City Research Online

Abstract

This study explored the lived experiences of twelve mental health care clinicians working therapeutically with suicidal clients and following client suicide. The participants included six mCounselling Psychologists, two Consultant Psychiatrists, three Community Psychiatric Nurses and a Cognitive Behavioural Therapist from an opportunity sample. The study took place within a National Health Service Mental Health Trust located in the South East of England. All the participants worked with suicidal clients. Nine had experienced the suicide of one or more clients. Employing interpretative phenomenological analysis, four key themes emerged: Being with suicidal clients, Impact of client death, Subsequent influential experiences and Evolving. Therapeutic intervention with suicidal clients emerged as being a source of anxiety for some participants, while others felt confident in wanting to explore the clients' concerns in depth. Following client suicide, shock, initial disbelief, fear, guilt and anger were apparent. Therapeutic relationships were influential in the participants' interpretations and understandings of the death. The attachment to the client was considered, by some, as being almost shameful, while others had tenuous therapeutic relationships. Some participants expressed potent feelings of grief arising from the loss. Past experience of bereavement by suicide emerged as shaping the views taken of suicidal clients and the responses to client suicide. Subsequent events, including involvement in an investigation into the cause of the death, were considered as being influential factors in the overall experience. Relationships with others which provided comfort and affirmation were considered to be a protective factor. While several participants gained support from clinical supervision, others felt that it did not meet their needs. An attempt was made to offer explanatory frameworks in order to situate the participants' experiences. Together with the effects of a loss, some participants' perceptions of failing as a competent professional added some support to the notion of threatened identity, due to rupture of the 'continuity' of professional identity. Transformative processes included gains, such as being considered as an 'expert.' The changes that are described are consistent with the reflexive practitioner position of Counselling Psychologists. The implications of the findings include Counselling Psychologists' involvement in the development of support systems. Finally, a suggested method of providing information to clinicians (Appendix 11) has been drafted as a result of the study outcomes.

Publication Type:	Thesis (Doctoral)
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Departments:	School of Health & Psychological Sciences > Psychology Doctoral Theses School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses

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