Brendan James Dunlop

Researchers have demonstrated that more transgender and nonbinary individuals are autistic, compared to cisgender populations (Bonazzi et al., 2026; Warrier et al., 2020). Transgender and nonbinary...

Objectives: Current evidence on the impact of personal trauma on health care professionals is mixed. Some studies suggest a personal history of trauma can be a risk factor for secondary traumatisation. Other research suggests that personal experiences of trauma can help professionals to better recognise their patients' trauma symptoms. Staff working in forensic mental health services face challenges, such as exposure to patient self‐harm and suicide. This study aimed to understand the impact of personal trauma on staff working in forensic mental health services and how this impacts their ability to give compassionate care in a challenging environment. Design: Qualitative methodology was used. Participant interviews were analysed using Interpretative Phenomenological Analysis. Methods: Seven participants were recruited from forensic mental health services across the Northwest of England who had personal histories of trauma. Participants completed a semi‐structured interview and questionnaires recording traumatic life experiences. Interviews focused on how staff were impacted by their experiences of trauma and if this had an impact on them giving compassionate care. Results: Three main themes were identified from participant interviews: reliving the past in the present, true empathy as both a gift and a burden, and the costs and benefits of gaining personal meaning and being changed by the work. Conclusions: Participants reported that trauma had both positive and negative impacts on their work. Overall, a common thread that emerged in all interviews was that trauma did not appear to be a barrier to compassion but rather a facilitator.

Objective: To identify competencies required for effective collaborative working within Primary Care Networks (PCNs). Methods: An online questionnaire about roles within PCN teams, importance of collaboration and experiences of connection and conflict within teams, was sent to Mental Health Practitioners (MHPs) and PCN/Practice Managers from several teams across Lancashire. Semi-structured interviews with similarly themed questions were conducted with MHPs, General Practitioners (GPs), and PCN/Practice Managers and analysed using reflexive thematic analysis. Questionnaire and interview data were combined, and themes were mapped onto 3 competency constructs (knowledge, skills and abilities, and personal characteristics). Results: Subthemes that were considered important to effective collaborative working in PCNs included: knowledge around shared goals, expectations, and role clarity; skills in communication and relationship building; embodiment of personal characteristics such as being engaged, accepting, and supportive. Conclusion: Clinical implications for promoting collaboration between staff working within PCN settings include meetings and joint training between PCN and NHS Trusts to establish network goals and expectations, regular team meetings and opportunities for face-to face activity to promote understanding of different roles and relationship building.

Background: Bisexual youth are at a disproportionate risk of non‐suicidal self‐injury (NSSI). Unique stressors, such as biphobia and bi‐erasure, and their impact on self‐esteem, identity and a sense of belonging may help explain this disproportionate risk. Affirmative therapies promote self‐acceptance and identity affirmation and may therefore be effective in boosting self‐esteem and reducing NSSI. Aims: This study aimed to assess the feasibility and acceptability of a cognitive behavioural therapy‐based, self‐esteem intervention for young bisexual people (aged 16–25) with experience of NSSI thoughts, urges and behaviour. Secondarily, this study examined indicators of change on measures of self‐esteem, NSSI, identity and belongingness. Methods: A case series design was used with eight participants who experienced NSSI urges, thoughts or behaviours in the previous 6 months. Participants received an affirmative, 8‐week, self‐esteem intervention and completed measures of self‐esteem, NSSI, belongingness and identity. Results: Six participants attended all eight therapy sessions, and two opted out before completion. There were no serious adverse events. The intervention was deemed to be acceptable and feasible, and evidence of improvements on measures of self‐esteem, NSSI, positive identity and thwarted belongingness was observed. Conclusions: The results suggest that this intervention is a safe, acceptable and feasible intervention, warranting further evaluation. Revisions and considerations for future trials of this affirmative therapy are proposed.

Background: Onset of Eating Disorder (ED) peaks in young people, and interpersonal factors can influence development and maintenance. With increased referrals to ED services, accessible, brief interventions may support early intervention and improve outcomes. Cognitive Analytic Therapy (CAT) is a transdiagnostic relational approach, which can offer benefit for a range of presenting difficulties. This study aimed to assess the feasibility and acceptability of a brief, CAT‐informed reformulation for young people with ED.Design: A case series design recruited eight young people who met inclusion and exclusion criteria to participate in the five‐session reformulation intervention.Method: Recruitment took place from NHS ED services. Feasibility and acceptability were measured via recruitment, retention, qualitative feedback and missing data. Psychological distress, ED severity, personal recovery and motivation to change were assessed at baseline, post‐intervention and follow‐up. Participants also completed sessional measures of psychological distress and alliance.Results: Eight eligible participants aged 15–24 years (M = 20.25, SD = 3.58) consented to take part and received the intervention. All participants attended all intervention sessions and completed all assessments. Participants reported positive experiences of the intervention. There was an associated reduction across clinical outcomes, including psychological distress and ED severity.Conclusions: This case series showed promising results on the feasibility and acceptability of a brief CAT‐informed reformulation for young people with ED. However, the study had a small sample size and no comparator control group. Larger scale exploration of a brief CAT‐informed reformulation for EDs among young people is warranted.Clinical Trial Registration: The study was preregistered with clinicaltrials.gov (NCT05746364).

Background: The mental health and well‐being of gender and sexuality diverse (GSD) people needs to be understood within a socio‐political and cultural context. Aims: In this paper, an intersectional, social and system‐based framework for understanding the mental health and well‐being of GSD people is presented, for practitioners within this field to consider GSD mental health experiences and challenges within context. Materials and Methods: Starting with a consideration of the current landscape of understanding, pivotal theories and understandings within the field are outlined. The need for a framework that centralises intersectionality and broader systemic considerations is presented. Results: The framework provided has an explicit focus on four key features: (1) intersectionality, (2) institutions, policies and laws, (3) people and groups and (4) social stories. Discussion: Consideration of each of these ‘circles of influence’ can help practitioners to understand the multi‐layered and intersectional experience of GSD folk and allows for an understanding of potential intervention at both an individual and systemic and societal level. Conclusion: Use of such a framework in practice goes above and beyond what is currently available by centralising the role and impact of such wider systemic variables through an intersectional lens. The framework can be applicable worldwide given its flexibility to consider and apply pertinent policies, laws, people, groups and social stories within a particular country or culture.

Background: Bisexual people are at an elevated risk for non‐suicidal self‐injury (NSSI). Psychological factors including self‐esteem and thwarted belongingness may help explain this risk. The aim of the current study was to investigate associations between self‐esteem, thwarted belongingness and NSSI urges and behavior in young bisexual people.Methods: Participants aged 16–25 from 25 countries took part in this microlongitudinal online survey study (N = 207). Mixed‐effects linear and logistic regression were used for analysis, given the nested structure of data. Analysis examined the relationship between self‐esteem and thwarted belongingness on NSSI urges and behavior at the same point in time, and lagged by one week.Results: At the same timepoint, self‐esteem and thwarted belongingness both had significant between‐ and within‐person associations with NSSI urges and behavior. For lagged models, self‐esteem had significant between‐person effects on urges, and thwarted belongingness had significant within‐person effects. For NSSI behavior, both variables were only associated with between‐person effects.Conclusion: Findings support previous research suggesting the importance of self‐esteem in explaining NSSI among sexual minorities. Preventative and intervention strategies to improve self‐esteem may help reduce NSSI risk. Future studies should focus upon the experiences of bisexual people with intersecting identities and ensure that studies are statistically powered from inception to detect effects.