Counselling psychologists and psychotherapists in the NHS: learning from their work with clients experiencing persistent embodied (somatic) distress

The intention of this research is to answer the question: Counselling psychologists and psychotherapists in the NHS: What can be learnt from their work with clients experiencing persistent embodied (somatic) distress?
Somatisation can be considered the most common health problem encountered in contemporary society, at both primary and secondary care levels within the NHS. Clients in persistent embodied distress often sit at the interface between health and mental health services, and this can prove very difficult for the clients and professionals involved in their care. This research explores the gap in the existing literature relating to the psychological understanding of working with ‘persistent’ embodied distress in the context of the NHS.
This research follows a qualitative constructivist grounded theory approach, and an explorative and reflective in-depth interview and focus group design. Eight counselling psychologists and psychotherapists with NHS specialist experience and knowledge of working with clients experiencing embodied (somatic) distress were interviewed as part of the study. The aim was to draw on existing experience and wisdom within the discipline to create a theory which can be used in future clinical practice.
The data was analysed, and the model was discussed within a sub-group of the original eight participants, who formed part of a data refinement process, before the finalised grounded theory was proposed: The Embodied Therapist as a Bridge in the NHS, highlighting a number of complexities and important connections and tensions within the work.
Unexpected findings from the study suggest that the cultural presence of the therapist is an important aid in the work with clients experiencing embodied distress due to the therapist’s own relationship with their body. In addition, new and exciting findings suggest the important contribution of the counselling psychology and psychotherapy professions ‘working at the edge’ of the NHS. Findings support a number of existing theories relating to attachment-informed practice in the NHS and the centrality of stress/trauma models and making mind-body-brain connections in work with clients in persistent embodied distress.
The research and grounded theory proposed have implications for the future clinical training and practice of both psychological and non-psychological staff working in the NHS with complex client presentations, experiencing persistent embodied somatic distress.