Between a rock and a hard place: an insight into the psychological therapist’s experience of having safeguarding concerns for their clients' children

Brown, Claire (2018) Between a rock and a hard place: an insight into the psychological therapist’s experience of having safeguarding concerns for their clients' children. DProf thesis, Middlesex University / Metanoia Institute.

Abstract

This study explores the therapists' experience when managing safeguarding concerns about their clients' children, with the aim of raising awareness and bringing the child into the therapists' mind. A review of the literature indicated that this is an undeveloped area, with existing research lacking attention to the impact of the therapeutic relationship on this ethical dilemma.
IPA (interpretative phenomenological analysis) was used to analyse the findings from six semistructured interviews with a mix of psychological therapists who had experienced concerns for their clients' children while working in non-NHS settings. This approach allows for an in-depth exploration into the subjective experience of the participant, while also recognising the reflective role of the researcher.
The findings indicate that therapists are struggling with a lack of confidence and experience in managing their child protection concerns, with an indication of a training need. This lack of confidence, combined with a range of complex emotions evoked in such work, increased the participants' need for support and supervision. Participants felt the need to alter their therapeutic practice and become more directive in order to ascertain clearer details about their concerns.
The findings have implications for the training and continued professional development requirements for psychological therapists. There is an indication for training focused on managing concerns in the context of the therapeutic relationship, more training around assessing the level of risk and the development of a prompt sheet with reflective questions to aid therapists in their thinking.
An identified limitation of this study is the range of participants in terms of gender and ethnicity; further research could explore more thoroughly whether these factors influence how concerns are managed. There is also scope to explore more specifically the impact of the therapeutic placement, to identify whether those working within large organisations, such as the NHS, feel more supported and contained in this type of work than those working more independently.

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