and subjective experience. Some other affective and cognitive disposition factors (e.g., depression and defensiveness) were considered for evaluating their probable mediation of the alexithymia's effects. While subjective experience was not affected by alexithymia, high scorers on the externally-oriented thinking factor showed reduced physiological reactivity in both film conditions. These effects were mediated through different disposition factors: either low affectivity (low depressed mood), which mediated alexithymia's effect on hyper-arousal responses (e.g., decrease of heart rate acceleration), or impression management (other-deception), which mediated alexithymia's effect on hypo-arousal responses (e.g., decrease of heart rate deceleration).

A phenomenological analysis of disaster-related experiences in fire and emergency medical services personnel.

This article explores the experiences of fire and Emergency Medical Services (EMS) personnel during and immediately after a technological event using a phenomenological approach. Personnel engaged in the rescue operations during and immediately after the Ghislenghien gas explosion reflected upon their experiences in their responses to a specially designed, self-reporting questionnaire that included open-ended questions. Firefighters reported more perceived threat and direct exposure to death than did EMS personnel. Qualitative analysis indicates that the central characteristics of this potentially traumatizing event were the suddenness and massiveness of the impact, and the fact that it involved young victims and/or multiple deaths. With regard to emotions, powerlessness, horror, fear, a sense of apocalypse, and grief were experienced by both firefighters and EMS personnel. Firefighters noted that the death of colleagues, the involvement of friends and family, the massive impact, and exposure to the burned victims were most shocking. Emergency Medical Services personnel and in-hospital staff reported the impact, the confrontation with death, the involvement of friends and family, and the pain, suffering, and screaming of burned victims as the most shocking aspects of this event. Qualitative differences in the lived experiences of firefighters, EMS personnel, and in-hospital staff might be explained by differences in life threat, contact with death, and various degrees of training.

Depressive affect among health care seekers: how it is related to attachment style, emotional disclosure, and health complaints.

The present cross-sectional questionnaire survey investigated depressive affect among persons visiting their general practitioner (GP). It examined the impact of a number of factors likely to be associated with depressive affect, including demographic variables, severity of medical condition, and personal factors such as ease in disclosing personal information, and attachment style. Results showed that among the sample of patients (N = 198) visiting their GP, depressive affect was generally quite high. In particular, those reporting more depressive affect were the elderly, those with more severe health problems, more psychological problems, and a lower level of emotional disclosure frequency. As expected, attachment style was also related to lack of well-being among patients: those with a less avoidant but more anxious attachment style reported higher levels of depressive affect. In total, 38% of the variance of depressive affect was predicted by this model. Security of attachment was also related to reasons why patients consulted their GP, with avoidant attachment related to physical problems and anxious attachment to mental problems. Theoretical relevance of the findings and implications for medical help-seeking are discussed.

Adaptación española del cuestionario de creencias sobre los efectos del compartimiento social de las emociones, BSEQ / Spanish adaptation of the beliefs about social sharing of emotion questionnaire: BSEQ

En este estudio se presenta la adaptación española del Cuestionario de creencias sobre los efectos del compartimiento social de las emociones, BSEQ (Zech, enviado). Se describe la valoración de la validez convergente del cuestionario al relacionarla con otros 'instrumentos que evalúan la expresión emocional. Se aplicó a 390 sujetos una bateria de pruebas; compuesta por ocho cuestionarios que evalúan aspectos relacionados con la expresión emocional. El BSEQ ha mostrado una adecuada consistencia interna, una alta fiabilidad test-retest, así como una estructura factorial compuesta por tres factores congruentes con los beneficios derivados del compartimiento social de las emociones: beneficios intrapersonales, beneficios interpersonales, así corno beneficios derivados de la no expresión social emocional. Los participantes están más de acuerdo con los beneficios intrapersonales que con los beneficios interpersonales del compartir emocional y están menos de acuerdo cono los beneficios de la supresión emocional, como se podía esperar de personas viviendo en una cultura individualista. Los resultados muestran que las mujeres, comparadas con los hombres, creen en mayor medida en los beneficios de la expresión social de las emociones. Se concluye afirmando que la adaptación española del BSEQ es un instrumento psicométricamente sensible para la medida de las creencias sobre los efectos del compartimiento social de las emociones (AU)