Experiences of clinical psychologists working in palliative care: A qualitative study.

BACKGROUND: Compassion fatigue refers to the emotional and physical exhaustion felt by professionals in caring roles, whereas compassion satisfaction encompasses the positive aspects of helping others. Levels of compassion satisfaction and fatigue have been found to be inconsistent in palliative care professionals, which could have serious implications for patients, professionals and organisations. OBJECTIVES: This study explored the experiences of clinical psychologists working in palliative care, all worked with adults with cancer, to gain an understanding of the impact this work has on their self and how they manage this. METHODS: A qualitative approach was taken, using semi-structured interviews and interpretative phenomenological analysis. RESULTS: Three superordinate themes were identified: commitment, existential impact on the self and the oracle. The participants' experiences were characterised by the relationship between themselves and their patients, the influence of working in palliative services on their world view and the impact of organisational changes. Differences between working as a clinical psychologist in palliative care versus non-palliative settings were considered. CONCLUSIONS: Professionals working in palliative care should be supported to reflect on their experiences of compassion and resilience, and services should provide resources that facilitate staff to practice positive self-care to maintain their well-being.

Contested understandings of recovery in mental health.

BACKGROUND: The concept of recovery is contested throughout the existing literature and in mental health services. Little research exists that gives voice to service user perspectives of recovery. AIM: This paper explores how service users in two recovery oriented services run by the National Health Service in North West England talked about recovery and what it meant to them. METHOD: 14 service users accessing these services took part in semi-structured qualitative interviews focusing on the concept of recovery. Data were analysed using an interpretive phenomenological analysis approach. RESULTS: Service users talked about recovery as a dynamic, day to day process as well as an outcome; specifically related to being discharged from inpatient settings. A number of factors including relationships and medication were cited to have the potential to make or break recovery. CONCLUSIONS: The study highlights the continued dominance of the biomedical model in mental health services. Service users appear to have internalised staff and services' understanding of recovery perhaps unsurprisingly given the power differential in these relationships. Implications for clinical practice are explored.