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Title: Negotiating the therapeutic relationship : therapists' experiences of working with young people who self cut
Author: Bloxham, Amy
ISNI:       0000 0004 2700 8694
Awarding Body: University of East London
Current Institution: University of East London
Date of Award: 2009
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There has been a substantial amount of interest in self-harm in young people over the last 8 years, with attempts to understand, define and identify models of intervening. The main focus of the literature has been on understanding the young person from a medical model perspective. This perspective has positioned the problem within the individual and tried to seek ways to cease the self-harm. However what seemed to be a limited way of understanding the young persons struggle has been described as leaving them feeling stigmatized, humiliated and misunderstood. In more recent years there has been an attempt to hear the perspective of the young person and self-harm has been considered as being a reflection of an underlying deeper problem, that could be located within relational, social or cultural origins. `Professionals' have also seemed to struggle and have described feeling overwhelmed, fearful, and disturbed by those who self-harm. Questions have been raised surrounding the understanding the `professionals' had of the young persons difficulties and if they met their needs sufficiently. Therapists from a range of theoretical orientations are known to work with young people who self-harm, however there is very little in the literature describing their experiences and understanding of such a phenomenon. There is also a dearth of studies focusing on self-cutting specifically, which is considered the most prevalent yet hidden form of self-harm. The research study aimed to qualitatively explore therapists' perceptions, experiences and understanding of the phenomena of self-cutting. The participants were therapists registered with a professional body who provided therapy for young people (aged 13-25 years old) who self-cut. Areas of interest explored through the use of a semi-structured interview; were the feelings and beliefs aroused within a therapist and how they coped with these, how the therapist viewed self-cutting in relation to a client's development and the therapists view of the therapeutic relationship when working with this client group. An IPA methodology allowed for an in depth analysis of the lived experience of therapists. Results highlighted three super-ordinate themes; `Who am I: struggle managing boundaries of therapist role'; `Therapists understanding of client's struggle' and an entwining of the struggles within `negotiating the therapeutic relationship'. Discussion surrounded the fluidity of the boundaries between client and therapist, whereby both struggled with identity and a merging between client/therapist could be expected to occur. There was not one specific theoretical model or intervention highlighted as being of particular use when working with this client group. It could be concluded that therapists have transferable skills that need to be applied flexibly within the broad context of the client's socio-cultural needs. Self-cutting seemed to represent a deeper underlying struggle for the client. The therapist could approach this struggle through the use of the therapeutic relationship as a vehicle and bridge for all therapists no matter their therapeutic orientation.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available