Abstract

Sexual and relationship needs of people with psychosis are generally overlooked despite established psychosocial benefits and reduced risk of relapse. Despite mental health professionals’ reluctance to initiate conversations about sexuality and intimacy with service-users, people with psychosis and their support networks have indicated their desire for professionals to address intimate topics. Clinical psychologists are specifically trained to address complex psychological issues; however, no research to date has explored their views around discussing sexuality and intimacy. Q-methodology was used to explore clinical psychologists’ personal and professional views about discussing sexuality and intimacy with people with psychosis. 27 clinical psychologists completed Q-sorts. Varimax rotation revealed three factors with distinct views; a majority perspective that highlighted the normality of sexuality and intimacy for people with psychosis and the acceptability of such conversations in clinical work for practitioners, a view focused on concerns about the appropriateness of discussing sexuality and the possibility that conversations could lead to increased risk, and a view that related to concerns about competency in addressing intimate subjects. The practical and clinical implications are discussed in terms of training need and limited access to sexual health services.

摘要

精神病患者的性需求和人际关系需求通常被忽视，尽管已确立心理社会益处并降低了复发风险。尽管精神卫生专业人员不愿与服务使用者就性行为和亲密关系展开对话，但精神病患者及其支持网络表明他们希望专业人员解决亲密话题。临床心理学家经过专门培训，可以解决复杂的心理问题；然而，迄今为止还没有研究探讨他们在讨论性行为和亲密关系时的观点。Q 方法用于探讨临床心理学家对与精神病患者讨论性和亲密关系的个人和专业观点。27 名临床心理学家完成了 Q 排序。Varimax 旋转揭示了三个具有不同观点的因素；大多数人的观点强调精神病患者性行为和亲密关系的正常性以及从业者临床工作中此类对话的可接受性，这种观点侧重于对讨论性行为的适当性以及对话可能导致风险增加的可能性的担忧，以及一种观点与对处理亲密话题的能力的担忧有关。实际和临床意义在培训需要和性健康服务的有限获取方面进行了讨论。一种观点侧重于对讨论性行为的适当性以及对话可能导致风险增加的可能性的担忧，以及一种与处理亲密话题的能力相关的观点。实际和临床意义在培训需要和性健康服务的有限获取方面进行了讨论。一种观点侧重于对讨论性行为的适当性以及对话可能导致风险增加的可能性的担忧，以及一种与处理亲密话题的能力相关的观点。实际和临床意义在培训需要和性健康服务的有限获取方面进行了讨论。