Catherine Butler

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• Doctorate in Clinical Psychology
• Co-Programme Director at University of Bath

The visibility and presence of people who have detransitioned following a gender transition is growing, with an increase in research on the needs and experiences of this group. This study presents a thematic narrative analysis of interviews from six females (M = 25.5 yrs; range = 21–32 yrs). All detransitioned after having at least one gender-affir...

Background: Although addiction therapists are faced with immense pressures to effectively support clients through relapses and overdose risks, the evidence base on relapse remains significantly limited. Aims: This study aims to generate novel understandings of substance misuse relapse from a lived experience perspective of addiction therapists. Met...

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We write this paper as DClinPsy staff who have implemented Association of Family Therapy and Systemic Practice (AFT) Foundation and Intermediate level accreditation embedded within DClinPsy training. We describe the context and landscape in which this has happened, the positives we believe it brings and the challenges we have faced along the way. W...

‘The clinical psychology trainee requires support not only with systemic ideas and their application, but also with the process of transition in which new ideas come into contact with and challenge old assumptions’ (Hill, 2014, p.280) John Burnham (2017) created a quadrant to map out how any situation holds possibilities and draws on/creates resour...

This chapter focuses on providing culturally competent therapy to clients from Sexual, Gender or Relationship Diverse (SGRD) communities.

Background Autistic people are overrepresented in gender clinic settings, but limited evidence is available to guide clinical decision making for this patient group. We aimed to generate a comprehensive understanding of the phenomenology of gender dysphoria in autistic people. Methods We conducted a multi‐perspectival interpretative phenomenologic...

Transgender individuals and their partners may face unique challenges that other couples do not. These unique challenges merit investigation, understanding and consideration by systemic practitioners in order to provide a culturally attuned service for transgender clients. A systematic review of the literature into the experiences of couples in whi...

Relapsing multiple times back into opiate and crack cocaine misuse significantly increases the risk for overdose death, of which rates continue to soar worldwide. This study aims to provide an in‐depth understanding of opiate and crack relapse from the lived experience perspectives of people in recovery from substance misuse. Semi‐structured interv...

Autistic people are more likely to be transgender, which means having a gender identity different to one’s sex assigned at birth. Some transgender people experience distress about this incongruence or gender dysphoria. Few studies have aimed to understand the inner experiences of this group. In this study, we used Interpretive Phenomenological Anal...

Background Autistic people face dilemmas regarding whether to disclose their autism due to the potential negative consequences. While there have been studies examining the issue of disclosure, a small but growing number have specifically investigated how autistic adults make decisions to disclose. The aim of the study was to understand the perspect...

G ender dysphoria is distress in relation to incongruence between an individual’s gender and sex assigned at birth. Gender clinics offer support for gender dysphoria, and there is a higher prevalence of autism in young people attending such clinics than in the general population. We aimed to investigate the lived experiences of autistic young peopl...

Autistic people are over-represented at gender clinics, but there is limited research to guide clinical practice with this group. We investigated the perspectives of clinicians working with autistic patients who experience gender dysphoria. We asked clinicians about the relationship between autism and gender dysphoria, and whether they work differe...

‘Rape mythologising’ has been found to be a reason why survivors of rape feel blamed, and might contribute to low rates of reporting or conviction. No research to date examines whether ‘rape mythologising’ occurs in the conversations of sexual health staff when discussing rape cases. Conversation Analysis was used to analyse a focus group conversat...

Adults and children with gender variance (GV) face misunderstanding and discrimination, sometimes leading to mental health difficulties. Family support has been found to buffer these difficulties or to compound them when lacking (Westwater et al., 2019). However, little is known about how GV is considered in the context of families. In the current...

Gender minority stress refers to social stressors such as discrimination and stigma that gender minorities are subject to. This study examines the relationship between gender minority stress and psychological well-being in trans and gender diverse young people (TGDYP). We used a cross-sectional design to investigate the relationship between gender...

This paper describes the development of a scale for measuring systemic supervision which is called the Systemic Supervision Rating Scale (the 3D‐SSRS). This scale was developed through a thematic synthesis of the systemic supervision literature, which included 137 papers on the subject. The scale was then subjected to a face validity investigation...

There has been recent emphasis on the assessment of competence in psychotherapy training courses to improve evidence‐based practice and outcomes for clients. The Systemic Practice Scale (SPS) was developed as a structured way of evaluating systemic practice. There is, however, little research on the impact and experience of competence measures, par...

Gender dysphoria is distress due to a discrepancy between one's assigned gender and gender identity. Adults who wish to access gender clinics are assessed to ensure they meet the diagnostic criteria for gender dysphoria. Therefore, the definition of gender dysphoria has a significant impact on the lives of individuals who wish to undergo physical g...

History is important. Whiteness and its effects of racism is part of our history – centuries of slavery and colonialism, eugenics and its influences on racist policies in the UK and beyond, continued scientific racism evident in our theories and research, the privileging of the norms of Whiteness in our clinical and research practices and training...

The number of people presenting at gender clinics is increasing worldwide. Many people undergo a gender transition with subsequent improved psychological well‐being (Paediatrics, 2014, 134, 696). However, some people choose to stop this journey, ‘desisters’, or to reverse their transition, ‘detransitioners’. It has been suggested that some professi...

Eating disorders are serious mental health conditions which commonly begin in adolescence. Multi-family therapy (MFT) is recommended for young people with anorexia, but to date the majority of research on the effectiveness of this intervention has been conducted in highly specialist eating disorder (ED) services. In England there is a national tran...

Offering timely and effective intervention to young people with Anorexia Nervosa (AN) is a current priority within our national healthcare services (NHS). Treatment guidelines recommend that services should consider including multi-family therapy (MFT) in treatment pathways for young people with AN. MFT is theorised, like all family-based treatment...

University provides individuals with the opportunity to develop greater independence in living skills and social networks, while also gaining valuable qualifications. Despite a high proportion of autistic individuals aspiring to attend university, many either do not seek or gain entry or drop out prematurely. Although some steps have been taken to...

This article reports on the long-term impact of an innovative module designed for specialist community public health nursing (SCPHN) students entitled Working Therapeutically with Families. The module was designed to develop students' skills and abilities in working therapeutically with families through the use of specific, systemic therapy techniq...

Background: Trans youth have been reported to have high rates of self-harm, depression and bullying, and find it difficult to seek support. However, much of this research comes from gender identity clinics; non-clinical samples and those who reject gender binaries remain under-researched. Aims: This study investigated the experiences of a community...

Adolescent substance misuse is increasingly being viewed as a systemic problem and several studies have shown the benefit of increased parental involvement. This article describes the evaluation of a ten‐week Non‐Violent Resistance (NVR) group parent training programme delivered within a Young People’s Specialist Substance Misuse Treatment Service....

Increasing life expectancy within cystic fibrosis (CF) raises challenges around previously neglected topics such as sexual and reproductive health (SRH). The study aimed to gather retrospective experiences of service provision around SRH to consider the role of the CF service, age of information provision and unmet needs highlighting possible impro...

Ensuring that practitioners are competent in the therapies they deliver is important for training, therapeutic outcomes and ethical practice. The development of the Systemic Practice Scale (SPS) is reported – a measure to assess the competence of students as trialed by Children and Young Person's Improving Access to Psychological Therapies (CYP‐IAP...

Problem-Based learning (PBL) is a widely used teaching method in UK Clinical Psychology training. This study considers the experience of using PBL as part of the University of Bath’s Doctorate in Clinical Psychology. Questionnaire and focus group analyses suggest PBL was predominantly experienced as useful by trainees when completed during the firs...

Background: The normalisation movement calls for more recognition of the sexual rights of people with intellectual disabilities to challenge classically paradoxical cultural beliefs: 'hypersexual' versus 'asexual'. Aims: This meta-ethnographic qualitative synthesis aimed to explore the voices of people with intellectual disabilities in regards t...

Re‐offending rates of perpetrators of domestic violence are high (Hester et al ., ) and there is a need for perpetrator programmes to reduce victimization. There is no clear evidence for the effectiveness of existing programmes (Bowen, Gilchrist and Beech, ; Herman, Rotunda, Williamson and Vodanovich, ; Smedslund et al ., ). A new perpetrator progr...

The number of older people with a diagnosis of HIV has grown significantly in recent years. People living with HIV experience high levels of HIV-related stigma and discrimination, however, how ageing and HIV related stigma intersect has only recently been examined. This review aimed to synthesise the stigma literature for older people with a diagno...

Purpose: Hospitalization can be stressful for patients and their families. Pre-hospitalization information is crucial in establishing a good basis for patient satisfaction. In order to develop better preparatory material for parents, this qualitative study explored whether parents of children with cystic fibrosis, admitted to a UK Children's Hospi...

Purpose The purpose of this paper is to examine the levels of clinician burnout in a community forensic personality disorder (PD) service, and explores how burnout may arise and be minimised within a service of this nature. Design/methodology/approach A mixed methods approach was utilised, assessing levels of burnout and making comparisons with a...

Objectives: As life expectancy increases in people with cystic fibrosis (CF), previously neglected topics such as sexual and reproductive health and relationships are becoming increasingly relevant due to the unique challenges they present to patients and services. The aim of this study was to gather retrospective experiences of sex and relationshi...

In this chapter we focus on the experience of bodily sensations of arousal and disgust in supervision. Therapists’ experience of physical arousal or disgust in clinical sessions is rarely openly acknowledged so that opportunities for potentially enriching exploration in supervision can be missed. Acknowledging that experiencing arousal or disgust i...

While intersectionality has become an established and much used theory in feminist and critical race studies, the concept remains relatively underused by systemic family therapists and on family therapy training courses. And yet systemic therapy embraces the multiplicity of human existence and examines the interplay of power relations. This article...

This book explores the diversity in lesbian, gay, and bisexual lives, with the aim of opening up therapists' understanding of this diversity so that they can work in an ethical, supportive and non-discriminatory way with these individuals. Offers a comprehensive look at diversity within LGB populations, including the interactions between different...

http://shop.bps.org.uk/guidelines-and-literature-review-for-psychologists-working-therapeutically-with-sexual-and-gender-minority-clients.html

In this discussion paper I do not necessarily have answers but I hope to ask some thought-provoking questions about arousal and disgust when they occur in the therapist. These two internal phenomena seem particularly relevant to my area of specialism of sexual health; however, these experiences might occur for any therapist working with individual...

This paper reports on an innovative HIV awareness project for African communities in London. Some of the challenges faced and lessons learned are described and reflections on the specific role and contributions of psychologists to this work are offered.

Sexuality is an important area of clients' lives yet it is often neglected, both in the consulting room and in training. This book examines issues of sexuality in a positive and affirming light and considers how sexuality-related issues can be introduced into therapy and training. The manual provides further reading, handouts for clients, self-refl...

This paper reports on an innovative HIV awareness project for African communities in London. Some of the challenges faced and lessons learned are described and reflections on the specific role and contributions of psychologists to this work are offered.

While there has been an increase in papers addressing working with lesbian and gay clients over the past two decades, this paper builds on this historical context to combine the latest developments in therapy with sexual and gender minority clients with principles of systemic theory and practice. Clear guidelines are provided on how to apply sexual...

The Civil Partnership Act (CPA) came into force in the UK on 5 December 2005, entitling same-sex relationships to formal legal recognition. It is the second piece of legislation (following the Adoption & Children Act, 2002) that begins to redress the legal inequalities between opposite-sex and same-sex couples by giving civilly partnered (CP'd) cou...

Of those women who seek asylum in Britain, a proportion will find their way into psychology services. Many of these women do not speak English and so interpreters are used. This paper investigates how interpreters make sense of and cope with interpreting rape stories.

This paper describes the challenges and opportunities involved in setting up a systemic couples clinic in a medical setting, with increasing pressures to justify the use of psychologist's time.

This article reports on a survey of clinical psychology training courses that measured levels of training in sex and sexuality. Findings suggest there is inconsistent provision in terms of quantity and breadth of coverage.

This paper describes the challenges and opportunities involved in setting up a systemic couples clinic in a medical setting, with increasing pressures to justify the use of psychologist’s time.

Catherine Butler & Elizabeth Shaw summarise the evolving work of the Division’s Faculty of HIV and Sexual Health

The need to promote safer sexual behaviour has taken on new urgency in the UK because of large increases in the number of sexually transmitted infections (STIs). The sexual health needs of people living with HIV and AIDS (PLHA) also require attention as part of health promotion efforts. Many sexual health clinics are however struggling with high de...

Catherine Butler reports on the joint conference held by the DCP Faculty of HIV/Sexual Health and the Lesbian and Gay Psychology Section of the Society on 18 November 2005

The need to promote safer sexual behaviour has taken on new urgency in the UK because of large increases in the number of sexually transmitted infections (STIs). The sexual health needs of people living with HIV and AIDS (PLHA) also require attention as part of health promotion efforts. Many sexual health clinics are however struggling with high de...

This paper explores the thinking behind and setting up of a new support scheme targeted at lesbian, gay and bisexual clinical psychology trainees. The journey from conception to reality is explored, detailing the most poignant dilemmas tackled along the way.

This paper addresses how theoretical approach, policy strategy and clinical practice are used to counter lesbian and gay oppression on both a ‘systems’ level and through therapeutic work with individuals. We locate our work in the context of a sexual health psychology service in central London, where the majority of clients are gay men. This paper...

This paper contains a teaching tool devised for a lesbian and gay awareness workshop. The tool takes the form of a-day-in-the-life-of story where homosexuality is the societal norm.

This article explores how lesbian and gay clinical psychology trainees attempted to integrate their personal identity with their developing professional identity. Three gay and six lesbian trainees were recruited by snowball sampling and via a lesbian and gay student website. Data were collected through semi-structured interviews and interview tran...