Káromkodásból katedrálist: lelkigondozás és spiritualitás összefüggései Jób könyvében

A Cathedral Built on Swearing? Interrelations between Counselling and Spirituality in the Book of Job. Given its enormous exegetical potential, pastoral care could clearly lay hold more of the Book of Job’s kerygmatic rather than its psychological certainties. In addition to the Book of Job being often read as a case study about the suffering person’s sense of justice and quest for meaning, Job’s experience has a spiritual overtone as well: he is faced with the question of the true nature of God and the need to find an adequate human response to it. Also, the Book is indicative of how people respond to the suffering and what witness and support they offer. In this paper, I evaluate the counselling strategies in the Book of Job identified by Manfred Oeming. I pay special attention to Job’s wife, and I argue that she should not be considered a proper counsellor, as she herself is stricken by the same tragic events as is Job. Instead, she is a fellow sufferer, although acknowledged as such only by extracanonical literature. What is more, she may be identified as the partner or the first and foremost caregiver of the sufferer whose challenges and difficulties remain unidentified, unspoken of, and unaddressed most of the time. As for the spiritual issues aroused by suffering, I suggest that both counsellor and counsellee must reach spiritual maturity to be able to understand and accept their experience of suffering as a genuine experience of God, and so, given time, this may make space for God’s theophany and healing presence. Keywords: Book of Job, suffering, spirituality, pastoral care, counselling, fellow sufferer, caregiver

‘Because Everybody is so Different’: a qualitative analysis of the lived experiences and information needs of rectal cancer survivors

ObjectiveTo (1) characterise (A) the lived experiences and (B) information needs of patients with rectal cancer; and (2) compare to the perceived lived experiences and information needs of colorectal surgeons.DesignWe conducted 1-hour semistructured qualitative interviews, dual independent transcript coding and thematic analysis.Setting/participantsInterviews included rectal cancer survivors (stages I–III), some accompanied by caregivers, at Dartmouth-Hitchcock Medical Center and experienced colorectal surgeons.ResultsWe performed 25 interviews involving 30 participants, including 15 patients with 5 caregivers, plus 10 physicians. Two major themes emerged. First, patients reported major impacts on their lives following rectal cancer, including on their everyday lives and leisure activities; identity, self-confidence and intimacy; mental health, especially anxiety. These impacts were mediated by their medical experiences, lifestyle and attitudes. Second, the diversity of effects on patients’ lives means that care, counselling and information needs should be personalised for a better medical experience and outcomes. Surgeons did not report knowledge of the full range of patient experiences and reported limited counselling in key areas, particularly concerning intimacy and mental health.ConclusionRectal cancer diagnosis, treatment and survivorship dramatically affect all people, regardless of which surgical treatment they undergo. Effects are varied and necessitate customised care, counselling and information, which surgeons are not currently providing. Because rectal cancer affects every part of patients’ lives, they need holistic support and information. Patients would benefit from substantial support after treatment as they establish a new normal.

Primary Mental Health Care Part 1: A Critical Review of the Irish System

Primary mental health care is an evolving system, in need of regular revision and requiring innovative and creative adjustments in order to provide the public with an easily accessible and appropriate level and type of service, based on best practice and evidence. This paper is the first in a series of three exploring primary mental health care. The Irish model of care, ‘Counselling in Primary Care’, is presented as well as a number of short-comings associated with that model. The short-comings include eligibility criteria governing access, limitations of service as well as waiting lists; and the medicalization of service delivery.

A dedicated stoma care counselling service to address the psychological needs of ostomates

Support from a specialist counsellor can help overcome the emotional challenges of stoma formation

LGBQ+ adults’ experiences of Improving Access to Psychological Therapies and primary care counselling services: informing clinical practice and service delivery

Lesbian, gay, bisexual, queer and other sexual minority (LGBQ+) people experience higher levels of psychological difficulties than heterosexual people. Evidence suggests that LGBQ+ treatment outcomes within England’s Improving Access to Psychological Therapies (IAPT) services are worse than the outcomes for heterosexuals, especially for bisexual people and sexual minority women. IAPT services provide evidence-based treatments like cognitive behavioural therapy (CBT), typically for anxiety or depression. This study explored LGBQ+ adults’ experiences with IAPT services and/or primary care counselling. LGBQ+ adults (n = 136) answered an online questionnaire (fixed-response and optional open-ended questions) about their access and treatment experiences. Descriptive statistics summarized multiple-choice responses. Qualitative data were analysed through thematic analysis. Before access, 41.9% of participants were concerned about experiencing LGBQ+ stigma/discrimination within psychological services. Only 13.2% of participants thought their sexuality negatively impacted their treatment, although prejudice/discrimination may be underestimated as 33.6% participants did not disclose their sexuality to practitioners and sexuality was not discussed in treatment for 44.0% of participants. Bisexual clients were significantly less likely to disclose their sexuality. The barriers LGBQ+ people described within IAPT or primary care services included: feared or experienced stigma in the services; reluctance to disclose sexuality; inconsistent discussion of sexuality in treatment; a lack of awareness and understanding towards LGBQ+ identities and community-specific challenges; and distrust, disillusionment and exclusion resultantly. Overall, 52.2% thought services could be improved for LGBQ+ individuals. This study identified multiple issues to be addressed in therapist training and service development.Key learning aims (1)The unique needs/experiences that LGBQ+ people bring to therapy, such as the need to disclose their sexuality and past experiences of stigma/discrimination, including how this differs within the community (e.g. bisexual people or LGBQ+ Black and minority ethnic people).(2)How these needs/experiences can result in barriers that make their treatment experience distinct from heterosexuals and influence their treatment outcomes.(3)What steps should be taken in future research and clinical practice to ensure improvements in the psychological treatment experiences of LGBQ+ people, including in relation to therapist understanding and training in LGBQ+-related issues.