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In spite of the increasing emphasis upon spirituality in the psychological literature, research continues to highlight concerns that issues relating to spirituality are regularly overlooked within a therapeutic setting. The aim of the current study was to develop an account of the way in which clinical psychologists understand and address spirituality within therapy. Semi‐structured interviews were conducted with eight clinical psychologists. The transcripts were analysed using the qualitative methodology of grounded theory, which also informed the data collection process. Two core categories were developed and termed spirituality as an elusive concept and finding harmony with spiritual beliefs. The diversity of meaning surrounding spirituality and the relative lack of engagement was found to create difficulty for constructing spirituality coherently as a concept. When specifically considering methods for identifying and addressing spiritual beliefs, contrasting approaches were identified. This diversity in understanding and approach has implications for the process and outcome of therapy, which are discussed in detail. Recommendations are suggested for developing spirituality as a more coherent and accessible concept, both within professional dialogue and the therapeutic context.

This paper reports the first British study to assess the construct validity of Beck's Hopelessness Scale (HS) and the Beck Depression Inventory (BDI). On the basis of interviews with 50 economically active parasuicide patients, it was confirmed that hopelessness accounts for the relationship between depression and suicidal intent. Moreover, it was shown that social desirability neither confounds the relationship between hopelessness and suicidal intent, nor has any predictive power in explaining variation in suicidal intent. On the other hand, the interval ('elapsed time') between the commencement of the parasuicidal act and of the research interview was significantly and positively correlated with suicidal intent, and elapsed time was a significant predictor of the total score on Beck's Suicidal Intent Scale. Two explanations for this finding are proposed: the first is based on the possibility that elapsed time is an indirect or proxy measure of medical seriousness; the second derives from the likely impact of prolonged hospital stay on the patient's interpretation or understanding of his/her behaviour. Researchers are advised to take into account the moderating effect of elapsed time when designing studies which examine psychological processes in parasuicide.

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The models of mental disorders held by clinical psychologists are implicit in their attitudes and inform all aspects of theory and practice. We found that trainee clinical psychologists continue to favour psychosocial over biological understandings of mental disorders, giving the cognitive, behavioural and psychodynamic models equal value overall, and stronger attitudes were supported by the evidence base. We found that trainee clinical psychologists organized their attitudes around a biological-psychosocial continuum and cognitive/behavioural and psychodynamic/spiritual dimensions. These findings may be useful for those involved in developing clinical training programs and multidisciplinary working because they provide an insight into the attitudes of emerging clinical psychologists.