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| Research Conference 2012 | |||||
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BACP's 18th Annual Research conference was entitled 'Understanding counselling and psychotherapy: preferences, process and outcomes' and took place on 11-12 May 2012. It was held at Boxburghe Hotel, Edinburgh. Click here for an evaluation of this year's conferenceAbstractsPre-Conference WorkshopPresenters: Dr Joe Armstrong, Amanda Hawkins and Mhairi Thurston Professional Role: Lecturer in counselling (JA) ABSTRACT: pre-conference workshop (Thurs, 18:00 - 19:30) Practice research networks: promises, pitfalls and potential A critical issue facing the counselling and psychotherapy profession at present concerns the question of how to build a strong and externally-credible evidence base for its effectiveness. There is an emerging view that unless we address this question, counselling and psychotherapy approaches may be sidelined in favour of therapies with a much stronger base of research findings that support their effectiveness. Ultimately, a lack of an evidence base for the effectiveness of counselling and psychotherapy approaches may mean that they struggle to survive and be recognised as credible interventions for mental distress, particularly within public sector settings. But how can we go about building this evidence base? There is much debate about the value and relevance of different types of research (eg qualitative versus quantitative) in relation to building such an evidence base for counselling and psychotherapy. However, perhaps a much more pressing issue concerns how we engage members of the counselling and psychotherapy community in research. Especially, when there is good evidence to show that findings from research have only limited influence on the everyday practice of counsellors and psychotherapists - often because it does not adequately address the issues they encounter in their practice. One approach to engaging practitioners in research that has been employed successfully is the establishment of ‘practice research networks'. Essentially, a practice research network (PRN) provides a structure within which researchers, practitioners and other relevant stakeholders can collaborate on collecting data and carrying out research studies. This workshop will present the work of two PRNs at different stages of development as case studies around which to engage in reflection and discussion regarding the challenges and potential of the practice research network as a means of promoting and developing research that might contribute to the establishment of an evidence base for counselling and psychotherapy. Dr Joe Armstrong from the University of Abertay will present the work of the recently established Scottish Voluntary Sector Counselling Practice Research Network and Amanda Hawkins, Senior Manager RNIB (Chair of BACP) and Mhairi Thurston, University of Abertay will present the work of the Vision Impairment Network for Counselling and Emotional Support (VINCE). The workshop will also provide opportunities for discussion in small groups and contributions from participants in larger plenary sessions. Friday KeynotePresenter: Professor John Cape Professional Role: Head of Psychological Therapies ABSTRACT: Friday keynote (Fri, 09.15 - 10.00) What makes a good counselling and psychological therapy service? The presentation will describe recent research on the quality of counselling and psychological therapy services. There are different elements to quality. A good service can be described as one which is accessible, provides appropriate treatment by adequately trained and qualified practitioners, people receiving treatment feel well treated and experience the service as meeting their needs, and it delivers good outcomes. To what extent do services vary in these qualities and are services which are better in one quality also better in others (eg do accessible services with shorter waiting times also provide therapies with better therapeutic relationships and better clinical outcomes?). The presentation will draw on unpublished analyses from the National Audit of Psychological Therapies for Anxiety and Depression and recent analyses of differences between IAPT services. John Cape is Head of Psychological Therapies, Camden and Islington NHS Foundation Trust and Visiting Professor, Division of Psychology and Language Sciences, University College London. Following training as a clinical psychologist in London in 1972-74 he worked as a mental health counsellor in California for three years. Returning to the UK, he has worked as a clinical psychologist and manager of psychological therapy services in the NHS for over 30 years. He has longstanding clinical and research interests in primary care mental health and in the organisation of counselling and psychological therapy services between primary and secondary care. He was clinical lead and steering group chair for the National Audit of Psychological Therapies for Anxiety and Depression which reported in November 2011 and chair of the NICE Guideline Development Group for the NICE Generalised Anxiety Disorder guideline published in January 2011. Saturday KeynotePresenter: Professor Else Guthrie Professional Role: Consultant in Psychological Medicine ABSTRACT: Saturday keynote (Sat, 09.15 - 10.00) Understanding counselling and psychotherapy for clients with physical symptoms and medical conditions This talk will focus upon ways in which counselling and psychotherapy can provide help for people who have physical health problems that are being exacerbated by emotional difficulties or relationship issues. It will draw upon the work we have been undertaking in Manchester using the conversational model of therapy to help people with severe irritable bowel syndrome, somatisation and other long term physical conditions such as diabetes and asthma. I will also describe the work we have done in training counsellors in the conversational model and the similarities and differences between the two approaches. The talk will also cover our experience in using ‘goodbye letters' and how helpful these letters can be for clients in the year post therapy. Else Guthrie is Consultant in Psychological Medicine at Manchester Royal Infirmary and Honorary Professor at the University of Manchester. She is a former Chair of the Faculty of Liaison Psychiatry, Royal College of Psychiatrists, former UK Vice-President of the Society for Psychotherapy Research, former Chair of the Research Committee BACP and is currently Chair of the Research Foundation Advisory Committee. Her research interests have been in exploring the relationship between psychological and physical factors in patients presenting in medical settings. In addition she has carried out a series of randomised controlled trials to determine the efficacy and effectiveness of conversational model therapy (psychodynamic interpersonal therapy) for a variety of different conditions. Current areas of research are efficacy effectiveness of psychodynamic psychotherapy and the psychological factors which determine use of unscheduled care in the physically ill. Azizah Abdullah 1Other Authors: Mick Cooper, Robert Elliott and Brian Rodgers Professional Role: PHD student ABSTRACT: paper (Sat, 11.30 - 12.00) Keywords: person-centred therapy, helpful processes, children and young people Helpful processes and helpful effects of creative practices in person-centred therapy with children and young people Aim/Purpose: To explore practitioners' perspectives on the ways in which creative practices (eg art and play therapy techniques) can be helpful in person-centred therapy with children and young people, and the potentially helpful effects of these methods. Design/Methodology: In-depth interviews were conducted with 30 person-centred therapists in the UK and 10 in the USA: both telephone and face-to-face. This qualitative interview data were then analysed thematically. Ethical approval was obtained from the Department of Educational and Professional Studies, University of Strathclyde. Results/Findings: b) With respect to helpful effects, the two main themes were: Research Limitations: The study focused only on practitioners' experiences and views, and is not from the client's perspective. Conclusions/Implications: The findings raise awareness and understanding of helpful processes and effects in using any creative art and play materials in working with children and young people.  Azizah Abdullah 2Other Authors: Mick Cooper, Robert Elliott and Brian Rodgers Professional Role: PHD student ABSTRACT: paper (Fri, 15.00 - 15.30) Keywords: hindering factor, unhelpful effects, person-centred creative practice Therapists' experience of hindering factors and unhelpful effects of using person-centred creative practices Aim/Purpose: In addition to helpful processes and effects of utilising creative practices in person-centred therapy (eg using creative, art or play methods), therapists also perceived factors that hindered the process as well as unhelpful effects. The aims of this study were therefore to examine hindering processes in therapy and associated unhelpful effects, thus enabling practitioners to refine their work. Design/Methodology: Qualitative interviews were conducted with 40 participants from UK and USA to explore their experiences of hindering processes and unhelpful effects that sometimes occurred when using various types of creative materials in their work with children and young people. A systematic qualitative analysis was carried out on transcripts of interviews conducted face-to-face and by telephone. The research received ethical approval from the Department of Educational and Professional Studies, the University of Strathclyde. Results/Findings: b) In addition, two main domains appeared for unhelpful effects: Research Limitations: The study focused only on practitioners' experiences and views, and is not from the client's perspective. Conclusions/Implications: The findings provide a list of problematic processes and effects that therapists using creative methods with children and young people should be aware of and try to avoid in order to ensure that clients gain benefit and positive impact. Dr Steph AdamProfessional Role: Independent semi-retired counsellor and clinical supervisor ABSTRACT: poster (Fri, 10.00 - 10.30) Keywords: dreams, therapy, qualitative, integrative, humanistic Dream theories: which one or none? Aim/Purpose: The purpose of this study was to explore participant's (who were also counsellors) views of one neuro-biological and six psychological dream theories for their usefulness in therapeutic dream work. Design/Methodology: This was a qualitative reflexive enquiry involving five participants (one psychodynamic-integrative and four humanistic-integrative counsellors) initially reading a selected case study for each dream theorist. The case studies reflected paradigms developed by: Hobson, Freud, Jung, Perls, Faraday, Cushway & Sewell and Hill. Participants were then interviewed face-to-face by the researcher using semi-structured questions to elicit the perceived strengths and limitations of each theory. The interviews were recorded, transcribed verbatim and analysed twice using grounded theory and heuristic methods resulting in a bricoleur approach to the final analysis. Ethical approval was given by The University of Manchester. Results/Findings: The findings identified that each theory had aspects which were helpful or unhelpful for counsellors working with client's dreams. The participants embraced or rejected specific theoretical constructs based on their therapeutic orientation; previous knowledge of dreams and personal values and belief systems. Research Limitations: Due to the small sample and the participant's similar theoretical orientations the findings cannot be generalised to a larger population. Conclusions/Implications: Counsellors who are humanistic practitioners may find therapeutic dream work more challenging. This is because there is not a psychological dream theory which is totally compatible with humanistic philosophy. Further research should be carried out with larger groups of practitioners. Ideally future studies should compare Freudian, Jungian and CBT practitioner's views of psychological dream theories. Relevant references will be available at the conference or via a request to the researcher's email address. Jane BalmforthOther Author: Professor Robert Elliott Professional Role: PhD student and counsellor ABSTRACT: paper (Fri, 15.00 - 15.30) Keywords: client disclosure, comprehensive process analysis, significant events research 'I was stumbling around...': a comprehensive process analysis of significant client disclosure in therapy Aim/Purpose: To explore clients' process of disclosure in therapy, the effects of the disclosure on subsequent sessions and the background to the disclosure event. Better understanding of clients' process of disclosing may help therapists facilitate and recognise significant disclosures. Design/Methodology: Participants indicated significant disclosures on HAT forms after each session. Brief structured recall was used to interview six participants about significant disclosures in therapy. The data were analysed using comprehensive process analysis (CPA) (Elliott, 1989) and a cross-analysis (open coding) was carried out of the CPA categories. Results/Findings: Initial findings of the cross-analysis indicate that clients planned disclosures in advance. Although clients tended to speak hesitantly while disclosing, disclosure was generally immediately experienced as positive. Client experiencing scale (CEXP) (Klein et al., 1986) ratings showed an increase in depth at one minute after the disclosure. Client-therapist bond did not predict disclosure. Disclosures remained significant at six and 18 month follow-up interviews. Research Limitations: The small sample size, restriction to person-centred therapy and white, mainly female, participants and therapists limit generalisability. Participants were also aware that the researcher was investigating disclosure; the research process may interfere with the client's processing. Conclusions/Implications: In this study, clients appeared to plan and look for opportunities to disclose even when the therapeutic relationship was not close, supporting previous research findings about the client as agent (eg Bohart & Tallman, 1999). However, if the therapist did not realise or acknowledge the importance of the disclosure the client's tasks for the session would be unfulfilled. Therapists' awareness of client discourse markers, such as tentative speech, embarrassment or making an announcement, may be key to recognising that the client is disclosing significant material. Amanda BargeProfessional Role: PhD student ABSTRACT: poster (Sat, 10.00 - 10.30) Keywords: endings, termination, internalisation, therapists' representation, grounded theory How does the style of therapeutic ending affect the client's internalisation process? Aim/Purpose: The aim of this pilot study is to examine clients' experiences of ending therapy and more specifically the possible role of the clients' post-therapy internal representations of their therapists in the process of ending. Little research has been carried out on this crucial stage of therapy and most of the other studies have been limited by their focus on either non-naive student counsellors or clients in extended psychoanalytic psychotherapies. This project is intended to explore the experiences of clients without a background in psychotherapy and who have also been involved in time limited person-centred-experiential psychotherapy. Design/Methodology: Using client post- and follow-up interview data from the University of Strathclyde's Research Clinic, the researcher thematically analysed 10 clients' experiences, as reported in the semi-structured client change interview. All the clients were seen by either a person-centred or emotion-focused counsellor, for 20 or 40 sessions. Results/Findings: Preliminary results suggest that clients experienced ending with their therapists as significant events. Last sessions sometimes left clients feeling abandoned and sad. Often the impact of ending was not explored in any depth before the last session, and clients struggled at times to be genuine about their reaction to the termination of therapy. On the other hand, some clients reported vivid representations of their therapists in their memories, which they could call upon when they needed support. Research Limitations: Small sample of clients, unlikely to fully represent the diversity of client experiences of ending. Only global thematic analyses have been completed so far. Conclusions/Implications: The initial conclusions point to the need for the therapist to be more aware of their clients' experiences as they approach ending therapy. Open discussion of ending is likely to reduce the danger of the client leaving therapy feeling abandoned and at a loss. Therapists perhaps might want to consider taking extra responsibility at this stage of therapy and discussing support networks and the potential value of mindfully retaining memories of the work and their therapist. Hope Bell et al. 1Other Authors: Dodie Limberg, Mark E. Young, E.H. 'Mike' Robinson, Sandra Robinson, Grant Hayes and Jesse Fox, John Super, Lamerial Jacobson, Kristina DePue, and Chris Christmas Professional Role: Doctoral student and graduate assistant, Counselor Education Program ABSTRACT: paper (Fri, 13.50 - 14.20) Keywords: counselor educators, identity development, doctoral programs, identity transition, program development Professional identity development of counselor education Doctoral students Aim/Purpose: At the Doctoral level, professional identity development is crucial due to the role change from practitioner to academic (Carlson et al., 2006; Hall & Burns, 2009). The purpose of this study is to understand and examine, using consensual qualitative research (CQR), experiences of counselor education Doctoral students (CEDS) that influenced their professional identity development. The primary research question for this study is: how do counselor education Doctoral students develop their identity as counselor educators? Design/Methodology: The authors utilised the qualitative methodology of CQR to collect data on identity-forming experiences of first, second, and third year CEDS at a university in the southeastern United States. A total of 18 CEDS agreed to participate with their fellow cohort members in a focus group designated by year. The focus groups were semi-structured with five open-ended questions asked in sequential order to promote consistency across groups and allow for rich data collection and in-depth responses (Heppner, Wampold, & Kivlighan, 2008). Data analysis followed the structure outlined by CQR methodology. Results/Findings: Results for the focus group interviews offered multiple common factors (domains) between and within cohort groups contributing to CEDS' identity development. Eight solid domains emerged: teaching, supervision of students, conducting research, attending and/or presenting at a conference, cohort membership, program design, mentoring, and perceived as a counselor educator by faculty. Research Limitations: At the time focus groups were facilitated, all participants were in the beginning of the respective years within the program, and all were from the same university in the southeastern United States. Selection of focus group questions were partially based on experiences and expectations of first year doctoral students, though unsupported domains were discarded later during data analysis. Additionally, some of the participants had previous knowledge of the focus group questions. Conclusions/Implications: From the results of this study, it seems clear that the development of counselor educator identity is intimately linked to the participants' training program. In particular, counselor educator identity seemed to develop during the practical experiences of "trying on" the professoriate. Additionally, the three primary domains of teaching, research and service (Calley & Hawley, 2008) that contribute to counselor educator identity were well represented in the data. Hope Bell et al. 2Other Authors: E.H. 'Mike' Robinson, Grant Hayes, Sandra Robinson, Dodie Limberg and Jess Fox Professional Role: Doctoral student and graduate assistant, Counselor Education Program ABSTRACT: poster (Sat, 10.00 - 10.30) Keywords: shared trauma, shared reality, disaster mental health, situational trauma, counselor trauma Shared trauma in professional counselors: a validity check Aim/Purpose: A shared trauma occurs when both counselor and client experience the same traumatic event simultaneously. The purpose of this study was to define and discuss the concept of shared trauma on professional counselors, as well as explore counselors' conceptualisations and knowledge of shared trauma. Design/Methodology: A literature review was conducted as a basis for the study, followed by a qualitative survey distributed to professional counselors who may have experienced a shared trauma. The survey consisted of open-ended questions that were designed for counselors to express their knowledge and experiences related to shared trauma, wellness practices, and risk factors. The sample parameters included residency in areas recently affected by large-scale disasters, specifically the region affected by Hurricane Katrina in 2005, and practice under a professional license for at least three years. Participants were sent a link to a short online survey, where answers were anonymous. Results/Findings: The results of the survey showed that the counselors in this small sample (n=9) were unsure of the definition of shared trauma. They often confused it with other forms of counselor trauma, such as vicarious and secondary trauma, however some were able to give examples of their shared trauma. Research Limitations: This research is serves as a preliminary validity check of the knowledge of counselors related to the concept of shared trauma. Limitations include the small sample size and limited distribution of the survey. As a qualitative validity check, these results may serve a jumping off point for future research. Conclusions/Implications: Through defining shared trauma and the related concepts, it is clear that shared trauma is a construct separate from vicarious and secondary trauma (Baum, 2010). Research in the last twenty years has brought to light the dangers counselors face when treating traumatised clients (Figley, 1995; McCann & Pearlman, 1990). Counselors are now trained in the effects of secondary and vicarious trauma, and prevention and treatment of these conditions. Shared trauma poses the same, if not greater risk to counselors, and can befall any community at any time. It should, therefore, be a concept about which counselors are knowledgeable. Ada BlairProfessional Role: BACP accredited practitioner, counselling service manager ABSTRACT: paper (Sat, 14.25 - 14.55) Keywords: astrology, belief, religion, therapist response, therapist orientation How do counsellors/psychotherapists respond to clients who introduce astrological beliefs into therapy sessions? Aim/Purpose: This pilot research project was conducted as part of a Masters in cultural astronomy and astrology at the University of Wales Trinity Saint David. The aim was to consider ways in which counsellors/psychotherapists work with clients' disclosed astrological statements/beliefs within therapy sessions: to ascertain the extent to which their training and subsequent therapeutic approach factor in the interaction and the reported influence, if any, of their personal opinions/beliefs/experience concerning astrology. For the purposes of this project astrology is considered to be a religious or quasi-religious belief which, in the eyes of many scientifically trained practitioners, is seen as non-rational and/or non-justifiable. It is hoped that the project will contribute to the debate regarding the place in therapy for clients' declared religious and/or quasi-religious beliefs including astrology. Design/Methodology: A combination of qualitative and quantitative research methods were employed, specifically questionnaires and semi-structured interviews. Questionnaires were given to 21 qualified, practicing counsellors/psychotherapists from a range of therapeutic approaches working within Edinburgh and the Lothians. Individual interviews were conducted with four of the respondents. Results/Findings: Nineteen questionnaires were returned (91%) with a majority of respondents professing some belief in astrology (84%) and with experience of clients introducing astrological belief into therapy (89%). 21% of respondents (four) were interviewed and all had some belief in astrology and had worked with clients who held astrological beliefs. Training and orientation, in addition to personal beliefs about astrology, were seen as influencing how these therapists interacted with clients. Therapists with no personal belief in astrology (16%) recognised the importance of helping clients integrate body, mind and beliefs, whatever those beliefs might be. Research Limitations: The study was conducted with a small number of participants from a specific geographical area therefore generalisations cannot be made. The small sample results in small variations in the number of responses leading to substantial variations in percentage results. As a pilot study done within a limited timeframe there was little opportunity to "trial" the questionnaire resulting in some issues with the wording of certain questions. Conclusions/Implications: The study suggests that how counsellors/psychotherapists respond to clients who introduce astrological beliefs into therapy sessions may be related to their therapeutic approach. Therapists with an interest in astrology may be more "alert" to its' introduction into therapy by clients. The place in therapy for clients' declared religious or quasi-religious beliefs and the experiences of clients who are believers in astrology may merit further investigation. Paula BroganOther Author: Dr Diane Hazlett Professional Role: PHD student ABSTRACT: paper (Sat, 13.50 - 14.20) Keywords: cancer counsellors, IPA, adaptation, connectivity, resilience Transitional space: a qualitative study of the experience of professional cancer counsellors Aim/Purpose: People with cancer move through transitional stages between health and illness, which are difficult emotionally and psychologically, and health care professional's difficulty with communication in these transitions around end of life is well documented (Seymour et al., 2010). This study explored the experience of professional cancer counsellors, with unstudied ability to engage communicatively around death and dying (Thorne et al., 2005). The aim was to understand the experience of counsellors who share this transitional space. Objectives were: 1. to examine the impact upon cancer counsellors of working with cancer sufferers. 2. to identify what professional cancer counsellors do within the therapeutic space. 3. to identify key themes, relevant to their adaptive process. Design/Methodology: A qualitative methodology using interpretative phenomenological analysis (IPA) was employed (Smith, 2008). A combination of three focus groups (n=12) and 6 individual in-depth interviews were recorded, transcribed and analysed, eliciting rich data on participant experience. Results/Findings: Key findings were the importance of meaning-making to counsellors around a) their personal fit to this counselling role and b) their developing relationship with cancer themes eg existential meaning of death. As both engage in a 'mutual dance' of therapy, characterised by counsellor ability to remain 'open' to movement or staying still. Attending to experiences in-the-moment, personal and professional growth occur mutually within the therapeutic space. The connectivity of the counsellor is skilful, and a combination of personhood, training and experience enables a 'holding role', - but ongoing exposure to the ‘heaviness' of cancer work may lead to compassion fatigue over time. Spiritual meaning making, self-awareness, active engagement in self-care and the importance of skilled supervision and supportive management were strong emergent themes in adaptation, and contributors to resilience. Research Limitations: Findings are not generalised to non-cancer counsellors, psychological professionals or others who do not work consistently in cancer care as part of their professional role. Conclusions/Implications: Transitional space is not just about movement through stages of illness, but mutual meeting and subtle movement within the relationship of therapy. Experienced counsellors are resilient and cope primarily by meaning making around death, but self-awareness must be supplemented by supportive supervision and management to avoid compassion fatigue. Future studies required into the structure of tailored support. Selina-Jane Brown and Annalisa DoveyOther Authors: Ali Bailey, Ambrose Gillham, Diana Beacom, Emily Cumming, Linda Harvey and Lorraine Forrest Professional Role: Trainee counsellors ABSTRACT: poster (Fri, 10.00 - 10.30) Keywords: sociopath, anti-social, diagnosis, treatment, person-centred The lost sociopath: challenges of working with a client group no longer recognised within DSM IVR Aim/Purpose: Gurley (2009) notes that ‘sociopathy' is no longer recognised by the Diagnostic Statistical Manual IV Revised (DSM IVR) as a discrete disorder, having been absorbed into the undifferentiated category ‘anti-social personality disorder' (ASPD). However, research suggests ASPD consists of distinct sub-disorders (Lykken, 1995). Our research aims to explore the implications of these diagnostic categories on the treatment of sociopathic clients, especially in relation to person-centred psychotherapeutic practice. Design/Methodology: The study was informed by the principles of Empirical Phenomenology (Hycner, 1999). Six psychotherapeutic practitioners working in institutions that provide therapy for clients with sociopathic disorders took part in semi-structured interviews conducted by members of the research team. Interview questions focused on the way in which potential clients from this group were assessed, the type of therapy they received, and the relevance of person-centred principles within this work. Interviews were audio-taped and transcribed, and a five-step explication process (Hycner, 1999) was used to identify emergent themes and anomalies. The project adhered to the BACP ethical guidelines for counselling research (Bond, 2004). Results/Findings: The overarching themes inherent in our data indicate that ASPD now includes highly diverse characteristics due to the absorption of previously distinctly defined mental disorders. There seems to be confusion amongst practitioners in relation to diagnosing and treating clients with ASPD, which is exacerbated by wider institutional issues some practitioners face. It appears practitioners are using alternative strategies to sub-classify clients' disorders; in turn this raises questions about the treatability of clients solely diagnosed with ASPD. Additionally, findings appear to reveal that there are inconsistent levels of understanding and application of the person-centred approach (PCA), whilst practitioners report ‘using' the model in the treatment of ASPD. Research Limitations: The small respondent sample makes it difficult to assess the relevance of these findings for the wider professional community. Conclusions/Implications: Findings indicate the broad classification of ASPD has resulted in practitioner ambiguity and the use of disparate sources to inform diagnosis and treatment, suggesting that the re-classification of sub-categories within ASPD is required to provide practitioners with uniform guidelines. Although the central importance of the therapeutic relationship is recognised within the differentiated treatments of ASPD and the PCA is reported to be used by practitioners in the field, it appears the approach is not fully understood nor extended, thus further research is required to clarify the effectiveness of the PCA in the treatment of sociopaths. Jill Collins and Colin DyerOther Authors: Alison Gibson, Sarah Parkin, Rosemary Parkinson and Diana Shave Professional Role: Senior Staff Counsellor/Freelance Research Consultant ABSTRACT: paper (Sat, 10.55 - 11.25) Keywords: action research, counselling, well-being, workplace, time-limited Counselling in the workplace: how time-limited counselling can effect change in well-being Aim/Purpose: To evaluate whether time-limited counselling in a workplace can effect sustained change in well-being. Design/Methodology: The study was carried out as a piece of action research by a staff counselling team in a university. The Warwick-Edinburgh mental well-being scale [WEMWBS] was completed by clients at the beginning and end of counselling, and at three and six months following. A non-treatment comparison group completed the survey at the same intervals. Results/Findings: The results of our investigation show clearly that the effect of time-limited counselling on distressed clients is overwhelmingly positive. The data from the treatment group suggests that they acquire an increased sense of well-being as a result of the experience of counselling with a significant statistical difference between pre-and post counselling treatment group scores on the WEMWBS and consistently higher scores found post counselling. Specifically, the findings of the project show that counselling for around eight sessions will be likely to produce significant change in approximately 70% of clients, which is sustained for six months after treatment ends. We also found evidence that the subjective assessments made by experienced practitioners could provide as accurate an assessment of wellness as the WEMWB scale. As the clients treated were entirely unscreened, these results provide both a benchmark for the effectiveness of counselling and also encouragement to the wider counselling profession in the shape of objective evidence that its work is effective, contributes to improved performance, and is a worthwhile investment in staff support by employers. Secondly, the project offers one model of the research process that can be followed and improved upon by other practitioners since it demonstrates that practitioner-led research carried out alongside normal working and during usual working hours can contribute significant data to the published evidence base. Research Limitations: The research was carried out alongside normal working and during usual working hours by the counselling team; data were lost by the pressure of work. Sample size of 134 in the treatment group, and 18 the comparison group were 18. The size of the comparison group needed was underestimated, resulting in a small sample. Conclusions/Implications: The provision of time-limited counselling by employers is an effective support for personal difficulties affecting work. James F CostelloProfessional Role: Counsellor and Senior Lecturer Institution: University of the West of England and South Gloucester Counselling Service ABSTRACT: paper (Fri, 16.30 - 17.00) Keywords: perinatal depression, masculinity, social learning, groupwork, reflexive action research Working with men in the context of perinatal depression Aim/Purpose: The impact of depression during the perinatal period may extend beyond the mother, having profound implications for the psychological wellbeing of her infant, and her immediate family. From a family systems perspective, interventions which include the father may benefit the family unit because ‘healthy men' provide better care and support. This research aims to improve the provision of support to families affected by perinatal depression. Design/Methodology: Reflexive action research describes this male clinician's reflection-upon-action, and reflection-in-action when working alongside men affected by perinatal depression. The transformation of practice (action) through the experience of working with over 30 couples, a public consultation group (seven participants) and five narrative case studies is described. Results/Findings: Men's experiences of couple group-work in the context of their partners' depression is more usefully understood through the lens of socially learnt behaviours. The engagement by men in adaptive help-seeking behaviour may be hindered through the masculine norms of autonomy, a fear of intimacy, an aversion to taking risks with self-esteem, and the unhelpful framing of problems as technical in nature. Research Limitations: For ethical reasons, the researcher was unable to explore the experiences of workshop participants who were actively engaged in the therapeutic work, beyond standard service evaluation. A significant limitation of work of this type is the absence of longitudinal data which would inform us of longer term outcomes. Conclusions/Implications: Couple/family group work interventions directed primarily toward supporting male partners of women affected by perinatal depression have been developed, by incorporating a blend of activities congruent with the adaptive tasks in which men engage when overcoming difficulties (ie normalising, reciprocating and re-framing). Susan CousinsProfessional Role: Counsellor ABSTRACT: paper (Sat, 14.25 - 14.55) Keywords: adoption, attachment, cultural diversity, trans-racial, university counselling Counselling the trans-racially adopted: surviving broken connections Aim/Purpose: To examine the salient issues presented by trans-racial adoptions in counselling and to offer recommendations for best practice for this population and others who may have attachment issues. Design/Methodology: The researcher completed an autoethnographic analysis of her own experience of being a trans-racial inter-country adoptee brought up in a conservative English town with a predominantly white population, including examining personal and family journals and letters, taking into account both personal experience and her reflections on the meaning of her experience in the context of her family and culture. Additionally, she analysed her counselling work with trans-racially adopted clients with whom she worked over a period of 15 years, in university settings, NHS settings and for the Post Adoption Centre, and carried out a composite case study analysis, incorporating phenomenological analysis and using empathy as an observation strategy to identify salient counselling issues. Clients gave permission for anonymous case material to be used for research purposes. Results/Findings: Many of the feelings and experiences reported by the clients mirrored the autoethnographic analysis of the researcher's personal experience in having been trans-racially adopted. A number of complex and emotionally-charged issues for trans-racially adopted clients were identified, including feelings of profound abandonment, attachment and separation issues, and a powerful and traumatic sense of displacement. There were also profound identity issues, with people experiencing a loss of an integrated identity. Clients displayed 'survivor's guilt' particularly if the adoption was from a developing country where others were left in poverty. They expressed a loss of birth language and culture, and had uncomfortable feelings about having second hand histories of their adoption. They felt 'unsafe' due to traumatic abandonment experiences, and were challenged by being angry about their adoptions while fearing anyone knowing about their anger for fear of being perceived as ungrateful. Research Limitations: This preliminary study was based on one counsellor's experience, and further studies with other counsellors and other people who had suffered early attachment losses without being adopted would be needed to validate the findings. Conclusions/Implications: Counsellors may fact unique challenges in working with trans-racially adopted clients as it may be difficult to display the core condition of unconditional positive regard when listening to uncomfortable feelings such as anger, displacement and despair. They may not feel prepared for the intensity and complexity of the emotions presented by these clients, such as feelings of anger about being adopted and idealisation of the imagined life they lost. Sharon CoxProfessional Role: Counsellor, supervisor and part-time PhD student ABSTRACT: paper (Fri, 15.55 - 16.25) Keywords: eating disorders, embodied subjectivity, heuristic research, grounded theory, reflexivity The embodied counsellor: exploring the counsellor's embodied subjectivity when working with clients presenting with eating distress Aim/Purpose: To investigate the significance of the counsellor's embodied presence in the therapy room to effectiveness of outcome with clients presenting with eating disorders. As this client group inevitably have troubled relationships with food, eating and their body, this paper will discuss the importance of counsellors having a relaxed and congruent relationship with their own body. Design/Methodology: Eleven counsellors have been interviewed to date using in-depth semi-structured interviews. Data gathering and analysis have followed a Bricolage approach incorporating grounded theory within Moustakas' heuristic research to ensure both rigour and depth. As the researcher is both a counsellor working with this client group and an individual with a personal history of eating distress, data analysis has encompassed a significant element of reflexivity. Results/Findings: Differences in embodied experience have emerged between the generic counsellors and the specialists which have implications for the effectiveness of both therapy and outcomes. A knowledge gap was discovered in the generic counsellors' self awareness around embodied subjectivity, highlighting a potential training issue. Research Limitations: This paper has emerged out of PhD research exploring possible effects on the counsellor's embodied subjectivity of working with this client group. The research has therefore not focused specifically on the implications of the counsellor's embodied subjectivity for successful outcome. It has however, indicated this as a significant factor and therefore highlighted it as a potential area for future research. Conclusions/Implications: If counsellors are able to present a congruent embodied experience within the counselling room, therapeutic effectiveness may be improved. Understanding the embodied experience is relevant for work with all clients, not just those presenting with eating disordered issues. Increasing counsellors' understanding of embodiment and the links between food, eating and being-in-the-world should play a more significant role in counsellor training and personal development. Dr Meghan Craig 1Professional Role: Counselling Psychologist ABSTRACT: methodological innovation paper (Fri, 12.05 - 12.35) Keywords: abductive reasoning, best explanation, causal mechanisms, systematic case studies, change Abductive reasoning as a method for drawing inferences to the best explanation of change processes in psychotherapy Background and introduction: A fundamental difficulty for psychotherapy is specifying those processes which are crucial in activating and maintaining change. Whilst it is fairly straightforward to list "active ingredients", it is much harder to demonstrate the causal role of these processes. This presentation will consider an alternative methodology for developing and testing theories about how change is occurring in the therapeutic process. Nature of the methodological innovation/critique being proposed: Abductive reasoning is a method of logical inference that comes prior to induction or deduction, and is a process that moves from a description of data patterns, towards reasoning about the best explanation. The method proposed here is derived from Haig's (2005) abductive theory of Method, and Thagard's (1978, 1992) theory of explanatory coherence. Intensive records from systematic single case studies will be presented to explain how the method may be applied in the study of psychotherapeutic change. The method follows a process of detecting patterns in client case records, and extracting robust phenomena from the data. Theories are generated to explain the observed changes, and these are developed through a process of analogical abduction. Competing theories are evaluated against each other using set criteria to draw inference to the best explanation. Conclusion and relevance to counselling and psychotherapy research practice: The proposed method of abductive reasoning is suggested as a means by which to reason to the most plausible and coherent explanation for how changes in psychotherapy occur. This is a hypothesis-generating process that would normally rely on experimental methods to test the explanations proposed. It provides a rigorous first step in the endeavour to move from the question of 'what works' in therapy to 'how it works'. Meghan Craig 2Other Authors: Mick Cooper and Joel Vos Professional Role: Counselling psychologist ABSTRACT: paper (Sat, 12.05 - 12.35) Keywords: systematic review, meta-analysis, effectiveness, existential, therapeutic interventions Existential therapies for psychological distress in adults: a systematic review and meta-analysis Aim/Purpose: This project aimed to undertake the first comprehensive, systematic review of the evidence on the effectiveness of existential therapeutic interventions with adults. Design/Methodology: This review followed the PRISMA guidelines (Moher et al., 2009) for reporting systematic reviews and meta-analyses. A search strategy was developed, and searches were conducted in key electronic databases. Relevant bibliography searches and references from recognised experts in the field were also included. Studies included were those from 1970 onwards; where participants were over the age of 18; were either randomised controlled trials, pre-post designs, systematic qualitative deigns, or case studies; explicitly used the term ‘existential' to describe either the therapeutic intervention or the focus of the therapeutic work; and reported specific outcomes for the intervention. At first stage, titles and abstracts of all identified studies were screened by two raters. At second stage, the remaining full text articles were sent for and screened by two raters. Results/Findings: The presentation will report on the number of papers included in the final analysis. Of these, the majority were studies conducted in the physical health field, and primarily focused on palliative care. Nineteen studies were randomised controlled trials. The paper will present the overall mean effect size for the interventions against control conditions at endpoint; the mean pre- to post-intervention effect size; and moderators of the effectiveness of the intervention. Research Limitations: A number of studies do not systematically report outcomes, preventing them from inclusion in the analysis. Due to wide variability in how studies are reported, data on follow-up time points had to be excluded from the analysis. Conclusions/Implications: Existential therapy shows some effectiveness, but the majority of systematic research in this area is in the domain of physical health and palliative care. Lois de CruzProfessional Role: Teaching Fellow and PhD student ABSTRACT: methodological innovation paper (Fri, 13.50 - 14.20) Keywords: bracketing interview, embracing, interpretative phenomenological analysis (IPA), thematic analysis, miscarriage Bracketing or embracing: reflections on the stance of the qualitative researcher Background and introduction: This paper explores the idea of using a bracketing interview as a reflexive tool in qualitative research (Gearing, 2004). Bracketing is a fundamental term in phenomenology having its roots in Husserl's philosophy. For Husserl, describing the essence of human experience involved stepping outside the "natural attitude" or bracketing preconceptions, a process also known as "reduction" (Smith et al., 2009). Therefore, a bracketing interview can be undertaken at the beginning of phenomenological research for the purpose of allowing the researcher to become aware of assumptions and how these might impact on the analysis. Nature of the methodological innovation/critique being proposed: Here the notion that it is possible to set aside assumptions is challenged and it is argued that a bracketing interview can facilitate the researcher to embrace their preconceptions allowing them to be more open to participants and to make more immediate and spontaneous connections with the research. The bracketing interview described in this paper was undertaken as part of a PhD using interpretative phenomenological analysis (IPA) (Smith et al., 2009) to research into women's perception of miscarriage many decades after the event. A colleague from the counselling psychology group at Keele University facilitated the interview for the purpose of allowing the researcher to reflect on her own experience of miscarriage. The interview was digitally recorded and transcribed verbatim. A thematic analysis was then undertaken on the transcript. Four themes, time-travelling, shadow child, a wind-egg and creative forces emerged from the analysis. The theme Shadow Child is the main focus of this paper (Braun and Clarke, 2006). Conclusion and relevance to counselling and psychotherapy research practice: Traditional reflexive bracketing may create tensions for the researcher, as it is difficult to be distanced and removed and at the same time transparent and involved in the research process. There is a possibility of collusion between the interviewer and interviewee and the danger that the focus of the research shifts from the participants' experience to the stance of the researcher. However, this paper argues that it is not through bracketing off but by embracing our preconceptions and exploring these in a reflective and transparent way that the researcher can become more fully involved and receptive to what might appear in the research. This impacts on an intellectual and personal level and can be ultimately a transformative experience. Dr Linda Dubrow-MarshallProfessional Role: Manager, Counselling and Wellbeing Service and Lecturer ABSTRACT: paper (Fri, 15.00 - 15.30) Keywords: single session psychotherapy, university counselling, psychotherapy outcome, case study, CORE Examining the efficacy of single session therapy - a qualitative and quantitative analysis in university settings Aim/Purpose: To examine the efficacy of single session therapy using quantitative and qualitative analysis and to demonstrate its effectiveness for selected cases in a university counselling service. Design/Methodology: The qualitative analysis was based on case studies of single session therapy gathered at two universities (Cardiff University and the University of Salford) which were analysed phenomenologically to yield an amalgam of themes of what had made the session meaningful, reported as composite studies. The quantitative analysis consisted of an examination of CORE pre and post therapy scores of 107 student clients who were seen by the researcher over a two year period at the counselling service at Cardiff University using the 'Cardiff model'. Fifty percent of the clients were seen for an extended single counselling session and a brief follow-up, and the other fifty percent were seen for additional counselling sessions. The CORE pre and post therapy scores were compared for these two populations. Students gave permission for their CORE scores and anonymous case material to be used for research purposes to meet the ethical approval of the universities. Results/Findings: In a sample of 53 clients seen for a single session, 60% demonstrated reliable improvement from pre to post therapy CORE scores, 32% demonstrated clinical change improvement, and 64% demonstrated clinical and/or reliable improvement. In a sample of 54 clients seen for more than a single session of therapy, 54% demonstrated reliable improvement, 26% clinical change improvement, and 57% clinical and/or reliable improvement. These figures indicate the effectiveness of single session psychotherapy for selected clients. The composite case studies illustrate which types of clients were suitable for single session therapy and how a strategic therapeutic approach was particularly helpful for specific issues, including academic difficulties, relationship problems, and bereavement. Research Limitations: The study was based on one counsellor's experience over two years. More information would be gathered through further expanded samples. Conclusions/Implications: This study demonstrated the efficacy of single session psychotherapy for selected students in a university setting. These findings have implications for counselling practices which are often burdened by large waiting lists and limited resources and who may benefit from offering single session psychotherapy to selected clients. Guidelines for the selection of these students are also suggested by this research. Katerina DunnProfessional Role: Counsellor ABSTRACT: paper (Sat, 15.00 - 15.30) Keywords: email counselling, therapeutic relationship, HE students, interpretative phenomenological analysis (IPA), transitional space 'To meet or not to meet - that is the question': a qualitative investigation into the online counselling relationship Aim/Purpose: Previous research has found quantitative ratings of the working alliance in both online and face-to-face counselling to produce similar results. This study aims to explore qualitative differences in these working relationships and to determine whether the experience of a relationship in one modality may alter attitudes to and experiences of relationship in the other. Design/Methodology: Semi-structured interviews were conducted via email through the delivery of consecutive e-questionnaires (Meho, 2006) with 10 former online clients and six online counsellors in higher education settings, to explore their experiences of the online therapeutic relationship and its impact on the counselling process and outcomes. These were analysed using interpretative phenomenological analysis (IPA). Results/Findings: Areas of focus emerged relating to the importance of the structure and processes involved; their impact on thinking and feeling; their impact on self and relationships (within and outside counselling) and changes that followed email counselling. Having ‘time to think' within the asynchronous exchanges, the anonymity and disinhibition afforded by the online medium, the creation of transitional space and the rich use of imagery all contributed to a sense of empowerment and relational depth. This led to positive change for many which for some in turn facilitated subsequent face-to-face counselling. Research Limitations: The respondents to the study may comprise a biased sample in that they largely indicate positive feelings about email counselling. Within the context of the study, this was to be expected and may indicate a shortcoming that needs to be addressed by future research, which could aim to explore the feelings and experiences of those who fail to engage in online therapy or who reject it as an idea. The study is small scale and cannot be generalised either to other client populations or to other online counselling situations. However, it begins to address a previously indicated need for more practitioner-based research in a growing area of service provision. The study provides a starting part for subsequent enquiry. Conclusions/Implications: The findings support the provision of counselling and therapy online and particularly its integration within existing face-to-face services. The possibility is raised of using asynchronous online counselling to engage clients who seek support but resist initial face-to-face counselling for reasons of shame and stigma. The study highlights particular and unique benefits for some clients of an asynchronous approach. Dr Ruth Elvish and Professor John KeadyOther Authors: Sammi-Jo Lever, Jodie Johnstone and Rosanne Cawley Professional Role: Clinical Psychologist/Professor of Older People's Nursing ABSTRACT: paper (Fri, 10.55 - 11.25) Keywords: psychological intervention, carers, dementia, review Psychological interventions for carers of people with dementia: a systematic review Aim/Purpose: Recent studies have provided promising findings about the impact of psychosocial interventions for older adult carers and carers of people with dementia. The aim of this work was to undertake a review of quantitative and qualitative studies to add to the substantive knowledge base. Design/Methodology: Key electronic databases were searched including PsycINFO and Medline. Inclusion criteria were developed to enable access to both quantitative and qualitative studies. Results/Findings: Four categories of psychological intervention were identified: i) psychoeducational skill building (n=8); ii) psychotherapy-counselling (n=1); iii) multicomponent (n=6), and iv) technology based (n=5). Research Limitations: Literature may not have been identified due to the criteria which we have used to define the parameters of this review. Conclusions/Implications: 1) Further research is necessary that explores the processes of change within psychological interventions; 2) Studies which explore the impact that the mode of delivery has on process and outcome is necessary; 3) An increase in the number of studies measuring the impact of psychotherapy/counselling is required; 4) The number of UK based studies in this field should be increased; 5) The qualifications of those delivering psychological interventions within this review is varied; standardisation of training/qualifications would be beneficial; 6) Interventions underpinned by cognitive-behavioural models can produce meaningful change; 7) Multicomponent and technology-based interventions which use a combination of individual/group sessions are most effective; 8) There is a continued need for social policy to focus on stigma within ethnic minority cultures; 9) In England, the commissioning strategy attached to the National Dementia Strategy should consider technology-based interventions as a support for family carers of people with dementia; 10) The updated findings from this review should be considered for inclusion in any revised national dementia guideline. Vivienne Fuller and Frances HarryOther Authors: Lydia Hatton-Campbell, Maureen Lishomwa, Rose Lloyd and Cheryl Sandford Professional Role: Trainee counsellors ABSTRACT: poster (Fri, 10.00 - 10.30) Keywords: empathy, narcissistic, relationship, boundaries Therapist perceptions of the capacity of clients with narcissistic personality disorder to enter into an empathic therapeutic relationship Aim/Purpose: Clients diagnosed with narcissistic personality disorder (NPD) have been deemed to be difficult to treat (Hollin, 2004) and narcissists are noted to lack empathy. This qualitative research aims to explore the relationships between counsellors and narcissistic clients. Its purpose is to explore the implications for person-centred practitioners working in the field with clients diagnosed with NPD. Design/Methodology: Respondents were practitioners with experience of clients diagnosed with/exhibiting symptoms consistent with NPD. The researchers carried out audio-taped, semi-structured interviews with four therapists. The data were analysed using interpretive phenomenology. The study followed the BACP guidelines for ethical research in counselling (Bond, 2004). Results/Findings: These practitioners reported that they were able to form therapeutic relationships with clients who exhibited symptoms consistent with a diagnosis of NPD. However, they reported a lack of emotional connectedness within the therapeutic alliance. In addition, they suggested that the relationship took longer to establish, and boundaries needed to be clearly defined because they experienced these clients as potentially manipulative. Practitioners reported that engaging in relationship with clients from this group could be an emotionally painful experience. Research Limitations: The findings are drawn from a small number of respondents and therefore, perhaps not representative of cultural nuances and national trends. Ethical concerns limited us to researching the topic from the practitioners' viewpoint only. Conclusions/Implications: The findings suggest that person-centred practitioners can establish empathic relationships with clients with NPD. However, this process can be protracted and emotionally demanding for the practitioner. An extended period of time and additional support for the counsellor maybe required to effectively build such a relationship. Lorena GeorgiadouProfessional Role: PhD student ABSTRACT: paper (Fri, 15.00 - 15.30) Keywords: counselling training, second language, culture, interpretative phenomenological analysis ‘It is difficult... it is a huge challenge, but...': trainees' experiences of counselling practice in a second language and culture Aim/Purpose: This paper is part of a Doctoral project in progress that explores the theme of counselling practice in a foreign linguistic and cultural context. It will present and discuss subjective experiences of non-native counsellors in training in relation to their counselling practice. Its purpose is to develop understanding of this under-researched, yet highly contemporary issue and to provide insight on the potential influence of second-language use on the therapeutic relationship. Design/Methodology: The project has obtained ethical approval from the University of Edinburgh. The research is embedded within the hermeneutic phenomenological approach. Data has been collected from four in-depth semi-structured interviews with non-native counsellors in training, who undertake their clinical placement in Scotland. The main themes explored in the interviews were linguistic, communicational and cultural issues that trainees experience in their practice and the ways they respond to the challenges presented. All interviews were transcribed verbatim and analysed following the principles of interpretive phenomenological analysis IPA (Smith, Flowers and Larkin, 2009). Results/Findings: Preliminary results show that non-native counselling trainees may face distinctive difficulties in their practice but feel competent and satisfied by their work. The most recurrent struggles involved expressing one's self adequately, understanding their clients' speech and cultural context and working with emotions. Fears of being perceived as incompetent and rejected by the client were frequently reported, but scarcely took place. Participants stated that awareness of being foreign and the relevant difficulties are always present, yet their intensity tends to decrease over time. Trainees are confident that the establishment of a good therapeutic relationship can bridge differences, as it is more important than words, and identified a wide range of benefits of cross-cultural therapy. Research Limitations: It is not possible to foresee all the limitations at this stage. Nevertheless, since the project aims to explore subjective experiences, its sample is small and purposefully selected. This naturally restricts the project's generalisability. Conclusions/Implications: The presentation of findings in this paper will contribute to the experience of a) current and prospective foreign counsellors and b) trainers and supervisors who work with foreign counselling trainees. The themes will have significance for aspects of counselling training that receive little attention at present, and will also contribute to an understanding of cultural identities and language use as an important element of the therapeutic relationship. Dr Patricia Goodspeed-GrantOther Author: Dr Pamela Monk Professional Role: Associate Professor ABSTRACT: paper (Fri, 15.00 - 15.30) Keywords: bariatric, emotional eating, qualitative research, obesity, counselling Exploration of social-emotional experiences after bariatric surgery: implications for counsellors Aim/Purpose: Morbidly obese persons often believe that bariatric surgery will provide permanent solutions to their weight-related problems. The purpose of this research was to understand any social and emotional issues that might arise as a result of the procedure that might help counsellors support bariatric patients after surgery. Design/Methodology: van Manen's hermeneutic phenomenology was utilised to explore the lived experience of participants' struggle with food, what factors have influenced weight-related outcomes, and whether obstacles to success remain. Participants were recruited from a bariatric surgery centre that offered pre-surgical assessment and postsurgical counselling. After obtaining the appropriate ethical approvals, individuals on the co-researchers counselling caseload were mailed recruitment letters inviting them participate in two 90-minute recorded interviews that would explore their expectations of and experiences with bariatric surgery. Fourteen responded, but due to scheduling conflicts, 12 individuals participated. In addition, a focus group comprised of the medical staff was conducted. All interviews were transcribed and shared with participants to check for accuracy and insights. Results/Findings: All had initially lost a significant amount of weight, although many regained some of it back. One unexpected outcome included changes in interpersonal relationships. Emotional eating remained problematic for the majority of the participants. Many found ways to circumvent the physical restrictions of the bariatric procedure, particularly during times of stress. Counsellors in bariatric settings have a role in helping clients address and resolve deep-seated emotional eating, as well as helping them to work through changes in their lives resulting from dramatic weight loss. Research Limitations: Given that some eating issues remained unresolved for those who reported surgical success, a more comprehensive picture might have been obtained had the sample included those who reported less positive experiences with surgery. Conclusions/Implications: While surgical interventions created physical barriers to overeating, emotional eating remained problematic, particularly during stressful life circumstances. Participants who utilised post-surgical counselling and support to address both emotional eating and any unexpected consequences of the surgery were more successful in making lifestyle changes. Implications for counselling and psychotherapy are discussed. Jan GroveOther Authors: Val Owen-Pugh and Elizabeth Peel Professional Role: Senior Lecturer in Counselling ABSTRACT: paper (Fri, 15.55 - 16.25) Keywords: same-sex, counselling, help-seeking, discourse analysis, social constructionism Client discourses on the process of seeking same-sex couple counselling Aim/Purpose: To explore the ways in which same-sex couples manage the process of seeking help for their relationships. In couple therapy, same-sex relationships are present and the very focus of the work, unlike individuals in therapy who can make decisions about when and how to disclose their sexual orientation (Kort, 2008). Design/Methodology: Twelve semi-structured interviews were conducted with 16 people (four couples and eight individuals) who had engaged in same-sex couple counselling and analysed using discourse analysis. Participants were recruited through an internet survey which forms part of a larger research project. Results/Findings: The way in which the couples positioned themselves as part of a ‘minority group' or part of a generic group of couples struggling with relationship issues impacted on the ways in which they discussed seeking help. For some couples there was a level of ambivalence about positioning the relationship as ‘mainstream' or as part of the LGB ‘minority', and counselling provision sought that would be able to embrace both sameness and difference. Other participants identified themselves, and their issues, in more binary terms, along with counselling services that were perceived as either straight or gay. Research Limitations: This is an under-represented and hard to reach group (Spitalnick & McNair, 2005). The participants were self selected and over represented by white, female, middle class, able-bodied and educated respondents and as volunteers, were more out (Caron & Ulin, 1997). Interviews are a somewhat contrived form of data collection and the discourses will be affected by the role of the interviewer (Potter & Wetherell, 1995). Conclusions/Implications: Counsellors and psychotherapists need to be alert to the way in which couples construct their relationships and mindful of the tricky navigations around similarity to and difference from different-sex relationships. These constructs will affect the ways in which couples seek therapeutic help. Terry HanleyOther Author: Aaron Sefi Professional Role: Lecturer in Counselling Psychology and Editor of Counselling Psychology Review ABSTRACT: paper (Fri, 13.50 - 14.20) Keywords: school-based counselling, practice-based evaluation, outcome research, YP-CORE, SDQ School-based counselling: whose problem is it anyway? Aim/Purpose: Counselling within schools has become a common feature of the pastoral care infrastructure for young people. In coming to the fore, the question of the effectiveness and efficacy of such support has arisen. Psychometric questionnaires are therefore now being regularly used to assess outcome. This study examines the findings of two of the most popular questionnaires when utilised systematically with young clients and observing teachers. Design/Methodology: Eight young people were followed through their counselling relationships. Standardised self report questionnaires (YP-CORE and the SDQ) were collected at regular intervals: (1) the onset of counselling, (2) the completion of counselling and, (3) a two month follow-up. Additionally, the teacher report version of the SDQ was also collected at the same points. The change indicated in each of these phases is examined and reported here. Results/Findings: The findings display some of the complexity inherent in trying to capture improvement within youth therapeutic services. In this limited number of cases, movement of perceived improvement or heightened distress fluctuated between self report measures and teacher report questionnaires. Research Limitations: This is a small scale study and is not meant to be presented in a way that can be generalised to other populations. The findings are presented to reflect upon the potential storylines that exist within studies presenting outcome data. Conclusions/Implications: Studies reporting outcome data in school based counselling can reflect incredibly complex therapeutic processes. With this in mind, it is suggested that standardised outcome measures should be considered alongside other measures such as goal based measures and service satisfaction reports. Justin HettProfessional Role: PhD student, counsellor ABSTRACT: paper (Sat, 13.50 - 14.20) Keywords: person-centred counselling, culture, non-directivity, social context, case-study research Can the person-centred approach be effectively used in the Syrian Arab context? A multiple case study analysis of process and outcome Aim/Purpose: It has been claimed that the non-directive, reflective nature of the person-centred approach renders it largely inappropriate for use with Arab clients (Dwairy, 2006; Chaleby and Racy, 1999). The study aims to investigate whether this is true in a Syrian Arab context by providing in-depth case study data which focuses on relevant cultural and clinical issues. Design/Methodology: A mixed method approach is adopted in the analysis of four cases of clients counselled at the University of Damascus in Syria. Drawing on full session transcripts, counsellor process and supervision notes, CORE-OM scores, After session reflection forms and interviews, the cases are represented in detail to allow for triangulation and peer analysis. It is also hoped that this will enable them to be a resource in the future both for research and practice. Ethical approval was granted by the University of East Anglia prior to starting the research, however conducting the study during the recent political unrest led to some complex ethical issues particularly related to location, which are discussed. Results/Findings: The research demonstrates that the approach can be effective in the Syrian context, resulting in internal client change such as increased self-acceptance, confidence and ability to deal with problems, as well as leading to behavioural change and improved relationships. It highlights the importance of the client's understanding of the counselling process, as well as illustrating how issues around role power can be successfully negotiated in forming an effective therapeutic relationship. Research Limitations: The study focuses on work done with only four clients in a specific context (a university counselling department) and therefore serves as a starting point for further research. Conclusions/Implications: The research provides some of the first rich case study data of its kind illustrating the successful application of the person-centred approach in a non-western context. As such it is of interest to researchers and counselling practitioners dealing with issues around non-directivity, social context, religious belief and role-power in the therapeutic relationship, both with ethnic minority clients in the West and elsewhere. Anthony HickeyProfessional Role: Hypnopsychotherapist and Lecturer ABSTRACT: paper (Fri, 16.30 - 17.00) Keywords: empower, concept, reflect, autonomy, context Interpersonal empowering as process in trauma therapy: a grounded theory Aim/Purpose: This research explored how trauma therapists from different disciplines and theoretical orientations responded with clients whom they identified as dissociating. The study considered the responses of therapists to the situations they encountered, in order to develop theories regarding process and structure with multidisciplinary relevance, which would support developments and improvements in future training, practice and research in relation to trauma and dissociation. Design/Methodology: This qualitative research adopted a grounded theory approach. Twenty participants were selected using a purposive sampling strategy. Questionnaires were used to collect qualitative information about participant therapists and also their perceptions of their clients' histories and current presentions. Participants were asked to discuss their responses in relation to a client they were working with whom they identified as dissociating and were invited to two hour-long semi-structured interviews around eight weeks apart so that their attitudes, perceptions and conceptualisations over time could be analysed. Interviews were audio-recorded and transcribed verbatim. Participants were also invited to keep a reflective log of their responses between interviews. Data were collected over two years with analysis conducted using constant comparison with the developing conceptual framework until theoretical saturation was reached. Analysis was supported using NVivo qualitative analysis software so that data could be coded, enabling concepts and associated characteristics and properties to emerge, and the grounded theory to develop. Results/Findings: Therapists are exposed to a range of competing models from which they may choose to draw in working with traumatised individuals. The findings of this research generated a grounded theory which proffers a model of ‘interpersonally empowering as process' which the evidence indicated was shared by psychological practitioners across disciplines and theoretical orientations. The model, which re-orients therapeutic alliance away from the deficit model, comprises four core elements of 'constructive discursive conceptualising', 'autonomising', 'informed reflecting', and 'contextualising'. Research Limitations: This research employed a purposive sampling approach in order to generate its theory. There would be value in testing the generated theory with a wider selection of participants. Because of resource constraints the research was confined to the UK. Conclusions/Implications: The theory which emerged from this research suggests that there would be strong gains from the adaptation of training for psychological contact in the areas of trauma and dissociation. Whilst the study focused on the responses of trauma therapists, the evidence reviewed during the course of the research suggests that there is potential for the grounded theory of 'interpersonally empowering as process' to be applied more widely to therapeutic relationships beyond this particular specialism. Abdul Rawuf HusseinProfessional Role: Student Counselor ABSTRACT: poster (Sat, 10.00 - 10.30) Keywords: Somalia, self-efficacy, adjustment, psychosocial Counselling Somali youth refugees in Malaysia Aim/Purpose: The establishment of oneself socially in a new country alone is a major psychosocial transition. Moreover, refugees could require more profound counselling intervention due to their peculiar challenges. In this study, the presenter aimed at identifying the psychosocial adjustment issues of Somali youth refugees' in Malaysia and provide an efficient intervention in helping the youth to uphold strong self-efficacy, overcome disadvantages and improve their life chance. Design/Methodology: Focus group as one of qualitative research method was used in this study to aid the representation of the participants' feelings, beliefs and behaviour. Moreover, the counselling process was based on Bandura's social cognitive theory which explains how individuals acquire certain behavioural patterns and also provides the basis for intervention strategies. Maintaining an ideal number of eight participants, the Support group lasted for two months and was based on open-ended interviews, effective listening and community involvement. Results/Findings: The fact that the intervention focused on promoting a healthy psychosocial adjustment of Somali youth refugees in Malaysia, it has significantly affirmed the reasonable impact of addressing the psycho-emotional challenges of the youth through nurturing a strong self-efficacy and healthy self-concept. The refugees revealed some unhealthy attitudes towards themselves, future and some significant individuals in their life, expressing vulnerability, reluctance and liability in front of their confronting state of affairs. However, the effective support from the Somali community leaders and UNHCR have substantially enriched the outcome of the guidance program. The conclusion was that, refugee youths are less likely to involve in juvenile delinquency when there is an adequate guidance and effective supporting system. Research Limitations: This study aimed at upholding the self-efficacy of Somali youth refugees residing in Gombak, precisely idaman and Taman Melati Malaysia. Though an important portion in refugee adaptation experience, this study did not deliberately address the mental health aspect of Somali youth refugees. Additionally, the population of the study is solely youth, age (13-20), as they construct the larger population of Somali community in Malaysia. Hence, adults and elderly people are not part of this study. Therefore, the findings of this study are limited to the Somali refugees with their exclusive and unique circumstances and peculiarities. Conclusions/Implications: Social workers and helping professionals should be well informed about the refugees' predicament, and try to understand refugee challenges from their own context, to appropriately decide the needs and preference in upholding refugees' welfare. Craig HutchisonProfessional Role: Teaching Fellow: Counselling and Psychotherapy ABSTRACT: paper (Fri, 16.30 - 17.00) Keywords: gay, phenomenology, perception, stigma, positive stereotype Stigmatised, welcome and mundane: heterosexual therapists' perceptions of their gay male clients Aim/Purpose: To qualitatively investigate the lived experience of heterosexual counsellors working with gay male clients in the UK Design/Methodology: Inductive, phenomenological. Thirteen semi-structured interviews were conducted with heterosexual therapists (six male, seven female) from a range of theoretical orientations. Results/Findings: There is no 'single' experience of encountering gay male clients in counselling. Instead, participants recounted a range of lived experiences - experiences which appeared to be significantly shaped by their perception of the meaning of a homosexual identity, their personal history of encounters with gay men, and their understanding of the culture or society in which they believed themselves situated. The 'intentionality' of the practitioner (the way consciousness is directed toward the objects of its perception) was therefore examined in relation to participants' perception of the client as: stigmatised; welcome; and/or mundane, and the consequences of this perception for the experience of working with the client are considered. In contrast with the existing research literature, there were no examples of overt hostility. Instead practitioners recounted their earnest desire to offer a safe, gay-affirmative environment to clients who were perceived to be stigmatised by the wider culture and their consequent anxiety about 'getting it right' for these clients (the stigmatised gay client); their feelings of warmth and welcome for clients who were seen to be psychologically open, articulate and safe, and who represented an opportunity for the practitioners' growth and learning (the welcome gay client); and their experience of the irrelevance of the client's sexual orientation to their therapeutic work (the mundane gay client). Positive stereotypes of gay men were particularly present in participants' accounts of the 'welcome' gay client. Participants also described moments of confusion and disorientation when their conception of the meaning of a client's sexual orientation (eg stigmatised) was at odds with the client's conception (eg mundane). Research Limitations: This was also a self-selected sample who may be particularly motivated to engage with issues of sexual difference. The researcher was not permitted to interview anyone over the age of 65. Conclusions/Implications: The deductive nature of previous research has led to an oversimplified understanding of practitioners' negative attitudes, beliefs and behaviours. The inductive stance taken in this study allowed some unexpected themes to emerge, including feelings of genuine warmth, concern, and the presence of a 'positive' stereotype of gay men. Sukwinder Jandu and Paul Cilia La CorteOther Authors: Alena Dierickx, Antony Maxom, Fiwa Onifade and Belinda Smith Professional Role: Trainee Counsellors ABSTRACT: PCCS poster winner (Fri, 10.00 - 10.30) Keywords: depression, profound relational contact, person-centred Are there aspects of depression as a state of being that facilitate profound relational contact in the person-centred psychotherapeutic process? Aim/Purpose: The aim of this research is to gain a richer understanding of the lived experience of depression (as the disorder is categorised in the Diagnostic Statistical Manual IV (APA, 2010). Specifically, the study seeks to examine the ways in which a state of depression may facilitate the ability of the sufferer to connect at a deep level in the therapeutic alliance and, if so, what are the implications for person-centred practice. Design/Methodology: The research group members became reflective researcher/respondents. The researchers wrote independent descriptive accounts that explored their lived experiences of depression. The findings were analysed employing the Duquesne method of descriptive phenomenology (Langdridge, 2007); common themes emerging within the data were identified and anomalies were noted. The study adhered to the BACP ethical guidelines for researching counselling/psychotherapy (Bond, 2004). Results/Findings: The findings suggest that aspects of being depressed facilitate a deeper understanding of an individual's relationship with self and others, both within everyday life and in psychotherapy. Being depressed can be associated with a desire for profound, relational-contact during the psychotherapeutic alliance as well as in other healing relationships, which can be fundamental to the recovery from depression. It also appears from the findings that individualised, self-directed healing strategies are vital to recovery; which strongly seems to support the Rogerian concept of the actualising tendency (Rogers, 1951). Research Limitations: This was a small research project limited to exploring the experiences of the participant researchers. The very nature of this research approach can lead to data analysis bias due to researchers' predilections. However, two external researchers audited the analysis, to ensure that effective triangulation of our findings had occurred. Conclusions/Implications: The findings strongly suggest that depression itself can trigger ‘a search for self', that the depressed persons' self-directed, actualising strategies and entering into a connected-relationship with another at profound intra and inter-personal levels facilitates recovery. Therefore, the findings appear to imply that the clinical implementation of the person-centred approach, with its offer of deep relational-connection, challenges the dominance of the ‘medical model' for the treatment of depression. Dr Kathleen Lane and Dr Judy MooreProfessional Role: Kathleen Lane is Senior Research Associate in the School of Education and Lifelong Learning; Judy Moore is Director of Counselling and Director of the Centre for Counselling Studies ABSTRACT: paper (Fri, 15.55 - 16.25) Keywords: counselling impact, higher education, student experience, student retention, person-centred The impact on student retention and the student experience of person-centred counselling at one higher education establishment Aim/Purpose: This purpose of this presentation is to demonstrate the findings to date of a study into the impact of counselling on the student experience and undergraduate retention which took place at the University of East Anglia between February and July 2012, through analysis of qualitative data and quantitative outcome measures. Design/Methodology: (1) Quantitative data were compiled through evidence from CORE and evaluation questionnaires on students' views of their experience of counselling (2009-2012). These indicate what percentage of students improved as a result of their counselling and whether they stayed in higher education (HE) as a result of their counselling. (2) Qualitative data came in part from the findings of a study by KL on barriers to student completion, based on views of students and staff, but was largely derived from interviews with up to 10 undergraduates. Participants were recruited in the spring semester 2012. Only those clients who had finished their course of counselling were invited to participate in the next stage of the research. Semi-structured interviews explored the experience of undergraduates of the counselling process, their thoughts on counselling vis-a-vis their work and their life, and their reflections on its impact on the student experience. Results/Findings: These were processed over an intensive research period from 1 February 2012 until 31 July 2012 and the findings to date will be presented at the conference. CORE findings so far indicate a predominantly positive outcome from the counselling and interviewees linked their experiences to factors including teaching, friendship and course compatibility. Research Limitations: These findings are from one university counselling service, which represents the person-centred approach. Given the short timescale, only undergraduate students were interviewed. Conclusions/Implications: Although CORE is commonly used in HE counselling services, qualitative research is virtually unknown in this context and this is the first study of its kind. Dodie Limberg et al. 1Other Author: E.H. Robinson, Sandra Robinson, Grant Hayes, Hope Bell and Jacqueline Swank Professional Role: Doctoral Student ABSTRACT: poster (Sat, 10.00 - 10.30) Keywords: altrusim, counseling students, qualitative research, model development, culture A cross cultural examination of counseling students' perception of altruism Aim/Purpose: This qualitative study sought to expand on a previous study to examine the applicability of a proposed model of the development of altruism as perceived by Master's level counseling students from four different cultures: (a) United States, (b) Uzbekistan, (c) Korea, and (d) India. The purpose of this study is to focus on the findings in relation to the four factors (biological, cognitive modesty bias, social learning, and religious/spiritual) proposed in the model. A comparison and contrast between each population is made, in order to further investigate the impact culture and setting may have on perceptions of altruism. Design/Methodology: A diverse group of students were represented within the sample in regards to gender, age, race/ethnicity, and program track. All researchers have researched the topic and have a clear understanding of the proposed model. The research team obtained permission from the institutional review board (IRB) at the university and the counselor education faculty to conduct the study prior to collecting data. The researchers collected data in two primary ways: (a) demographic questionnaire, and (b) semi-structured interviews. Initially, the research team members analysed the data individually. The team members used grounded theory to analyse the themes emerging within the data and the connections between the themes and subthemes. Utilising a coding system allowed the researchers to sort the data, in order to organise and analyse the data for meaning. The coding system was used to make comparisons and find similarities across the populations. Results/Findings: This study examined the applicability of a proposed model of the development of altruism as perceived by master's level counseling students from four different cultures. The results of this study provide initial support for the proposed model of the manifestation of altruism when considering the perceptions of counseling trainees and the impact culture has on the development of altruism. Research Limitations: The presence of the interviewer may have impacted the participants' responses, and the participants may not be able to equally articulate their responses. Conclusions/Implications: The findings have implications for the counseling profession. Individuals reported a perceived relationship between altruism and the success of a counselor. This finding supports future research aimed at continually investigating the perceived relationship between altruism and counseling success. Dodie Limberg et al. 2Other Authors: E.H. Robinson, Sandra Robinson, Grant Hayes, Hope Bell, Jacqueline Swank and Tracy Hutchinson Professional Role: Doctoral student ABSTRACT: poster (Fri, 10.00 - 10.30) Keywords: counselor education, altruism, assessment development, client outcomes, factor analysis A measure of altruism and motivational factors of counselors: impact on client outcomes Aim/Purpose: The goal of this poster is to describe the development of a measurement for altruism and implications for counselor educators and practicing counselors, the Heintzelman Inventory. The reliability and validity of the instrument will be discussed, exploratory and confirmatory factor analyses contributing to the construction of the instrument will be explained, and a discussion of counselor identity formation and its association with client outcomes. Design/Methodology: The target population (n=400) consisted of counsellors in training attending a graduate counselor education program accredited by the Council for Accreditation for Counseling and Related Educational Programs (CACREP). Permission from the institutional review board (IRB) at the university to conduct the study was obtained. The Heintzelman is a self-reporting questionnaire that has two sections. The first section contains 40 items that are divided into five areas; the second section focuses on obtaining demographical information. The data were analysed using the Statistical Package for the Social Sciences (SPSS, 2008) and LISREL (2006).When all assumptions were considered, we continued with the exploratory factor analysis (EFA). We also conducted a test-retest and internal consistency to ensure reliability. Finally, we conducted a confirmatory factor analysis (CFA) to examine whether the proposed model fit the data and supported the factor structure. Results/Findings: This study contributes to the counseling literature by presenting empirical support for a newly developed instrument designed to measure altruism and other motivational factors influencing an individual's decision to enter the counseling profession. An examination of counselor's in training level of altruistic caring, as measured by the Heintzelman inventory, and it's relationship to client outcomes was completed (Hutchinson, 2011). Altruistic caring behavior, specifically within counselor identity formation (ie factor six, when a trainee decided to become a counselor), predicts client outcomes as measured by the outcome questionnaire (OQ-45, Lambert et al., 1996) (Hutchinson, 2011). Research Limitations: The sampling method utilised in this study has various limitations. First, this study involved participants from one counselor education program. Additionally, the study involved only participants from a CACREP program. Conclusions/Implications: The instrument provides assistance with identifying areas that motivate an individual to pursue a career in the counseling profession. Thus, identifying these motivating factors may assist counselor educators and supervisors with mentoring students and assisting them in their personal and professional growth and development. Jane Macaskie and Melanie MottOther Authors: Dr Bonnie Meekums, Florence Doku, Kate Holt, Eleni Michael and Juliet Thornton Professional Role: Lecturer in psychotherapy and counselling (BM) ABSTRACT: paper (Fri, 14.25 - 14.55) Keywords: student research, transformation, collective biography, identities, reflective practice Transforming identities through student engagement with research Aim/Purpose: This research was designed to investigate the impact of undertaking small scale Masters research on the developing identities of trainee counsellor / psychotherapists. Design/Methodology: This study received ethical approval within the University of Leeds School of Healthcare. The design was a collective biography (Dalzell et al., 2010; Wright et al, 2011). All eight students completing the dissertation in 2011 were invited to participate; five chose to do so (FD, KH, EM, MM, JT). The other two researchers were the programme manager (BM) and a module leader (JM). The five student researchers prepared a reflexive account of their research journey, and shared this with their co-researchers in a five minute presentation during a two hour group meeting. During the presentations, the other two researchers made reflective analytic notes based on two holistic foci: the overall narrative coherence, including sequential connections between the different presentations; and thematic metaphors. Results/Findings: The narrative sequencing arising from the first analytic strategy will be performed and is not amenable to written description. The thematic metaphor analysis revealed several potentially binary and competing identities:
All co-researchers had migrated beyond such binary interpretations of identity and embraced a ‘both/and' position. Despite difficulties in grappling with the initially alien discourses of research, engagement with research was ultimately experienced as transformational in terms of practitioner identities, leading to enhanced self-esteem and confidence. Certain research methods, particularly those creative methods designed to elicit unconscious material, had translated into clinical environments and enhanced practice. Pedagogic strategies emphasising community helped develop researcher identities. The pedagogical innovation of a 'mini conference' was experienced as transformational, both for audience (who gained confidence in pursuing their own research) and presenters (who experienced being witnessed by benevolent peers). Research Limitations: This is a small scale, localised study; generalisation is not possible. Conclusions/Implications: The research has implications for how trainers support students undertaking research, in particular through pedagogic strategies involving community, and in emphasising methodological practice-research links. Jane MacaskieProfessional Role: Teaching Fellow in Counselling ABSTRACT: paper (Sat, 10.55 - 11.25) Keywords: transformation, discourse analysis, Foucault, resistance, reflexivity Mining the seam, riding the white water: a discourse analysis approach to understanding therapists' experiences of transformation Aim/Purpose: The study aims to investigate therapists' experiences of transformation in their personal and professional lives and the possible impact on practice. Design/Methodology: Unstructured interviews were conducted with seven counselling and psychotherapy practitioners to explore their experiences of personal and professional transformation. Follow-up interviews using an adaptation of interpersonal process recall (Kagan et al., 1969; Larsen et al., 2008) invited a reflexive exploration of significant moments in the initial interview. A Foucauldian (1972, 1981) discourse analysis was conducted, focusing on the kinds of stories practitioners told about their experience, the constructions they placed upon them, and the assumptions that appeared to be taken for granted in therapy discourse as manifested in the interview data. Results/Findings: 1) Experiences valued by participants were relational, challenging, and were sometimes understood as transpersonal; 2) participants framed experiences as transformational when they involved resisting the ways they felt themselves to be discursively positioned (Winslade, 2005); 3) some experiences in training and supervision were felt to be constraining; 4) the assumption that transformation is a primary aim of therapy is itself a dominant discourse which may constrain what therapists do and think about their practice. Research Limitations: 1) This is a small scale study and findings cannot be generalised; 2) the study itself operates within the therapeutic discourses it seeks to analyse. Conclusions/Implications: 1) The study suggests that a critical approach to the language of transformation and therapeutic change uncovers normative assumptions about therapy goals and practices, which may have implications for researchers, practitioners, trainers and service providers; 2) supervisors, trainers and researchers are encouraged to be aware of the power relations involved in their practice and mindful of the potential impact on supervisees, trainees and research participants; 3) the importance for therapists of resisting discursive positioning suggests that clients may also benefit from therapeutic approaches which attend to how they are positioned by underlying discourses. Thomas MackrillProfessional Role: Researcher/consultant ABSTRACT: paper (Fri, 14.25 - 14.55) Keywords: drinking, alcohol, offspring, counselling, child abuse Treatment-seeking young adults from families with alcohol problems. What have they been through? What state are they in? Aims/Purpose: When a client entering counselling says their parents drank too much, what does this mean? What have they been through and how significant is this for how they are doing now? This study surveys the childhood experiences of treatment-seeking young adult offspring of problem drinkers (AOPDs) and their psychological state at treatment baseline. The study was conducted by a Danish counselling service that is also an advocacy organisation for AOPDS. The study aims to draw attention to key issues facing AOPDS. Design/methodology: Clients (n=502) entering a Danish nationwide treatment facility for young AOPDS were surveyed about their childhood experiences and symptom levels. Results/findings: Eight percent of the clients' mothers and 75% of clients' fathers were problem drinkers. Twenty-seven percent had at least one problem drinking stepparent. Mothers had on average drank during 11.4 years of the clients' childhood (O-18 years). Fathers had on average drank during 13.4 years. Forty-six percent knew or believed that at least one of their parents suffered from a psychiatric illness. Forty-four percent reported physical violence. The mean number of childhood years of physical violence was 7.8 years. Sixty-three percent reported psychological abuse. The mean number of childhood years of psychological abuse was 9.7 years. Thirty-eight percent had not spoken to anyone about their family's alcohol problem. A further 20% had only spoken to a parent or sibling. Research Limitations: The study's retrospective nature and the various biases related to autobiographical memory are the key limitation. Conclusions/implications: The study highlights the high degree of variation in AOPD clients' childhood experiences and in their levels of distress as adults, corresponding with studies of non clinical samples. The study offers a bleak image of the extent of parental drinking, and the extent of physical and psychological abuse and other factors in these clients' childhood homes. Given the extent and severity of childhood problems and clients' lack of communication regarding these issues during their childhood, mentioning parental drinking to a counsellor is a potentially highly significant counselling event, demanding counsellor sensitivity and attention. Lorraine ManleyProfessional Role: GP counsellor and supervisor ABSTRACT: paper (Sat, 14.25 - 14.55) Keywords: counsellors experiences, counselling young people, person-centred counsellor, personal and professional development, therapeutic relationship The experiences of person-centred counsellors maintaining therapeutic relationships with young people. A qualitative study Aim/Purpose: The purpose of this study is to enable person-centred therapists to share their personal experiences of the challenges, rewards and insights within their practice. To discover how they view person-centred therapy as having a positive impact on their clients and how they use it to develop and maintain a therapeutic relationship with a young person. Design/Methodology: This study involved seven person-centred therapists selected from secondary schools, youth services, pupil referral units, the NSPCC, and private practice, who participated in semi-structured interviews. The data were analysed using the constant comparative method (Maykut and Morehouse, 2003). Immersion of the data took place and inductive analysis (Strauss and Corbin, 1990) was applied. Ethical guidelines and levels of risk appertaining to research in counselling were applied, assessed and approved by an ethics committee at the University of Chester. Results/Findings: Twenty six categories were generated with the emergence of six outcome groups and 14 propositional statements. The findings gave insight into the complexity of this specialist area of counselling, demonstrating the importance of Rogers theory (1957) of the therapeutic relationship, indicating it as the only appropriate therapy to use with a young person. The main findings focused on the clinical challenges the counsellor faced in the context of confidentiality, the number of sessions, supervision, young people's development and mental health. It also explored the thoughts and feelings of these therapists, what they found challenging and rewarding, and what personal insight they gained from this work. Research Limitations: This was a small scale study using only person-centred therapists, therefore, may not give a true indication or consensus of what it is like for therapists from other traditions, and did not possess any universal truths about the effectiveness of person-centred therapy. Participants valued the experience however, there may have been personal agendas which impacted on the honesty and depth of the data. Conclusions/Implications: Overall these therapists are dedicated to the work describing it as rewarding, a privilege, and satisfying to see positive change in a young person. However, there was a consensus about the difficulty of engagement with a young person who presented serious behavioural and mental health issues, which resulted in resistance to counselling, therefore questioning its usefulness. It highlighted poor and inadequate supervision impacting on the counsellor leaving them feeling frustrated, burnt-out, stressed, and overwhelmed. The study concluded further research in these areas was needed. Jon MarchOther Author: Clare Symons Professional Role: MA Programme Leader (JM); Acting Director - Counselling & Psychotherapy Programme (CS) ABSTRACT: paper (Fri, 14.25 - 14.55) Keywords: psychodynamic, therapeutic frame, practice, qualitative, practitioner research "It created a barrier... but actually it was a way in" - working psychodynamically when clients bring physical objects to sessions Aim/Purpose: To investigate the experiences of psychodynamic practitioners whose clients bring physical objects into sessions which influence the work. Design/Methodology: This qualitative study comprised 11 semi-structured interviews with professionally qualified psychodynamic practitioners with varying levels of experience. Convenience sampling was used and the data were submitted to a generic thematic analysis. A working model connecting the main findings was produced and illustrated with interview material. Results/Findings: Fifty-four themes emerged across 16 categories, which were grouped into five domains. Such experiences generally occurred in an escalating series of episodes at times of therapeutic impasse, with clients characterised by pre-verbal presentation and/or attachment issues. Practitioners' emotional responses could arise suddenly and forcefully, with disturbing reactions outweighing positive ones. Feeling invaded was routinely reported and acting on feelings of compulsion was not uncommon. Participants proposed two primary functions for brought objects - regulating intimacy and unconscious symbolic expression. Although frequently challenging, these experiences were universally valued for promoting therapeutic movement. Their significance was often overlooked and they rarely consciously shaped subsequent practice. Research Limitations: Evaluation must be tentative owing to the dearth of material on this topic to relate findings to. Some findings describe ubiquitous psychodynamic phenomena and are of limited value, although they can corroborate other findings when appearing in conjunction. The findings cannot be applied to other modalities, nor can they be generalised to broader psychodynamic populations owing to the qualitative design. Findings concerning any lasting influence on subsequent practice were only available for seven interviews. Conclusions/Implications: Items can indicate therapeutic deadlock, mobilised pre-verbal material, attachment issues and whether a client has a fundamentally neurotic, borderline or psychotic character organisation. They can point to changes in symbolic functioning and rapidly and directly give vital warning signs of psychosis or serious disturbance. Practitioners should check for an impasse, consider their part in this and be alert to brought items and what they may reveal about clients' developmental level, attachment style and current symbolic functioning. Practitioners should anticipate potentially powerful emotional responses, focus on mirroring and containment and attempt to identify who or what is represented, or why they might be experienced as too distant or too close. Susan McGinnisOther Author: Mick Cooper Professional Role: Coordinator, Counselling in Schools Projects ABSTRACT: paper (Sat, 10.55 - 11.25) Keywords: person-centred play therapy, children with special social, emotional and behavioural needs (SEBN), primary school, feasibility study, randomised control trial The development of a randomised control trial to assess the effectiveness of person-centred play therapy for children with special social, emotional and behavioural needs (SEBN) Aim/Purpose: In the five year period from 2004-09, the number of children in Scotland identified as having social, emotional and behavioural difficulties more than doubled in the secondary school sector and almost tripled in the primary sector. The perceived view is that social, emotional and behavioural needs are occurring at a younger age and with more severity. Costs to society are 10 times greater for those who were seriously antisocial in childhood than for those who were not. In recent years, a limited range of psychological interventions, mainly of a cognitive-behavioural nature, have been established as effective for the treatment of aggression and antisocial behaviour in children. However, not all children will benefit from these interventions and there is a need to establish a wider range of potential approaches for working with these difficulties. This paper presents a report on the development of a pilot randomised controlled trial of person-centred play therapy in two special schools for children with special social, emotional and behavioural needs. Design/Methodology: The basic design for the pilot trial is a comparison of 12 weeks of person-centred play therapy against twelve of waiting-list for 16 primary school children aged six to 10 who have been designated as having special social, emotional and behavioural needs. Design issues that will be discussed include: objectives, protocols, hypotheses, recruitment, ethical considerations, inclusion/exclusion criterion, clinical assessment, randomisation, manualisation, sample size, outcome measures and analysis. Results/Findings: Results for feasibility and outcomes for a minimum of 16 children will be available. Research Limitations: Small sample size, lack of controlled follow-up. Conclusions/Implications: This is the first controlled study in UK to evaluate the effectiveness of person-centred play therapy with this client group. The study could be of major significance in adding to the range of therapeutic options with primary school aged children who have special social, emotional and behavioural needs. Dr Colleen McLaughlin, Dr Carol Holliday and Dr Barbie ClarkProfessional Role: Senior Lecturer, Affiliated Lecturer, Researcher ABSTRACT: paper (Sat, 12.05 - 12.35) Keywords: counselling, children, young people, effectiveness An update of the research on counselling children and young people: a systematic scoping review Aim/Purpose: Updating the counselling children and young people review by Harris, B. and Pattison, S. (2004), with a particular focus on the effects of interventions. This paper reports on:
Design/Methodology: Using the key words counselling, psychotherapy, play therapy, children, young people, adolescents, outcomes and effectiveness bibliographic databases were searched. Initially 517 papers were identified and 102 papers have been included in the final review, addressing both the methodological and substantive issues. Results/Findings: The main findings are:
Research Limitations: The same 2004 study search terms were used and the original papers not reanalysed. The grey literature and other languages were not included. Conclusions/Implications: Counselling and psychotherapy for children and young people is effective. There is a large body of evidence that is complex and multifactorial. John McLeodProfessional Role: Professor of Counselling Institution: University of Abertay Dundee ABSTRACT: poster (Sat, 10.00 - 10.30) Keywords: client, outcome, process, preference What do clients want? A practice-friendly review of research into client preferences for therapy Aim/Purpose: A growing body of research suggests that clients enter therapy with ideas about the kind of therapeutic processes that will be most helpful for them, and that fulfilment of these preferences is associated with positive outcomes. The aim of this paper is to present and review the research literature on client preferences and knowledge in relation to therapy. Design/Methodology: A practice friendly literature review was carried out. Relevant studies were identified for a systematic search of databases, and summarised in terms of their implications for practice. Results/Findings: The findings of research in this topic indicate a set of dimensions along which clients vary in respect of their views about what would be helpful in therapy. There appears to be some fluidity or flexibility in these views, with clients being open, to some extent, to therapy ideas and methods that are not consonant with their preferences. Clients whose preferences are not reflected in the therapy they receive, frequently report disappointment with their therapy. A set of practice principles, derived from this review, are offered. Research Limitations: Further attention might be addressed to issues of methodological rigour and relevance, and cultural setting, in relation to the studies included in the review. It was not possible to carry out a systematic historical analysis of trends in the findings of research into client preferences. Conclusions/Implications: It is important for therapists and therapy organisations to develop ways to engage with client preferences. At the same time, there are many questions about the sources and strength of client preferences, and therapist strategies for collaborative exploration of these factors, that require further research. Marijke MoermanProfessional Role: Counsellor / student ABSTRACT: paper (Sat, 10.55 - 11.25) Keywords: counsellor, grounded theory, person-centred, semi-structured, suicide Working with suicide: the impact on the person-centred counsellor Aim/Purpose: Suicide remains a major public health issue, with suicide prevention strategies high on the UK's public agenda. This research sought to identify the impact working with this client group has on the individual practitioner. The focus on person-centred counsellors is based on the tension between their core ethos and, personal values and beliefs. From a person-centred perspective the client has an innate potential to be their own agent and therefore take control of their distress by attempting to take their own life. This may present a difficult dilemma for practitioners, working within the person-centred approach. Design/Methodology: Semi-structured interviews with a purposeful sample of 10 person-centred counsellors. A constant comparative method was applied to analyse transcribed data, from which four main categories emerged: ‘experiencing the therapeutic encounter', ‘experiencing the self within the therapeutic encounter', ‘seeking solace - finding understanding' and ‘counsellor's grounding through knowledge'. Results/Findings: Although deeply affected, both personally and professionally, by clients' stories, participants were able to reclaim their strength through seeking and finding support from supervisors, peers, holistic self-care and tacit knowledge. Formal training was identified as lacking in counselling training courses. Research Limitations: Relatively small participant sample; different approach/discipline may have resulted in different outcome. Emotional aspect of topic may have influenced data collection and analysis. Conclusions/Implications: To incorporate in basic formal training a particular focus on working with suicide to enable the counsellor to work effectively with suicidal ideation. The impact of working with suicidal ideation is intense and affects the counsellor personally and professionally severely, whereas attention to this particular topic in training is sparse. Reference: Rogers, C. (1951). Client-Centred Therapy. 1998 Edition. London: St. Edmundsbury Press ltd Dr Naomi Moller and Dr Andreas VosslerProfessional Role: Principle Lecturer, Psychology; Full time paid role (NM) ABSTRACT: methodological innovation paper (Fri, 13.50 - 14.20) Keywords: story-completion, projective, qualitative, survey, innovation Story completion in counselling and psychotherapy research: the benefits of a qualitative projective method Background and introduction: The therapeutic field has a long history of using projective techniques and research suggests that projective methods provide an important means to assess aspects of psychological functioning that may not be accessible through other methodologies. For example, the Rorschach ink-blot test (1921) is still widely used to assess psychological functioning and personality and the test has impressive empirical credentials (eg Hiller, Rosenthal, Bornstein, Berry & Brunell-Neuleib, 1999). Other well known projective tests include the adult attachment projective, Rotter incomplete sentence blank and the thematic apperception test. Empirical evidence for projective methods comes mostly from quantitative studies and those projective methods associated with coding schemes that standardise assessment of projective responses (eg Rorschach and AAP). However there is also a tiny body of research that qualitatively analyses story completions (Walsh & Malson, 2010; Whitty, 2005). Nature of the methodological innovation/critique being proposed: This presentation introduces qualitative projective story-completion, a method in which participants are provided with a story stem and asked to complete the story, for example: "Claire and John have been going out for a year. Then Claire realises that John is seeing someone else," (Whitty, 2005). Sample sizes are flexible - from 22 (Walsh & Wilson, 2010) to over 100 (Whitty, 2005; Kitzinger & Powell, 1995) - and though content analysis and discourse analysis have thus far been used other qualitative methods, such as thematic analysis (Braun & Clarke, 2006) would also work well for data analysis. Conclusion and relevance to counselling and psychotherapy research practice: Story-completion is being proposed as an intriguing methodological innovation for counselling and psychology therapy research that offers a non-intrusive method to access otherwise difficult to reach phenomena. Qualitative researchers using the story-completion method have praised it for its ability showcase the contemporary discourses on which participants draw, as well as provide access to data in areas where there are barriers to direct self-report such as lack of self-awareness or difficulty in admitting to feelings, thoughts and behaviours (Kitzinger & Powell, 1995). In the therapeutic arena, the method also has the ethical benefit of being less intrusive/distressing than direct questioning about phenomena. The paper will provide examples of research questions and data to illustrate. Melanie MottProfessional Role: Counsellor ABSTRACT: poster (Sat, 10.00 - 10.30) Keywords: centring prayer, depression, psychotherapy, spirituality, transformation The role of faith-belief and spirituality in creating and healing depression Aim/Purpose: To explore the relevance of faith-belief and spirituality to counselling and psychotherapy through a storied exploration of depression and to examine how meditative prayer can contribute to wellbeing. Design/Methodology: Analytic autoethnography (Anderson, 2006). Ethical approval was sought and given by the School of Healthcare Research Ethics Committee at the University of Leeds. A summary of the author's major life events was described using evocative writing generated during the research period and excerpts from journals written during severe depression. The concepts raised in the personal writing were then explored in the light of counselling theory and practice, and by means of autoethnographic methods to situate the writer's experience in its cultural context (Muncey, 2010). Results/Findings: Six Movements make up a notional Symphony of contributing factors in the development of depression and the journey back to wellbeing. Cultural assumptions specific to a particular faith context were found to have impacted on both mental and spiritual health. Combined psychiatric and spiritual interventions were found to be more effective than only one of these, and the importance of understanding a person's spirituality in terms of attachment patterns was identified. The significance of language in maintaining depression and of centring prayer as a means of bypassing language-based therapeutic interventions was identified. Research Limitations: This research is limited by the fact that it draws from only one subject although the depth and detail which is possible when autoethnography is combined with an analysis of the wider literature counteracts this. Conclusions/Implications:
References: Anderson, L. (2006). Analytic Autoethnography. Journal of Contemporary Ethnography, 35(4): 373-395. Muncey, T. (2010). Creating Autoethnographies. Sage. Pargament, K. (2011). Spiritually Integrated Psychotherapy: Understanding and Addressing the Sacred. Guilford Press. Nikhil NaagOther Authors: Wei Xu and Tilly Forster Professional Role: Research and Evaluation Officer ABSTRACT: poster (Sat, 10.00 - 10.30) Keywords: counselling in schools, school-based intervention, play therapy, cost effectiveness An economic analysis of The Place2Be's integrated school-based therapeutic services for children Aim/Purpose: The evidence suggests that investing in children's mental health and wellbeing now will pay off in the future, in improved life chances and achievements, better educational attainment, greater productivity, better health, greater community involvement, and less use of health services, social care, criminal justice services and welfare benefits (Foresight Mental Capital and Wellbeing Project, 2008). Design/Methodology: An economic analysis has been conducted to identify the potential long-term economic and social benefits of school-based individual and group counselling delivered by national charity The Place2Be. In the 2007/08 academic year 2,344 children from 119 schools received individual and group counselling. Of these, 1,855 children received individual counselling and 489 children received group counselling. Children's outcomes were assessed using the strengths and difficulties questionnaire (SDQ) pre-intervention and post-intervention. For the purposes of this study, only those children for whom completed teacher and parent SDQ scores were obtained and who had shown clinically significant improvement were included in the analysis. Results/Findings: It was found that the intervention achieved 112 cases of mental health improvement and prevention of mental disorders and mental health problems in the short and long term. It was calculated that the total savings over the lifetimes of this group of 112 children could be £15 million. The total cost of The Place2Be's individual and group counselling in the 2007/08 academic year was £2 million. The cost-savings exceed the costs of providing the service by £13 million giving a net return on investment of 600%. Moreover, the initial costs of the intervention are repaid after five years, with net cost savings in the years thereafter. Research Limitations: The difficulty of attributing the outcome to the intervention, the long time span that is needed to capture any cost savings and other financial benefits accrued over time and the methodological difficulty in expressing psychosocial outcomes in monetary terms. Conclusions/Implications: This economic analysis provides further evidence that early intervention through school-based counselling not only provides a foundation for long-term improved resilience and mental wellbeing but also offers subsequent financial and human cost savings for children, families and the wider community. Shona Neil, Lois de Cruz, Jane Hunt, Maggie Robson and Mairead WalshProfessional Roles: Counselling Teaching Fellows, counsellors ABSTRACT: workshop (Fri, 11.30 - 12.30) Keywords: collective biography, vulnerability, autoethnography, embodied experience Performance of a collective biography ‘vulnerability' Relevance of the workshop to counselling and psychotherapy research: It is well accepted that relationship is a key component in successful counselling outcomes, and therapist qualities are key to successful relationship (Duncan et al., 2009). One of those qualities is the ability and willingness to be and show vulnerability with clients (Mearns & Cooper, 2005; Cooper, 2008). The aims of the workshop: Students on an MSc Counselling Psychology found Brene Brown's (www.ted.com/talks/brene_brown_onvulnerability.html) reflections on vulnerability in professional humanistic roles very powerful. Influenced by this recognition, we as the tutor team undertook research using collective biography - drawing on autoethnographic philosophy. Our investigation was ‘Vulnerability' - as counsellor, counselling researcher and counselling trainer. The research (process and outcomes) proved invaluable in developing the team's capacity to be and show vulnerability in these areas. How the workshop will be structured: The presenters will share in performance style the research results and invite workshop participants to consider in direct response to that performance (a) their response to the display of vulnerability and (b) their own experience and feelings of vulnerability in the roles of counsellor, researcher and teacher; reflect on how they might develop their capacity for vulnerability and its appropriate, congruent, expression. This will be about individuals' internal process and reactions rather than any requirement for workshop members to share personal information. Key points for discussion: The performance style is in line with an objective of evocative autoethnography (Ellis, 2004; Sparkes, 2000) which seeks to include the ‘audience', by offering data in a way that it evokes a feeling response in the audience that has the potential to stimulate action. So, for example, audience members may feel that they want in some way to explore their own vulnerability with colleagues outside the presentation, may recognise the huge potential for this tool to be applied to other topics and perhaps for team building in counselling/research/teaching teams. Who will benefit from attending the performance? As a team we found this approach had benefits far beyond the research purpose. In exploring together we found it safer to risk deeper parts of ourselves thus creating a closer more effective team. Whilst this benefit will not be realised in the workshop, participants may choose to use this way of exploring to similar effect in their own settings. Dr Denis O'HaraOther Author: Fiona O'Hara Professional Role: Programme Leader MSc in Counselling ABSTRACT: paper (Sat, 11.30 - 12.00) Keywords: sources of hope, therapist's hope, blockages to hope, despair, hope-based strategies Counsellors' conceptions of hope and their function within therapy Aim/Purpose: This paper reports Part B of a two-part study on counsellors' hope. Part A of the study aimed to explore the relationship between counsellors' hope, self differentiation, and epistemic style, especially how the latter two constructs influenced counsellors' levels of hope. Part B of the study aimed to identify counsellors' understanding of hope and how this was operationalised within the therapeutic context. Design/Methodology: The study used a mixed methods design using quantitative and qualitative questionnaires with 70 participant therapists as well as 11 semi-structured interviews. The quantitative aspect of the study employed a within-subjects correlational design and the qualitative aspect relied on a grounded approach to the data. Only the qualitative data will be reported in this paper. Results/Findings: Part B: The participant therapists defined hope and its operation within therapy in a range of ways including its source, direction, and action. Participants often expressed a semi-surprised recognition of the profundity and centrality of hope within the therapeutic process. A number of qualitatively different personal conceptions of hope were identified. Engagement by the client with the dialectical nature of hope and despair was recognised as a commonly observed feature of the recovery of hope. The place of the therapist in contributing to a range of hope related tasks such as exploring the possibility of hope, searching for a hidden but a priori hope, constructing hope with the client, and holding hope for the client were acknowledged. A number of hope based strategies used by participants were also identified. Research Limitations: A stronger focus on therapists' understanding of the sources of hope and how this might be more actively incorporated into the therapeutic process was not developed sufficiently. Similarly, the motivational or agentic dimension of hope was not well captured within the present study. Conclusions/Implications: The range of conceptualisations of hope and its place within therapy demonstrated its multidimensional nature. Participants acknowledged the importance of hope within the therapeutic process but recognised that this awareness was often more tacit than explicit. A range of therapist hope supporting functions, tasks, and strategies were identified and suggestions for future research were offered. Michelle OldaleOther Authors: Dr Jo Atkinson-Hearn and Dr Christopher Stone, University College London (Deafness Cognition and Language Research Centre) Professional Role: Psychotherapist, Trainer ABSTRACT: paper (Fri, 11.30 - 12.00) Keywords: Deaf therapist, hearing client, sign language interpreter, power-in-relationship, regulatory power The therapeutic triad - aspects of power in relationship where the therapist is Deaf, the client is hearing and a sign language interpreter is present Aim/Purpose: To address the lack of research investigating interactions when the therapist is from a language minority group as opposed to the client. In particular to explore aspects of power in relationship where the therapist is Deaf, the client is hearing and a sign language interpreter is present. Design/Methodology: Informed consent was gained from all participants, one Deaf therapist and seven interpreters. Participants completed reflective notes on aspects of power in relationship which were analysed using a grounded theory method. Results/Findings: Preliminary findings suggest that where ‘conduit' models of interpreting (Roy, 1993; 2002 in Pöchhacker, 2004) are used (interpreter as neutral communication channel) interpreters regulate aspects of their self and personal power (impact of client material, direct communication with client), in order to facilitate the relationship between the therapist and client. This is lessened where a collaborative or 'bilingual worker' interpreting model is used (Raval, 2003), (interpreter as active participant in therapy). This leads the authors to suggest a phenomenon of ‘regulatory power' as a model for this aspect of power within this and other relationships. Findings also suggest that aspects of power in relationship are based upon intrapersonal factors (eg regulation of personal material), interpersonal factors (eg quality of therapist/interpreter working alliance) and societal/situational factors (eg reported client responses to Deafness/disability/presence of Interpreter, accessibility of environment). Research Limitations: A limited sample was used there being few Deaf therapists undertaking work with hearing clients. Data were not gained from a client perspective, an area for potential future research. Conclusions/Implications: 'Regulatory power' may be a useful concept in supporting therapists who use interpreters to work with the impact of the power dynamic in relationship, consider impact on the client-therapist relationship and enable consideration of appropriate support mechanisms for both therapist and interpreter (Trivasse, 2010; BPS, 2008). Further research is warranted to investigate the phenomenon of ‘regulatory power' in other, including group contexts. Dr Valerie Owen-PughProfessional Role: Lecturer in Counselling and Psychotherapy ABSTRACT: paper (Sat, 11.30 - 12.00) Keywords: workplace learning, counselling and psychotherapy, service delivery, counselling research clinic, learning management, learning dispositions Perceptions of structure and process in the production of psychodynamic counselling: a study of workplace learning in a counselling research clinic Aim/Purpose: This research addressed the informal and incidental ways in which counsellors learn while counselling, a form of learning generically referred to as 'workplace learning' or 'learning in working'. It focused on a counselling research clinic and was informed by relevant theories of workplace learning, most notably, Lave and Wenger's (1991) communities of practice model, Fuller and Unwin's (2003) distinction between expansive and restrictive learning, and Felstead et al.'s (2009) work and learning framework. The research question posed was: 'How do the clinic's staff understand, design and utilise its workplace learning opportunities?' Design/Methodology: This research adopted a case study format. Ten individuals, including counsellors at varying levels of training, together with managers, administrators and other interested parties, agreed to participate in semi-structured, one-to-one interviews. The findings were subject to a thematic analysis. Desk research and in vivo observation were also carried out, to collect information concerning organisational aims, obligations, staffing structures and procedures and the ways these might restrict or enhance opportunities for workplace learning. Results/Findings: Counsellors placed very high value on the learning opportunities offered by the clinic. A wide range of informal learning opportunities were recognised by staff. Among these, perhaps predictably, the assessment and recording of clients' CORE scores were acknowledged to provide valuable learning opportunities. Perhaps less predictably, it emerged that the clinic's receptionists played a key role in promoting and controlling the workplace learning opportunities available to counsellors. Even so, there was notable variability in counsellors' readiness to take advantage of their opportunities for workplace learning. Overall, it was clear that counsellors were being offered a workplace that was well designed to promote professional growth. Research Limitations: This study was based on a single organisation. It will therefore be necessary to carry out further research, by collecting additional data from staff working in a variety of contrasting counselling settings. Conclusions/Implications: This particular clinic is working well to promote the professionalism of its counsellors. However, these research findings remind us that, since counsellors inevitably vary in their learning histories and dispositions, they will vary also in their utilisation of workplace learning opportunities. Peter Pearce and Ros Sewell 1Other Authors: Jane Hunt, Maggie Robson, Trish Hobman and Lynne Lacock Professional Role: Lecturers in Counselling, Academics, CfD Trainers ABSTRACT: paper (Fri, 10.55 - 11.25) Keywords: counselling, depression, IAPT, training, evaluation Aligning practice with the evidence base for counselling clients with depression in the NHS: an evaluation of the first IAPT counselling for depression (CfD) training programme Aim/Purpose: Translating clinical guidelines into clinical practice in the field of counselling and psychotherapy is a complex process. Therapies delivered in controlled trials are often manualised and adherence to the manual monitored. By contrast routine practice is non-manualised, carried out by therapists with varying levels of training, and experienced therapists tend to deviate from the tenets of their initial training. Therefore, qualifications and professional title alone cannot be taken as evidence of proficiency in an evidence-based therapy. Counselling for depression or CfD is a person-centred/experiential, evidence-based, NICE recommended psychological therapy and is now available as a treatment choice within IAPT services (Hill, 2009). This paper will present findings from a research project that investigates the experiences of seventy counsellors who have undertaken the first CfD training intended to standardise the counselling being offered within IAPT services for depressed clients, and to assist counsellors in using interventions that are evidence-based and supported by the NICE guidelines (Hill, 2010). During 2011, the first three CfD trainings were delivered in London, Warwick and Manchester. The CfD training is for qualified humanistic/person-centred therapists with a minimum of two years post-qualifying experience of providing counselling in an NHS setting. They are offered five days of training in the competence framework, followed by 80 hours of supervised counselling practice during which four tapes are submitted and rated against the CfD competencies. Design/Methodology: This research utilises a mixed method design. A questionnaire will be circulated to all counsellors who have undertaken one of the three CfD trainings, and six semi-structured interviews will be conducted with volunteers from these training cohorts. The findings from the questionnaire will be analysed using descriptive statistics, and the semi-structured interviews will be analysed thematically. Results/Findings: Becoming familiar with and working to, a competency framework, using an adherence scale and receiving model coherent supervision focused on these competencies, were positive experiences for most participants. Further, receiving clear and constructive feedback on adherence recordings was also experienced as supportive of most trainees' development as CfD practitioners. Research Limitations: The semi-structured interviews will be conducted with only six of the counsellors who have undertaken the CfD training. Therefore findings from these interviews cannot be generalised to all counsellors who have undertaken the CfD training to date. Conclusions/Implications: CfD training is currently in its infancy and the findings from this research will be used to shape the subsequent delivery of CfD training, and to identify areas for future research in the training and delivery of CfD. Peter Pearce and Ros Sewell 2Professional Role: Head of Person-centred dept. and MSc Tutor respectively ABSTRACT: paper (Fri, 14.25 - 14.55) Keywords: secondary school, qualitative research, person-centred, contact Tenuous contact: person-centred work at the difficult edge with young people. New theoretical concepts emerging from qualitative research on counselling in an inner city secondary school Aim/Purpose: This paper aims to present findings emerging from more than a decade of counselling in a secondary school setting suggesting some new ways to help understand the experience of working with teenage process and contribute to a model of researching and counselling young people. Design/Methodology: In the context of a school with 100+ languages spoken, majority asylum seeker/refuge families, poor literacy and high conditionality to conform with adult expectations, questionnaires and even semi-structured interviews with young people were found either to be shaming or elicit little, 'rich' data so the challenge has been to develop contextually appropriate data streams which might lead to meaningful evidence. A bespoke approach has evolved which gathered 100+ unsolicited comments from young people, teaching staff and others who consented, alongside 20 semi-structured interviews with consenting staff members and 10 years of journals recording our reflexive conversations examining our own perspective as researchers. These various data streams have been analysed using thematic analysis (Boyatizis, 1998; Braun and Clarke, 2006). In both the work and the research the authors have tried to create conditions for group narrative in which the voice of the individual is not lost. Results/Findings: This research contributes to the development of a model for researching and counselling young people and has led us to propose the new term, ‘tenuous contact' to describe the sometimes fleeting and ‘fragile' style of contact that can be part of the counselling relationship with young people. Rather than seeing tenuous contact as a deficit the authors have found it to be sufficient to support effective counselling for young people. High value can be derived for young people from ‘tenuous contact'; fragments over time, for both the counsellor and the young person, eventually forming into a coherent picture and young people found these moments of ‘tenuous contact' manageable and easy to digest. Research Limitations: Small sample - one school. Conclusions/Implications: This research highlights that counselling young people requires a specific, different skill set and theoretical map and this has implications both for the training of counsellors, and for the use of trainees, to work with young people. Maggie RobsonOther Authors: Sue Pattison, University of Newcastle and Kathryn Hunt University of Queensland Australia Professional Role: Senior Lecturer and Director of Counselling Psychology ABSTRACT: paper (Sat, 13.50 - 14.20) Keywords: evaluation, semi-structured interviews, thematic analysis, therapeutic interventions, foundation phase Evaluation of therapeutic interventions to support well-being in the foundation phase in schools Aim/Purpose: Four pilot studies were commissioned by the Welsh Assembly Government in four regions of Wales to evaluate the provision of counselling in primary schools. In Wrexham, four schools were identified and therapeutic interventions were developed for use with Foundation Phase (three to seven years) staff and pupils. The purpose of this paper is to describe the method and results of the evaluation of therapeutic interventions in Foundation Phase Schools in Wrexham. Design/Methodology: Heads of each school, school staff involved in implementing the project in each school and the therapists involved in delivery of the project were interviewed at the beginning, middle and end of the project (n=10). In addition, interviews were carried ut at the beginning and end of the project with a Local Authority representative and the Early Years Co-ordinator. Data were analysed using a thematic approach focused on the following issues: i) the implementation of the strategy ii) good practice iii) information on service delivery iv) benefits/effectiveness v) expectations vi) what could be changed? vii) what should be left the same? Results/Findings: Full results will be displayed in the presentation but the overwhelming evidence gathered suggests that this project has been very successful. The evidence indicated that that the therapeutic interventions were associated improvements in psycho-social and emotional wellbeing, somatic wellbeing, and involvement/engagement. Research Limitations: Small data set; evaluation did not set out to generalise the results but to gather the perceptions of those involved in implementing the therapeutic interventions of the success of the project. Conclusions/Implications: The researchers concluded that the positive results seem to be because of the high regards the therapist was held in by the other professionals, the possibility for swift delivery of the intervention, the tailoring of the individual interventions to meet the needs of the school and the sustainability of the interventions. These interventions can be extended throughout the schools in the project and to other schools who have not been involved in the project. Jeannette RoddyProfessional Role: PhD student and BACP Accredited counsellor/psychotherapist ABSTRACT: paper (Fri, 16.30 - 17.00) Keywords: domestic violence, grounded theory, psychotherapy, counselling, process A client perspective on the process and outcomes of domestic violence counselling Aim/Purpose: This research investigates the client's perceptions of domestic violence counselling, identifying what they found supported or undermined the process. Design/Methodology: In this qualitative PhD study, four different, geographically separate domestic violence agencies each recruited a minimum of three participants who had received counselling associated with suffering domestic violence. Participants (male and female) had worked with therapists from a range of theoretical backgrounds and were interviewed three to 18 months after counselling had finished. They varied in age and in their economic and social backgrounds. Ethical approval was given by York St. John University and by each of the agencies prior to commencing the research. This approval included the provision by the agency of additional counselling to participants should it be required. Semi-structured interviews were conducted and then transcribed and analysed using an adapted grounded theory methodology. Participants could choose to participate in reviewing and providing feedback on the research outcomes. One in six of the interviews was independently reviewed to check for bias in analysis. Results/Findings: A clear process for beneficial domestic violence counselling emerged. Key factors within the process included the significant time required to establish a therapeutic relationship, the need for the therapist and participant to understand the nature and mechanism of the identified abuse, addressing previous traumatic life events such as childhood abuse or rape as they emerged, and the importance of participant defined therapy duration. A short period of consolidation occurred prior to ending. Working with a therapist who was consistent and non-judgemental was significant. There was no preferred theoretical orientation for therapists identified. Participants were able to identify specific outcomes, both positive and negative, from their experiences of counselling. Research Limitations: As a small qualitative study, this research is limited in its generalisibility. Conclusions/Implications: Therapists working with these clients will require knowledge of domestic violence models, high levels of congruence and non-judgement and an ability and willingness to work with traumatic material. Time limited therapy may not be appropriate. Further work is required to assist early identification of this client group and enable beneficial interventions or referrals to be made. Dr Brian RodgersProfessional Role: Researcher ABSTRACT: methodological innovation paper (Fri, 10.55 - 11.25) Keywords: visual, creative, holistic, outcome, evaluation Beyond numbers and words: the untapped potential of visual methods of outcome evaluation Background and introduction: Counselling and psychotherapy outcomes have traditionally been measured using standardised quantitative questionnaires. Though efficient for large numbers of participants, this method is not well suited to capturing the unique and subtle ‘shifts' that clients often report when qualitative methods are utilised. Further, such questionnaires usually focus on only the psychological aspects of the individual, missing the wider social implications of therapy. Additionally, the use of words and numbers alone potentially misses the more creative, holistic, and insightful outcomes of therapy. Nature of the methodological innovation/critique being proposed: Visual methods can be seen as offering an alternative form of data collection which is not reliant on either words or numbers. Sperry (1973) argues that science, and indeed modern society in general, has tended to favour the cognitive and expressive functioning associated with the left hemisphere of the brain such as the analytical thinking and reasoning required for linguistic and numeric processing. In contrast, processes associated with the non-verbal right hemisphere of the brain such as creativity, insight, holistic perception, spatial construction, pattern matching, etc have been discriminated against. Deacon (2000) contends that this traditional privileging of numbers and words over more creative forms of data has inherently limited our ability to study living, dynamic systems. Similarly, Harper (2002) suggests that visual methods "evoke deeper elements of human consciousness than do words; exchanges based on words alone utilise less of the brain's capacity than do exchanges in which the brain is processing images as well as words" (p.13). From this perspective, Oster & Gould Crone (2004) propose that visual methods offer a form of communication with a richness, uniqueness, complexity and spontaneity that can go beyond ordinary awareness and is not usually available through words alone. This paper will outline a number of visual methods which offer the potential to be utilised for investigating the outcomes of counselling and psychotherapy from this more non-verbal perspective. Conclusion and relevance to counselling and psychotherapy research practice: Visual methods offer an intriguing potential to capture a different 'view' of the outcomes of counselling and psychotherapy. By ignoring this potential, researchers are artificially limiting the 'stories' that participants are able to communicate about their experience of therapy. It is time that the field widens its vision about what constitutes 'outcome', and starts to employ more creative approaches to investigating what 'comes out' of therapy. Amal RosliOther Authors: Charnley L Professional Role: 5th Year Medical Student ABSTRACT: poster (Fri, 10.00 - 10.30) Keywords: primary percutaneous coronary angioplasty, anxiety, psychological support, readmission, myocardial infarction Primary angioplasty: the implementation of advanced practitioner follow-up Aim/Purpose: To reduce inappropriate readmission of patients after receiving emergency coronary angioplasty through early advanced practitioner follow-up. Treatment for myocardial infarction (MI) has changed dramatically with the implementation of primary percutaneous coronary intervention (PPCI). Baseline data demonstrated high local readmission rate. Only three of the patients readmitted were clinically appropriate who required admission for subsequent medical treatment thus, suggesting considerable readmissions for anxiety related sequelae. Anxiety and depression have been linked to increased morbidity and mortality in this patient group (1). The researchers share our results which are believed to be the first British study assessing the impact of PPCI clinic establishment on readmissions. Design/Methodology: Kotter's 8-step model for change was identified during the steering group meetings as a robust model to be utilised in this project (2). The project was outlined as vital to the improvement of patient services, patient experience and the reduction of readmissions. PPCI clinic checklist was developed and agreed by an effective and strong coalition of multidisciplinary team. The outpatient PPCI clinic appointment was designed to facilitate individualised nursing care and to assess patient's and carer's level of understanding and insight into the diagnosis and prognosis of MI. Individual physical, psychological, sexual, emotional and spiritual needs were discussed and outcomes negotiated. Signposts or referrals to other healthcare workers, agencies and organisations were made depending on the patients' and their families' needs. Results/Findings: Significant reduction in inappropriate readmissions (P < 0.0001) was achieved after the implementation of PPCI clinic. PPCI clinic resulted in better access to mental health care, improved patient's psychological support, increased compliance with secondary prevention, increased uptake in cardiac rehabilitation phase 3 and empowerment of patients to accept responsibility for their own health. Research Limitations: Unknown sufficiency in sample size and duration of study. Conclusions/Implications: Early identification of anxiety and depression in PPCI clinic leads to a more effective management of psychological care by means of appropriate access to counselling and psychotherapy. There is a clear link between anxiety and depression with motality post MI hence with early access to counselling and psychotherapy leads to a more effective management of psychological care, fewer inappropriate readmissions hence reduces the financial burden on NHS resources. Alistair RossProfessional Role: Director of Psychodynamic Studies ABSTRACT: paper (Sat, 13.50 - 14.20) Keywords: spirituality, spiritual phenomena, quantitative and qualitative methodologies, clinical work, theoretical orientation Identifying spiritual phenomena experienced by therapists in client work Aim/Purpose: To examine the spiritual identity of therapists and their experience of spiritual phenomena occurring in client work. Despite contemporary interest in spirituality in therapy (Ross, 2006, 2010; Pargament, 2011) there is limited quantitative data available. This study offers new quantitative data using a questionnaire, also inviting qualitative responses subject to a thematic analysis. Design/Methodology: One hundred and four therapists (from students to experienced practitioners), completed a 46-item questionnaire. This identified their understanding of spirituality and the frequency in which 36 spiritual categories were encountered in clinical settings. Ethical approval was obtained and data anonymised. Results/Findings: Using a six-category descriptive definition of spirituality, 46% of respondents had ‘a specific belief in a divine being' although only four percent adhered to ‘a spiritual or religious belief system' while 51% viewed personal beliefs as ‘important' and ‘very important' for their work. Adopting a likert scale respondents rated 11 categories of spiritual phenomena occurring ‘often' or ‘very often' and 12 categories ‘rarely' or ‘never'. The 'rarely' or 'never' occurring categories were those adopting clear religious terminology, such as 'holy', 'sacred', or 'prayer'. The highest rated category was ‘sensitivity to the other person'. Detailed findings (beyond the scope of this summary) reveal differences related to the theoretical orientation of therapists. Research Limitations: The words used to describe spiritual categories were not always clearly understood and open to interpretation. The desire to use ‘open' language to enhance inclusion also raises the possibility of alternative meanings. Some questionnaires had missing data. Conclusions/Implications: There are few quantitative studies on spirituality (Coyle, 2008), largely originating from the USA (Pargament, 2011). Other studies focus on health rather than therapy-related issues (Bussing, 2010). This research offers insights into a range of phenomena viewed as having a 'spiritual dimension'. The increasing cultural interest in spirituality is something therapists need to be aware of, and prepared for, in their work. The nature of spirituality is under-researched in the UK and requires more in-depth analysis of therapist and client experiences, quantitatively and qualitatively. Dr Elizabeth C Roxburgh and Sophie RidgwayProfessional Role: Lecturer in Psychology ABSTRACT: paper (Sat, 12.05 - 12.35) Keywords: interpretative phenomenological analysis, synchronicity/meaningful coincidence, counsellors, psychotherapists, psychologists Exploring the meaning in meaningful coincidences: an interpretative phenomenological analysis of synchronicity in therapy Aim/Purpose: There has been limited systematic research that has explored the phenomenology of synchronicity experiences in different clinical settings. This study aims to redress this by exploring the process and nature of these experiences from the perspective of the clinician. Design/Methodology: A qualitative study using interpretative phenomenological analysis (IPA; Smith, 1996, 2009) explored the phenomenology of synchronicity experiences by interviewing a purposive sample of clinicians who report such experiences in their therapeutic sessions. Semi-structured interviews were conducted with three counsellors, three psychologists and three psychotherapists and focused on how synchronicity experiences are interpreted, what features influence these interpretations, how participants make sense of these experiences, and whether synchronicity experiences were perceived to be useful in therapy. Ethical approval was received from the School of Social Sciences Ethics Committee. Results/Findings: Three superordinate themes were identified that illuminate how participants interpret, understand, and deal with synchronicity experiences in therapy: 'sense of connectedness', 'therapeutic process', and 'professional issues'. Most participants commented on how their experience of synchronicity in the therapeutic setting was a profound moment that facilitated growth in their clients and resulted in a stronger therapeutic relationship. These superordinate themes also have 10 constituent subthemes which will be reported at the conference alongside participant extracts to demonstrate how they are grounded in the data and as a way of validating interpretations. Research Limitations: Due to the small sample size inherent in most qualitative research designs, findings cannot be generalised to any great extent, but can provide insights into how some therapists makes sense of synchronicity experiences. Smith and Osborn (2003) point out that IPA research seeks to explore in-depth the lived experience of individuals who are a homogeneous group rather than making generalisations that are applicable to all. Conclusions/Implications: Synchronicity experiences are perceived to be a useful ‘tool' for the therapeutic process, which has important implications for training and supervision. Findings support an integrative approach to therapy that acknowledges anomalous experiences, such as synchronicity events, as subjectively real for the client and therapist. Dr Salma Siddique and Kerri Warner STA MScProfessional Role: Academic, Clinical Anthropolgist and Psychotherapist (TA) ABSTRACT: paper (Fri, 16.30 - 17.00) Keywords: supervision, qualitative, ethnographical, transactional analysis, reconstructions An evaluation of how counselling and psychotherapy supervisees undergo a transformation of perspectives that give meaning to their experiences of practice through learning within a group process Aim/Purpose: To explore within the supervision group the participants' learning and application to clinical practice using an ethnographical approach through examining the cultural worlds of their clients and group members. Design/Methodology: The authors co-facilitated a supervision group of eight counsellors and psychotherapists with mixed theoretical backgrounds for 10 days over 10 months. The facilitators were from a transactional analysis (TA) background and offered opportunities for sharing clinical practice with a particular emphasis on looking at self and the other within a cultural context. A participant observation approach (ethnographical methodology) was used within the group setting. Qualitative data were gathered from supervisees through audio recording of all supervision group sessions. Individuals were asked to keep their own reflective journals and chose whether to share in the group. There were evaluations after each session and an overall evaluation. Berne's (1961) eight operational stages was used as a model to calibrate the evaluation findings and narratives from the group. Results/Findings: Reflections from the supervisees' reflective learning journals gave diverse interpretations by the group members to see themselves as witnesses of the lives of their clients and showed a better understanding of the power of their own role and how it related to a wider social and political context. The mix of modality, social identity and life experience, competency and skill has given them an opportunity to meet aspects of 'self in the other.' The space each created for the other enabled them to critically reflect on their own resources as therapists. Language and other symbolic systems produced in the group were tolerated and mediated different interpretations. Supervisees were able to identify and evaluate the aspects of learning that were effective with their client(s). Research Limitations: The research design will need to be repeated with a more diverse range of counsellors and supervisors over a longer period to demonstrate reliability. Conclusions/Implications: The ethnographic inquiry approach can be useful in developing a narrative and a coherency of the supervisee's practice and give meaning to the individual's identity and role in the supervision group. Supervision supports and facilitates the act of bearing witness for counsellors' and psychotherapists' relationships with clients within a societal context. Dr Anita SilvesterProfessional Role: Head of Staff Counselling ABSTRACT: methodological innovation paper (Fri, 11.30 - 12.00) Keywords: co-operative Inquiry, generalisability, methodological choice, informative, transformative The purpose, pleasures, potential and pitfalls of co-operative inquiry - a methodological critique Background and introduction: Co-operative inquiry as a research methodology was initially developed and promoted during the latter part of the 20th century (Heron, 1996; Reason, 1988). However, there is limited literature available to indicate that it is still widely used. The author recently undertook a Doctoral research project using co-operative inquiry and this critique considers issues surrounding the use of this methodology and its implications in the 21st century. Following a basic introduction to co-operative inquiry the challenges encountered will be elaborated upon. Nature of the methodological innovation/critique being proposed: Issues specific to co-operative inquiry will be discussed and critiqued. These include the challenge of gathering participants as co-researchers (considering the level of commitment required) and the arguments and reasoning behind analysis (or not) of a co-operative inquiry. The advantages and disadvantages of using this approach instead of a more conventional interview or questionnaire will be considered alongside the attraction of such an approach for counsellor researchers. The potential and difficulties for the generalisation of any results will also be discussed. A significant question asks how, if a group is truly co-operative, can the initiating researcher be sure that their research question will be answered? These issues will all be considered in the light of the philosophical roots of both person-centred counselling and co-operative inquiry. Conclusion and relevance to counselling and psychotherapy research practice: Co-operative inquiry challenges the standard approach to research of the 'academic researcher' interviewing the research participant by bringing a greater level of equality to the research process. By enabling all participants to be co-researchers, who are fully involved in the research process, research is made accessible, comprehendible and potentially inspiring to the participants. This has the potential to encourage more counsellors to engage with research, an additional benefit of the informative and transformative nature of co-operative inquiry. Lindsay Smith and Lucy BirtwistleProfessional Role: Retired 2009 ABSTRACT: poster (Fri, 10.00 - 10.30) Keywords: religion, childhood, life-story narratives, issues for therapy from growing up with religion, children Children growing up with religion: 10 narratives explored for personal and therapeutic insights Aim/Purpose:
Design/Methodology: A qualitative method using personal biographies was chosen. The researchers collected eight selected narrative accounts from experienced practitioners. Each account was written in the chosen form of the contributor as they reflected on the impact religion had on their growing up. In the spirit of heuristic enquiry the researchers completed the same task. The narratives were analysed using grounded theory to establish core categories, using a phenomenological overall framework. Ethical approval was given by York St. John University Research Ethics Committee. Results/Findings: The researchers established from the accounts that growing up with religion had significant effects on the contributors. Potential core counselling issues raised were analysed following the order of their reported frequency: self concept; fear, guilt, shame and anxiety, responsibility, belonging, creativity and inspiration, beyond the material world, perceptions of God, questioning, moments of change; trauma, loss, separation, family origins and cultural legacy, sex and sexuality and gender. Research Limitations: The research subjects were drawn from a self-selected group. Recruitment of them from a professional journal limited the demographic; fewer men than women, all contributors over 40, limits to the diversity of religions explored to a broadly western Christian tradition. No comparison group was established. Conclusions/Implications: Specific potential issues for counselling arising from growing up with religion can be identified. Particular ways that clients and counsellors might address these more effectively were indicated. Mo SneddonOther Authors: Siobhan Canavan and Mary Catherine Burgess Professional Role: Practitioner; PhD Student ABSTRACT: workshop (Sat, 11.30 - 12.30) Keywords: heuristic, reflexivity, research, suicide, impact Confronting mortality: challenges and discoveries in doing and supervising heuristic research into suicide Relevance of the workshop to counselling and psychotherapy research: Research into suicide demands a level of self-awareness of our own attitudes, anxieties, and beliefs about suicide because these feelings, known and unknown, hold the potential to influence actions and decisions in practice and in research. Heuristic inquiry uses the self of the researcher in a reflexive process that demands self-search, self-dialogue and self-discovery. However, as death is an inescapable fact of life and can evoke feelings of separation, isolation, anxiety and fear, it is not so difficult to understand why we feel anxious when faced with suicide and why research in suicide often draws on an ‘experience-far' approach. The researcher's willingness to uncover his or her own attitudes, beliefs, values and anxieties about suicide may influence the course of research in this area. The supervisors of such research may be drawn into a process of self-exploration in relation to their own death and understandings, attitudes and beliefs about suicide. The challenges of the researcher-supervisor relationship in this type of research lie in the potential gap between the researcher's willingness to engage with death and suicide and the supervisor's readiness to engage with their own death awareness. This workshop explores the challenges, impact and gratifications of researching and supervising suicide research that employs a heuristic approach. The aims of the workshop: To explore the gratifications and challenges in an evolving research process from an ‘experience-far' to an ‘experience-near' approach to suicide research. To highlight the impact and importance of reflective self-awareness and the inner life of the researcher, therapist or supervisor when researching and working with suicide. To communicate a felt sense of what it is like to work with and research suicide. How the workshop will be structured: The presenters will introduce the research and its challenges and the format and purpose of the workshop. The concepts of heuristic research and reflexivity will be briefly defined. Participants will be invited to discuss the barriers and benefits of adopting ‘experience-near' reflexive methodologies to suicide research in small groups before returning to the group as a whole to discuss the ways in which conducting ‘experience-near' research could impact on the researcher, supervisor and practice. Key points for discussion: The impact of ‘experience-near' reflexive methodologies in suicide research. The importance of reflective self-awareness in suicide research and practice. Clinical consequences of heuristic research into suicide. Who will benefit from attending the workshop: This workshop will be of interest to practitioners, supervisors, trainers and researchers who have a professional or personal interest in suicide. Lesley SpencerProfessional Role: Senior Lecturer in Counselling ABSTRACT: paper (Sat, 14.25 - 14.55) Keywords: Illness narrative, identity, trauma, memory, co-construction Re-claiming an identity of strength after nearly dying: nuanced adaptations in an illness narrative Aim/Purpose: The aim of this paper is to explore how and why aspects of an ‘illness narrative' might have subtly changed between three interviews spread out over a 19 month period. Through retelling key parts of her traumatic story of being misdiagnosed and nearly dying from heart failure, ‘Emily' is able to re-claim an identity of strength after a near death experience. The potential significance of these nuanced factual adaptations in her narrative presentation of a traumatic event were examined. Design/Methodology: The three interviews explored in this paper contribute to a single case study, examining a family's experience of receiving genetic counselling for dilated cardiomyopathy. NHS ethical approval was obtained for this study. The repetition of stories within the interviews were compared using narrative thematic analysis (Riessman, 2008) Results/Findings: Like Schiff et al.'s (2006) findings about the constancy of holocaust survivors' core narratives, this study suggests that there was much consistency in Emily's re-told narratives. However the changing use of memory is highlighted, through the nuanced shifts in the factual detail and the emphasis placed on aspects of Emily's subsequent accounts. In her first narrative she expresses being powerless and ‘feeling neglected'. By her third narrative she talks about ‘professional negligence' showing she feels empowered to fight back through official complaint and legal action. Through these three re-tellings, Emily moved from a ‘restitution narrative' to a ‘quest narrative' (Frank, 1995) transforming her post trauma identity from powerless victim to altruistic campaigner seeking justice for others. Research Limitations: As this is a single case study the results cannot be generalised. Conclusions/Implications: These findings are relevant to therapists and researchers because they show the process of identity re-construction after a traumatic event. Emily's transition (Sugarman, 2004) is illustrated, as well as indicators of post-traumatic growth (Tedeschi & Calhoun, 2004). The role of the narrative interviewer was to ‘witness' the transformation and provide Emily with an opportunity to co-create subtly different versions of her story teleologically (Brockmeier, 2000:60). This process contributed to her reviewing past, present and anticipated future identities as a woman recovering from heart failure. This paper suggests the therapeutic usefulness of a highly developed alertness to the nuance of developing narrative positioning. Dave Stewart and Mick CooperOther Authors: Lisa Bunting and Jacqueline Sparks Professional Role: Children's services manager (DS) ABSTRACT: paper (Sat, 15.00 - 15.30) Keywords: school counselling, treatment outcomes, client treatment matching, child psychotherapy, child directed outcome informed therapy Client directed, outcome informed school-based counselling for psychological distress in children: outcomes and predictors of change Aim/Purpose: The aim of this study was to evaluate the outcomes of a client directed, outcome informed (CDOI) approach to school-based counselling for psychological distress in children aged seven to 11 years old, and to identify predictors of change. Design/Methodology: The study adopted an observational, cohort design, with levels of psychological wellbeing and distress compared from baseline to endpoint, and multilevel regression analysis used to identify predictors of change. The primary outcome measure was the child-completed child outcome rating scale (CORS); with parent- and teacher-completed versions of this measure, and parent- and teacher-completed versions of the strengths and difficulties questionnaire (SDQ), used as secondary outcome measures. Participants were 288 children from primary schools in Northern Ireland. Results/Findings: The CDOI intervention was associated with significant improvements in wellbeing on the primary outcome measure from baseline (M = 25.56, SD = 8.32) to endpoint (M = 37.92, SD = 4.26), with an effect size (d) of 1.49. Improvements were also significant on all secondary measures, with pre- to -post-intervention effect sizes ranging from 0.55 to 1.40. On the primary outcome measure, greater improvements were associated with older age, the presence of a disability, more sessions, and the use of CBT methods; particularly where clients had 10 or less sessions. Research Limitations: As with all cohort studies, a lack of control conditions means that the effectiveness of the intervention cannot be established beyond doubt. Details of the specific methods used by the counsellors were also limited. Conclusions/Implications: The findings suggest that school-based CDOI counselling may be an effective intervention for psychological distress in children. Nic StreatfieldOther Authors: Alan Phillips and Liz Brewster Professional Role: Counsellor ABSTRACT: poster (Fri, 10.00 - 10.30) Keywords: student counselling, digital natives, student engagement, CORE, social networking Well-Connected - digital natives and psychological support Aim/Purpose: University students are digital natives who rely on digital communication and social networking to access information and support. Understanding digital communication methods is vital to supporting students' mental health and wellbeing needs. There is a need to develop online mental health services so that students can access support and information. This paper outlines the Well-Connected project at the University of Sheffield, which is using social networking and student engagement techniques to co-create a student-focused website providing high quality information and signposting to appropriate mental health services. Building on this work, a digital communication strategy will be developed, pioneering the use of social networking technologies to provide innovative psychological support for digital natives. Design/Methodology: A three-part qualitative research design was adopted:
Results/Findings: Current online resources are predominantly text-based and do not utilise social networking. Student engagement provides innovative and interesting solutions to the problem of providing suitable online resources. Research Limitations: Student consultants are self selecting and may not reflect the diversity of the student population. Discussing mental health issues can be difficult and so some students may not participate. However, strategies are in place to encourage a wide range of students to participate, including online spaces for anonymous contributions. Conclusions/Implications: Developing a digital communication strategy will help to inform future interaction with students and provide accessible and appropriate support. Producing student designed and created resources also improves accessibility. Increasing digital communication may have implications for delivering future mental health promotion. Justin ThomasOther Authors: Amani Al Hashmi - Zayed University; Man Chung - Zayed University; Keith Morgan - Liverpool Hope University UK; and Minna Lyons - Liverpool Hope University UK Professional Role: Assistant Professor ABSTRACT: poster (Sat, 10.00 - 10.30) Keywords: grandiosity, narcissism, schema, defence The mask model of narcissism: exploring the "defensive grandiosity hypothesis" Aim/Purpose: Narcissism has been conceptualised as involving attempts to conceal or defend against negative self schemata (implicit negative beliefs about one's own self-worth). This idea has been termed the ‘mask model of narcissism'. Empirical explorations of this model have, to date, proven equivocal. This study explores narcissistic personality traits across two distinct cultural groups, hypothesising narcissism to be associated with negative self schemata. Design/Methodology: A cross-sectional correlational study was conducted with undergraduate participants from the United Kingdom (UK) and the United Arab Emirates (UAE). Full ethical approval was granted for the study by Zayed University human subjects research ethics committee. Participants (n=232) completed the narcissistic personality inventory (NPI), and also performed an incidental learning task involving the surprise recall of self-referential adjectives. A relatively greater recall of negative adjectives was viewed as indicative of negative self schemata. Results/Findings: Amongst those scoring in the upper quartile of the NPI, narcissism scores were positively correlated with the recall of negative adjectives even after controlling for age and memory. There was no relationship between positive adjective recall and NPI scores. UAE participants obtained significantly higher scores on the NPI across all subscales except ‘exploitativeness', where no difference was found. Research Limitations: This study used an analogue sample and was correlational so generalisability and causation are cannot be discussed. Future studies might also benefit from employing multiple measures of narcissism/grandiosity. Conclusions/Implications: More extreme levels of narcissism may reflect self enhancement strategies rooted in negative beliefs about the self. Furthermore, socio-cultural factors, beyond individualism and collectivism, appear to play an important role in the expression of narcissistic personality traits. In the context of psychotherapeutic practice grandiosity might signal depressogenic/negative self schemata and intermediate beliefs which could be explored using implicit methods to circumvent defensiveness. Val ThomasProfessional Role: Lecturer in Counselling ABSTRACT: paper (Fri, 12.05 - 12.35) Keywords: mental imagery, psychotherapy, therapeutic function A qualitative study of mental imagery in psychotherapy: identifying a set of common therapeutic functions Aim/Purpose: Considering the general acknowledgement of the therapeutic potential of working with clients' mental images, there is a significant gap in the literature regarding the development of inclusive theoretical frameworks for this practice. The aim of this study was to make a small contribution to developing more inclusive theory through identifying some common characteristics of mental imagery in clinical work. Design/Methodology: The data comprised published reports of clinical work with mental imagery. The English language therapy-related literature was scoped with the intention of producing a range of reports from which to select a sample. In order to generate a contemporary range of therapeutic approaches and to introduce an element of standardisation, the scoping was limited to reports of one-to-one clinical work with adults gathered from post 1970s academic, peer reviewed, therapy-related journals. A purposive sample of 22 case vignettes was selected and this was subjected to standard grounded theory data analysis procedures. Results/Findings: The study disclosed one over-arching category of therapeutic function. This main category comprised six categories of particular functions of mental imagery in therapeutic practice and these were provisionally termed as follows:
In addition the findings highlighted the multifunctionality of mental imagery ie one single mental image can display a range of therapeutic functions both simultaneously and serially during a therapeutic episode. Research Limitations: These findings are based on a small sample that does not represent the full range of therapeutic approaches. Therefore it is unlikely that all therapeutic functions of mental imagery have been captured and adequately conceptualised. Conclusions/Implications: This exploratory study has generated a hypothesis that therapeutic function could provide a basis for a more inclusive framework for this practice. The findings are suggestive of a potential multi-functional model of mental imagery in counselling/psychotherapy. However much more research is needed to test this hypothesis. Dr Andreas Vossler and Dr Naomi MollerProfessional Role: Lecturer in Psychology ABSTRACT: paper (Fri, 15.55 - 16.25) Keywords: infidelity, metaphors, couple counselling, metaphor analysis, discourse Infidelity in counselling and psychotherapy literature: the power of metaphors Aim/Purpose: The aim with this study is to explore the language and metaphors used in the literature on therapeutic work with infidelity, and how this ‘therapeutic discourse' can influence the implicit theories held by practitioners and the ways they help their clients to make sense of what has happened in their relationship. Infidelity is reportedly one of the most common problems in couple counselling and therapy, with a significant percentage of couples seeking help to address the effects of an extramarital affair or other forms of infidelity (Doss et al., 2004). It is often seen as one of the most difficult and challenging problems to work with in practice (eg Kessel et al., 2007). In response to these challenges, clinicians and therapist have written and published an abundance of books and articles on the treatment of infidelity (eg Carlson & Sperry, 2010; Peluso, 2007; Piercy et al., 2005). There are also increasing efforts to develop treatment programmes and clinical guidelines for couple therapy with couples where one partner has had an affair in recent years (eg Baucom et al., 2006; Bravo & White Lumpkin, 2010; Fife et al., 2008; Snyder et al., 2008). By analysing the utilised metaphors, the study investigates the underlying conceptualisation of infidelity offered to the readers of these publications. Design/Methodology: This study trials a qualitative methodology using systematic metaphor analysis, a research methodology originally conceptualised in cognitive linguistics (Moser, 2000; Schmitt, 2005). Publications in English language on working with infidelity (handbooks and journal articles) from the last 10 years are searched for metaphors related to infidelity. Metaphors are identified using Lakoff and Johnson's inclusive definition, that being ‘the understanding of one thing in terms of another' (1980). The analysis of texts and metaphors is still in process but will be completed in due time before the conference. Results/Findings: First preliminary results show common pattern of metaphoric concepts for infidelity, including medical metaphors (heart attack, virus), toxic events (poisoned tree) and natural disaster (earthquake, dark night). Metaphors for the therapeutic work with infidelity draw on medical treatment models (building immunity, fighting against the invader). The metaphoric concepts used are often value-laden and seem to stand in contrast to a neutral, value free way of working with a couple presenting with this problem. Research Limitations: Further research is needed to validate/extend the results in regard to the impact of the literature on practitioners' understanding and conceptualisation of infidelity. Conclusions/Implications: Metaphors used in the counselling and psychotherapy literature are culturally and socially defined and mirror the strong norms in society against extramarital sexual relationships. Patti WallaceProfessional Role: Lead Advisor, University and College Counselling ABSTRACT: paper (Fri, 16.30 - 17.00) Keywords: higher education, further education, counselling, achievement, retention, student experience, employability The impact of counselling on academic outcomes in further and higher education: the student perspective Aim/Purpose: To explore students' views on the impact of their experience of in-house counselling with particular reference to recognised academic outcomes. Design/Methodology: Following from a preliminary study (Wallace, 2011) based on an analysis of pre-existing service evaluation questionnaires, this study employed a self-report questionnaire design incorporating four quantitative questions, each addressing one recognised academic outcome - retention, achievement, employability and overall student experience and two open questions on helpful and unhelpful aspects of the counselling experience. All Association for University and College Counselling (AUCC) members were invited to participate via the AUCC mail base. Participating services were asked to distributed the questions to all students completing counselling in the period 1 September - 31 December 2012. Analysis of quantitative data were via SPSS and qualitative data via thematic analysis. Results/Findings: Data from 1263 students from 42 universities and 11 further education (FE) colleges were submitted. Findings from the study evidenced a positive impact of counselling on all four academic outcomes. Counselling was also seen to impact positively on other aspects of students' lives. Some unhelpful aspects of counselling provision were identified. Research Limitations: This research was designed to address the need within the sector to establish an evidence base for the contribution in-house counselling makes to students in higher and further education. As such it had a number of limitations, mainly, that in order to gain the engagement of a large number and a wide cross-section of institutions, only a short, focussed, simple to administer questionnaire could be used, and that variations in the process of administration occurred across sites. Conclusions/Implications: The particular value of in-house counselling provision in supporting students' academic attainment and experience was highlighted, demonstrating the contribution counselling makes to both individual and institutional goals. Professor Sue WheelerOther Author: Professor Delia Cushway Professional Role: Director of the Doctoral Programme ABSTRACT: paper (Sat, 15.00 - 15.30) Keywords: supervision, social work, process, outcome Supervision: a lifeline for child protection social workers Aim/Purpose: The project aims to explore whether clinical supervision can enhance the practice and wellbeing of child protection social workers. Design/Methodology: Thirty-eight social workers in the child protection team of a local authority were recruited to receive 15 sessions of clinical supervision in either small groups of three or individually. The supervision was conducted by highly experienced supervisors in or near to the offices the social workers usually worked. Base line data were collected from each participant. Social workers and supervisors were required to complete a range of questionnaires every session measuring alliance and helpful aspects of supervision. The base line questionnaires were administered to all at the end of the nine month project. Focus groups were held and recorded with social workers who participated in the project. Results/Findings: Descriptive information about the sample and the outcome data will be presented briefly. The focus of this paper will be the results from the helpful aspects of supervision qualitative data. A preliminary analysis of the data has revealed a high level of satisfaction with the supervision offered and a degree of surprise that the sessions have been so valuable. Supervisors completed a matching questionnaire and there was a high level of agreement about helpful events. Supervisors found the sessions highly distressing at times as vulnerable, neglected or abused children were often discussed. Supervisors valued the support they received through group support sessions with the project organisers. The project highlights the way in which experienced counselling supervisors can enhance the performance of other professionals. Research Limitations: Two major weaknesses of the research include the difficulty recruiting a 'control group' and the collection of completed questionnaires. Conclusions/Implications: Clinical as opposed to line management supervision has a lot to offer social workers and should be implemented more widely. Mark WiddowsonProfessional Role: Psychotherapist, PhD Candidate ABSTRACT: paper (Fri, 15.55 - 16.25) Keywords: transactional analysis, psychotherapy, depression, case study research, process and outcome research The process and outcome of TA psychotherapy for the treatment of depression Aim/Purpose: The researcher has investigated the process and outcome of short-term transactional analysis (TA) psychotherapy for the treatment of depression using a naturalistic sample of clients presenting for therapy in private practice or in a voluntary agency setting in four different geographical areas of the UK. Design/Methodology: Using systematic case study research combining both quantitative and qualitative data and analytic approaches, the researcher has analysed a series of case studies of short-term TA psychotherapy for the treatment of depression using a combination of hermeneutic single case efficacy design, pragmatic and theory-building case study methods. A cross-case analysis to identify themes and patterns in outcome and the process of change in both good and poor outcome cases has also been conducted. Results/Findings: Two cases have clear good outcome, two cases mixed outcome and one case has poor outcome, suggesting that short-term TA psychotherapy is a promising intervention for treatment of depression. Important process factors include therapist relational skill, identifying maladaptive patterns, interpersonal changes and emotional processing were all helpful therapeutic processes. Research Limitations: Due to small sample size, generalisations cannot be made. Also, the research has not used a control group, so direct comparisons cannot be made. Conclusions/Implications: Short-term TA psychotherapy is a promising therapeutic approach for the treatment of depression and further research investigating the process and outcome of TA therapy is warranted. Shyh-Heng WongProfessional Role: PhD student ABSTRACT: paper (Sat, 15.00 - 15.30) Keywords: suffering, ethics, psychotherapy, reflexibility Suffering transaction and witnessing: a phenomenological understanding of psychotherapy Aim/Purpose: The aim of this study was to understand the key therapeutic process in counselling parents with disabled children. From both therapist and the parents' reflections on their own lived experience, ‘suffering' was explored inter-active and inter-subjectively, as having its ‘transacted' values and weights. In this term, therapy itself is regarded as the practice of ethics. The therapist, who is traditionally thought as a helper and the professional ‘witness', is argued as also a ‘passive sufferer' who is ‘witnessed' by his/her clients. This study shows how the development of a therapeutic relationship transacts the ‘suffering' between sufferer and witness as well as therapist and client. Design/Methodology: The researcher used clinical experience of the psychotherapy with working with the families with disable children to analyse the process of ‘suffering transaction'. He recorded and analysed all sessions with the clients over a four month period. For the purposes of this paper, two families' sessions were selected for in-depth analysis. The use of reflexivity helped the researcher to collect the re-contextualised lived experience of suffering. Hermeneutic phenomenology was adopted to form an interpretive analytical model of ‘suffering transaction'. Results/Findings: The themes of suffering, how it is expressed, experienced and contained by both clients an therapist, have been represented as the core analytical focus. A therapeutic process was redeemed as the interactive and inter-subjective process of transacting suffering, in which both client and therapist are witnessing each other and witnessed by each other. Research Limitations: This study used a reflexive and phenomenological approach and it is based on a small sample and the work of one practitioner/researcher. Conclusions/Implications: This study concludes that the understanding of another's experience of suffering is interpersonal and the experience itself is transactional. The findings of this study suggest that understanding ‘suffering' should be focused on its ethical inter-subjectivity, rather than its objective reality. Monika ZabaProfessional Role: Psychology student ABSTRACT: paper (Fri, 15.55 - 16.25) Keywords: counseling, community psychosocial workers, Rwanda, secondary traumatisation, PTSD Secondary traumatisation among community psychosocial workers (CPWs) in Rwanda - a preliminary study Aim/Purpose: CPWs in Rwanda serve their communities by intervening in trauma crises and providing basic counseling to trauma victims. As most of them have experienced Genocide 1994 and are not professional trauma counsellors they belong to a risk group for secondary traumatisation (Elwood, Mott, Lohr, & Galovski, 2011). This study aimed at assessing trauma symptoms and secondary traumatisation in this sample. Design/Methodology: The participants were 106 CPWs operating in five districts in Rwanda. Trauma symptoms were assessed with trauma symptoms checklist 40 (Elliot & Briere, 1992) and PTSD checklist civilian version (Blanchard, Jones-Alexander, Buckley, & Forniers, 1996). To preliminary assess secondary traumatisation the subjects were asked whether they think the problems they have reported are related to their work as CPW and/or to their personal history. All assessments were based exclusively on self-report data meaning information gained directly from the participants through questionnaires. Results/Findings: To assess clinical relevance of trauma symptoms participants were allocated to three groups: 1) all PTSD symptoms according to DSM-IV (1 re-experience, 2 avoidance, 3 hyperarousal); 2) subliminal PTSD (either no avoidance symptoms or one symptom missing for full PTSD diagnosis); 3) no clinical relevant PTSD symptoms. Fourteen percent of subjects showed full PTSD, 18% subliminal PTSD. Women reported more PTSD, dissociation, anxiety, and sexual abuse symptoms than men. A univariate variance analysis revealed significant differences between PTSD-symptomatic vs non-symptomatic participants concerning dissociative and depression symptoms. Generally, those who reported their problems are related to both their work as CPW and their personal history were the most symptomatic and reported significantly more depression, sexual abuse symptoms, more sleep disturbances than other participants. Interestingly, they did not report more PTSD symptoms in general, except for re-experiencing symptoms. Research Limitations: This preliminary study is limited by imprecise measurement of secondary traumatisation and lacking assessment of past traumatic events. Lack of longitudinal design is also a limitation to be addressed in further research. Conclusions/Implications: The findings indicate that CPWs depict a vulnerable group for secondary traumatisation. Further research should concentrate more on the role of personal trauma in this sample. Additionally, more supervision sessions should be guaranteed as a possible prevention method for secondary traumatisation. SYMPOSIASymposium A Sym A - Jo Pybis et al.Other Authors: Terry Hanley, Sheila Spong, Karen Cromarty, Akvile Daniunaite, Zenib Ahmad Ali, Katherine McArthur, Jamie Murdoch, Ruth Levesley, Nick Turner, Claire Leahy, Claire Dowd, Andy Hill, Mick Cooper, Lucia Berdondini, Alex Barlow, Neil Humphrey, Peter Jenkins and Michael Wigelsworth Professional Role: Research Facilitator (JP) ABSTRACT: symposium A overview (Fri, 10.55 - 12.25) Keywords: school counselling, psychological change, randomised controlled trial, satisfaction, survey School-based counselling (SBC) in UK secondary schools: satisfaction, effectiveness and availability The aims of the symposium: To present current research on levels of satisfaction, effectiveness and availability in UK secondary school-based counselling. Contribution of each symposium paper to the overall theme: Hanley begins by presenting the results of a survey of all secondary schools in England and Scotland to explore the availability of SBC. Next, Spong presenting four case studies that were undertaken as part of the Evaluation of the Welsh Government school-based counselling strategy. This qualitative aspect of the evaluation reports on interviews with school-staff, parents and counselling service users, specifically considering levels of satisfaction and accessibility of SBC services. Daniunaite and Ahmad Ali next present a qualitative study on natural change amongst young people who have been identified for SBC but have not received the intervention. This raises issues about the methods that may be most appropriate to assess the effectiveness of SBC, and the need for controlled trial. Following on from this, Murdoch, Levesley and Turner present preliminary findings of a pilot randomised controlled trial of SBC. Finally, McArthur presents an individual case study comparing data taken from a pre-counselling waiting period with post counselling measures of psychological distress. Implications of the symposium theme for counselling and psychotherapy theory, research and practice: At a time when SBC is being considered for statutory regulation in Wales and at the same time the Government have put £32 million pounds into other forms of psychological support for children and young people, it is essential that SBC demonstrates its effectiveness and impact on the lives of young people. Role of the symposium discussant: N/A Sym A - Terry HanleyOther Authors: Alex Barlow, Neil Humphrey, Peter Jenkins and Michael Wigelsworth Professional Role: Lecturer in Counselling Psychology and Editor of Counselling Psychology Review ABSTRACT: symposium A paper 1 (Fri, 10.55 - 12.25) Keywords: school-based counselling, survey, prevalence, satisfaction A scoping review of school-based counselling services within England and Scotland Aim/Purpose: Despite the increased interest in school based counselling within the United Kingdom, there is presently very little up to date empirical evidence accurately reporting how many schools are engaged in such activities in England and Scotland. This project investigates the prevalence of such services and the attitudes towards them by school staff within these two countries. Design/Methodology: A brief survey has been circulated to all secondary schools in England and Scotland (n=3,499). This survey has focussed upon whether schools have a counselling service and the way in which this service is funded. Additionally, teaching staff who have been involved in the organisation of such services have been asked how satisfied they are with the services. This data will be presented using descriptive statistics and compared to findings from other work in this area. Results/Findings: The findings of this survey are still ongoing but will be reported during the presentation. Research Limitations: Canvassing all secondary schools in England and Scotland will inevitably lead to a relatively high attrition rate. The omission of a large section of the schools in these countries needs to be treated with some caution. Conclusions/Implications: The results from this survey will provide an up to date bench mark for the provision of school-based counselling in England and Scotland. Furthermore, it will provide a litmus test for the value that schools who have counselling services place upon such provision. Sym A - Sheila Spong and Karen CromartyOther Authors: Claire Leahy, Claire Dowd, Andy Hill, Mick Cooper and Jo Pybis Professional Role: Senior Lecturer in Counselling (SS) ABSTRACT: symposium A paper 2 (Fri, 10.55 - 12.25) Keywords: school counselling, young people, children, Wales, case study Implementing the Welsh Government strategy for provision of school-based counselling: four case studies Aim/Purpose: This work was undertaken as part of the Welsh Government funded evaluation of its strategy to make school-based counselling available to young people across Wales. It presents an analysis of the perspectives of school staff, parents and students on counselling provision within four schools in Wales. Design/Methodology: A case study design was adopted, looking at four secondary schools in Wales. Data were collected through interviews and case studies. Interviews were held with a total of 49 individuals, including school staff, parents and counselling service users. In addition, seven focus groups of students were held. Interviews and focus groups were recorded and analysed thematically. Results/Findings: Levels of satisfaction with the provision of counselling were high in all participant groups. The provision of counselling was seen as projecting a caring ethos in the schools as well as having a positive impact on clients. Services varied substantially in their organisation, profile within the school, and the level of accessibility for students through self-referral, and each approach had its own advantages and disadvantages. Reported limitations of the services were primarily around the available accommodation, and a need for a greater availability of the service, in particular to meet the needs of some sections of the student population. Research Limitations: Although the four schools in the study varied on key characteristics, they cannot be assumed to be typical of all secondary schools in Wales. The identification of participants within each school was necessarily undertaken in conjunction with school staff, which carries the potential for bias. Conclusions/Implications: The implementation of the Welsh Government School-based Counselling Strategy has been well received within these schools. Tensions around profile, waiting time and rooming were managed in a variety of ways by the different services. Sym A - Akvile Daniunaite and Zenib Ahmad AliOther Author: Mick Cooper Professional Role: Postgraduate students ABSTRACT: symposium A paper 3 (Fri, 10.55 - 12.25) Keywords: self-healing, counselling in schools, adolescents, waitlist, psychological change Psychological change in distressed young people who do not receive counselling: does improvement happen anyway? Aim/Purpose: To explore psychological change and self-healing processes in young people, and to critically assess the effectiveness of school-based counselling (SBC), by studying natural change processes in young people who were identified for SBC, but did not receive this intervention. Design/Methodology: A qualitative study, with 14 young people, aged 14-15, on a waiting list for school based counselling. Data were collected utilising a semi-structured interview protocol, analysis based on a largely phenomenological approach. Results/Findings: Young people reported a variety of changes, very similar to those experienced in counselling. They attributed these positive changes to their own capacity to self-heal, the support they received from family and friends to facilitate it, and to the effects of the research. Research Limitations: A small sample of young people motivated to change, self-referring, interested in the benefits of counselling, attending school regularly and not at high risk which may not be representative of all young people referred to counselling. Conclusions/Implications: This study reveals that the young person's self is central to the healing process. It also indicates that healing processes with, and without counselling, have a high degree of commonality. This raises important questions regarding the effectiveness and impact of school counselling. Sym A - Jamie Murdoch, Ruth Levesley and Nick TurnerOther Authors: Mick Cooper, Karen Cromarty, Andy Hill and Jo Pybis Professional Role: Jamie Murdoch - Relate Central Office Services Manager (Children & Families); Ruth Levesley - Centre Manager Relate Birmingham; Nick Turner - Director of the Relate Institute ABSTRACT: symposium A paper 4 (Fri, 10.55 - 12.25) Keywords: counselling young people, schools, Relate, humanistic psychotherapy, randomised controlled trial Pilot randomised controlled trial of a Relate school-based counselling service: preliminary findings Aim/Purpose: The aims of this pilot randomised controlled trial (RCT) were to contribute to evidence on the effectiveness of school-based counselling, and to evaluate the feasibility of a school-based RCT design. This presentation sets the Relate context for the development of this study, outlines the work involved in establishing the project, presents preliminary outcome results, and compares these findings against those in earlier trials conducted in Glasgow and the North-East of England. Design/Methodology: The study design is based on a method developed by Katherine McArthur (BACP Research Conference, 2010), using pastoral care referrals to identify young people aged 13-18 who are experiencing psychological distress. Participants meeting the eligibility criteria for inclusion in the trial were randomised to either school counselling or waitlist for one school term (10 weeks). Outcome assessments were taken at midpoint and endpoint. The primary outcome is change in psychological distress as measured by YP-Core. Results/Findings: Twenty-three young people have been randomised (approximately 50% of those assessed). The trial is currently ongoing and preliminary outcome data will be available from January. Research Limitations: This is a small scale project, however it is hoped it will be able to be extended further and combined with other similar studies in order for a meta-analysis to be conducted. Conclusions/Implications: The results from this trial will inform on the effectiveness of school-based counselling. Sym A - Katherine McArthurOther Authors: Mick Cooper and Lucia Berdondini Professional Role: PhD student ABSTRACT: symposium A paper 5 (Fri, 10.55 - 12.25) Keywords: case study, school-based counselling, children and young people Does school-based humanistic counselling reduce psychological distress? A case study Aim/Purpose: To investigate the effectiveness of school-based humanistic counselling through a case study protocol, which will analyse session transcripts, qualitative interviews and quantitative measures of psychological distress taken from a pre-counselling waiting period and throughout counselling. Design/Methodology: This paper presents an opportunistic, retrospective benefit study based on an n=1 design, using data collected as part of a pilot randomised controlled trial comparing school counselling against a waiting list control. Results/Findings: Qualitative reports suggested that the young person valued and benefited from school-based counselling, experiencing a number of positive changes. Measures of psychological distress, self-esteem and goal attainment are discussed in comparison with average results from the original sample. Research Limitations: Results are not generalisable due to a sample size of one, and available data do not allow a full time-series analysis to establish effectiveness of the intervention in this case. Conclusions/Implications: This investigation of the benefits experienced by one young person in humanistic school-based counselling demonstrates its potential value for clients. Symposium B Sym B - John McLeod et al.Other Author: Sue Wheeler Professional Role: Professor of Counselling ABSTRACT: symposium B overview (Fri, 10.55 - 12.25) Keywords: counselling, psychotherapy, training, research Training counsellors and psychotherapists in research skills and awareness The aims of the symposium: Although there is broad acknowledgement within the counselling and psychotherapy profession of the relevance of research for practice, little attention has been devoted to ways of encouraging therapy trainees and practitioners to engage with research. This symposium presents a series of studies that examine the issues involved in providing training in research skills and awareness for students on counselling and psychotherapy training programmes. Contribution of each symposium paper to the overall theme: The papers in the symposium provide a range of approaches to the issue of training counsellors and psychotherapists in research skills and awareness. The paper by Widdowson examines students' views on research in advance of taking part in research training. Brown and Harriott report on a study of student experiences of taking part in an intensive, participatory form of research training. The contribution by Wheeler and colleagues shifts the focus to the challenges faced by counselling and psychotherapy trainers, in respect of delivering high-quality, relevant training experiences for their students. Finally, McLeod reports on some preliminary findings from the use of a brief instrument for monitoring student engagement in research. Implications of the symposium theme for counselling and psychotherapy theory, research and practice: The research presented in this symposium makes a contribution to facilitating wider discussion around the role of research competencies in counselling and psychotherapy practice, and identifies a number of implications for therapy training programmes. Role of the symposium discussant: No discussant - open discussion. Sym B - Mark WiddowsonProfessional Role: Psychotherapist, PhD Candidate ABSTRACT: symposium B paper 1 (Fri, 10.55 - 12.25) Keywords: psychotherapy training, research training, focus groups, thematic analysis Perceptions of psychotherapy trainees of psychotherapy research Aim/Purpose: The research-practice gap and lack of engagement with research by trainees and qualified therapists is a widely discussed issue amongst psychotherapy researchers. The present study investigates the perceptions of psychotherapy trainees of psychotherapy research and explores what would encourage them to participate in research. Design/Methodology: Two focus groups comprising of 16 trainees in total were conducted at two separate psychotherapy training institutes to explore trainees' attitudes and perceptions. Data were analysed using the Braun and Clarke model of thematic analysis. Results/Findings: Three superordinate themes emerged: negative perception of research; recognition of the importance of research; and requirements for facilitating engagement in research. Participants identified some areas of anxiety around the challenge of engaging with research, but were also enthusiastic and energised by the possibility of undertaking a research study. A range of suggestions for enhancing the relevance of research teaching were offered by participants. Research Limitations: The main limitation of this research is the relatively small sample size, which included only UK based transactional analysis psychotherapy trainees, which may limit the generalisability of the findings. Conclusions/Implications: The results suggest that interest in and willingness to participate in research exists, however it is necessary for negative perceptions about research to be addressed and for researchers to design projects which are supportive of participants. Implications for training and research project design will be discussed. Sym B - Christine Brown and Juanita HarriottProfessional Role: Counsellor trainer ABSTRACT: symposium B paper 2 (Fri, 10.55 - 12.25) Keywords: counsellor, experience, person-centred, research, training Why incorporate a research unit into counsellor training? A study of students' experiences Aim/Purpose: To analyse the impact on practice and professional development, and the experience of students, in relation to a counselling research training unit embedded within a BACP accredited counsellor training programme. Design/Methodology: A survey questionnaire, incorporating both fixed response and open-ended items, was used to collect data from students from seven training cohorts. The questionnaire was developed for the present study and encompassed 16 items designed to elicit information about attitudes to research, the experience of engaging in research activities, personal and professional learning, and demographic information. Completed questionnaires were received from 51 respondents (36% response rate). Data were analysed using a method of qualitative thematic analysis, informed by phenomenological principles. Results/Findings: The results of the survey indicated that students reported positive leaning outcomes in a range of areas, including professional competence, person self-confidence and self-awareness, planning and time management, teamwork skills, and development of an interest in research. Some students described aspects of the learning process as stressful. Research Limitations: The study was based at one training institution, and caution needs to be used in generalising to other settings. Although the response rate was typical for survey research, it may be that less satisfied students may have declined to complete the questionnaire. Conclusions/Implications: The findings of this study suggest that team-based participative research training has the potential to make a positive contribution to learning outcomes in counselling and psychotherapy training. Further research is needed in order to evaluate the general applicability of these findings. Sym B - Sue WheelerOther Authors: John McLeod, Robert Elliott, Kaye Richards and Julia Meek Professional Role: Professor of Counselling ABSTRACT: symposium B paper 3 (Fri, 10.55 - 12.25) Keywords: evaluation, trainers, research methods Training the trainers in research methods: an evaluation Aim/Purpose: In 2007 a consortium based at the University of Leicester were awarded an ESRC/RDI grant to promote the training of counselling and psychotherapy trainers in research methods, through the project "New Horizons for counselling research: training the trainers in research". The key aim was to encourage the incorporation of an understanding of research into counsellor training courses and the delivery of research methods training. This paper reports on the evaluation of the completed 18 month project, in respect of participants reasons for doing the course, and what they learned from it. Design/Methodology: A wide range of data were collected from 77 participants before, during and after events. The workshops and summer school were observed and notes were taken by members of the project team. Participants were asked to complete a short paper-based feedback questionnaire at the end of each workshop and at the summer school. The questionnaire sought to capture participants' profile data and views about the training event. A training needs analysis questionnaire was completed by participants, collecting data on participants' current level of research training and identity gaps in their knowledge. Results/Findings: The analysis of the data revealed that there are many gaps in the knowledge, experience and confidence of counselling and psychotherapy trainers in delivering research knowledge and methods in training courses. The dominant theme that emerged from the qualitative data were participants' own need to know more about research. They saw the training event as an opportunity to assess their current level of knowledge, highlight gaps in their knowledge and identify their own future training needs. Research Limitations: Follow-up data were not collected, and the impact of the training programme on the subsequent performance of participants was not assessed. Conclusions/Implications: The findings of this study suggest that there is at present a significant area of unfilled need in relation to the research training for tutors on counselling and psychotherapy programmes, and an absence of consensus around good practice in research training for these professional groups. The results of the study provide a basis for the development of policy and provision in these domains. Sym B - John McLeodProfessional Role: Professor of Counselling ABSTRACT: symposium B paper 4 (Fri, 10.55 - 12.25) Keywords: counsellor competence, measure, personal development, research The development of a model and measure of counsellor/psychotherapist research competence Aim/Purpose: The aim of this paper is to introduce a model of counsellor/psychotherapist research competence, and describe an assessment and learning tool that has been devised in order to assess this construct. Design/Methodology: A seven item counsellor/psychotherapist research competence inventory was completed by students in two training institutions. Results/Findings: The results of this study indicate that the scale items are meaningful to trainees, and that the scale as a whole is sensitive to change and to differences in pre-training research knowledge. Research Limitations: This is an exploratory project, which does not incorporate the complete range of reliability and validity checks necessary in order to establish the psychometric properties of a scale. Conclusions/Implications: This study has generated a brief, user-friendly measure that can be applied in research into the impact of research training, and which has the potential to make a contribution to professional development and self-awareness. Further work is needed to establish and consolidate the validity of this tool. Sym C - Seamus Prior et al.Professional Role: Counselling and Psychotherapy ABSTRACT: symposium C overview (Fri, 10.55 - 12.25) Keywords: client, experience, under-represented, unheard Unheard voices: researching the client experience of people from hard to reach and under-represented client groups The aims of the symposium: While the client's voice is growing in strength in counselling research, there remain client groups whose voices continue to go unheard, whether by virtue of social marginalisation, complexity of research access or politics of research funding. This symposium brings together four research papers focused on deepening an understanding of therapy experiences of service users from groups who are rarely represented in published research. Based within counselling and psychotherapy at the University of Edinburgh, the symposium researchers apply critical social science epistemologies to the contexts and practices of the talking therapies. They employ in-depth qualitative methodologies to foreground clients' narratives of vulnerability and distress and their understandings of the role of counselling in their recovery. They draw on their therapeutic skills as practitioners to generate rich and complex data sets. They use a range of heuristic, reflexive, narrative and phenomenological approaches in their analyses. Contribution of each symposium paper to the overall theme: Drawing on personal experience, focus group research and scholarship in disability studies, Johnson illuminates key processes of shaming and silencing in disabled people's experiences in therapy. Canavan takes up the theme of shame, secrecy and silence in her research on the counselling experience of mothers who have been abused as children and their accounts of the impact of counselling on their parenting. Prior's work gives voice to the recovery process recounted by drug users, revealing understandings of therapeutic change processes and reflections on the value of meaning-making and emotion-focused, rather than behaviour-focused, interventions. Against the backdrop of most investigations of service user experience coming from the minority western world, Srichannil presents a refreshing alternative in her research into clients' experiences of a specifically indigenised Buddhist counselling approach in Thailand. Implications of the symposium theme for counselling and psychotherapy theory, research and practice: The symposium papers demonstrate how careful planning, good collaboration with services and sensitive research skills, drawing on therapeutic experience, may enable research access to traditionally under-represented client groups. Themes of shame, silencing, invisibility, secrecy and access are developed. Role of the symposium discussant: Introduce the symposium and each paper and facilitate dialogue among presenters and between audience and researchers. Summarise key themes. Sym C - Chomphunut SrichannilProfessional Role: PhD student in counselling ABSTRACT: symposium C paper 1 (Fri, 10.55 - 12.25) Key words: clients, experience, Buddhist, counselling, Thailand Clients' experience of Buddhist counselling in Thailand Aim/Purpose: Buddhist counselling, a counselling approach in Thailand, is still under-researched. Although there are a growing number of empirical studies on Buddhist-informed counselling and psychotherapy, the main focus of the research has been to address the effectiveness of the approach, providing evidence of symptom reduction (eg Hanrinth and Rungreangkulkij, 2008; Toneatto, 2002). These studies have relied mainly on quantitative methods, in which the evaluation of effectiveness is made through ratings made by a researcher or counsellor, rather than from the perspective of clients. It is thus not clear how this kind of counselling works or how it is experienced by the clients involved. Moreover, existing research on Buddhist-informed counselling has largely been conducted with non-Buddhist populations in Western countries rather than with clients from Buddhist contexts. This study seeks to fill these gaps in the literature by using a qualitative approach to explore how clients make sense of their experience of Buddhist counselling in Thailand. Design/Methodology: This research is part of a wider PhD project which involved researching counsellors' experience of Buddhist counselling through focus groups and interviews, and clients experience through interviews. This paper will focus on one of the four clients. Two semi-structured interviews with the participant were carried out over a period of two weeks at her home, which resulted in three hours of data. The data were transcribed verbatim and analysed using interpretative phenomenological analysis. Results/Findings: The results showed how the participant felt about her experience of Buddhist counselling. She articulated this experience in terms of feeling that she had gained psychological insight enabling her to identify her real problem, let go of her problem, and then receive relief. One particularly significant result to emerge was that she felt she had integrated the insights gained from the counselling into her daily life, and so felt better equipped to deal with problems by herself. Research Limitations: The results reported in this paper derive from a single time-specific and culturally specific case. The results therefore may not be generalisable beyond this research project. Conclusions/Implications: This study gave voice to the subjective account and personal experience of a client's experience of Buddhist counselling, in a manner not possible with a quantitative investigation. The results also contributed to a better understanding of the client's experience of Buddhist counselling in a Buddhist country. References: Hanrinth, S. and Rungreangkulkij, S. (2008) Buddhist-oriented individual counselling for depressed chronic illness patients. Journal of Mental Health of Thailand, 16(1),: 14-23. Toneatto, T. (2002) A Metacognitive Therapy for anxiety disorders: Buddhist Psychology Applied. Cognitive and Behavioral Practice, 9: 72-78. Sym C - Connie JohnsonProfessional Role: Teaching Fellow and PhD student ABSTRACT: symposium C paper 2 (Fri, 10.55 - 12.25) Keywords: disability, counselling, psychotherapy, relational barriers, narrative How do disabled people experience counselling? Aim/Purpose: Disabled people in western societies are the bearers of negative social and cultural images and face many barriers to daily living, yet counselling is regarded with some scepticism by disabled activists and writers. The aim of this research is to explore the nature of the subtle barriers that are encountered in the client/counsellor relationship when the client is disabled; to find out how clients and counsellors might work with these barriers therapeutically and to establish what counselling can offer to disabled people. Design/Methodology: Most visibly disabled people experience the ‘gaze' of members of the public on a daily basis and are therefore reluctant to be exposed to other forms of ‘gaze', including that of the researcher. It is vital that participants are fully involved in the research process; that the research is reflexive, and that it is not experienced as oppressive. This is therefore a collaborative project using a mixed method approach. An initial focus group along with some in-depth interviews with disabled counsellors was conducted as the first phase in the research and the second phase will involve interviewing disabled clients in-depth on a one-to-one basis. Clients' experiences will be represented through their own narrative accounts and the data will be analysed reflexively using narrative methods with recognition given to social, historical and cultural contexts. Results/Findings: Themes emerging from the focus group include issues of identity; relational issues across a range of impairment categories; experiences of the counselling relationship; and benefits and drawbacks of counselling for disabled people. Research Limitations: The research is based on a small, localised sample of participants to allow for in-depth data generation, analysis and presentation. Rather than being a broad ranging, generalised study of factors involved in counselling disabled people, the emphasis is on in-depth knowledge and understanding of the relational barriers that can occur when working with disabled people in counselling. The notion of a disabled identity is troublesome in determining the range of participants to be included. Conclusions/Implications: Many counsellors in the UK are lacking in understanding about the everyday experience of being disabled, yet with sensitivity, willingness, personal development and adequate training on the part of the counsellor, counselling can have much to offer disabled people. This research offers further insight into broader themes involved in working with difference and diversity in counselling and psychotherapy. Sym C - Seamus PriorProfessional Role: Counselling and Psychotherapy ABSTRACT: symposium C paper 3 (Fri, 10.55 - 12.25) Keywords: drug user, narrative, therapeutic process ‘From lines of coke to lines of meaning': psycho-stimulant drug users' narratives of therapeutic change processes Aim/Purpose: To investigate the therapeutic process from the perspective of psycho-stimulant drug users. To give voice to the recovery experience of this under-researched and often hard-to-reach client group. Design/Methodology: As part of a wider service evaluation (Bondi et al., 2008) individual semi-structured interviews were conducted with eight service users of a person-centred counselling service for psycho-stimulant drug users in Scotland. The interviews focused on the clients' understandings of their personal processes of change through therapy. Narrative analysis was employed to analyse their accounts. Five of the eight participants had completed their counselling and three, while still in counselling, were sufficiently established in their work such that the research interview did not interfere with the therapeutic process. All participants remained engaged with the counselling service and the research team worked closely with the service to ensure participant well-being through the research process. Ethical approval was granted by the university ethics committee. Results/Findings: The two main findings are: 1. The significance of the joint meaning-making process in therapy where client and counsellor co-construct meaningful accounts of how the client's life has gone astray and drugs have come to predominate; 2. The importance of the lived experience of a therapeutic relationship which addresses the emotional issues which underlie the development of the drug problem. Research Limitations: A small scale qualitative study with clients from one service and one cultural background. Conclusions/Implications: While the value of specific drug use reduction interventions and behaviour modification programmes, adopted primarily in health care services, is acknowledged, this research demonstrates the importance of relational therapies, as either an alternative or an adjunct to other services. This research highlights the importance of meaning-making and emotion-focused therapeutic work, even for those with severe addictions. References: Bondi, L., Burston, A., Plows, V., Prior, S. and Smith, S. (2008) Crew Drug Counselling Service: Evaluation Study. Edinburgh: University of Edinburgh. Sym C - Siobhan CanavanProfessional Role: Lecturer ABSTRACT: symposium C paper 4 (Fri, 10.55 - 12.25) Trying to breathe through a wee hole: parenting and counselling - the experience of mothers who were sexually abused as children Aim/Purpose: The voice of survivor-parents has not, until recently, been present in the research literature on sexual abuse; there is little research on the experience of survivors as parents or on the ways in which counselling for survivor parents impacts on the experience of parenting. This study, carried out on behalf of a Scottish agency which provides support for abuse survivors, addressed three main questions:
Design/Methodology: Service users, all of whom are mothers who had participated in counselling within the agency, were invited to participate in the research in some or all of three ways: participating in a focus group, an individual semi-structured interview and by questionnaire. The data generated were analysed under a number of emergent themes which related to the questions above. Results/Findings: The findings presented in this paper relate to the following themes:
Research Limitations: This research was conducted with one group of female participants within one sociocultural context; replicating the study in another context and with male survivors could add to the present study. Conclusions/Implications: The study draws attention to the ways in which dominant discourses can challenge survivor parents in their decisions to become parents and in their relationships with their children throughout the life course. It evidences the many ways in which parent survivors are affected by their childhood experiences within the context of their experience of being a mother. It draws attention to the significant role of counselling in working through these issues and it highlights the transformative and reparative power of other caring/familial relationships such as grand parenting and fostering. Sym D - Robert Elliott, Graham Westwell and Elizabeth FreireProfessional Role: Professor ABSTRACT: symposium D overview (Fri, 13.50 - 14.50) Keywords: person-centred/experiential therapies, therapy adherence/competence, therapist facilitative conditions, therapeutic relationship, therapy process The person-centred and experiential psychotherapy scale (PCEPS): field trial results and next steps The aims of the symposium: The person-centred and experiential psychotherapy scale (PCEPS) is a new, 15-item observer rating scale measure of humanistic (person-centred and experiential) psychotherapy competences. The purpose of this symposium is to report on the results and implications of our field trial of PCEPS, and to discuss its future uses and applications, eg in counselling training and as a training outcome measure. Contribution of each symposium paper to the overall theme: Freire's presentation will open the session by first summarising the field trial geneneralisability study design in which six raters were trained and rated 120 10-or-15 minute segments drawn from 60 counselling sessions with 20 clients seen by 10 counsellors. She will then report the interrater and inter-item reliability findings of the field trial. Next, Elliott will report the results of the generalisability study components of variance analysis. After that, Westwell will present convergent validity evidence by comparing PCEPS ratings to client and therapist post-session ratings of the therapeutic relationship. The session will conclude with one or two discussants and an open discussion of the potential uses of the PCEPS for research, training and professional development. Implications of the symposium theme for counselling and psychotherapy theory, research and practice: The PCEPS operationalises widely-held competences for humanistic psychotherapy and counselling, and represents an extended effort to create a dialogue between classical person-centred and experiential "tribes" within the humanistic approaches. It was developed to support randomised clinical trials of person-centred-experiential psychotherapy/counselling but could also be used as an outcome measure in training studies. It has many potential uses in professional training, ranging from initial counselling skill practice to professional accreditation and continuing professional development. Role of the symposium discussant: Laco Timulak (Trinity College, Dublin) and Pete Sanders (PCCS Books) will lead off and help stimulate a discussion of theoretical, research, and training implications and applications of the PCEPS. Sym D - Elizabeth FreireOther Authors: Graham Westwell and Robert Elliott Professional Role: Lecturer in Counselling Psychology ABSTRACT: symposium D paper 1 (Fri, 13.50 - 14.50) Keywords: person-centred/experiential therapies, therapy adherence/competence, therapist facilitative conditions, therapeutic relationship, therapy process How consistent are ratings and raters on the PCEPS? Inter-rater reliability and item structure Aim/Purpose: This study aimed to assess the reliability of the person-centered and experiential psychotherapy scale (PCEPS), a new adherence/competence measure of person-centred and experiential psychotherapies. Design/Methodology: One-hundred and twenty audio-recorded segments of therapy sessions selected from the archive of taped therapy sessions of the Strathclyde Therapy Research Centre were rated independently by two teams of three raters using the PCEPS. Six segments were systematically selected from 20 clients seen by 10 therapists (two clients per therapist); in the first, middle, and last third of therapy; and in the first and second half of therapy sessions. Half of the segments were 10 minutes long and the other half were 15 minutes long. Six therapists were experienced therapists and four were counsellors in training. Seven of the therapists identified their work as 'person-centred', and three of the experienced practitioners identified their work as 'process-experiential' (although one of these was not fully trained in this approach). Three raters were qualified and experienced person-centred therapists and three raters were person-centred counselling trainees in their first year of training. This paper presents the inter-item and inter-rater reliability results from the study, followed by exploratory factor analyses to study scale structure. Results/Findings: Mean inter-rater alpha reliabilities for individual items varied from .68 (for dominant or overpowering presence) to .86 (for core meaning). Average inter-rater reliability across the 15 items was .78, while the inter-rater reliability of the 15 items when averaged together was .87. Inter-item reliabilities were quite high: .98 for the whole. Exploratory factor analyses revealed a 12-item facilitative relationship scale that cut across person-centred and experiential subscales (alpha: .98), and a nonfacilitative directiveness factor (three items, alpha: .89). Research Limitations: Therapy process measures in general and therapist adherence/competence measures in particular can be criticised for ignoring context and participant internal experiences, while attempting to generalise from relative brief segments of therapy to therapist performance in general. The present study would also be strengthened by comparison to non person-centred-experiential therapies. Conclusions/Implications: The PCEPS has potential for use in RCT research as well as in counselling training and supervision, but will require further testing and validation Sym D - Robert ElliottOther Authors: Elizabeth Freire and Graham Westwell Professional Role: Professor ABSTRACT: symposium D paper 2 (Fri, 13.50 - 14.50) Keywords: person-centred/experiential therapies, therapy adherence/competence, therapist facilitative conditions, therapy process, measurement What affects ratings on the PCEPS? A components of variance analysis Aim/Purpose: This study aimed to carry out a components of variance generalisability theory study of the PCEPS, in order to inform decisions about how best to sample psychotherapy/counselling sessions for adherence/competence evaluations. Design/Methodology: Two teams of three raters used the PCEPS to independently rate a broad sample of therapy sessions carefully selected from the archive of taped therapy sessions at the Strathclyde Therapy Research Centre to comprise a complex generalisability study of method factors that might affect ratings. The design included 12 factors: items, person-centred vs experiential subscales; raters within teams; more vs less therapeutically experienced raters; rating teams; early vs late segments within sessions; 10 vs 15 min segments; early vs middle vs late sessions within clients; clients within therapists; therapists; student vs professional level therapists; person-centred vs emotion-focused professional level therapists. Results/Findings: Therapists generally received higher ratings on the person-centred subscale items than the experiential process items. Student therapists scored lower on all items. There were no differences between PCT and EFT therapists on person-centred and experiential subscales and on the general facilitative relationship factor. PCT therapists scored significantly lower than EFT therapists on the directiveness factor, but this appeared to be due to one not-fully-trained EFT therapist. Ratings were consistent, with few differences between: early and late segments within sessions; 10 vs 15 min segments; early, middle and late sessions with the same client. Some variance was accounted by clients within therapists; however, the largest amount of variance was associated with therapist differences. Research Limitations: Some of the factors examined were partially confounded with one another, complicating interpretation. The raters knew some of the therapists being rated, including two of the investigators, which undoubtedly influenced their ratings, in spite of efforts to counter bias. Because each rater rated the same therapist six times, raters soon formed impressions of therapists, which may have carried over to later ratings. Conclusions/Implications: The results point to strong differences among therapists, which requires replication with a much larger sample of fully trained therapists not known to the raters. Nevertheless, on the basis of the results we obtained we can recommend a four-segment sampling strategy: one segment X two sessions X two clients (vs. the 12 segments used here). Sym D - Graham WestwellOther Authors: Robert Elliott and Elizabeth Freire Professional Role: Senior Lecturer in Counselling ABSTRACT: symposium D paper 3 (Fri, 13.50 - 14.50) Keywords: therapy adherence/competence, person-centred-experiential therapies, therapeutic relationship, therapist facilitative conditions How well do PCEPS raters agree with client and therapist perceptions of the relationship? A convergent validity study Aim/Purpose: The particular focus of this study is to analyse the association between relational assessments already completed by the client and therapists of the same sessions rated by PCEPS raters. This is needed in order to evaluate the degree of convergent validity for the PCEPS, a key aspect of psychometric quality and a requirement for evidence based process measurement. Design/Methodology: Freire's paper outlines the design and methodology for the PCEPS project. There is a rich archive of relational assessment data in the research clinic, which has already been completed by both the client and the therapist. This includes: the therapeutic relationship scale - client (TRS-C), TRS - therapist (TRS-T), working alliance inventory (WAI-12), client post session questionnaire (CPSQ) and the revised session reactions scale (RSRS). These data correspond to the audio segments of therapy used by the independent raters to test the PCEPS instrument. Results/Findings: Results will be presented at the conference as at the time of this submission the analyses had not yet been completed. Judging from previous findings in the literature, we expect correlations of about .4 between PCEPS ratings and client and therapist ratings on the therapeutic relationship scale, given the conceptual overlap between PCEPS and TRS; however, the researchers expect correlations with the WAI-12 to be somewhat lower (about .3). Research Limitations: The relatively small sample of 54 sessions means that statistical power to detect correlations smaller than .4 will be limited. In addition, the therapeutic relationship scale is itself a new instrument of unknown reliability and validity, while the WAI-12 may not fit with person-centred therapy. Conclusions/Implications: The researchers have developed a competence/adherence measure for person-centred-experiential therapies, which can be used to clarify and specify therapeutic processes for practitioners. The data to be presented here will support the wider use of the PCEPS in counselling research and training. Sym E - Kathie Crocket, Elmarie Kotzé and Paul FlanaganProfessional Role: Counsellor Educators, Department of Human Development and Counselling ABSTRACT: symposium E overview (Fri, 13.50 - 15.20) Keywords: research ethics, reflexivity, discourses, practitioner research Practitioner research ethics: perspectives from Aotearoa New Zealand The aims of the symposium: Qualitative research has a long history of emphasising the ethics of knowledge production. In practice such an emphasis produces many points of tension for researchers: as studies are conceptualised and planned, in the midst of data-generating activities, through the steps of analysis, and in re-presentational strategies and publication. This symposium situates illustrations, from each presenter's research practice, of moments of focused engagement with the ethics of knowledge production. By each focusing on a "moment" in research practice, the papers in this symposium show how each presenter has moved through the ethical questions of these moments. Contribution of each symposium paper to the overall theme: Each presentation in this symposium situates research ethics in post-structuralist theory, each focusing on a particular phase of research practice. The first paper focuses on reflexivity in preparing an application for ethical approval for research in the sensitive area of childhood sexuality. The significance of supervision in producing movement for ethical research practice for a student-researcher, investigating relationships in her own family in relation to Anorexia/Bulimia, is the focus of the second paper. The third presentation focuses on the ethics of representational practices and the relational responsibilities of a researcher to witness both self and other. The abstracts for papers two and three offer examples of the data that will be discussed to illustrate the presenters' accounts. Implications of the symposium theme for counselling and psychotherapy theory, research and practice: This symposium includes research relating to the following areas of counselling practice: childhood sexuality; anorexia/bulimia; adolescent mothering; school counselling; bi-culturalism; masculinity; transnational identities. This symposium includes the following approaches to qualitative research in counselling: discourse analysis; autoethnography; bibliotherapy-related research; individual and group interviewing. Role of the symposium discussant: The presenters are teaching colleagues. The discussant will chair the symposium, introduce each presenter, and take questions. Sym E - Paul FlanaganProfessional Role: Senior Lecturer, Department of Human Development and Counselling ABSTRACT: symposium E paper 1 (Fri, 13.50 - 15.20) Keywords: reflexivity, research ethics, discourse, sensitive topics, child sexuality Ethical beginnings: reflexive questioning in child sexuality research Aim/Purpose: This presentation reports on research of the ethical preparation for a PhD project on discourses of childhood sexuality. The particular ethical questions relate to researching the following: a sensitive topic; potentially vulnerable participants; the kinds of questions asked, and analysis of narratives from adult and child participants; and of being a male researcher. An ethic of social justice and the value that research should inform and develop counselling practice, situate the researcher within a context of care for clients, care for the profession, and care for self. These ‘cares' are also a focus of ethical review for this study. Design/Methodology: Using social constructionist understandings of children's identities, child sexual activity is located not as an individual action, but as occurring within discourses (eg childhood, culture, gender, education, sexuality). Qualitative research methods of individual and group interviews were proposed for adults and individual interviews for children, in eliciting narratives of understandings of child sexuality. Alongside drawing on the knowledge in the literature on power relations and discourses on children's sexuality, deconstruction of discourses will support investigation of how adults (teachers, parents, counsellors) are shaped by these discourses in order to comment on and discipline/guide children in their development of sexuality. Results/Findings: A full proposal of the research, together with an application to the ethics committee, was accepted. A number of questions are drawn from this vital process for researchers involved in sensitive areas with vulnerable participants, and in particular, questions around researcher safety. These are examined in the light of discursive positioning and witnessing to self. Research Limitations: This presentation reports on the proposal and application for ethical review - the particular research project is on-going. Conclusions/Implications: Reflexivity is an ethical position in research in the field of counselling. This is particularly so with sensitive issues and vulnerable participants. Researcher safety is perceived in terms of an understanding of relations of power and positioning within discourse. Sym E - Elmarie KotzéProfessional Role: Senior Lecturer, Department of Human Development and Counselling ABSTRACT: symposium E paper 2 (Fri, 13.50 - 15.20) Keywords: autoethnography, supervision, anorexia/bulimia Ethical mo(ve)ments in data-generating practices Aim/Purpose: This presentation highlights the moments within the data-generating phase of a research project when the researcher faced personal limitations on how to go on. The presentation argues that it was within the territory of supervision that movement and repositioning of the researcher were facilitated. Design/Methodology: A student-researcher investigated individual and family relationships in relation to anorexia/bulimia (a/b) in her own family. The research included an autoethnography, and interviews with family members shaped by the ethos of participatory action research and biblio-therapy-related practices. On the researcher's invitation, the supervisor and a colleague researched the personal, professional and academic landscape of the supervision relationship, one year after completion of the first project. Results/Findings: Researching the supervisory relationship produced the following student-researcher response: "... the supervision sessions were deliberate strategic acts of protest against a/b... These acts of protest were always contestable, and at times it was tricky, sometimes dangerous for both researcher and supervisor as a/b attempted to wedge gaps in the foundations ... At times it felt like having to ask the supervisor to crawl with me, slowing the work down... Looking back, I wonder if there was ever any other way the supervision could have been different.... At the same time as the question is asked, I know there was no other way to do supervision and produce a work that was academically, professionally and personally acceptable. Without risk, I may never have secured the degree of voice, agency and presence now available..." Research Limitations: Time and space for family members to reflect on the completed research journey of the student-researcher; tenuous relationships and vulnerability as well as the risks involved in researching family relationships and anorexia/bulimia. Conclusions/Implications: Refined and clear ethics applications to the research committee of the university; negotiate clear supervisory relationship, guidelines and contract. Sym E - Kathie CrocketProfessional Role: Director of Counsellor Education, Department of Human Development and Counselling ABSTRACT: symposium E paper 3 (Fri, 13.50 - 15.20) Keywords: witnessing practices, representation, practitioner researchers Ethical mo(ve)ments in representation Aim/Purpose: This presentation illustrates representational practices that enact relational ethics in research reporting. The challenge of producing ethical representational practices is of critical interest to both practitioner-researchers and research theorists. Calling on counselling ethics, practitioner-researchers frequently experience the imperative of honouring participants' accounts of their lives in reporting research. As well, a researcher's own biographical situation shapes any research reporting, whether their situation is made explicit or not. This ethical dilemma may be expressed as a question of how a researcher manages their subjectivity as they report the research. This presentation suggests that witnessing practices; translated into research from narrative therapy; offer researchers a means to manage their subjectivity in ethical ways. Witnessing practices offer a researcher a relational presence, in research reports, that honours the contributions of research participants, as well as making visible the shaping effects of the research on the researcher's life. Design/Methodology: Examples from practitioner research are used to illustrate how researcher subjectivity is managed through the use of witnessing practices. Results/Findings: Examples on DVD include: "At the age of 27 two blue lines appeared on a pregnancy test. I was terrified. Days later I was sitting with a young woman, just a few days shy of 17, who had just come face to face with her own two blue lines. During our conversation I could identify with so many of the thoughts and feelings she was having about her pregnancy, yet there were also significant parts of her story that I knew I would never experience. I would become a mother, yet this young woman would become a teenage mother." "[Author] writes of having a relationship with you [research]. I think for me it has been a love affair. It has been passionate and all consuming." Research Limitations: Witnessing practices do not fit positivist research. Conclusions/Implications: Research report-writing takes researchers to the heart of the politics of knowledge production: how are the lives of research participants represented? How do researchers acknowledge their presence and their relational responsibilities? Witnessing to self and other offers a strategy to respond to these questions. Sym F - John McLeod et al.Other Author: Mick Cooper Professional Role: Professor of Counselling ABSTRACT: symposium F overview (Sat, 10.55 - 12.25) Keywords: change process, client experience, pluralism Research into pluralistic approaches to counselling and psychotherapy: client experiences of multiple change processes The aims of the symposium: This symposium presents a series of studies that examine the existence of multiple, complementary change processes within counselling and psychotherapy practice. Contribution of each symposium paper to the overall theme: The paper by McMillan examines client experiences of change processes in a structured psycho-educational group intervention for emotional eating problems. Omylinska-Thurston has explored the perceptions of cancer patients around what is helpful for them in the psychological therapy they receive. Baxter has analysed everyday coping and change strategies used by people for overcoming periods of persistent low mood. These papers illustrate how different methodologies can be applied to the investigation of this topic. Implications of the symposium theme for counselling and psychotherapy theory, research and practice: Using contrasting methodologies, with different populations and clinical settings, these studies demonstrate that client understandings of what has been helpful for them to comprise an invaluable resource that can be used to inform the design of therapy services. Role of the symposium discussant: No discussant Sym F - Lynsey McMillanProfessional Role: Counsellor ABSTRACT: symposium F paper 1 (Sat, 10.55 - 12.25) Keywords: client experience, eating problems, group intervention, qualitative research Client experiences of change processes in a psycho-educational group intervention for emotional eating problems Aim/Purpose: "Emotional eating" refers to the act of frequently eating for psychological reasons such as boredom, anxiety, loneliness, sadness and anger rather than physical hunger. According to Buckroyd and Rother (2008) "there are psychological uses of food that maintain psychic equilibrium for a substantial minority of obese people". The use of food for affect regulation frequently results in weight gain and obesity. Conventional weight loss programs and drug and surgical innovations fail to address any underlying issues. There is a growing argument that there needs to be a place for psychotherapeutic approaches to obesity within the wider debate of tackling this "epidemic" and more research on psychological approaches in this area is required. The aim of this study was to explore the experiences of clients who took part in a psycho-educational group for "emotional" eaters. Design/Methodology: A mixed methods approach was used to study eight participants who took part in a five week "understanding your eating" psycho-educational course. Quantitative data were taken using three self-report questionnaires, and qualitative data were recorded via semi-structured interviews post intervention. Interviews were analysed using a grounded theory approach. Results/Findings: Post-intervention, the participants noted a number of key changes including: an increase in insight in terms of eating behaviours; greater awareness of negative internal dialogues; reduction in binge eating and an increase in alternative self-soothing strategies; greater openness with others about food/eating issues; less of a dichotomous "all or nothing" mindset; increase in self-accepting attitudes. Significant benefits were reported in all participants who completed the group. Research Limitations: The study was carried out on only one group, and no long-term follow-up was carried out. It is possible that other change processes might be observed in groups facilitated by a different counsellor, or comprising participants with different backgrounds and eating profiles. Conclusions/Implications: Psychological treatments which address underlying emotional barriers to weight loss have an important role to play in the field of eating disorders. It is important to design counsellor-led psycho-educational programmes in ways that enable participants to engage with a multiplicity of change processes. Courses of this type may be useful as a springboard into long-term behavioural change and weight loss programmes. Sym F - Joanna Omylinska-ThurstonProfessional Role: Chartered Counselling Psychologist ABSTRACT: symposium F paper 2 (Sat, 10.55 - 12.25) Keywords: cancer patients, psychological therapy, helpful factors, pluralism, patients' needs What do cancer patients find helpful in psychological therapy? Aim/Purpose: Consistent with pluralistic approach to psychotherapeutic research, this study aims to identify the range of factors and therapeutic methods that cancer patients find helpful in psychological therapy. Design/Methodology: Eight patients who completed psychological therapy with a NHS Psychology Service for Cancer were recruited. Data was gathered using semi-structured interviews following adapted Client Change Interview. The interviews were analysed using adapted Thematic Analysis. NHS Ethical Approval was gained for this study. Results/Findings: All patients wanted to talk in therapy about overwhelming feelings (fear, feeling low, shame, anger) and adjustment issues (losses, fear of cancer recurrence, work issues, body image issues, communication with family) following cancer diagnosis and treatment. Non-cancer issues were also activated during therapy for five patients (relationships dificulties, childhood abuse, panic attacks). All patients found it helpful talking with a neutral expert outside family. The "expressive" side of talking was most helpful. Linking with that, the therapists' ability to build the therapeutic relationship (therapeutic alliance and non-judgemental attitude in particular) were most helpful. The patients' own motivation to get better was important for all patients. Core therapy skills such as reassuring and encouraging were helpful as facilitated patients own internal resources. All patients indentified therapists' "cancer knowledge" as important which included understanding medical information as well psychological aspects of cancer diagnosis and treatment which had a normalising function for them. Patients also found problem-solving helpful for adjustment issues in particular. Other therapeutic methods such as CBT, fomulation, bibliotherapy, relaxation and expressive activity were also helpful. Research Limitations: The results of this study are limited to the patients' recall of what was helpful for them in therapy. The small number of participants interviewed and the subjectivity of the qualitative analysis limit the generalisability of the findings. Conclusions/Implications: This study confirms, in line with pluralistic approach (and current NICE guideliness) that a range of psychotherapeutic approaches are helpful for cancer patients depending on their psychological needs. The results show that cancer patients value neutral space where they can talk and express their feelings and difficulties and they appreciate the therapist who is approachable and non-judgemental. The results also show that cancer patients want the therapist to be more active including being reassuring and encouraging in order to mobilise patients' own internal coping strategies. Also the therapists' "cancer knowledge" is important for patients which has implication for therapists training and linking with medical professionals. Sym F - Walter BaxterProfessional Role: Counsellor ABSTRACT: symposium F paper 3 (Sat, 10.55 - 12.25) Keywords: client experience, depression, interpretive phenomenological analysis, low mood, task analysis Accepting responsibility for personal well-being: everyday strategies for overcoming periods of persistent low mood Aim/Purpose: The aim of this study is to establish a set of tasks drawn from the personal, cultural and social context of people's lives that are used when overcoming self-defined persistent period of low mood (PPLM). Design/Methodology: Interview transcripts of six participants who self-identified as having overcome a persistent period of low mood were analysed using an interpretative phenomenological analysis approach. Results/Findings: The key themes that emerged were: accepting responsibility for personal well-being; understanding the source of PPLM; acknowledging emotions and feelings and managing the response; moving from withdrawal to social connection; talking collaboratively with others about the PPLM; engaging in comforting rituals and spiritual practices; turning to professional sources of help; achieving recovery a step at a time. Research Limitations: The sample was only six people and therefore, prevents being able to generalise the results to a population. The participant's self-selected to be in the study. Future studies might look at the selection criteria to see if there was some empirical measure that could be applied to each participant's degree of depression. Finally, a future study may benefit from applying their more rigorous definition to the task list. Conclusions/Implications: Implications for theory: this study provides support for the validity of collaborative working. Also participants reported the process of conceptualising their experience in terms of tasks was reported as positive. The task list allows the counsellor to have a map of what the experience of living with a persistent period of low mood is like for clients. Being offered a set of tasks also allows the client the chance to gain some perspective on and begin to address their lived experience. Further research could be done looking for the most effective methods for addressing each individual task. Also, the task list allows inexperienced counsellors a means of anticipating the process of counselling clients with persistent low mood and gives guidelines when determining competencies in this area. Sym F - Rolf SundetProfessional Role: Lecturer in Clinical Psychology ABSTRACT: symposium F paper 4 (Sat, 10.55 - 12.25) Keywords: patient focused research, feedback, service user and therapist experience, qualitative research Patient focused research supported practices in a municipality based family therapy service: what happens? Aim/Purpose: Patient focused research has established feedback to therapists as part of evidence based psychological practices. What happens in the session when such feedback is included has seldom been described in the research literature. The aim of this study was to investigate how service users and therapists evaluated and experienced the use of feedback from two measures, the outcome rating scale (ORS) and the session rating scale (SRS). Design/Methodology: Experiences of service users and therapists were investigated through focus group interviews. Participants included seven therapists and five service users. The study received prior approval from a Regional Medical Ethics Committee in Norway. The analysis used a hermeneutically modified method of text condensation. One researcher did the analysis. The second researcher participated on the basis of having lived experience as a service user in Mental Health. The result of the analysis was given a special focus by the second researcher concerning space to the service user voice and checking the findings against his experience of the interviews. Results/Findings: Five main themes were identified, reflecting service users' experiences, therapists' perspectives, evaluation issues, and the function of the measures. Specifically, service users pointed out a range of generally helpful aspects of the use of the feedback measures. Almost all family members recommended OSR and SRS as being helpful in telling about disagreements with their therapists and communicating to their therapists their wishes and preferences. Participants reported that they answered ORS and SRS honestly. Family members and therapists were able to identify valuable conversational processes connected to the use of ORS and SRS. All seven therapists recommended the use of ORS and SRS. Research Limitations: Limitations are that there can have been a skewed recruitment of service users due to therapists recruiting their own clients, and the therapists by their leaders. A participant check was not included. Conclusions/Implications: These measures and their associated practice are feasible and should be continued. The measures function as conversational tools that create openings for conversations about and the realisation of better outcome, a well functioning and collaborative therapeutic relationship, and the realisation of service user preferences. Sym F - Vicki WatsonOther Authors: Mick Cooper and Katherine McArthur Professional Role: Trainee Counselling Psychologist ABSTRACT: symposium F paper 5 (Sat, 10.55 - 12.25) Keywords: client experience, helpful aspects of therapy, insight, process maps, thematic analysis Helpful processes in counselling: a pluralistic analysis of client activities, therapist activities and impacts Aim/Purpose: The aim of this study was to explore the specific activities that clients found helpful in counselling and their impact. Three aspects of helpfulness were explored: a) what clients themselves did that they found helpful, b) what helpful therapists' activities facilitated these client activities and c) the impact/effect of these activities. Design/Methodology: This study employed thematic analysis of 11 clients' post-session feedback on a modified helpful aspects of therapy form. The therapy provided was person-centred/relational, framed within a pluralistic sensibility. "Process maps" were used to visually represent the helpful processes. Process maps provide one way of conceptualising what specific helpful client methods resulted in perceived change and what specific methods, if any, did the therapist use to facilitate this change. Results/Findings: "Talking" was identified as the most helpful client activity, with a wide range of other activities also found to be helpful. In terms of helpful therapist activities, clients particularly valued being asked questions and given directions and suggestions, although the therapists' "ways of being" were also considered facilitative. The impacts of these helpful events, as indicated by clients, resulted in three main effects of gained insight/awareness, completed tasks and changes in client feelings. Process maps were constructed for gained insight/awareness theme and revealed possible pathways that lead clients to gaining insight/awareness during therapy. Research Limitations: The main limitation of this method is the complexity and size of the data set required for analysis. A further drawback to the current study is that participants received therapy from one of only two therapists. Conclusions/Implications: The findings of this study are consistent with meta-analysis carried out on helpful aspects of therapy, although "asking questions" emerged for the first time as a particularly helpful therapist activity. In terms of developing a new method to explore change pathways during therapy, process maps seem suited to being able to conceptualise how the client and therapist contribute to change. Sym G - Liz Bondi et al.Professional Role: Professor of Social Geography ABSTRACT: symposium G overview (Sat, 10.55 - 12.25) Keywords: theology, spirituality, Christianity, Buddhism, Sufism Psychotherapy, theology and spirituality in Scotland: current research The aims of the symposium: The aim of this symposium is to present and discuss current research on the relationship between psychotherapy, theology and spirituality in order to contribute to debates about the traditions that underpin and animate counselling and psychotherapy in the UK. The symposium examines how Christian, Buddhist and Sufi traditions have infused the theory and practice of counselling and psychotherapy. In so doing it considers the continuing relevance of the concept of psychotherapy as "the cure of souls" as well as convergences with traditions of spiritual healing. Contribution of each symposium paper to the overall theme: The first paper ("The interaction of philosophy, theology and therapy: some Scottish perspectives" by David Fergusson) brings to bear the perspective of philosophical theology to understand the mid-20th century "encounter" between psychotherapy and theological ideas in Scotland. This provides important intellectual context for the papers that follow. The second paper ("What is counselling/psychotherapy? How the interweaving of psychotherapy and Christianity in post-war Scotland is remembered and resonates today" by Liz Bondi) develops these ideas by drawing on oral history interviews to trace how key individuals narrate the interweaving of Christianity and psychotherapy in the development that underpin the development of counselling in the last three decades of the 20th century. The third paper ("Person-centred practice and the metaphysics of Unity of Ibn Arabi in the postmodern context" by Dot Clark) offers an account of a 21st century encounter between psychotherapeutic practice and theological ideas from the Islamic tradition. The final paper ("Telling stories about vocation: spirituality and religion in the self narratives of Scottish counsellors" by Alette Willis) also focuses on 21st century accounts, tracing the continuing relevance of Christianity as well as the emergence of Buddhism and wider discourses of spirituality in Scottish counsellors understanding or/and debates about what they do. Implications of the symposium theme for counselling and psychotherapy theory, research and practice: How the practices and discourses of counselling and psychotherapy are understood has long been contested. In an era of evidence-based health-care, the pressures of technical rationality are enormous. Practitioners and researchers necessarily engage with such discourses in order to make services available. At the same time, what brings practitioners and clients into counselling and psychotherapy often connects closely with more ineffable questions about meaning and spirituality. By showcasing research that examines the continuing relevance of theological ideas for psychotherapy, the symposium provides a forum in which these concerns are acknowledged and discussed. Sym G - David FergussonProfessional Role: Professor of Divinity ABSTRACT: symposium G paper 1 (Sat, 10.55 - 12.25) Keywords: theology, philosophy, psychotherapy, Scotland, Macmurray The interaction of philosophy, theology and therapy: some Scottish perspectives Aim/Purpose: The paper will provide an overview of the ways in which the different disciplines of philosophy, theology and psychotherapy interacted in mid-20th century Scotland. Attention will be devoted to the influence of John Macmurray who was a significant influence upon Guntrip and many others. The account of this interaction will point to the wider intellectual and spiritual location for practices of psychotherapy, although it simultaneously reveals the danger of attempting a fusion of discourses that fails to respect the complementarity of disciplines. Design/Methodology: The approach will be historical and philosophical. It will explore the transmission of ideas in the early 20th century through a study of key texts, personal contacts and institutional forms. Attention will also be devoted to situating key concepts and themes within the traditions of Scottish philosophy in the late 19th and early 20th centuries. Results/Findings: A keener awareness of patterns of interaction will arise by attending to the confluence of ideas in philosophy, theology and psychotherapy and the institutional settings which facilitated this process. The effects of this interaction upon the work of several key practitioners in the field will be noted, followed by some reflections on its contemporary relevance. Research Limitations: The paper will focus only on Scotland in the mid-20th century although parallels with other contexts can be drawn. It will approach the subject from the perspective of a philosophical theologian, not a psychotherapist. Conclusions/Implications: The importance for psychotherapy of maintaining conversations across disciplinary boundaries will be argued, while also noting the need to resist a totalising discourse. Sym G - Liz BondiProfessional Role: Professor of Social Geography ABSTRACT: symposium G paper 2 (Sat, 10.55 - 12.25) Keywords: Christianity, oral history, ministry, secularisation, Scotland What is counselling/psychotherapy? How the interweaving of psychotherapy, and Christianity in post-war Scotland is remembered and resonates today Aim/Purpose: This paper draws on oral history testimony to recover and disseminate understandings of counselling rooted in the interweaving of psychotherapy and Christianity in post-war Scotland. Design/Methodology: The paper draws on a series of 14 oral history interviews, informed also be extensive archival work. Interview transcripts are analysed using narrative methods including poetic transcription. Results/Findings: In a period of declining religious observance in Scotland and elsewhere, ordained and lay ministers found in psychotherapy new ways of expressing their vocation and conducting their ministry. Several extant counselling services evolved out of these new applications of psychotherapeutic ideas in the engagement of congregations and the communities. In these accounts counselling and psychotherapy become ways of countering some of the consequences of secularisation. For example, while secularisation separates religion from other arenas of life and is associated with increasing individualisation, oral history testimony shows how practitioners understood their own need and the needs of those with whom they worked in terms of a rich interweaving of the personal, interpersonal, theological and spiritual through which connections were fostered and relationships strengthened. Research Limitations: This paper does not seek to generalise beyond the particular period, location and networks to which it refers. Conclusions/Implications: The vision of counselling and psychotherapy articulated in the oral history testimony on which this paper draws is not acknowledged in dominant discourses today, which typically present these practices as analogous to medical treatments applicable to people suffering from diagnosable quasi-medical conditions. Many counsellors work in settings where a medical model grounded in technical rationality is highly influential (along with its language of clinical and cost effectiveness). This paper offers an alternative way of understanding the tradition in which they are embedded. The implications of this alternative account for the training of counsellors and psychotherapists as well as for counselling and psychotherapy practice are far reaching. Sym G - Dot ClarkProfessional Role: Career Development PhD student ABSTRACT: symposium G paper 3 (Sat, 10.55 - 12.25) Keywords: person-Centred, Ibn Arabi, theology, self, process Person-centred practice and the metaphysics of unity of Ibn Arabi in the postmodern context Aim/Purpose: The aim of this paper is to exemplify the theme of the symposium with an examination of how the practice of person-centred therapy is animated by the Islamic mystic (Sufi) tradition. Design/Methodology: This paper presents the reflexive, autoethnographic account of a person-centred therapist who undertook full-time, intensive study of the writings of Ibn Arabi (1165-1240CE) on the metaphysics of unity and who discovered that this experience complemented and enriched their established person-centred practice. The critical autobiographical method employed involves presenting a layered narrative which is analysed through different perspectives, from that of the individual, to those of the School where Ibn Arabi was studied and the person-centred approach, to the wider socio-cultural context of early 21st century Scotland in which the experience was situated. Results/Findings: The dialogue between person-centred theory and practice and the metaphysics of unity of Ibn Arabi is illustrated here by selecting two themes: the nature of the self, and what it means to trust process. It is argued that both discourses support an understanding of the self which expands beyond the level of the conditioned individual. Both traditions also advocate giving attention to and trusting whatever is unfolding in experience, whether it is named the actualising tendency or reality. Research Limitations: The specialised focus of an autoethnographic study is mitigated here to some extent by situating this paper within the broader dialogue of the symposium as a whole. Conclusions/Implications: Rather than assert any overarching, transcultural equivalence between these two very different traditions, the themes which arise between them are explored in the context of current conversations taking place in feminist and postmodern theology. Daphne Hampson's post-Christian, feminist theology is drawn on to support an expanded understanding of the self which is deeply relational. John Caputo's postmodern theology of the event contributes to an understanding of what it means to be responsive to whatever new is trying to happen through our inescapable situatedness. The contention is that theological ideas can be seen to complement and enrich the on-going growth and development of person-centred practitioners themselves, as well as supporting their therapeutic practice. Sym G - Alette WillisProfessional Role: Postdoctororal Research Fellow, School of Divinity ABSTRACT: symposium G paper 4 (Sat, 10.55 - 12.25) Keywords: religion, spirituality, vocation, self-narrative, career Telling stories about vocation: spirituality and religion in the self-narratives of Scottish counsellors Aim/Purpose: To explore the role that religion and spirituality play in giving meaning to the lives and practices of Scottish counsellors and psychotherapists. Design/Methodology: This study draws on two sets of semi-structured interviews with counsellors and psychotherapists across Scotland. The first interviews were undertaken in 2001/02 with 92 counsellors and managers of services in Glasgow, Edinburgh, and the Highlands and Islands of Scotland (see Bondi 2006). Participants were asked how they got into counselling, what counselling means to them and what made them the person they are today. The second set of interviews were undertaken from 2010/11 with 14 people key to the development of counselling in Scotland who had ties to religious and/or spiritual traditions (see theology and therapy website). Ethics approval was obtained through the University for both sets of interviews. Data were analysed using a narrative approach facilitated by Atlas.ti software for qualitative analysis. Results/Findings: In the stories told by counsellors, a significant minority reported religion and spiritual belief (primarily Christianity and Buddhism) played important roles in their decision to enter the profession. Others with no religious affiliation used narrative tropes from religion and new age spiritualities such as "vocation" and "providence" to describe their career choices. Religious and spiritual beliefs were sometimes challenged through training and practice and sometimes discovered or reinforced. The role of religion and spiritual belief within counselling itself was somewhat controversial. Research Limitations: This study only involved counsellors in Scotland and the bulk of the interviews were conducted a decade ago, so may not apply to the younger generation of people entering counselling. Conclusions/Implications: Religious and spiritual beliefs are important to the life choices and counselling practices of a significant minority of Scottish psychotherapists and counsellors. This has implications for the ongoing recruitment, training and supervision of counsellors. Sym H - John McLeod et al.Other Author: Mick Cooper Professional Role: Professor of Counselling ABSTRACT: symposium H overview (Sat, 13.50 - 15.20) Keywords: case study methods, health, pluralistic framework Using systematic case study research to develop a pluralistic framework for counselling in long-term health conditions The aims of the symposium: The diagnosis of a long-term health condition may lead to an emotional and relational crisis for the patient, as a result of threats to long-established patterns of living and sense of self. Previous research into the efficacy of counselling and psychotherapy for people experiencing long-term health difficulties has yielded equivocal results. A pluralistic framework for practice is particularly suited to work with clients with long-term health conditions, because it enables the therapist to be flexibly engaged with different client issues at different points during the process of therapy. The complex, client-focused and contextualised nature of this work means that methods of systematic case-based inquiry represent an appropriate approach to the development of a model of the therapeutic tasks and methods that arise in this area of practice. Contribution of each symposium paper to the overall theme: The paper by Miller uses data from a case series of pluralistic counselling with clients diagnosed with HIV, to develop an analysis, using grounded theory methodology embedded within a pragmatic case study design, of a key therapeutic task, that of developing a shared understanding. Thurston reports on client experiences of helpful processes in a single case of pluralistic counselling with a client who had undergone sight loss, based on a modified hermeneutic single case efficacy design (HSCED). McLeod and McLeod present a model of pluralistic practice derived from analysis of a case series of clients with a variety of long-term health conditions (multiple sclerosis, cancer, fibromyalgia), using a modified HSCED approach. These studies illustrate the application of different strategies of systematic case study research, and exemplify the possibilities of case-based practitioner research in the construction of models of practice for clients who are coping with long-term health conditions. Implications of the symposium theme for counselling and psychotherapy theory, research and practice: The findings of these studies confirm and reinforce the value of a flexible, pluralistic approach to working with this client group, with an emphasis on the construction of a collaborative and caring client-therapist relationship. The findings question the relevance of the use with this client group of approaches to counselling that focus on unitary models of change. The findings of these studies also have implications for the enhanced use of systematic practitioner case studies as a means of building a pragmatic evidence base for counselling and psychotherapy. Role of the symposium discussant: None - open discussion. Sym H - Erin MillerOther Author: Carla Willig Professional Role: Lecturer in Counselling Psychology ABSTRACT: symposium H paper 1 (Sat, 13.50 - 15.20) Keywords: case study, HIV, pluralistic, understanding Pluralistic counselling with HIV positive clients Aim/Purpose: Living with HIV has been described as a process of constant adjustment and re-adjustment as the person attempts to create both a good quantity and quality of life. Most of the counselling and psychotherapy literature on this topic has focused on the efficacy of cognitive behavioural therapy (CBT) for this client group. However, some of the theory behind the CBT model has been questioned in relation to the needs of the HIV positive community. The aim of this research is to explore the experience of HIV positive clients receiving a counselling approach informed by a pluralistic framework of goals, tasks and methods. Design/Methodology: A grounded theory approach was used to analyse 12 pluralistic counselling sessions with each of three HIV positive clients. The author took the role of practitioner-researcher, working pluralistically with the three participants and then analysing the data. Thirty-six hours of pluralistic therapy were audio-recorded, transcribed and then analysed using grounded theory strategies. Feedback sessions were also conducted with each of the clients in order to highlight the experience of the client and invite their voice into the research. Reflections on being a pluralistic therapist were also explored. The client work and analysis were then integrated into three pragmatic case studies. Analysis of data were audited by an experienced qualitative researcher. Results/Findings: These HIV positive clients had specific ‘relational goals' for therapy, including the goal of having the experience of being the ‘expert' in the room. Therapeutic tasks that were central for all three clients included ‘self care' and 'increasing quality of life'. A range of therapeutic methods were used. The therapeutic relationship was found to be a method within this framework. In the analysis and feedback sessions high levels of collaboration between the therapist and the client were explored. A possible outcome of this level of collaboration seems to be an increase in the client becoming a ‘creative scientist' or a ‘second therapist' during the process of therapy. Additionally, a common element for all three clients was the absolute importance of ‘creating a shared understanding' between the therapist and the client. Research Limitations: The key weakness of the study is the lack of quantitative data that might have allowed triangulation of qualitative themes. Conclusions/Implications: The conclusion of this research is that the author suggests the inclusion of ‘creating shared understanding' into the pluralistic framework. It also highlights some of the goals, tasks and methods that may be of importance when working with this client group. Finally, the findings of the study demonstrate the potential of grounded theory analysis in case study inquiry. Sym H - Mhairi ThurstonOther Author: John McLeod Professional Role: Lecturer in Counselling ABSTRACT: symposium H paper 2 (Sat, 13.50 - 15.20) Keywords: case study, CORE, methodology, pluralistic, sight loss Counselling for sight loss: using case study methodology to develop a practice model Aim/Purpose: It is well documented that acquired sight loss negatively impacts on identity and can lead to depression, suicidal ideation, social isolation and loneliness. With an aging demographic, the prevalence of acquired sight loss is rising. Nearly two million people in the UK are blind or partially sighted. There is growing recognition of the need to provide emotional support for people with sight loss. However, little is known about effective counselling interventions for this client group. Case studies have the potential to play an important role in the development of theory and practice, particularly in relation to this specific client group. Design/Methodology: Findings will be presented from the analysis of a single case study in which the client was a 70 year old woman who had experienced sudden and irreversible post operative sight loss. She received six sessions of counselling from a sight impaired counsellor working within a pluralistic framework. The client completed the CORE outcome measure and a goals scale at each session, along with process measures. Sessions were recorded and transcribed. A change interview was conducted at the end of session six. This data set were analysed by an inquiry team, using a modification of Elliott's quasi judicial hermeneutic single case study efficacy design. Ethical approval was obtained from the University Research Ethics Committee to conduct this study, and the client engaged in an informed consent process at the beginning and end of her therapy. Results/Findings: The case analysis is briefly presented, in terms of the outcome of the counselling and the therapeutic processes that contributed. Results indicated that this case had a positive outcome, with the client reporting that she felt more hopeful and less lonely at the end of session six. The implications of this study for practitioners seeking to counsel sight impaired clients are discussed. Research Limitations: The key weakness of this study is that a limited range of data were collected from the client, who represents only one among several patterns of sight loss. Further systematic case studies with a wider range of sight impaired clients are needed to determine the generalisability of the findings. Conclusions/Implications: The study provides an example of systematic case study research, and places this approach within the context of the development of a practice framework for a specific client group. Systematic case study research has potential to make a substantial contribution to the research literature, and to deepen our understanding of issues presented by specific client groups. Sym H - Julia McLeodOther Author: John McLeod Professional Role: Lecturer in Counselling ABSTRACT: symposium H paper 3 (Sat, 13.50 - 15.20) Keywords: case study, health, pluralism, transactional analysis Process and outcome in pluralistic transactional analysis counselling for long-term health conditions: a case series Aim/Purpose: Living with a long-term health condition is experienced by many people as highly stressful. The psychological impact of chronic illness can include anxiety, depression, post traumatic stress disorder, and relationship difficulties. The present study used a case series to examine the process and outcome of pluralistically-informed transactional analysis (TA) counselling in three clients suffering major on-going health problems (multiple sclerosis, fibromyalgia, cancer) that had already been the focus of substantial levels of medical intervention and had resulted in considerable pre-counselling decrements in quality of life. Design/Methodology: A rich case record was assembled for each client, incorporating therapist notes, transcripts of sessions, scores on standard outcome measures, and a follow-up change interview. These case materials were analysed using a modified hermeneutic single case efficacy design (HSCED) approach, to identify key helpful process within the therapy, and to determine the nature of the outcomes of the intervention. Results/Findings: All three cases were classified as good outcome. A set of core therapeutic tasks could be identified across all three cases, encompassing the development of a caring collaborative relationship, a flexible approach to scheduling, and attention to a wide range of therapeutic tasks including coping with the stress of dealing with the NHS, reviewing relationships with family members, and facing up to the possibility of death. Research Limitations: The fact that no poor outcome cases were observed limits the generalisability of findings. All three clients were women - it may be that other therapeutic responses might be associated with male clients. In addition, all the clients in the study had been diagnosed some time before entering counselling - it is likely that other emotional and interpersonal issues would be more salient in the immediate post-diagnostic period. Conclusions/Implications: The findings of the study suggest that a pluralistic counselling approach, based on a TA model, may be particularly relevant to the needs of people living with long-term health conditions. Sym I - Seamus Prior et al.Other Authors: Judith Fewell, Claire Hsiao, Rose Cameron and Tanya Richardson Professional Role: Counselling and Psychotherapy ABSTRACT: symposium I overview (Sat, 13.50 - 15.20) Keywords: reflexivity, practitioner, researcher, new New approaches to reflexivity in practitioner research The aims of the symposium: The four papers in this methodological innovation symposium offer new interpretations and re-workings of practitioner-researcher reflexivity. Based within counselling and psychotherapy at the University of Edinburgh, the symposium researchers apply critical social science epistemologies to the contexts and practices of the talking therapies. They employ concepts from psychoanalysis, narrative theory and feminism to examine counsellors' and researchers' reflexive engagement in the therapeutic process and research thereof, challenging the boundaries between practice and research, and between case study research and autoethnography. Contribution of each symposium paper to the overall theme: Turning on its head the traditional approach to the 'case study' where the author-researcher analyses a 'case' treated, Fewell challenges therapists to take themselves as the case to be investigated. She explicates an autoethnographic research methodology applied to the therapist as person, practitioner and client, which provides unique insights into therapeutic process and practice. Drawing on her research on intimacy in therapy, Richardson analyses the intimate relationship between the researcher and her experience of the research process. She counters the critique that reflexive research is overly subjective, demonstrating the necessary distancing and the adoption of the 'third position' required in employing reflexive methodologies. Cameron troubles the border territory between research reflexivity and practitioner reflexivity, arguing for the impossibility of any clear demarcation. Using examples from her research, she shows how the practitioner experience of the researcher contains the potential to provide valuable contributions to research knowledge. Hsiao's work provides a detailed case study of the foregoing themes, as she explores how reflexivity assisted her in the identification and understanding of her research topic: an investigation of the experience of cultural dissonance in counselling psychology training in Taiwan. She also examines how reflexivity has guided her in the analysis of her empirical findings. Implications of the symposium theme for counselling and psychotherapy theory, research and practice: The symposium papers offer theoretically rich and conceptually rigorous re-workings of reflexivity as a methodological approach of choice for practitioner-researchers, offering highly reflexive accounts of the application of reflexivity in research. Role of the symposium discussant: Introduce the symposium and each paper and facilitate dialogue among presenters and between audience and researchers. Summarise key themes. Sym I - Tanya RichardsonProfessional Role: Counsellor and PhD student ABSTRACT: symposium I paper 1 (Sat, 13.50 - 15.20) Keywords: reflexivity, intimacy, distance, containment, psychoanalysis Intimacy and reflexivity: how close are we to the research process? Background and introduction: This paper considers the way in which negotiating relational territory, by balancing closeness and distance, is required not only in the work of counselling and psychotherapy, but also in a research process. The paper is based on an understanding of human experience as context dependent (Flyvbjerg, 2001), and builds on prevailing ideas of the researchers use of self (Etherington, 2004). It draws on psychoanalytic ideas and relational debates about separateness and inter-subjectivity to theorise reflexivity as a research method in counselling and psychotherapy research. The paper proposes that reflexivity offers a way to work fluidly within and between the positions of separation and connectedness. Nature of the methodological innovation/critique being proposed: The paper argues that a reflexive methodology can be thought about as requiring a distancing of oneself from ones experience, as characterised by the psychoanalytic principle of the triangular space (Britton, 2004). It also links reflexivity with the concept of containment (Bion, 1970) to describe a process in which both the practitioner and the researcher are required to move from having an experience, to then distancing themselves sufficiently to reflect on, metabolise, and perhaps theorise that experience. A version of reflexivity is presented which requires the researcher to fluidly move between being in an experience, and being outside of and reflecting on an experience. The paper challenges the idea that a reflexive methodology in research is too subjective, inappropriately centralises the researcher, or leaves insufficient space between the researcher and their research. This paper argues that it is within the fluid movement between objective and subjective positioning, that it is possible for researchers working reflexively to manage the delicate balance of connectedness while retaining some distance from their research. It suggests that it is in the movement between these positions and in the space between them, that creativity, interpretation, analysis and theorising are possible. It is also argued that reflexivity, as an ongoing part of a research process, also avails itself to examining phenomena which are particularly difficult to ‘pin down', because of the capacity to chart and register change and transitions. Conclusion and relevance to counselling and psychotherapy research practice: By linking psychoanalytic ideas of triangular spaces, and containment with existing understandings of reflexive research, this paper suggests that reflexivity offers way of approaching research which supports both staying close to and connected with the research phenomena, but without surrendering the distance required to metabolise and theorise it. It also promotes a version of working reflexively which stays within the ontological and epistemological frame which underpins the practice it seeks to investigate, seeking coherence within and consistency between the governing principles of practice and research alike. Sym I - Judith FewellProfessional Role: Honorary Fellow and psychoanalytic psychotherapist ABSTRACT: symposium I paper 2 (Sat, 13.50 - 15.20) Keywords: case study, narrative, reflexivity, therapeutic relationship, psychoanalysis Understanding therapeutic practice through the therapist's reflexive engagement in their process Background and introduction: As counselling and psychotherapy establishes its research credentials in a mental health discourse dominated by psychology and psychiatry, there has been an increasing emphasis on research epistemologies which claim objectivity and scientific status, usually constructed within third person voices. This paper seeks to redress the balance by foregrounding an explicitly reflexive, engaged and personally involved approach to counselling research, reflecting both the core values and practices of the profession. With the resurgence of interest in the case study approach (McLeod, 2010), this paper argues for the place of the therapist's reflexive analysis of their practice as a principal branch of case study research in counselling. Nature of the methodological innovation/critique being proposed: The presenter argues for the return to the therapist's reflexive personal narrative as case study for a deeper and more nuanced understanding of what goes on between and within therapist/counsellor and client. Drawing on psychoanalytic and narrative concepts, the presenter will explore how past and present stories of the counsellor/therapist both within and outside the therapy room can illuminate therapeutic processes and practices and further our understanding of the therapeutic relationship. Conclusion and relevance to counselling and psychotherapy research practice: The telling of stories is fundamental to what it means to be human. An examination of the multiplicity of subjective and inter-subjective therapeutic tales present in the therapy room, how these stories are told, how they influence the meaning-making and the processes of change and resistance to change will significantly add to the scholarship of the field of research into therapeutic practices. Sym I - Claire HsiaoProfessional Role: PhD student in Counselling and Psychotherapy ABSTRACT: symposium I paper 3 (Sat, 13.50 - 15.20) Keywords: reflexivity, counselling training, culture, Taiwan Feeling matters: a reflexive approach to understanding the challenge of being a westernised counsellor in Taiwan Background and introduction: This paper explores how reflexivity underpins the research into the challenges which Taiwanese practitioners face in their process of studying and practicing western counselling in Taiwan. As a Taiwanese practitioner, the author experienced barely detectable and initially indescribable inner conflict and anxiety on the process of becoming a westernised counsellor. Reflexivity enabled the author to clarify unexplored feelings about training process and helped to formulate both research questions and methods. The author then went on to apply a reflexivity interview approach with 11 Taiwanese beginning counsellors. Nature of the methodological innovation/critique being proposed: Through moving in and out of several levels of awareness, the reflexive approach enabled the author to: (1) understand own untouched and undetected struggle in becoming a westernised counselling practitioner as a Taiwanese person and formulate research questions; (2) properly respond and empathise with participants' stories and difficulties during the interviews; (3) acknowledge and interweave own experience with existing theoretical discussions, the stories of participants and the authors new understanding through the process. Conclusion and relevance to counselling and psychotherapy research: In this research, not only are the political, historical and cultural factors which caused those difficulties and the consequences in Taiwan analysed, but also how the author produced critical reflections on the whole research process and how the author generated knowledge through reflexive engagement with research, personal experience and interviews. Sym I - Rose CameronProfessional Role: PhD candidate ABSTRACT: symposium I paper 4 (Sat, 13.50 - 15.20) Keywords: practice-research, reflexivity, richness, language, impact Researching one's own practice Background and introduction: Practitioners are being increasingly encouraged to become researchers and to draw data from their own practice. Such data is unavoidably covered in the practitioner-researcher's fingerprints. Research that addresses this creates the potential for creating knowledge about actual practice as well as the topic being researched. This paper will explore the rich layers of complexity and reflexive opportunity afforded by using data from one's own practice as a therapist, supervisor, trainer and writer. Nature of the methodological innovation/critique being proposed: The mixed-methodology research described in this paper draws data from therapy and supervision case material, a recording of a training course and assignments written by students on a training course. Textual and narrative analysis of the data reveal the practitioner-self hovering between the research participants and the researcher-self and prompts reflection upon and analysis of the impact the practitioner-self has on the data generated. Conclusion and relevance to counselling and psychotherapy research practice: Practice-research necessitates reflexive analysis of the practitioner's influence upon the data generated as well as the researcher's situated analysis. |
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