Background For ICD-11, the WHO emphasized the clinical utility of communication and the need to involve service users and carers in the revision process. Aims The objective was to assess whether medical vocabulary was accessible, which kinds of feelings it activated, whether and how users and carers would like to rephrase terms, and whether they used diagnosis to talk about mental health experiences. Method An innovative protocol focused on two diagnoses (depressive episode and schizophrenia) was implemented in 15 different countries. The same issues were discussed with users and carers: understanding, feelings, rephrasing, and communication.

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AimThe present study examined the view of the therapist as an attachment figure and the relationship between client adult attachment in close relationships and client attachment to the therapistMethod27 clients in ongoing therapy were asked to complete measures of adult attachment andclient attachment to their therapists. In addition, five participants were interviewed with regard to their perceptions of their therapist and the therapeutic relationship.FindingsQuantitative analysis suggested that client attachment may be activated in the context of the therapeutic relationship. In particular, ‘Need for Approval’ was significantly associated with both ‘Fearful/Avoidant’ and ‘Preoccupied/Merger attachmentto the therapist’; ‘Preoccupation in Relationships’ was positively correlated to ‘Preoccupied/Merger attachment to therapist’. Qualitative findings further suggested that the therapist serves as an attachmentfigure for clients.Implications for practiceThe therapeutic relationship contains features of an attachment relationship and therapists are often seen by clients as a secure basis for exploration. In this context, thebehaviour that clients present in therapy is seen as meaningful and its exploration can contribute to the deconstruction and re-appraisal of internal working models of self andothers. Implications for the practice of counselling psychology are discussed.

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