In this article I explore the issues surrounding confidentiality and consent in the writing of psychotherapy case reports. An important theme is the challenge of protecting a patient's privacy while furthering knowledge in the field through publication. I discuss some of the complexities as well as the relevance of present day requirements for informed consent, including a consideration of the provisions within the Declaration of Helsinki (1964, last revised 2013). To illustrate the difficulties inherent in writing about our work I give examples of three cases: Freud's patient Sergei Pankejeff (the 'Wolf Man'), Gloria (the patient in the 'Gloria Films'), and a contemporary patient, 'Jeremy', whose therapist published an account of her work with him. The writing of case material is complex and resists easy solutions; there can be no "one-size-fits-all" approach but instead the therapist writer's careful consideration on a case by case basis of his or her motivations for writing, what the patient is really consenting to, whether patient consent can ever be truly informed, and how writing and publishing a case might impact on the safety and well-being of the patient (including others connected to the patient), as well as on the therapeutic relationship itself.

During lockdown in response to COVID-19, students in the Master of Psychotherapy at Auckland University of Technology were required to rapidly move their clinical work online. We surveyed these students about their experience of working clinically online. We used a mixed-methods approach and analysed qualitative data using grounded theory methods. Students found the move online challenging in terms of the technological challenges, lack of professional clinical space, and establishing and maintaining the therapeutic alliance. Students showed a strong preference for in-person (or, face-to-face) clinical work, along with scepticism about the efficacy of online therapy, though some acknowledged its convenience and others its currency and relevance. Most expressed a need for more specific training in online therapy. The literature finds equivalence between the effectiveness of in-person and online therapy. However, it acknowledges that online therapy can impose increased strain on clinicians and finds that clinician expectations directly impact their capacity to manage online clinical work.

During the 2020 lockdown in response to COVID-19, students in the Master of Psychotherapy at the Auckland University of Technology (AUT) were required to rapidly move their clinical work online. We surveyed these students about their experience of working clinically online. We used a mixed-methods approach and analysed qualitative data using grounded theory methods. Students found the move online difficult, with technological challenges, the loss of a professional clinical space, and having to establish and maintain the therapeutic alliance in the unfamiliar online setting. They showed a strong preference for in-person clinical work, along with scepticism about the efficacy of online therapy, though some acknowledged its convenience and others its currency and relevance. Most expressed a need for more specific training in online therapy. Students rated their technological skill level higher than their levels of interest in online communication. This suggests that preferences, rather than technical skill, influenced their hesitancy for working clinically online. While online therapy can impose increased strain on clinicians and directly impact their capacity to manage online clinical work, the literature finds strong and consistent evidence that online therapy has equivalent outcomes to in-person therapy. There is significant emphasis in the literature on the disjunct between the outcomes evidence and therapist expectations. This is modified somewhat by training and experience in online therapy. We recommend that research- active psychotherapists engage actively and collaboratively with the profession, through professional bodies, to encourage research-informed professional development and practice for clinicians; and that further research is conducted into effective strategies for training in online clinical delivery.

This paper discusses an aspect of my PhD study on understanding psychotherapists’ experience of ongoing learning. For this study I interviewed 12 practising psychotherapists living in Aotearoa New Zealand. The personal nature of psychotherapists’ ongoing learning and, in particular, the interconnectedness between an individual’s life, past and present, and his or her vocational life as a psychotherapist, emerged as a significant phenomenon. Interview data were analysed using hermeneutic phenomenology as the philosophical underpinning. Resonances between hermeneutic phenomenology and psychotherapy practice are explored. I offer a number of participant stories from the interviews I conducted, together with an interpretation of these narratives. Heidegger’s thinking about “meditative thinking” and Sorge (care) is drawn on, as well as Bion’s idea that thinking/dreaming one’s lived experience is a principal means by which one learns from experience. This research revealed that, over the course of their professional lives, psychotherapists move towards responding to what is essential for their own learning and that this is often an unconscious process. What matters to the individual begins to emerge and to show itself more fully. This has implications for prescriptive and systematised approaches to learning; the question is posed as to how we attune to the movement of our soul. Whakarāpopotonga He matapakihanga tā tēnei tuhinga i tētahi wāhanga rangahautanga o taku tohu Kairangi: te wheako o te ako haere tonu o te kaiwhakaora hinengaro. Tekau mā rua ngā kaiwhakaora hinengaro e mahi ana e noho ana i Aotearoa, i uiuia e au mō tēnei rangahau. Ko te wheako whaiaro o te ako haere tonu o te kaiwhakaora hinengaro me te here o te koioranga tangata onamata ki nāianei me tōna koiora mahi tohunga kaiwhakaora hinengaro, i kitea he mea tino whakahirahira. I huri ki te tirohanga e kīa nei ko te āta whakamāoritanga, arā te “hermeneutic phenomenology”, hai tātarii ngā kohinga uiuinga. Ka tūruhahia he paorotanga mai i tēnei tirohanga ki te momo mahi a te kaiwhakaora hinengaro. Ka horaina atu ētahi o ngā kōrero whakaurunga o ngā uiuinga nāku i hiki, me ngā whakamāramatanga hoki mō aua kōrero. I tōia mai anō hoki tā Heitakatirohanga ki te ‘whaiwhakaarohanga hōhonu’ me te aroha me tā Pīona whakaaaro e kī nei, ko te whakaarohanga/moemoeānga wheako whaiaro a te tangata te ara matua o te akohanga mai i te wheako. Ikitea i tēnei rangaha, i roto i te roanga ake o ā rātau mahi mātanga ko ngākaiwhakaora hinengaro urupare haere aiki te iho mō tōna ake mātauranga ahakoa he hātepe maurimoe. Ko te mea nui ki te takitahika tīmata ki te puea haere ake ki te whakaatu whānui haere ake i a ia. He whainga rara tēnei mō te momo whakahau whakahaerenga ki te ako; ko te pātai koia me pehea tewhakahāngai ki te whakanekenga o te wairua.

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