Mothers' Psychological Functioning Following Childhood Burn Injury: A Trauma Perspective

Bogan, Allison Margaret (1999) Mothers' Psychological Functioning Following Childhood Burn Injury: A Trauma Perspective. D Clin Psy thesis, University of Glasgow.

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Psychologists are increasingly being asked to provide expert evidence in legal procedures. In the majority of cases (80-90%) the psychologist will provide this evidence in the format of a written report alone and will only occasionally be asked to appear in court to support that report (Gudjonsson 1985). It is also common for a clinical psychologist to be added to provide information with regard to a patient's benefit claim or application for housing. Although there is growing interest in this area of professional practice, with a number of articles providing guidelines for report-writing and making court appearances (Cooke 1990; Brookes 1995), little empirical research has looked specifically at the service-provision aspects of psychological report writing. However, Steinberg et al (1997), in a study of psychologists' mandatory reporting of child maltreatment, acknowledged that the therapeutic relationship can be affected in such cases. Similarly, recent research in the Unites States has examined therapists' use of the 'Tarasoff Ruling' and questioned the effect this practice can have on the therapeutic relationship. The Tarasoff Ruling refers to legislation establishing a duty to protect intended victims of patients who pose a serious threat and the legally sanctioned practice of warning the victim. Binder & McNeil (1996) found that, contrary to what they had expected, there was generally a minimal or a positive effect on the therapeutic relationship with their patient. The psychodynamic concept of the 'therapeutic alliance' (TA) has, in recent times, being more widely accepted within other models of psychotherapy. TA is defined as 'a non-neurotic, rational, reasonable aspect of the relationship which the patient has with the therapist which enables him/her to work within that relationship and is more than simply the wish to get better' (Henry et al 1994). The quality of the therapeutic alliance is now generally recognised as an important factor in the prediction of outcomes in therapy (Henry et al 1994) and TA has been found to be a 'moderate' predictor of outcome (Horvath & Symonds 1991). Given the growing body of literature supporting the importance of the therapeutic relationship and how this can be affected by certain practices which psychologists perform, we should consider the potential impact of psychological report-writing on the therapeutic relationship. If this practice is found to have an impact on the therapeutic relationship then this is surely a matter of professional concern. Anecdotal accounts often suggest that psychologists, who have been requested to write psychological reports, identify some impact on the therapeutic process and the therapeutic relationship with the patient. Furthermore, the writing of a psychological report could place the psychologist in a compromising position, whereby their sympathies and concerns for their patient may be at odds with their professional and clinical judgement. In this way, countertransference issues may play an important role in the psychologists' writing of these types of reports. The aims of this study were to • describe the type of psychological reports requested, and the patients to whom they referred, within an NHS Psychology Department over a 20 month period, • examine how psychologists interpreted their role in the writing of these reports, • report any issues of professional concern arising through the writing of the report, • examine the objectivity and degree of accuracy with which psychologists believe they represented the patient in the report, and • investigate the potential impact of writing such reports on the therapeutic relationship and course of treatment with a client.

Item Type: Thesis (D Clin Psy)
Qualification Level: Doctoral
Additional Information: Adviser: Sandy McAfee
Keywords: Clinical psychology
Date of Award: 1999
Depositing User: Enlighten Team
Unique ID: glathesis:1999-76244
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 19 Dec 2019 09:15
Last Modified: 19 Dec 2019 09:15

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