|
|
|
|
|
 |
• research conferences: |
|
|
|
research conference 2002 index of presentations | abstracts | evaluation RONNIE AARONSON Professional
Role: Counsellor/Teacher ABSTRACT: Poster Boredom - A Study of Practitioner Boredom Aims: To investigate how therapists make sense of boredom in the counselling session, and how this understanding effects their therapeutic response to it. My interest in boredom generally stems from my experience of teaching children with learning difficulties, and the challenge of making the teaching material "interesting". I also found as a psychodynamic counsellor that it was difficult to engage with some clients some of the time and I started to wonder whether this was always due to projective identification. The literature search identified boredom as a defense, but whose defense, and against what, appeared to be problematic. I was also interested in how this assessment affected which therapeutic intervention the therapist did, or did not make. Methods: Focus groups were used to generate grounded theory which was used, together with information thrown up by the literature search, as the basis for a questionnaire. Follow-up telephone interviews were used for the purpose of triangulation (Silverman 2000) and to verify findings that the questionnaire generated. Sample: The questionnaire was sent to 60 participants taken from the UK Counselling and Psychotherapy Directory 2000. 30/60 respondents took part. Analysis: The research generated both quantitative data and qualitative data. Quantitative data is presented in the form of bar charts. The content analysis of the qualitative data was undertaken by means of immersion and categorization (McLeod 1999). Findings: To follow. So far: Expected data - when therapists understand boredom as a projection, especially projective identification, they more usually make an interpretation to the client. When therapists see the boredom as the result of a defense that they are employing, they are more likely to do nothing or to take the issue to their supervisor/therapist. Professional
Role: 3rd Year PhD student ABSTRACT: Paper Working Together: Psychosocial Work in Women's Aid Refuges Aims: On any day, nearly 7,000 women and children are sheltering from domestic violence in Women's Aid refuges in the UK. This study seeks to establish how support is given to women, the range and types of support available and when different kinds of support, including individual counselling and group work, seem most appropriate. Methods: Data from Women's Aid surveys is being used to establish the extent of service provision, together with case studies in three refuge projects in differing locations. These involve observation and semi-structured interviews with current and past residents and project members. The research has been designed in collaboration with the projects, taking account of individual areas of concern. Particular problems arise in contacting past residents and also in securing a wide variety of views on the support given. To some extent these can be overcome by longer-term contact with the refuge. Interim Findings: Early indications are that women coming to a refuge are affected by a process similar to that involved in bereavement, with fluid and overlapping stages of progression and a need for changing types of practical and emotional support. Key elements in facilitating this process appear to be peer support, a respectful and empowering approach from workers and the continuing availability of counselling, counselling skills and group work integrated within the environment. Also critical is support to ensure the cessation of violence and safe accommodation in the future. Conclusions: This research indicates a way of conceptualising the time spent in a refuge, understanding changing support needs and the importance of emotional as well as practical support from a variety of sources working together to empower women. Professional
Role: Ph.D Student ABSTRACT: Paper 'I Have To See You In Text: A Relationship in E-Mail Counselling' This qualitative study investigated whether or not e-mail counselling can be a therapeutic tool when working with client (e-catharsis, trust and empathy). I attempted to discover whether 'shy and quiet' students and those having negative experience in face-to-face counselling would benefit from such service. E-mail counselling was offered to sixty (21 male and 45 female) students in my former undergraduate 'Counselling and Guidance' course in a university in Malaysia. Students were briefed about the nature of this study, ethical issues and to agree on an informed consent if they wish to participate. Eleven students responded but only eight (3 male, 4 female and 1 unknown) underwent the complete counselling process in eight weeks (4 e-mail sessions per client). Data collection using open-ended questions pertaining to personal background (optional) and e-mail counselling's experiences were done through e-mail interaction. Data were coded and analysed to find significant themes and pattern. Email counselling seems to appeal to 'capable and visible' students who have found face-to-face counselling as beneficial. Students who responded to my email counselling were academically above average students. They asked questions and took part enthusiastically in counselling labs. My intention to get reaction from 'shy and quite students' did not materialised. Clients said that they would participate in e-mail counselling only if they have some ideas about the counsellor. Some aspects of the email counselling have it own therapeutic value that cannot be replicated in face-to-face modalities (deep personal issues, problem focused, session in print). E-mail counselling does have therapeutic elements and e-catharsis, trust and empathy are likely. Positive face-to-face counselling motivates individual to engage in e-mail counselling. Prior relationship and some idea about the counsellor are desirable. Future research on why 'shy, quiet and below average' students did not participate in e-mail counselling is suggested. Professional
Role: PhD Student (3d Year) ABSTRACT: Paper Power in Therapy: Good and Bad Clients? This is a work-in-progress paper which discusses research forming part of a Ph.D at the University of Wolverhampton. The paper will discuss how therapists and clients construct their notions of each other through the therapeutic relationship, and how these notions may mobilise power issues. The research aim was to investigate the role of power in therapists' notions of 'good' and 'bad' clients, within a social constructionist paradigm. The research proposes that therapist and client notions are constantly changing as they work together within a therapeutic relationship. Therapist notions of 'good' and 'bad' clients are mobilised through their active use of language. In this way language creates meaning through the utilisation of social constructions, which are made available by certain discourses. Method: Two studies have been conducted, and a final follow-up study is currently being planned. Study 1 involved two focus group interviews with six trainee counsellors. Study 2 involved one-to-one interviews with six trained counsellors. The final study will involve one-to-one interviews with six clients. Analysis of the data took the form of a Foucauldian Discourse Analysis, according to principles set out by Willig, (2001). Findings: Findings supported a social constructionist way of looking at this topic: When mobilising 'good' and 'bad' notions of clients, therapists draw on major discourses which offer them certain social constructions. Findings supported that discourses and constructions offer therapists positionings which impact on power differentials between client and therapist. The main finding here, was that the construction of power is variable, and is therefore reliant on contextual cues. Conclusions: The therapeutic relationship is both complex and context specific. This research is relevant to therapy in practice as accounting for discourse in the ways in which therapist and client work together, may offer an insight into how therapist notions of clients can be explained by context and culture, rather than therapists' personal characteristics. In this way, it may become interesting to address how therapists may be constrained by their contextual discourses, which provide "space" for notions of 'good' and 'bad' clients. Willig C (2001). Introducing Qualitative Research in Psychology: Adventures in Theory and Methodology. Buckingham: OUP. Professional
Role: (KA) Consultant ABSTRACT: Workshop Researching The Uses of Innovative Avatar and Virtual Environment Technology for Counselling and Psychotherapy Aim: Introducing the theoretical concepts taken from empirical research that has led to researching avatar/virtual technology as a viable method of conducting Counselling and Psychotherapy over the Internet. To demonstrate innovative technology formed by therapists working together with technology to better research concepts such as client empowerment, disinhibition effect, anonymity effect, distance therapy advantages (global barriers), and client choice of therapist. Audience participation includes discussion with the panel about how their client work and research could be affected by working with technology. Demonstrations of the technology are:
The workshop will close on a brief summary by Kate Anthony into specific research questions that are being raised by Counsellors and Psychotherapists embracing technology. This will concentrate on the conference theme of "Working Together", from the point of view of working with technology as opposed to resisting it because of traditional Counselling and Psychotherapy schools of thought. Professional
Role: Ph.D Student/Counsellor (Japan) ABSTRACT: Paper Working Together - Means of Supporting International Students Aim of the study: Every year, an increasing number of Japanese students go abroad to study. Although they are highly motivated, many find it difficult to cope with life in an unfamiliar environment. Those difficulties are often related to their emotional conditions. The aim of the present study is to find what kind of support can meet their emotional needs and facilitate them to be effective as a student and as a resident abroad. Methods: I conducted a one-year longitudinal research project with Japanese international students in England by questionnaires (N=49) and interviews (N=18). The questionnaires concern students' background, experiences, feelings and emotions before and during their study abroad, and the collected data are mainly analysed quantitatively. The interviews cover the similar questions to those in the questionnaires, but more in depth and the data are analysed qualitatively. Findings: The findings show that the students frequently experienced emotional difficulties over the year. It is also shown that establishing and maintaining relationships with both other Japanese and local students are a large concern for many students. Despite this fact, most of them did not find currently available support systems helpful and struggled by themselves and talked enthusiastically about what they really wished to have to overcome those difficulties. Conclusions: As a consequence of the increases in the number of international students and because of growing interests in multicultural issues, there has been much discussion of support systems from different research perspectives. However there are few studies that focus on what such students actually need. In the presentation, by carefully examining those Japanese students' stories of experiences during their study in England, I would like to preliminarily report some of the findings and discuss possibilities of a support system which really meets international students' needs. Professional
Role: Project Manager and Counsellor ABSTRACT: Paper Thinking about Mothering: An Evaluation of the work of The Mothering Project, a Psychodynamic Therapeutic Service for Mothers. The Mothering Project is a new therapeutic service for mothers, aiming to improve quality of parenting through increasing mothers' confidence, self-esteem and capacity to reflect on themselves and their children. The Project is set within an established psychodynamic women's counselling centre, working with women on low incomes, who have had no access to higher education or previous counselling. The Mothering Project was evaluated in order to gain a greater understanding of three domains:
Qualitative methods were used to elicit the views of clients and staff members. In-depth semi-structured interviews were conducted with 5 former clients and 5 staff members. This data was triangulated with data from questionnaires at the beginning and end of therapeutic interventions. Results indicate that clients come to the Project because they are isolated, have difficulties mothering their children, suffer from a range of mental health problems, struggle with unresolved issues from the past, and live in conditions of deprivation. The Project was viewed as accessible, providing a varied programme of individual and group work focused on mothering, within a calm and welcoming environment. Results indicate that the strengths of the service may lie in the combination of a flexible, creative, friendly approach with clients, alongside a rigorous level of thinking by staff about each individual client, from a psychodynamic perspective. Some significant gains were identified: a decrease in depression and anxiety, alcohol and drug use, and isolation, and an increase in self-esteem, confidence in mothering and hope for the future. Severe and prolonged depression was not felt to have been helped by attendance at the Project. Ending their contract was experienced by some as very difficult. Implications for the provision of therapeutic services for mothers are discussed. Professional
Role: Reader in Counselling ABSTRACT: Workshop "Writing" The workshop offers an opportunity for participants to consider their approach to writing (or not writing) and some alternatives which may increase enjoyment and output. The main method is brief exercises and discussion. Fantasies and irrational beliefs about successful writers explored and a multi-stage model of writing for publication is considered. Two general themes are (1) to consider a wide variety of strategies, including some which orthodox approaches discount or miss and (2) that each person's strengths as a writer should be developed first and the opposite (complementary) strengths added later and in a subsidiary way. The workshop is based partly on MBTI theory, which assumes that there are best ways for each writer and that the best approach for some people will be the worst for others, and partly on Robert Boice's research. Bayne, R. (1995) The Myers-Briggs Type Indicator A critical review and practical guide Cheltenham: Nelson Thornes. Boice, R. (1994) How writers Journey to Comfort and Fluency. A Psychological Adventure Westport, Connecticut: Prager. Authors: Liz Bondi, Judith Fewell, Árnar Árnason and Colin Kirkwood Professional
role: (LB) Professor of Social Geography ABSTRACT: Paper Working
Together In The Context Of Counselling: Between Purity And Community Professional
Role: Former consultant in counselling to University of Bristol/Counsellor
and Psychotherapist in Private Practice. ABSTRACT: Paper Defending Against Experiencing: An Exploration To The Threat To The Essential Passion And Professionalism Of Counsellors And Academics. The research in this paper was undertaken in an attempt to understand the processes underlying the denial by the then senior university management of the passion and professionalism of qualified and accredited counsellors which limited the development of a fully professional counselling service. The paper explores the denial of the experience of passion and professionalism in academia by traditional british universities, which was found to be closely linked to the original processes around counselling, drawing on a case study focused around the provision of a staff counselling service. It is grounded in a review of the major psychoanalytic perspectives on organisations and links this to co-operative inquiry as the methodological approach most sympathetic to such counselling and psychoanalytic perspectives in both theory and practice. Co-operative inquiry involves researching with, not on, people and stresses the perspective and experiences of those with whom the research! Is conducted: it enabled participants to explore, to develop and to change the original research question for themselves. The study was based on a collaboration with three university staff groups, facilitated by the author and conducted over a five year period. The research concludes that there is a defending against "experiencing" which inhibits the passion and professionalism of academia, not counselling alone. Drawing on the earlier review of psychoanalytic perspectives on organisations the paper conceptualises a range of ways of understanding the processes, unconscious and conscious, at work in the university. It offers conclusions and implications for the development of staff counselling services and staff development, as well as some methodological reflections. Professional
Role: Counsellor, MA Student ABSTRACT: Paper Working Monolingually with a Bilingual Patient: The Therapist's Experience This paper is based on a research dissertation to be submitted in June 2002, as part of the MA in Counselling at the University of Reading. My interest in the topic arose out of my own experience both as a psychodynamic counsellor who has worked with bilingual clients, and as a teacher of foreign languages. Aims: The purpose of this qualitative study was to explore the meanings that psychodynamic counsellors and psychoanalytic psychotherapists gave to their experience of working in English with a client /patient who used English, proficiently, as a second language. I focused particular attention on the therapist's countertransference, which has received little attention in the literature. I examined how therapists' theoretical backgrounds influenced the way in which they thought about and worked with the phenomenon of bilingualism. Finally, I asked therapists for their recommendations for the profession. Methods: I conducted semi-structured, audiotaped interviews with a purposive sample of ten participants, from June 2001 to February 2002. The sample was obtained through contacts with counselling and psychotherapy organisations, and other media. I analysed the data using phenomenological and hermeneutic principles. Brief summary of the findings: The main theme was 'separation and connection'. Many therapists expected a 'language barrier', and anxieties about communication were common before meeting the patient. Most therapists listened with extra attention to their bilingual patients, even when they were very proficient English speakers. Other findings included therapists' reactions to foreign accent, and indications of envy of the bilingual patient. Implications: The results indicate that awareness of the underlying psychodynamic meanings of bilingualism is important in the assessment of bilingual patients or clients, for supervision and for the ongoing therapy. There are also implications for the inclusion of the issues on training courses. Professional
Role: Counsellor in Private Practice/Co-ordinator of Counselling,
Stevenage and North Herts Counselling Centre ABSTRACT: Paper Containment - Freedom in the Client Aim: To explore the possibility of the tension (or polarity) between the concepts of containment and freedom in the client that may enable/disable emotional movement from the client's perspective. Method: Five client co-researchers kept journals of their thoughts and feelings after weekly counselling sessions for four months. A bricolage methodology, incorporating reflexivity, grounded theory, hermeneutics and heuristic process formed a collaborative inquiry which took two years to complete. Improvements need to be made on the definition of terms used in the study for the term 'containment' is already widely used in another context and the term 'freedom' has a well documented philosophical background which needs to be taken more into account. The main strength of the project is perhaps in the feedback of the co-researchers which confirms the researcher's previously held belief that there is a tension or polarity between the concepts of containment and freedom. Findings: Each co-researcher felt that the individual analysis of their journal fitted with their own understanding as well as giving insights into their internal world. They also found that the theoretical constructs created from the work made sense of their feelings and the process of emotional movement in counselling. The study suggests that the tension between containment and freedom does exist for the client but a larger study, over a greater time period will continue to investigate the concept. Conclusions: There is still a long way to go! However even the glimpse that this study gives into the client's internal world does offer a new way of looking at the client's experience of counselling and so in turn may add to the counsellor's understanding of the circumstances that enable/disable emotional movement and change. Professional
Role: Journalist and Transpersonal Psychotherapist ABSTRACT: Paper The Experience for Journalists of Emotions and Trauma Aim:
The aim of this investigation was to explore the way in which journalists: Summary of Findings: Journalists with experience of reporting conflict and traumatic events (such as rail crashes, the Middle East, African genocide or the September 11 attacks on America) have a markedly higher likelihood than a journalistic control population to display symptoms of Post Traumatic Stress Disorder (PTSD). However, journalistic organisations and culture are only slowly coming to accept the emotional dimension of the profession. Journalists (at least in the main English language areas) are trained to consider themselves as dispassionate observers reporting only facts. In reality, they can be profoundly affected - emotionally and spiritually - by what they observe. Furthermore, the journalism which they believe to be objective bears the (often unconscious) mark of that involvement. Larger media organisations such as the BBC and Reuters provide confidential counselling services for their staff. However, the therapy and counselling professions have so far done little to adapt and develop their practice specifically to meet the needs of journalists - whether clinically traumatised or seeking personal meaning in their work. Methods and approach: This presentation will present material from in-depth, therapeutic interviews with nine serving foreign correspondents, and contrasts it with other similar surveys. A summary of various seminars and conference findings on the subject of journalists reporting on conflicts will also be discussed. Conclusions: In conclusion, there is very little qualitative data on how journalists experience and process the emotions generated in their work. Further in-depth research is needed, ideally in individual therapeutic and also group settings. Therapists and counsellors, and their professional bodies need to develop appropriate ways of working with journalists, to include debriefing, groupwork and peer counselling as well as traditional individual therapy. There is an urgent need both for public discussion about these issues in the media themselves, as for the introduction of appropriate training and awareness-building at all levels - for aspiring journalists in the journalism schools, for new recruits to established organisations and in continuing training for the experienced journalist. For the purposes of this paper, the term journalist is used to embrace reporters and correspondents working for all kinds of news media, and also producers, cameramen and fixers. Professional
Role: Counsellor ABSTRACT: Poster Counselling: A Complex Case? Counselling always occurs in a social/institutional context and is influenced by its setting, hence the importance of including work settings in research. This poster is based on an audit of the work of one counsellor working in a cognitive-behaviourally oriented clinical psychology department in an inner city hospital. It describes the location of counselling within the local system and raises issues including:
Second
Presenter: John Waite Professional
Role: Psychotherapist, Researcher ABSTRACT: Paper and Poster Investigating Paradigms of Helping and Healing In Mental Health: Confused Clients and Potluck Psychotherapy Professionals? Aim Three approaches to mental health are studied:
The debate within the psychology profession is seen in discourses between clinical and counselling psychology and in conflicts within counselling psychology. There are two aims:
Summary: Design: Grounded theory and phenomenological analysis with in-depth interviews reveal the discourses and underlying paradigms. Method: Participants selected for experience, diversity of approach and training: from psychiatry, general practice, clinical and counselling psychology, psychotherapy, counselling. Informed consent obtained. In-depth interviews undertaken:
Summary of findings Phenomenological analysis of discourse revealed emerging themes:
Conclusions Next stage of research: Application of analysis to the professions. Addressing concerns around the central paradigm within medical, psychotherapy and psychology professions. Use of Focus Group to address effective multidisciplinary working. Application of analysis with reference to profession of counselling psychology. Investigating the position of counselling psychology and the role of counselling psychologists as emerging professionals. RUTH CALEB and PUSHPINDER CHOWDHRY Professional
Role: (RC) Head of Counselling Professional
Role: (PC) MSc Course Tutor ABSTRACT: Paper Beyond the Individual - The Changing Role of the University Counselling Service Aim: The last decade has seen enormous changes in the provision of Higher Education in the UK. These changes have included widening participation to include 'non-traditional' students, the growth in student numbers and the increased numbers of student with mental health difficulties. This joint Doctoral Project researches the changes that University Counselling Services had experienced in their work with students and staff, and explores the impact that these changes have had on the role of their services within their institutions. Summary of Methods Used
Findings: There was a response of 60% to the questionnaire. The findings demonstrate a growing participation in a tremendous range of roles that are rarely recognised formally by universities, including staff development, training, teaching, staff consultation, staff counselling, committee and working party attendance, and other university-wide initiatives, as well as attendance at external groups and organisations. Insight was also gained into the process of working together on a joint doctorate, an experience that gave rise to more than the sum of two individual minds, but shaped a third dimension of creativity in the development of our doctoral project. Conclusion: The different roles that Heads of Counselling Services identified show the remarkable range of activities engaged in by University Counselling Services all over the UK, as well as the one-to-one counselling that services offer to students. The results of the questionnaires, with the case-studies, will eventually be presented in the form of a documentary film, which will demonstrate the needs of today's university students and the widening roles taken on by University counselling Services, to meet the emotional and psychological needs of students and staff, while supporting the mental wellbeing of the university community as a whole. Professional
Role: Senior Psychologist ABSTRACT: Paper and Poster Empirically Supported Computerised CBT: Efficacy, Effectiveness And Change Mechanisms Aim: Cognitive Behavioural Therapy (CBT) is recognised as a treatment of choice for anxiety and depression. However, delivered in its usual one-to-one, face-to-face manner, CBT is expensive and its availability is limited and inequitably distributed. Beating the Blues, a computerised CBT programme for anxiety and depression, is an innovative solution to this problem. Delivered in eight weekly sessions as a stand-alone programme Beating the Blues requires minimal clinical supervision and can be delivered in primary care. This paper presents empirical support for the use of Beating the Blues in primary care settings. Method: In a randomised controlled trial, patients suffering from anxiety and/or depression who received Beating the Blues showed significantly greater improvements in depression and anxiety compared to treatment as usual, improvements which were retained, undiminished at 6-months follow-up. Symptom reduction was paralleled by significant and enduring improvements in work and social adjustment. Findings: Early findings from an open trial in primary care indicate that benefits established by randomised controlled trial appear to translate into worthwhile effectiveness in routine practice settings. Change mechanisms in computerised CBT are also explored drawing on analysis of session-by-session ratings of anxiety and depression. Conclusions: These results demonstrate that computerised, interactive, multimedia CBT under minimal clinical supervision is feasible and acceptable in primary care. Beating the Blues adds significantly to short-term and long-term symptomatic improvement and to work and social adjustment. These findings permit, via computerised CBT, wider dissemination of effective psychotherapies for patients suffering from anxiety and/or depression. Computerised CBT can play an important part in meeting unmet need for psychological help in primary care, freeing counsellors and psychotherapists working face-to-face with clients to focus on those clients for whom computerised therapy of this kind may prove insufficient. KHATIDJA CHANTLER and SOPHIE SMAILES Professional
Role: (KC) Independent Researcher, Counsellor and Supervisor Professional
Role: (SS) Lecturer and Counsellor ABSTRACT: Paper Acknowledging, Negotiating and Working with Difference: Domestic Violence and Minoritisation Aims of the Study This study seeks to identify, model and evaluate support for South Asian, African-Caribbean, Irish and Jewish women escaping domestic violence. As abuse features heavily in what clients bring to counselling, our study helps to increase understanding of the multi-dimensional nature of abuse by both exploring the common experiences of women, as well as highlighting the racialised dimensions of abuse which are rarely acknowledged. Summary of Methods Used The study is jointly funded by the European Social Fund and the Manchester Metropolitan University and is based in the Women's Studies Research Centre. It is an 11month study, being conducted by a culturally diverse group, due for completion in July 2002. The approach used is qualitative and has three phases:
Process, Findings and Implications The culturally diverse group, in which we work seeks to make explicit, and to explore, issues of diversity both within the research group and with research participants. Our work as person centred counsellors partly informs this process and parallel processes have surfaced which are relevant to our practice. Significant themes have already emerged which present challenges to 'working together'. These include issues of 'cultural' matching, both within the research process and as signifiers for practice, how the wider political context impacts on what can be told and heard, and the interfaces between culture, class, gender and abuse. Professional
Role: Counsellor ABSTRACT: Paper Work Related Post-Traumatic Stress in Nurses AIM: The aim of the study was to determine the level of symptoms of post-traumatic stress in nurses using the RCN Counselling Service where bullying at work is a factor. The study was conducted among clients undertaking counselling at the RCN's Belfast office by the RCN Northern Ireland Board counsellor, Karen Doherty. METHOD: Trauma levels were assessed using a standard inventory validated in disaster and combat situations. (the Hammarberg PENN Inventory). Trauma levels were compared for individuals before and after counselling, at six months plus and against a control group. The counselling method used was Cognitive Behavioural counselling which research has shown is the most effective therapy for trauma victims. Trauma symptoms were assessed against DSM IV criteria. In depth semi-structured counselling interviews were used to check for all possible sources of trauma past or present. FINDINGS Phase one study n = 16 16 subjects were identified with PTSD symptoms during the study period. This represented 30% of clients seen at the centre during the year. Hammarberg PENN Inventory scores for this group were well above the 35 threshold predictive of a diagnosis of PTSD (mean 50.4, SD 8.45). Phase two study n = 41 41 subjects were identified with PTSD during the study period. PENN Inventory scores for this group were well above the 35 threshold. The same 41 subjects were also identified as being in a clinical population using the CORE-OM. Most scores had reduced by end of counselling and by six months + only two subjects scored above the CORE clinical threshold of 1.29 and the PENN threshold of 35 Conclusions This study has shown that the PENN inventory is a reliable tool for rapidly identifying those with PTSD symptoms resulting from work-related trauma. Analysis of CORE data shows that the majority clients moved from a clinical to non-clinical population, using the standard CORE benchmark. However, analysis of data from the RCN's Working Well initiative, which included CORE-OM, suggests that the threshold of 1.29 is too high for nurses. In that survey, 50% of the nurses undergoing counselling scored lower than 1.29 (actually scored over 1.1), meaning they would have been missed if the CORE scores were the only method of assessment in the selection process. More research needs to be done in this area, possibly taking different professional groups into account. Professional
Role: Professor of Psychology and Director of the Centre for the Study
of Experiential Psychotherapy. ABSTRACT: Plenum Paper 'Evaluating the Effectiveness of Therapy in your own Practice: Hermeneutic Single Case Efficacy Design' Several writers have recently proposed expanded single case quasi-experimental designs that are not tied to behaviourist assumptions about psychotherapy or counseling. These include Fishman's (1999) "pragmatic case study design," Schneider's (1999) "multiple-case depth research," Bohart's (2000) qualitative adjudicational design, and Elliott's (2002) "hermeneutic single case efficacy design" (HSCED). These designs overlap substantially, and all take an interpretive approach to examining client change and its causes. They investigate two knowledge claims: (a) that the client actually changed, and (b) that therapy was responsible for client change. In this presentation, I outline one of these approaches, Hermeneutic Single Case Efficacy Design (HSCED). HSCED uses a mixture of quantitative and qualitative methods to create a network of evidence that first identifies direct demonstrations of causal links between therapy process and outcome, and then evaluates plausible nontherapy explanations for apparent change in therapy, including nonimprovement, statistical artifacts, relational artifacts, client expectations, self-correction, extra-therapy events, psychobiological factors, and reactive effects of research I illustrate the method with clinical data, and discuss key issues such generalizability and using systematic, quasi-judicial processes to evaluate inferences. Bohart, A.C. (June, 2000). A qualitative "adjudicational" model for assessing psychotherapy outcome. Paper presented at meeting of Society for Psychotherapy Research, Chicago, IL. Elliott, R. (2002). Hermeneutic Single Case Efficacy Design. Psychotherapy Research, 12, 1-20. Fishman, D.B. (1999). The case for pragmatic psychology. New York: New York University Press. Schneider, K.J. (1999). Multiple-case depth research. Journal of Clinical Psychology, 55, 1531-1540. Professional
Role: Lecturer/counsellor/supervisor/researcher ABSTRACT: Workshop 1 Writing For Publication In CPR Journal As the newly appointed assistant editor of CPR I shall facilitate a workshop offering a forum for discussion about how to get a paper published in CPR. I will invite participants to explore the meanings of 'context', 'reflexivity' and 'creative and engaging writing'. Participants will be invited into group discussion about their hopes, fears and expectations about submitting a paper and published authors will be encouraged to offer insights from their own experiences. The process will be explained from submission to publication so that intending authors can be as informed as possible before taking the plunge. Life belts and water wings will be on hand! Professional
Role: Lecturer/counsellor/supervisor/researcher ABSTRACT: Workshop 2 Editing A Book as Narrative Research Methodology This workshop aims to examine the idea of editing a book as a narrative research methodology. I will base the workshop around the learning I have gained through producing two edited books in the last 12 months: 'Counsellors in Health Settings' and 'Rehabilitation Counselling in Physical and Mental Health'. Each of these books is an overall narrative that contains many stories written by individual storytellers. These storytellers write from a personal position that is reflexive and contextualised. I intend to draw parallels between my work in editing these books and undertaking research. The processes overlap in many ways that might not have been recognised or articulated. Many people who edit books would not describe themselves as researchers, something I would dispute. The workshop will provide an opportunity for people who are interested in knowing more about editing books to discuss their ideas and questions - as well as debating the issue of editing a book as a research method. Practical information can be shared and discussion of ethical issues that arise in this kind of work will be highlighted. Authors: Beverley Flitton and Professor Julia Buckroyd Professional
Role: School Counsellor ABSTRACT: Paper (Note: the article to which this abstract belongs will be published in EBD 7(3) Journal) Exploring The Effects of a Fourteen-Week Person Centred Counselling Intervention With Learning Disabled Children Nationally it has been recognised that learning disabled young people may be at risk of developing mental health problems. The Foundation for people with Learning Disabilities has launched a one-year enquiry into meeting the mental health needs of this group. Additionally, with the introduction of the Special Needs and Disability Act 2001, there is a need to ensure equal access to services for learning disabled young people. If this is to happen then a model for access and the effects of counselling has to be thoroughly researched and presented. The aim of the study described here was to explore the effects of a person centred counselling intervention on the learning disabled child's self-concept. The participants were pupils who attended a London Borough school for Moderate Learning Difficulties. The head teacher selected participants who he thought might benefit from counselling. The study is qualitative and incorporates two parts:
This study used a projective technique to measure the child's self-concept. As a way of overcoming inherent speech and language difficulties and anxieties about self-expression, person centred art therapy was used as an adjunct to counselling. The study indicates that three out of four pupils demonstrated an improved self-concept. However, only one out of four teachers' questionnaires indicated a positive movement within the child. A more extensive project is required to substantiate the findings of this pilot study. The research has been documented and the results will be published later this year. The Diana, Princess of Wales Memorial Trust has recently awarded funds to the University of Hertfordshire to replicate and extend upon this work. Professional
Role: Counsellor/Psychotherapist ABSTRACT: Paper The Phenomenon of Love As The Key Agent For Change Within The Therapeutic Relationship The aim of this research was to study three specific things:
To obtain the information required, eight therapists were interviewed from different approaches and backgrounds. Therapists were chosen at random, once their theoretical approach had been established. The research was conducted using a qualitative, phenomenological approach following the heuristic process of data collection and analysis as developed by Moustakas. The research question was also posed on the BACP research noticeboard. This realised over a dozen responses. The results of this research showed a general support of the first two questions. All participants (interviewees and respondents) identified the therapeutic agent of change as 'love', and the absence of adequate love as the cause of their dis-ease. Regarding the third part of the question, the therapeutic relationship itself, participants identified the qualities, or aspects, of love as: Acceptance
- (unconditional) 8 out of 8 Reasons
for dis-ease: The literature
search provided similar results: Professional
Role: Nurse Lecturer ABSTRACT: Paper An Exploration of The Person-Centred Process Within A Multi-Disciplinary Cardiac Rehabilitation Programme Aim: To identify the phenomenon that may influence the counselling process when working with patients during a rehabilitation programme. Methods: A review of the literature revealed that the conceptual understanding of person-centred counselling process within a multi-disciplinary cardiac rehabilitation team was limited. The study described here drew on a grounded theory approach (Strauss and Corbin, 1990) in order to determine those phenomenon that could influence the counselling process when working with participants of an 8 week cardiac rehabilitation programme. The 18 month study involved the counsellor working with up to 6 clients per week (no. of sessions 1-26). The data was collated from: the counsellor's personal diary; records of individual and group supervision sessions; records of meetings with the multi-disciplinary team. The limitations of the study include issues related to its lack of eligibility, however, it has provided insights that could lead to work that may verify the findings. It also raises issues around the value of counselling within the sphere of rehabilitation. Summary: The organisation of the multi-disciplinary team, and, the counsellor's anxiety influenced the engagement of the client in the therapeutic process. Collusive elements identified within the counselling process that had an adverse effect of the relational depth of the process. There were limitations in assessing the effectiveness of counselling within the context of a cardiac rehabilitation programme. Conclusions: Up to 35% of people who have a heart attack each year are diagnosed as suffering from mental illness, often anxiety and depression (Jones and West, 1995; American Association of Cardiovascular & Pulmonary Rehabilitation, 1995; Thomas, 1995; Crowe, et. al. 1996; Department of Health 2000). However a review of the literature revealed a lack of conceptual understanding of how the counselling process could be used with these patients. The difficulty in evaluating the effectiveness of counselling in cardiac rehabilitation has implications for working within this sphere of health care. References: American Association of Cardiovascular & Pulmonary Rehabilitation (1995). Guidelines for cardiac rehabilitation and secondary prevention programs. 3rd ed. Human Kinetics. Champaign. Crowe, J. M. Runios, J. Ebbesen, L. S. Oldrdge, N. B. Streiner, D. L. (1996) Anxiety and depression after acute myocardial infarction. Heart and Lung. March/April pg. 98-107. Department of Health, (2000) Coronary Heart Disease National Service Framework. London. Jones and West (1995) Cardiac Rehabilitation. BMJ Publishing Group London. Strauss, A. L. and Corbin, J. (1990) Basics of qualitative research; grounded theory procedures and techniques. Sage publications Inc. London. Thomas, J. J. (1995) Reducing anxiety during phase 1 cardiac rehabilitation. Journal of Psychosomatic research. vol. 39. no. 3. 295-304. Professional
Role: Lecturer in Psychology ABSTRACT: Paper Men's Talk about Food and Guilt: A Discourse Analysis Presentation Aim: To identify and discuss a study of men's talk about food and guilt in relation to its implications for therapists. Methods: The paper is based on a doctoral study employing a discursive analytic methodology. Eight men were interviewed in-depth about their approach to food and eating four times over the period of a year. The results were analysed using a hybridised form of the discursive action model (DAM), which focused on the 'actions' performed by speakers in talk. In this paper, the discursive actions performed by men when talking about food and guilt will be considered Summary of Findings: A number of discursive strategies are employed by men to deny or downplay guilt in relation to food and eating. It will be argued that these strategies are a product of the social construction of food-related guilt as potentially indicative of a problematic approach to eating. Problems with eating are commonly associated with women and may also imply a lack of control in relation to food. It will be suggested that these associations may constitute an interactional dilemma for men in managing identity concerns while at the same time presenting difficulties with eating and food. Awareness of this dilemma may enable therapists and referral agencies to engage more effectively - particularly at the early stages of any intervention - with men experiencing difficulties with food. Conclusions: It will be argued that the presentation of food and eating as a concern by men must be viewed in the context of a number of cultural constructions relating to gender and identity. Questions will be raised with regards to the possible effects of therapeutic collusion with such constructions and their relationship to food and eating. Professional
Role: Head of the Multi-agency Behaviour Support Team (MABST) Abstract: Paper Effective Practice In Behaviour Support The purpose of this doctoral research, which employed a comparative case study approach, was to examine the way successful behaviour practitioners conceptualised their role and competence base, and the principles and values associated with effective practice. It represents practitioner research in the sense that the researcher worked as a behaviour support teacher and service manager throughout the course of research. However she did not study her own work or service, but a range of behaviour support services, which were able to provide evidence of their effectiveness. All services worked in the school context, but differed in relation to size, socio-economic context, model of work and other variables. A variety of methods were used to collect a chain of data with a bearing on these issues, including interviews employing "hierarchical focusing" and "personal construct" methodologies providing the core data. Analysis of each case was "grounded" in the data, and the presentation of the successive cases in the dissertation builds a substantial evidence base for the findings and conclusions of the research, which represent the most general and substantive themes to emerge, irrespective of key variables. The findings provide first of all a detailed description of the professional role, core activities and competence base supporting effective practice. All services had core process models, seen as "the way we work here," and informed by psychological, counselling and educational models. They suggest that successful practitioners worked not only in, but also with context, building adult partnership providing adult partners with that which was necessary and sufficient to meet the needs of vulnerable children. Hence, all identified counselling skills as fundamental to their work, as well as a range of knowledge and skills embedded in but additional to those of competent teachers. They developed their specific expertise largely through in-service training and professional support structures, which emphasised collegiality and reflective learning. These findings provide an original theoretical model for behaviour support, in which core aims, activities and professional development of behaviour support teachers is underpinned by a system of values reflected both in the casework and in-service context, and derived from the common experience of negative features, which characterise "the situation we're dealing with," "what needs to be done, " and "what we need to do it." These findings and conclusions have had important implications for the researcher, informing her ongoing work as the leader of a large multidisciplinary team, and as a key contributor to LEA policy in Tower Hamlets. They also have original and important implications for the development of policy and practice in behaviour support, for the professionalisation of the behaviour support role, and the development of appropriate training frameworks. Professional
Role: Research Development Managers ABSTRACT: Poster The Character of Counsellors: Initial Findings From The BACP Membership Survey Aim The aim of this survey was to gather information to characterise the BACP membership according to key factors of importance in the current climate, especially with regard to the forthcoming statutory regulations. Design After consultations and piloting, the questionnaire was distributed with the October issue of CPJ to all our members. A database and counts reports supplied by a Data Capture Company was analysed by the BACP Research Department. Findings It was found that most counsellors are experienced at their work, a relatively highly qualified group with a clear, well established commitment to CPD and that nearly half of those respondents who were not accredited are eligible for accreditation with BACP. BACP members are also clearly a diverse group representing a vast range of models in their training. Follow-up In response to the questions whether the received sample (response-rate 20%) is representative of the total BACP population a follow up survey on a random sample of the whole individual membership is underway. Conclusion The results are encouraging as they show high levels of qualifications amongst BACP members and suggest that BACP and its membership will be in a strong position with regard to possible forthcoming statutory regulations of the profession. Professional
Role: Research Development Manager and Honorary Research Fellow, Strathclyde
University ABSTRACT: Workshop Getting Funding for Research The purpose of this workshop is generate information on useful tips and methods for identifying the best sources of funding for research for those wishing to apply for funding for research projects from small scale practitioner based studies to large scale projects requiring large amounts of money. As opposed to concentrating on fixed formulae for success or derivative "expert opinion", the workshop will draw upon the knowledge, experience, resources and creative suggestions of the participants. Those with direct experience of any aspect of the research funding process will therefore be especially welcome. Questions to be considered may include:
The workshop will allow maximum time for input and discussion from delegates. A brief presentation to raise some issues of importance will be followed by debate and discussion. The results of this workshop will be used to directly influence the work of BACP and may be made available to those wishing to apply for research funding. Professional
Role: Lecturer and Course Leader MSc Counselling in Healthcare and
Rehabilitation ABSTRACT: Paper Testimony as a Form of Remembrance This paper presents the initial findings of a study exploring the psychological process of giving a testimony. Several archives in the USA, Israel, Germany and the UK have recognised the value of testimony, primarily as a means to record, and communicate recent history. However the experience of giving a testimony for the testifier has been neglected. Twelve survivors of the Holocaust, who have given one or more testimonies, are being interviewed in order to understand the extent to which giving a testimony is a healing process. The transcribed interviews are analysed by the use of case-study and narrative analysis. Field notes and the researcher's personal journal also contribute to the data. The relationship between being a researcher and being a psychotherapist is considered. Issues arising for the participants are discussed. These include: the drive to tell 'the story', the impossibility of describing the 'undescribable', the fear of not being believed, the nature of memory, re-unifying identity, relationship to family and friends and the context of later life. It is hoped that the outcomes of the study will provide insights into the ways of working therapeutically with people who have long-term traumatic memories, as well as an increased understanding of the testimony process. Professional
Role: Supervisor ABSTRACT: Paper Therapeutic Help for Troubled Same Sex Relationships Overall Aim of Study This study aimed to learn more about how to support and help same sex couples therapeutically through listening to the experiences of gay men and lesbians. Summary of Method Qualitative data was collected from single sex focus groups (six men and nine women) that each met twice. An initial broad question was used asking the group to reflect on issues that had arisen in their relationships and what had been or might be therapeutic. Focus groups offer opportunities to develop ideas and themes that might not occur in individual interviews and different themes emerged in the two gender groups. The data was analysed using the constant-comparative method and the emerging themes used as the basis for writing up this research. Summary of Findings
Conclusions
Professional
Role: Lecturer in Counselling and Human Relations ABSTRACT: Paper A Systematic Scoping Review of Counselling Children and Young People - What Works and What Is Further Needed? This presentation will consider the results of a research review of counselling young people and children. This review has been carried out by the University of Nottingham, Centre for the Study of Human Relations. The review considers the majority of English language empirically based research publications of counselling and psychotherapy addressing a wide range of direct work with child and young people as recipients of individual and group counselling and psychotherapy across a range of therapeutic modalities, participation settings and research methodologies. The need for further empirically based research is discussed in order to advance the relevance of counselling in addressing children's emotional, social and behavioural needs and improve the status of counselling as a relevant, effective and research evidence based intervention with children and young people. Professional
Role: Director, Centre for Counselling and Psychotherapy Education ABSTRACT: Paper A Transpersonal View of Guiding Voices New research into the differences between Guiding Inner Voices and Hallucinatory Inner Voices is presented. Two clinical examples are discussed in which the voices which appeared in the early stages of psychosis later transformed to become voices of inner guidance when the client achieved a state of psychological balance. In both cases the guiding voices have remained supportive as the client's psychological health has improved. It is suggested that intuition, which usually offers guidance in people's lives, can in the case of a mystical experience speak aloud so as to be heard by the person consciously, and in the case of psychosis can fragment into several voices which express intuition in a distorted or delusory way, thereby misguiding the person. A continuum of consciousness model is used to explain the various inner states experienced, from hallucinatory voices to guiding inner voices. Co-presenter: CHRISTINA LYONS Principal Lecturer UCLAN Co-author DEBBIE KNOTT Senior Lecturer UCLAN Professional
Role: Principal Lecturer/Divisional Leader for Mental Health ABSTRACT: Paper An Evaluation Study Reporting The Experiences of Clinical Supervision by Prison Officers Working with Inmates with Mental Health Problems Following a health care needs assessment in local prisons, 90% of prisoners were reported to be experiencing mental health problems (Church & Fleeman 2000). A subsequent local survey 'Closed Doors, Open Minds', recommended that specialist mental health care be available throughout the prison (Bullivant et al 2000). This precipitated the development of a therapeutic skills course. The complex nature of prison culture and the need for on-going support for prison officers during and following course completion was identified, involving a collaborative venture between mental heath nursing lecturers at Liverpool John Moores University, the Liverpool Criminal Justice Liason Service and the Secure Commissioning Team and four local prisons. This paper aims to outline the use of clinical supervision by mental health nurses with prison officers as a means of training, development and ongoing support for working with people with mental health problems. The seven stage framework is described. Small group supervision within three groups within the university setting were facilitated by mental health nurse lecturers with prison officers gradually assuming more responsibility for their peers learning. These first three stages of this framework were evaluated by the prison officers using a 'talking walls' exercise. A summary of audio-recordings of the nurse lecturer's experience as supervisors is also included. Subsequent stages of the framework planned for the future are outlined involving the continuation of clinical supervision of prison officers within their own respective prisons after the course has been completed and involvement of specialist mental health nurses to assume the role of supervisors. It is anticipated that the first cohort of prison officers will eventually supervise their peers who undertake the next course in an effort to cascade training and supervision throughout the four prisons. Flow diagram outlining the framework using ¯ Prison officers develop skills in reflection through attending module on experiential learning ¯ Prison officers engage in three small groups of supervision using Driscoll's structured model of reflection facilitated by nursing lecturers in the university ¯ Prison officers gradually assume more responsibility and facilitate the three small supervision groups supported by nursing lecturers in the university ¯ On completion of the course four small groups of supervision are self-facilitated by the prison officers in their respective prisons supported by nursing lecturers ¯ Clinical nurses are selected and prepared for assuming the role of clinical supervisor ¯ Four small groups of supervision continue within respective prisons self facilitated and supported by clinical nurses ¯ Prison officers having completed the course to assume role of small group supervisor of other prison officers supervised by clinical nursing supervisors Authors: Olga Herrero (presenter), Lluis Botella, Begoña Jiménes, Glòria Poch (Ramon Llull University, Barcelona, Spain) Professional
Role: Psychotherapist ABSTRACT: Poster Clients: Voices About Meaningful and Not Meaningful Events In Psychotherapy Groups: A Grounded Theory Analysis Abstract: In this poster, we present what clients have to say about change and meaningful events (or not meaningful ones) in psychotherapy groups. The present study is based on the idea that clients' theories about what is helpful and unhelpful in therapy are also relevant to its course. For this reason, we discuss a qualitative analysis of helpful and unhelpful events in constructivist/narrative psychotherapy groups and, in particular, with breast cancer patients. Our sample is made up of 40 participants in three different therapy groups, which lasted for ten weekly sessions. After each session in every group, clients were asked to write about helpful and unhelpful events in that particular session. Once events were recalled, they were coded and analyzed following a grounded theory methodology. Keywords: Grounded Theory Methodology, Meaningful and Not Meaningful Events, Psychotherapy Groups, Breast Cancer Patients. Professional
Role: Lecturer in Counselling ABSTRACT: Paper Training Together: The Role of Community Meetings on Counsellor Training Courses This study explores the community meeting on BACP accredited counsellor training courses. The requirement for courses to hold such meetings, combined with a paucity of guidance as to their purpose, can place counsellor trainers in the dilemma of having to hold meetings, the function of which they themselves may not fully understand. The study attempts to elucidate this dilemma by gathering together the best information available from counsellor trainers across the country. Using questionnaires to survey by post trainers on 56 BACP accredited training courses, in January 2000, the study elicits background information about trainers, courses and the organisation of community time, along with more complex opinions relating to the meaning and purpose of community meetings. Data generated includes both descriptive statistics and written text, which are analysed by a combination of quantitative and qualitative methods. Possible links between the nature of the course and the implementation of community time are explored, as are links between core model and explanations of community group process. A variety of theoretical approaches to community are reviewed including sociological, group analytical, therapeutic community, median group and counsellor training perspectives. The applicability of psychotherapeutic theory derived from psychiatric settings to community groups on counsellor training courses is questioned. The need for a much clearer definition of community is recognised and a tentative, trans-theoretical description of community group process is posited, which, in turn, requires further research. Professional
Role: Psychotherapist ABSTRACT: Paper Heart To Heart - Working With Heart Transplantation The prime coping strategies utilised by heart transplant recipients when dealing with the physical and emotional aspects of transplantation are denial, partial denial, acceptance and external emotional support. The aim of this study was to identify:
Ten heart transplant recipients were seen over a period of six years. The duration of therapy ranged from three weeks to over three years. Most sessions were an hour duration, although this varied from twenty minutes to over two hours depending upon the health of the patient. All sessions were held on the hospital premises, with the majority of patients seen on the ward. My model of working was primarily existential, suiting the immediacy of my clients' life/death situations. Lack of referrals resulted in a small number of patients. This is partly due to the lack of awareness of the therapists being part of the transplant team. However newer clinicians and nurses are increasingly aware of the therapist role and are working towards a more cohesive team. The active co-operation of the patients has always been a major strength of this study. For the future there will be an increase in:
This study demonstrated the spontaneous use of the range of coping strategies with partial denial being utilised by the majority. All patients expressed a desire for long-term emotional support. Expressing that emotional support lessened the feelings of being alone and afraid, reduced the stress associated with rejection and medication issues, hence enhanced their quality of life and possibly survival. Building closer working relationships between all members of the transplant team, patients/clinicians/nurses/therapists would enhance the quality of life for both patients and staff. Professional
Role: Lecturer in Counselling ABSTRACT: Paper Collaborative Process Research Project: The Experience of Loss in Childhood Aim: This paper will report on the progress of a study, which aims to learn more about the process of loss experience in childhood Method: Co-operative inquiry - in this model of research the group carrying out Person-centred inquiry people involved with children experiencing loss, either as carers, counsellors, other professionals and adults who have experienced loss as a child. In the group the inquirers engage in reflection as co-researchers and are also active as co0subjects. The group uses reflection and action to refine and deepen each other. The aim for all participants to be fully involved as possible, both in the content and in the method of inquiry. There is epistemic participation i.e. this is to do with the relationship between knower and the known. The researchers as knowers participate and get involved as subjects in the experiences that are to be known and that are the focus of the inquiry. There is also political participation i.e. to do with the relation between people in the inquiry and the decisions that affect them. The subjects, those who provide information about themselves, also participate as researchers in the thinking and decision making that generates, manages and draws knowledge from the whole research process. 'Propositions about human experience that are the outcome of the research are of questionable validity if they are not grounded in the researcher's experienceÞ..This rigour is called for by the human sensibilities, in a relation of reciprocal participation and dialogue with others similarly engaged.' (*Heron, 1996 p21.) With this in mind the group works as an experiential, intersubjective culture, using language. The researchers share a nonlinquistic understanding of their being in the world, generated through empathic resonance with each other's livid experience. Findings: Not available yet Conclusions: Not available yet Heron J (1966) Co-operative Inquiry - Research into the Human Condition, London, Sage Professional
Role: Health Researcher ABSTRACT: Poster The First Two Years Experience of Child Bereavement Support Posts In 1997 The Child Bereavement Trust (CBT) won a Department of Health grant to establish eight new Bereavement Support posts around the country, based on three model posts, including that of Jenni Thomas, Founder and Chief Executive of CBT. The evaluation used in-depth interviews with postholders and their managers and analysis of diaries kept by the postholders. An questionnaire was completed anonymously by 184 staff whose work was affected by one of the new posts. 15% of the staff who returned such questionnaires had attended a CBT course run in-house, arranged by the postholder and these courses were also studied using questionnaires. The evaluation of the new posts showed that both formal counselling for families, and informal support and training for staff in the relevant clinical areas, were proving valuable. Managers gave strong anecdotal evidence of the benefits to parents, and 70% of other staff reported that the post holder's work had positively affected how they care for families. Professional
Role: University Lecturer ABSTRACT: Poster Some Benefits Experienced by Hospice Nurses from Group Clinical Supervision A small clinical supervision group consisting of five hospice nurses met together in their workplace one hour weekly for twelve weeks. Issues concerning professional practice were examined with the help of a researcher (AJ) who acted as facilitator. At the end of the group's life AJ asked all nurses to complete a modified Q-sort in the form of a questionnaire related to the workplace and twelve identified helpful factors (Yalom, 1975). Two weeks later the hospice nurses were interviewed in group format and asked to consider the reasons for their choice of answers. The data revealed that collectively - Interpersonal Learning (Output), Identification, Catharsis, Family re-enactment, Group Cohesiveness and Self-understanding were experienced by the hospice nurses as the most helpful factors to the group. Existential factors, Guidance, Universality, Interpersonal Learning (Input), Instillation of Hope and Altruism were identified as less important. Variations in individual responses showed different ways in which a group might meet the needs of its members. The study concludes with the suggestion that work discussion groups can offer nurses the means to calm, regulate and plan their interactions with themselves and others. Clinical supervision is an effective format for exploring issues concerning professional practice allowing nurses to learn from each other, offer support, recognise how others see and esteem them as fellow workers and moderate concerns and anxiety related to their work. Group work is likely to raise anxiety in all participants however and preparation and support are required for the group facilitator. Carefully chosen membership is also considered important to the safety of members and successes of the group. (Yalom, I.V. (1975) The Theory and Practice of Group Psychotherapy. New York, Basic Books.) Professional
Role: Head of College Counselling Service & Private Practitioner ABSTRACT: Paper An Evaluative Inquiry into The Setting Up and Management of a University Counselling Service The aim of this qualitative study is to carry out an evaluative inquiry into the Setting-Up and Management of a University Counselling Service. Moustakas' (1994) qualitative 'heuristic inquiry' was the social-scientific methodology used in this project. The main sources of data were: (i) qualitative data, (ii) autobiographical material gathered from deep levels of personal inquiry, (iii) analysis, (iv) self-dialogue through a process of self-interviews and (v) semi-structured collaborative interviews with the other co-participants. A two-way process examined the phenomena within the inquiry:
Five core themes were originally identified:
The analysis and subsequent results indicated further emergent sub-themes, which offered additional material drawn from the above categories. Appropriate checklists were drawn up to demonstrate the findings gathered from the collated experiences and shared opinions of all participants. It is considered that these findings will make a difference not only to the narrator but also to other practitioners, if presented with a similar challenge of setting-up and managing a university counselling service. Ultimately, these findings provide the possibility of enhancing academic pursuit as the provision of supporting the psychological and personal development of university students is enhanced. This project is designed to provide three separate products - academic papers, conference presentations and training days - each designed to impact the wider community of counselling and psychotherapy. Moustakas, C (1994), Phenomenological Research Methods, London: Sage. Professional
Role: Senior Lecturer/Cognitive Behaviour Therapist ABSTRACT: Paper A Partnership Approach To Working Together: Core Tasks Of Psychotherapy Aim: Factors influencing the effectiveness of psychotherapy Summary of method: Literature review Summary of findings: Core tasks essential for working together Conclusion: How therapists and clients work together in the implementation of these core tasks. Literature review shows that successful therapeutic change is closely related to the partnership of therapists and clients working together. The state of the art that involves the therapist and client working together is crucial if one wants to be successful at cultivating clients awareness of their problems; instilling clients' confidence in the change process; and sustaining therapeutic gains. This paper will examine the core tasks in the partnership approach of the therapeutic process that apply across different psychotherapeutic approaches. Among the core tasks to be considered as important in the literature review are developing therapeutic alliance and engaging clients; educating clients; nurturing hope; teaching client skills; collaboratively working with clients to identify possible internal and external barriers to change; ensuring the clients accept and take credit for change; and conducting relapse prevention. An additional core set of the therapeutic tasks has been identified for patients who have had a history of, or who are experiencing victimisation. These include helping clients understand and manage traumatic stress; cultivate meaning to their traumatic experiences; work back to normalisation. A formulation model that guides assessment, treatment planning and implementation will be considered. This paper will also examine the mechanisms of change underpinning the model and provide examples on how these core tasks can be implemented. Professional
Role: Counsellor and research student ABSTRACT: Poster Client Perceptions of Counselling: Before, During and After Aims There has been relatively little work done on client perception. I believe there is a real need for a study that focuses fully on the client's initial perception of counselling and how these perceptions evolve as the therapeutic process develops and reaches completion. The purpose of the study is to
Method This is the first year of a three year PhD study at Sheffield Hallam University. The research is informed by methods within hermeneutic inquiry using semi-structured one-to-one interviews (18 in total) and case study I am focussing on two user groups from each of the following areas Educational support in HE: Liverpool University and University of East Anglia Primary care: GP practice in Liverpool suburb and rural area of Norfolk Voluntary sector: Liverpool and Norwich Findings I am currently carrying out interviews amongst the general public and in the HE student counselling sector, and have findings to present in poster form in terms of emerging themes or influences on pre -counselling perceptions such as socio-economic background, age, attitude/philosophy of life, rural/urban life style My reading of the range of published works of clients' perceptions of therapy reveals issues of transference/dependence, helplessness/powerlessness, therapy as destructive, therapy as healing But it is still 'early days'. Professional
Role: (DL) Head of Professional Development Foundation ABSTRACT: Workshop Case Formulation Models In Working With Children Case Formulation models as gradually influencing clinical and counselling practice. This paper will briefly look at the origins of case formulation models and contrast them with diagnostic models on clinical and counselling practice. The Case Formulation approach has had most impact on behavioural and cognitive approaches to counselling. However, inherent in the model is more theoretically inclusive framework. A variety of perspectives might e used to understand the client. A framework for case formulation will be outlined and participants asked to reflect on their own approach to the tasks that case formulation presents. A Case study will be used to illustrate the issues. Case formulation models build unique theoretical explanations for each client based on the context within which their issues are presented. It has a value beyond its CBT origins. The presenters draw upon a combined experience of fifty years in developing and researching these approaches. Professional
Role: Head of Professional Development Foundation ABSTRACT: Children with Behaviour Problems in Schools Practitioner led research offers an alternative perspective. Much research on children services has addressed concerns that do not necessarily assist practice development. The research presented in this paper looks at a twenty year study that was formed on the basis of practitioners looking at their practice and devising a range of approaches to address concerns. It indicates that traditional predictors of difficulties in childhood do not help us to understand change. The findings from the research indicate that effective programmes have long term impacts. By adopting a research perspective our practice is improved and services to clients made more useful. The paper will provide an opportunity for discussion of both the findings and the issues affecting practitioner researchers. Professional
Role: Counsellor/Therapist ABSTRACT: Paper Working Together to Increase our Understanding of What is Helpful in Counselling Adult Survivors of Child Sexual Abuse. Overall Aim of Study This presentation is based on a MSc Research Thesis, carried out by me in 2000, which investigated counsellor perceived helpful and non-helpful critical incidents in counselling adult survivors of child sexual abuse. This study was undertaken because of an identified shortage of research into counselling in this important area. As a counsellor and post-graduate student, I wanted to increase my knowledge of what was helpful, and to share this with other practitioners in community and statutory agencies. Summary of Methods Semi-structured interviews using Critical Incident Technique were carried out with eleven experienced counsellors working Rape Crisis Centres in the Republic of Ireland. The resulting data were categorised using the constant comparative method, and were inductively and deductively analysed. Findings indicated that experienced rape crisis counsellors use a wide range of interventions and techniques grounded in well-established counselling theory and research informing counselling for this client group. The analysis identifies the quality of relationship between counsellor and client as the most important factor distinguishing helpful from non-helpful incidents. Participants emphasised a relationship of safety, trust and collaboration, and of constantly monitoring the pace of interventions. Counsellor self-awareness, and an understanding of the socio-political as well as psychological aspects of child sexual abuse were also emphasised. The strength of a small-scale, descriptive study lies in seeking to shed light on individual experience, therefore one cannot generalise from this study. Also study documents only counsellor perspective. Implications for Future Research/Practice Results from this study could provide a framework for a further study documenting client perceptions. I am currently interested in carrying out such a study. Also, methods used could be replicated in other types of voluntary and statutory agencies, to provide a broader picture of what is helpful and relevant in the complex process of counselling adult survivors of child sexual abuse. How Audience Participation is to be Achieved Short Presentation followed by group discussion. Also possibly linking in with similar/related presentations. Co- Presenter: TIM BOND Professional
Role: (CL) Professor of Counsellor Education ABSTRACT: Paper An Investigation of Counselling Activity in Selected Countries Aim: The aim of this study was to investigate counselling as a process in a number of countries. It examined the kinds of help available to people with specific difficulties. It sought to discern whether the ways of helping include activities that might be thought of as counselling. Method: As a way to discover what forms of help might be available to people in a given country, a series of stressful incidents confronting one family of average income living in a large town were developed into a questionnaire format. Data were collected from sources in 15 countries through interviews at international counselling conferences. Interviews were also conducted in the United Kingdom. United States, Costa Rica, and Malaysia. In addition, questionnaires were sent to experts knowledgeable about social welfare issues in a number of countries. Data were analysed both qualitatively and quantitatively. Findings and Conclusion: It is apparent that as a process counselling is available in a number of countries even if it is known by another name. Across the 15 countries, it is apparent that people have traditional and culture-specific sources of help for problem-resolution and decision-making outside of a context that consists of a trained and credentialed counsellor. The data further indicate that helpers facilitate responses to expressions of need on the part of people being helped and initiate action on behalf of helpees. It is also evident from the findings of this study that helpers across cultures employ a number of facilitative communication skills that promote the helping process. Audience Participation: The presenters of the study will engage the audience in a discussion of reactions to and questions about the methodology, findings and conclusions of this research endeavour. Professional
Role: Lecturer in Occupational Therapy/Lecturer in MSc Counselling
in Healthcare and Rehabilitation/Counsellor ABSTRACT: Paper An Exploration of The Effectiveness of Assertiveness Training For Mental Health Service Users Mental illness can be a very debilitating and damaging force on an individual's appreciation of self, with the consequences that the individual lacks the awareness and resources to identify any personal abilities, skills or means of helping themselves. The individual may feel powerless to bring about any possible or positive change in the lives and the use of Assertiveness training has great potential in redressing the imbalance, by enhancing self-esteem and providing individuals with the knowledge, skills and choices to effect a change. The focus of Community care has also meant much shorter acute psychiatric admissions and the inter-phase between hospital and community is much more crucial and important. The work of mental health professionals in the community has therefore been more focused on enabling and equipping the Service User to manage their illness and maintaining their quality of life. As a consequence of the above factors and a local identified need, the researcher embarked on a comparison study involving (30) participants, 14 intervention and 16 Control. The intervention participants attended a six week course in Assertiveness training, whilst the control group did not receive any form of input. Both groups were assessed through a selection of quantitative and qualitative measures, with the former including Powell's assertiveness Questionnaire, Heatherton State Self-esteem Scale, Locus of control Scale, Task Achievement Scale and the latter consisting of a Post course Feedback Questionnaire and Interview. The quantitative results were analysed using the SPSS program, where both the Mann-Whitney U-Wilcoxon Rank Sum Test and the Spearmen Rank Correlation Test were applied, whilst the qualitative results were analysed through the coding of themes and content analysis. Both sets of results were conclusive in supporting Assertiveness training as being effective in improving levels of Assertiveness, Self-esteem and Locus of Control and Empowerment amongst intervention participants and further derived a significant and positive correlation between all three variables highlighted. The resulting effectiveness and success of the above intervention resulted in the continued provision of Assertiveness training as a valuable therapeutic intervention within the specific Community Mental Health Service. Professional
Role: Health Visitor/Clinical Development Team Leader ABSTRACT: Paper Counselling Skills Underpinning An Individualised Management Programme Increases Mothers' Understanding and Enjoyment of Their Crying Babies Aim To explore both mothers and health visitors' experience of coping with a crying baby. To compare a new individualised evidence based support programme with traditional health visiting. No one successful treatment has been identified to date. Infant / mother attachment is threatened and in the extreme a crying baby is at risk of abuse. This study was an attempt to provide a holistic approach by compiling previous research into a flow chart. Method Combined quantitative and qualitative methodology were used. A quasi-experimental design was used involving two sociodemographically similar health centres. Postnatal mothers with crying babies were recruited, 10 in the control and 9 in the intervention. 15 health visitors were recruited 8 in the control and 7 in the intervention. The Semi- structured questionnaires included standardised scales and rating scales. Intervention The control group received traditional health visiting and the intervention group attended the Crying Baby Clinic staffed by health visitors trained (10 hours) in basic counselling skills and in the management of crying babies using an evidence based individualised management planner. Analysis Quantitative analysis with Cohen's effect size and U measures demonstrated improvement, clinically significant at d= 0.8 U1=46.22% in conjunction with reported or noticeable change. The principal qualitative analytic technique used was content analysis. Results Quantitative: All mothers improved over time in the seven variables but the intervention group demonstrated a greater rate of improvement. Enjoyment of the baby (d= 0.65 U1 = 41.6%) and understanding of the baby 67% (frequency); reduced distress (d=0.4 U1=27.4%) and reduced depression 66% were the most marked differences The intervention health visitors demonstrated clinical significant improvement in all areas; satisfaction with practise U1 = 70.18%, effectiveness U1 = 77.2% and in raised knowledge levels U1 = 66.7%. The control's satisfaction with practice deteriorated Maternal satisfaction with the Crying Baby Clinic was 78%. Conclusion The experience of mothers distressed by their crying babies can be improved by an individualised support programme. Recommendations from the study have already been incorporated into the health visitors packages of care in the above trust. They suggested the programme should be used by each health visitor rather than in a formal clinic setting. ATHENA MAROUDA-CHATJOULIS and ANGELIKI LEONTARY Co-Author: Vasilios Gialamas, Associate Professor, University of Athens Professional
Role: (A Chatjoulis) Social Psychologist, Psychotherapist ANGELIKI LEONTARY Psychologist, Associate Professor, University of Thessally, Greece ABSTRACT: Paper Problem Solving Orientations In Young Adults: The Role Of Attachment. Previous research indicates that individuals with secure attachment organizations report higher levels of relationship satisfaction, more frequent positive emotions, better affect regulation and more compromising and integrating styles of problem solving (Hazan, 1991; Lopez et al., 1997). In the present study our goal was to further understanding of how security feelings are associated with problem solving skills and relationship problem-solving orientations. It is suggested that internal working models would shape individuals' perceptions and experience of their interactions with others and this in turn would influence their problem-solving skills and predispose them to manage interpersonal conflicts constructively or destructively. Participants were 150 young adults with an age range 18-24, who completed self-report measures on attachment styles, problem solving skills and relationship attitudes. Correlational and multiple regression analysis yielded results that were consistent with theoretical expectations. A more secure attachment style in young adults was likely to be significantly related to problem solving skills and interpersonal problem solving strategies. Implications for counseling interventions concerning attachment styles, problem-solving skills and relationship problem solving orientations are discussed. Professional
Role: Therapist in Private Practice ABSTRACT: Paper A Critique of Heuristic Inquiry as Represented by Clark Moustakas The critique briefly describes Moustakas's contribution in terms of its historical and philosophical context and outlines his methodology and gives illustrations from his communicative genre. This critique arose from my own heuristic investigations into the effect of life-events on therapists' lives. I found myself constrained by the following issues:
The paper then describes possible alternative ways of using the form of inquiry for non-phenomenological work. It suggests variations to the methodology and a more bespoke form of communication the synthesis which comes at the end of the inquiry. This is illustrated both from my own research in progress and from other sources including Etherington (2000). It concurs with Denzin N.K. and Lincoln V.S. (eds) (1994) encouragement of the researcher as "bicoleur". This paper is an analysis. It reviews the available literature and the author makes comment in the light of his present research. The goal is to stimulate debate on a more adventurous use of heuristics beyond its established paradigm. The paper concludes with a series of options for the future which, it is hoped will stimulate discussion and cross-fertilisation of ideas. There are exciting possibilities in terms of the relationship between constructivism and constructionism, in the field of auto-ethnography and particularly in the co-construction of narrative, both academically and in the practice of counselling. I contend that heurism belongs to the whole research and practice endeavour, and not put to a particular phenomenological paradigm. References: Denzin N.K. and Lincoln V.S. (eds) (1994). Handbook of Qualitative Research. London: Sage Etherington K. (2000). Narrative Approaches to Working with Adult Male Survivors of sexual abuse. London: Jessica Kingsley Moutakas C. (1990). Heuristic Research. London: Sage. Professional
Role: Psychotherapist/Trainer ABSTRACT: Paper Linking Social History and The Therapeutic Process of Black Issues Background Work as clinical team manager at the African Caribbean Mental Health Association raised two questions.
Aim: I used a questionnaire asking 21 black counsellors and 21 black clients what it meant to receive and offer therapy between black people. (Presented at conference 'Black & White Therapy' Freud Museum 1991) Summary: a) All clients were happier counselling with 'someone like me' and felt they did not have to work so hard to be understood. b) Therapist's training was lacking an acknowledgement of black people's perspectives and experience. Conclusions: Strengths: This gave an answer to question 1. Weaknesses: This did not answer question 2. Follow up research linked to Question 2. Aim: To decipher ways that recovery happens outside of the therapy room. 'Is There a Cathartic Process in the expression of black women's experience through poetry?' (Mckenzie-Mavinga. 1997) Literature research on published writing by and about black women's writing. Summary: a) Themes developed by black women writers often related to identity issues, slavery, colonisation, and migration. b) Repetition, expression and sharing of common themes could be viewed as a form of catharsis. Strengths: Sharing of common issues is important. Weaknesses: There was no way of evidencing whether a therapeutic process had taken place. Further issues for discussion/research writing and other forms of creative expression used to process black issues? What is the role of history in the therapeutic process of black issues? Research in progress is based on the link between history and the therapeutic process of black issues. Aim: to publish questions and answers that assist practitioners to address black issues. Participation will be achieved by presentation and discussion of questions and answers. Professional
Role: Counsellor/Trainer ABSTRACT: Paper Men's Experience of Considering Counselling Aim: Agency Statistics in the UK reveal that fewer men than women attend counselling, ratio of about 1:2. This contrasts with the increasing numbers of men committing suicide, with more than 4 male completed suicides to 1 female completed suicide. When there is such clear evidence of men's distress, how is it that they do not seek help from counselling at the same of increased rate as women? This study aimed to gain further understanding of some of the issues that might be contributing to men's reluctance to seek help, by investigating men's experience of considering counselling, prior to their first session. Method: In the initial phase of the study, 47 men who had considered and ultimately attended counselling, responded to a questionnaire, requesting both quantitative and qualitative data. In the second phase, a sample of 10 men were interviewed regarding their experiences of considering counselling, using a semi-structured interview schedule. A grounded theory method of analysis was used to generate and analyse the participants' experiences. Findings: Three interconnected categories emerged that had impacted on the men's experience of considering counselling: societal perceptions of counselling and gender roles; change of experience over time; and knowledge - 'knowing' and 'not knowing' the protocols and processes of counselling. Cross linked with these themes were the pathways taken by men towards counselling: identifying the problem, help seeking, talking about personal issues and finding a counsellor. The key hurdles experienced by many participants when considering counselling emerged as lack of information and a fear of entering into unacceptable and unknown territory. Conclusions: Specific recommendations are made that emphasise the importance for prospective male clients to be given detailed knowledge of the counselling process prior to the first appointment, and for their to be increased awareness by counsellors and referring agents, of male gender issues. Professional
Role: Special Health Visitor/Homeless/Asylum Seekers/Domestic Violence ABSTRACT: Paper Surviving Dispossession - A Study of Disparate Teams Working Together With Hopelessness The initial aim of the study was to review the coping strategies utilised by various teams working with the homeless and asylum seekers, and explore the use of supervision and de-briefing mechanisms. The research project utilised an hours taped interview, similar in method to an initial counselling interview. The subjects included two specialist social workers, two liaison police officers, two health employees, two workers for one of the charities working with the homeless and a volunteer. The interviews took place over a three month period and the tapes were then transcribed and explored for themes within four areas; self, emotions, family history and career. I had anticipated that each tape would take approximately four hours to transcribe. They took between eight and eighteen hours each. Studying themes took a further eight hours. Findings Similarities in personality types, coping strategies and backgrounds were considered likely. However, although subjects showed some similarities in each area, there were fewer similarities cross-professionally. The differences in supervision were noticeable, both in type and uptake. Generally the teams functioned well together. However, subjects functioned in very different roles and this may have had a direct impact on the results. The only themes across the subject fields examined were the subjects' commitment to the client work, and a general belief that change was possible. However, over the years the subjects tended to become more negative about their roles and exhibited higher levels of burnout. Conclusions The cohort was too large for this type of work, at this level. I gained more information than could be utilised. Similar personality types are not essential for effective teams. The highest level of burnout was exhibited by staff who: 1) Stayed in current employment for many years 2) Had less effective networks outside their work place 3) Did not have access to, or refused supervision 4) Indicated a sense of threat from the system in which they worked. 5) Felt generally unsupported by the management structure 6) Had a more hands-on role. Professional
Role: Counsellor ABSTRACT: Paper NO SEX PLEASE! WE'RE LESBIANS! An Organic Feminist Enquiry Into A Perceived Gap In Psychosexual Services And Literature The aim of my enquiry was to explore the disparity between my professional experience and subjectivity with 'expert' literature, and to compare this with experiences of other practitioners. I am an out lesbian and had noticed the absence of lesbians in psychosexual literature. Whilst completing an MA in Women's Studies I came across a sex therapy text, in which the only reference to lesbians was to point out the chapter was dealing with gay men, and that lesbians did not come forward for help in this area. This was news to me, as I frequently work with lesbians on these issues. In this account of my MA dissertation, I will describe the process and experiences that led me to focus on this particular area of enquiry, the recruitment of fifteen participants and the group discussions that I held with them. Participants [mainly N.H.S. employees] were in comparative categories, psychosexual trainee therapists [the first year of an M.Sc. in psychosexual medicine] and generalist counsellors who identify as lesbian. I will discuss the material that emerged from the meetings and my literature review, and reflect on contributions this work has made to future enquiry and, most importantly, to service developments. I conducted the research from a feminist perspective, utilising standpoint theory through a facilitative approach in the discussion groups. That is, I fully acknowledged my subjectivity and context and encouraged participants to do so, to speak from our experiences, to record what we 'know' rather than what we 'know about'. Summary of findings
Professional
Role: RCN Counsellor/PhD student ABSTRACT: Paper Using My Role as RCN Counsellor to Research The Lived Experience of Nurses Suspended from The Workplace. Aim: My work involves counselling nurses and I became increasingly concerned at the distress that nurses were experiencing as a result of being suspended from the workplace. This led to researching the issue to understand more of the phenomenon and to see if there were ways of making the process of suspension less psychologically damaging. Method: I am using a combination of qualitative and quantitative methodology within a broad framework of action research. The qualitative is the main component using individual interviews with nurses who have been through the suspension process, RCN Officers and RCN Counsellors. Also focus groups of nurses, RCN activists and managers are being held to discuss a composite scenario of the suspension process. These are being analysed using Grounded Theory. The quantitative has three components, an adjusted repertory grid analysis, data collection regarding the number of nurses suspended, the reasons, the length of time and an analysis of CORE data comparing suspended nurses with other groups. Findings: This is research in progress so the findings to date are to be seen in this light. There are some emergent themes from the Grounded Theory analysis concerned with sense making and polarity of experiencing. There is emerging quantitative data from the repertory grid, which complements the polarity of experiencing theme, and there is some comparative CORE data available, which highlights the psychological distress of the nurses and the helpfulness of counselling. Conclusion: I want to focus on the process to date and how my role as counsellor has enabled me to research this sensitive issue within the nursing world. Key issues are
Authors: Gina Netto (presenter), Sabine Gaag, Mridu Thanki with Liz Bondi and Moira Munro Professional
Role: Director ABSTRACT: Paper Improving Counselling Services for Asian People Aim: The main purpose of the study was to consider the accessibility and appropriateness of counselling services for Asian people. Methodology: The study consisted of two parts. Firstly, interviews were conducted with 38 Asian people to investigate their views of counselling and their experiences of using counselling services. Secondly, 13 agencies in the voluntary sector were reviewed to examine the accessibility and appropriateness of their services. Main findings: Awareness of counselling among people who had not used the service was low, although they suffered from depression, anxiety or stress. However, most people who had used the service found that it had a positive impact. Both clients and non-clients of counselling expected counsellors to treat them as equals and would like to be consulted on the choice of counsellor and language used. Generally, agencies' ability to provide choice was limited. Black-led agencies stressed the importance of possessing a deep understanding of the racial background of their clients while mainstream agencies tended to trust that counsellors would learn the significance of these issues from their clients. Conclusions and future implications: Low awareness of the existence and nature of counselling services is a major barrier to accessing counselling. While there are some areas where Asian clients needs and preferences are met by agencies, there are others where there are either gaps or mismatches. Strategies which would increase access to counselling include increasing the number of external referrals and self-referrals. The appropriateness of counselling services can be enhanced by increasing the number of trained counsellors from diverse communities, providing adequate training and involving black professionals with relevant experience. Service provision should also be reviewed through ethnic monitoring and providing mechanisms for feedback from black clients. Professional
Role: Lecturer ABSTRACT: Paper 1 Maintaining Research in a Voluntary Bereavement Counselling Organisation; Collaboration, Consultation and Constraints. Aim: To reflect upon the challenges of establishing, maintaining and completing a PhD research study within a small, voluntary bereavement counselling organisation. Methods: This presentation will catalogue the five - year lifespan of a qualitative research study incorporating an action research study designed to develop a counselling manual to support bereaved individuals who have a learning disability. During this time, over two hundred people with learning disabilities have accessed the service, incorporating 1,012 counselling sessions. This presentation will use a reflective account of the researcher's journey from collaboration to establish the work, through the considerable consultation process in maintaining the research and will identify the constraints to promoting research within a voluntary counselling organisation. Findings: Issues surrounding the initial identification of the need for such a service will be clarified; the process of establishing collaborative working within paid / volunteer counsellors will be described; the development of an appropriate research orientation will be justified and the challenges of consistently maintaining this research through organisational change will be explored. The triadic role and function of the researcher in maintaining the tension between developing a unique counselling and support service (remaining a clinician), facilitating the research (becoming a researcher) and maintaining a full time post as a lecturer (the paid role) will be critically explored. Conclusions: Doing research is often difficult, and conducting research within organisations where the workforce is often fluid can raise additional challenges for those trying to maintain consistent data collection. This presentation acknowledges that such research is achievable, but is often fraught with difficulties and the resilience of the researcher (and the research) remains paramount. Professional
Role: Lecturer ABSTRACT: Paper 2 Using Action Research To Develop A Bereavement Counselling Manual For People With Learning Disabilities: A Collaborative Approach Aim: The aim of this research was to construct a bereavement counselling and support manual for people with learning disabilities. Methods: Action research involving a three phase approach (establishing the research; piloting the tools; evaluating the work) was used and involved both qualitative and quantitative methodologies incorporating pre and post counselling questionnaires; self rating questionnaires; focus group discussion; case studies and sessional evaluation sheets. This triangulation of approaches was used to develop and test the effectiveness of a bereavement counselling manual that would be used as a guide to those offering bereavement counselling and support for people with learning disabilities. Findings: The results of the pilot phase highlight: the 'normality' of grief for people with learning disabilities; reinforce the nature of bereavement counselling as a talking therapy, despite the many creative methods being used by the counsellors involved; illustrate the effectiveness of using two models of intervention (Worden's Task model {1991} and Heron's Six Categories {1990}) with this client group; support the usefulness of the manual; offers much powerful material to compliment and enhance the co-construction of the manual in preparation for the main study and demonstrates the power and importance of stories to aid the professional understanding of the bereavement counselling experiences of this client group. Conclusions: This research builds upon the current, limited empirical research regarding bereavement counselling for people with learning disabilities. The resultant manual should be of use to established counselling agencies, new services, carers, counsellors and volunteers alike all wishing to develop appropriate counselling and support for this client group. Professional
Role: Senior Lecturer ABSTRACT: Paper Meanings of Art For Women Living With Chronic Illness: Implications For Counsellors In Health-Care Settings This qualitative study explored the meanings of textile artwork identified by women living with long-term illness (such as cancer, multiple sclerosis and arthritis). There has been little research into how people construct a meaningful lifestyle in the shadow of chronic illness, and the role that artistic leisure occupations may play in preserving a positive view of self and the future. Available studies have mostly focused on art-as-therapy, drawing on the observations of art therapists during therapy sessions with their clients. Yet reasons for engaging in artwork during psychotherapy and during leisure time may be quite different. Semi-structured interviews were carried out with 30 women in their homes, and were analysed using the constant comparative approach. Many of the participants had only taken up textile art since the onset of illness. All perceived their artwork as vital for maintaining a positive outlook, and for enhancing quality of life. The participants regarded their creative artwork as having many health-promoting functions, including filling an occupational void, distracting thoughts away from illness, enabling the experience of flow and spontaneity, expressing grief, and maintaining a favourable self-image. For most participants, textile artwork had also motivated other life-affirming pursuits such as developing new social relationships, sharpening observational skills, and contributing to others' well-being. In the words of one participant, art represented a 'lifestyle coathanger' for numerous activities, and challenged the self-absorption, loneliness and restrictions imposed by illness. Counsellors working in health-care settings may be encouraged to explore the meanings and potential of leisure-based creative activity when working with people living with chronic illness. Professional
Role: Lecturer ABSTRACT: Paper Identity Sites: Alienation, Absence and Confusion This paper explores identity as the act of situating oneself in the social and relational world. It involves the performance of telling and receiving stories about ourselves and using them to negotiate a position in the world. Stories about race are very powerful, they trigger many uncomfortable emotions, which can challenge the way we give meaning and make sense of ourselves. How as workers do we reject and effectively silence such stories? Alternatively, how do we create spaces, which enable them to be heard and affirmed? I will be reflecting on the initial stages of and ongoing PhD research project which aims to understand how race is experienced in everyday lives and to explore peoples ability to resist ways in which their racial identities are inscribed by dominant discourses and narratives The research is a heuristic lived inquiry into my own journey which is complemented by a co-operative inquiry involving a diverse group of twelve participants who come together to reflect on how their existence and social relations is shaped by race. As a piece of social action research, it is intended that by claiming a space to share and exchange stories participants are able to locate themselves and act to change their social relationships. The findings challenge development theories of identity development, showing that identity is not a state that is achieved but instead is a performance in the negotiation of relationship. The co-construction of identity is affecting not only the client but also those of us who work with them. Alienation, absence and confusion have been identified as sites for doing this work. The claiming of a space where we can work together to tell, hear and reflect on our stories is seen as an important but tenuous process which raises methodological issues which will be explored. I will conclude with an argument that therapy organised around a dualistic and fixed notion of race is likely to be particularly helpful. Authors: David Purvis, Suzanna Rose (presenter) and Heather Burn-Murdoch Professional
Role: Project Leader, Berkshire NHS Psychological Injuries Unit ABSTRACT: Paper Setting Up And Developing An NHS Psychological Injuries Unit - The First Two Years Exposure to traumatic events, whether developmental or adult (or both) are important and well-known antecedents to psychopathology. Over the last 20 years there has been resurgence in interest in the subject paralleled with an increase in theoretical/clinical research and development activity. Against this background and in response to this identified need, a small NHS specialist traumatic stress service was set up in West Berkshire in December 1999, with the support of Berkshire Health Authority. In November 2001 this expanded to incorporate the whole of Berkshire. The service is well used, clinically effective and popular with both users' and staff. Additionally, this tertiary specialist service is based on issues addressed within the mental health national service framework and evidence based practice - both central tenets of current NHS good practice. This presentation will present the second clinical audit of the service using objective and subjective outcome measures. There will be a discussion of the future development of such units. Professional
Role: Lecturer ABSTRACT: Paper An Evaluation of the Sense Deafblind Peer Mentoring Programme A qualitative evaluation of the Sense Deafblind Peer Mentoring Programme was carried out which examined areas such as the training and support received by the mentors, and the effects of the Programme for mentee and mentor. Questionnaires were completed by 8 trained mentors and 11 mentees. All participants had Usher syndrome which comprises congenital partial or profound deafness and the existence of retinitis pigmentosa (reducing peripheral vision which degenerates throughout adulthood). Main findings were: The trainee mentors saw the training as increasing their self-awareness as they acquired mentoring skills. As peer mentors, they recognised a growing confidence and ability to relate to others and to understand their own problems in a new perspective. Ongoing supervision was reported as a useful information exchange of each other's work. Mentees reported that they had benefitted from the Programme having solved numerous practical problems by receiving information from their Mentor for example, on benefit access, gaining access to College, and acquiring computing facilities. Advice n mobility and communication issues were noted as particularly helpful. Mentees welcomed the emotional and practical support provided by their Mentor, as they adjusted to particular difficulties such as loss of role as a parent or breadwinner. Mentees also received support on mobility or communication adaptations necessary as a result of worsening vision. Overall, the programme was successful in meeting the needs of those which Usher syndrome. As a result of this evaluation, the programme is planning to pilot the feasibility of offering small 'mentoring' support groups for those which Usher syndrome, which would be facilitated by a trained mentor. Secondly, it is intended to offer 'hearing' family members the opportunity to train as Mentors to allow siblings, mothers, fathers or partners to access the Mentoring programme. NANCY SHERMAN and LORI A RUSSELL-CHAPIN Professional
Role: (NS) Associate Professor, Licensed Clinical Professional Counselor,
Accredited Clinical Supervisor ABSTRACT: Workshop Moving To The Future: Innovation In Counsellor Field Experience Instruction And Supervision The field experience or practicum/internship in counsellor training is an essential aspect of the development of competent counsellors. In this interactive workshop, the presenters offer teaching and learning strategies that model the instruction and supervision of field experience courses. The goal of integrating theory into practice through supervised field experience is divided into several essential components that participants will examine including 1) Getting Started and Reducing Fear, 2) Understanding Supervision, 3) Preparatory Skills for Case Presentation, 4) Diversity, 5) Ethics and the Law, 6) Counsellor Wellness, and 7) Professionalism. Innovative, practical and interactive strategies and methods illustrate each component. Evidence of the effectiveness of these methods is presented based on outcome research. Several methods are applicable for clinical supervision offered outside of an academic counsellor training program. Participants will be involved in the following examples. For "Getting Started and Reducing Fears", participants are given the Carl Jung quote, "You can only take your clients as far as you have gone yourself." The quote serves as the basis for discussing challenges during the field experience and searching for available resources. To assist in better understanding supervision needs, a short inventory, the Counseling Interview Rating Form, will be completed while analyzing a videotaped counselling interview. For the component of "Preparatory Skills for Case Presentation" participants will view and use an interactive CD-ROM on interviewing skills, and for the "Diversity" component, they will be introduced to a simulation to activate and understand the filters we all use in understanding differences and cultural identities. Research will be offered on the efficacy of these teaching strategies, along with other outcomes based results. Participants will leave the program with several new strategies for teaching field experience courses that demonstrate praxis, integrating theory into practice. Professional Role:
Project Manager ABSTRACT: Workshop Working Together - An Internal Naturalistic Formative Meta-Evaluation Of A Three-Year Department Of Health-Funded Project In Twenty-One Charitable Counselling Centres In England The Project generated data from 803 clients from groups identified by the Department of Health ('Psychotherapy Services: A Strategic Review' 1996) as known not to be accessing statutory provision of talking therapies in the National Health Service (i.e. disadvantaged). Data from 2,000 clients not in these groups was collected. Both groups were studied for comparative purposes. Overall aim of the presentation: The overall aim is to present learning from an internal formative meta-evaluation of a Department of Health Project, which ran over three years in 21 voluntary counselling centres in England. Findings could be relevant to those studying the current counselling voluntary sector, especially in the fields of evidence-based practice and 'matters that local audiences might find interesting' (Guba and Lincoln 1981). Information will include descriptive information, information about concerns, issues, constraints, values, value for money, standards and worth and merit assessments. (Guba and Lincoln)
Summary of Methods Responsive and naturalistic approaches drawing from hermaneutics and the ideas of Guba and Lincoln were used. Cronbach's (1975) idea of focusing on refinements and improvements during the process of the study and Scriven's (1973) ideas of a 'goal-free' model of assessment of effects and a profile of needs against which the importance of effects is assessed were also considered. (The Project itself used mixed methods - quantitative (especially CORE and scaling) and qualitative methods (especially Grounded Theory). The presentation will not be including the findings of the Study.) Summary of Findings Data is still coming in from centres, but findings will include the following:
The Presentation As the theme of the Conference is 'Working Together', we would like to present our findings as a team - practitioner, manager, and researcher and possibly administrator. Audience participation would be sought about the voluntary sector, and experience of factors affecting evaluation research - possibly a short 'focus group' to supplement our findings. References Breakwell Glynis & Millward Lynne (1995) Basic Evaluation Methods Analysing performance, practice & procedure BPS Books Leicester. Caccia,J. & Watson J.P. (1987) A counselling centre and a psychiatric out-patient clinic. Bulletin of the Royal College of Psychiatrists, 11, 182-184. Cronbach L.J. (1982) Designing evaluations of educational and social programmes. Sam Francisco: Jossey-Bass Publishers Department of Health (December 2001) Choosing Talking Therapies Department of Health (1996). NHS Psychotherapy Services in England: Review of Strategic Policy Guba E.G. & Lincoln Y.S. (1982) Effective Evaluation. San Francisco. Jossey-Bass Pubs. Guba E.G. & Lincoln Y.S. (1989) Fourth Generation Evaluation. Newbury Park, C.A. Sage Hudson Mike (1999) Managing Without Profit Penguin Kember, David Lai et al, (1990) Naturalistic Evaluation of Distance Learning Courses. CADE: Journal of Distance Education Love Arnold J. (1991) Internal Evaluation; Building Organisations from Within. Sage pubs. McLeod John (2000) The importance of the voluntary sector in the provision of counselling services Talk delivered at AGM Couple Counselling Dundee. McLeod John (2000) Assimilating research and inquiry into the culture of counselling Paper given to 8th. Annual International Counselling Conference, University of Dundee. McNamara Carter (1998) Basic Guide for Program Evaluation - from www.mapnp.org/library/evaluatn/fnl_eval.htm Powell, W.W. (1987) The Non-Profit Sector: A Research Handbook, Yale University Press, New Haven Chapter 9. 'Managing Public Services' Quinn Patten, Michael (2002) Utilisation-Focused Evaluation Checklist Rowland Nancy & Goss Stephen (2000) Evidence-Based Counselling and Psychological Therapies: Research and Applications Routledge Scriven Michael (1991) Evaluation Thesaurus Sage Pubs. Sullivan Thomas J. (2001) Methods of Social Research Harcourt Tolley Keith & Rowland Nancy (1995) Evaluating the Cost-Effectiveness of Counselling in Health Care Routledge UNICEF - A Guide for Monitoring and Evaluation http://www.unicef.org. Vaux A. et al. (1992) Independent Consulting for Evaluators Sage pubs. Wpf Network Statistics 1999-2000 Professional
Role: Director of MSc Programmes and CLIO Centre for Research in
Counselling and Learning ABSTRACT: Workshop Singing and Dancing With The Wolves: Using Storytelling As A Way Of Exploring And Engaging With Counselling Research Training This workshop will explore some of the uses of storytelling as a vehicle for presenting the ideas and practices of 'Counselling Research' to practitioners in creative and engaging ways. During the workshop participants will have the opportunity to listen to a re-telling of one particular 'traditional' storyÞ. the story of the wolf woman Þ and to experience their own practices of witnessing, telling and re telling and re-searching stories within a learning community. Participants will also be invited to reflect on these stories and experiences and encouraged to critically examine any emerging issues and ideas about Counselling Research and the training of Counselling Practitioner/ Researchers. The facilitator will take up an interviewing position more traditionally associated with 'the narrative therapies' to elicit responses and critical explorations from the communityÞsome of the questions to explore might be: What difference does the hyphen make when we write research or re-search? What are the stories we tell ourselves about being a researcher and being a practitioner? What are the 'regimes of truth' around counselling research and how it should be conducted? What would happen if we all gave up on research and re-search and wrote stories about our practice instead? What would happen if we gave up on research and told stories about our practice instead? What would happen if we all called ourselves co-researchers alongside our clients and gave up 'being therapists? What if Counselling Re-searchers stopped writing books and started producing documentary films? Professional
Role: Chartered Psychologist ABSTRACT: Paper Bullying and PTSD Overall aim of study: The study looks at the nature and impact bullying in the workplace The key questions addressed in the study are:
Summary of method(s) In this study, a hundred and sixty five care professionals (CP) were surveyed to establish the incidence of bullying and the observation of bullying occurring in their place of work. Each CP completed a survey that included the IES-E, a post-traumatic stress questionnaire. In the survey the nature of the bullying was recorded as well as the CP's opinion on the quality of the support available within the organisation. From the data gathered the patterns of symptoms were compared with those of employees involved in armed raids. Summary of findings This study showed that in the previous two years 40% of the care professionals had been bullied and 68% had observed bullying taking place. These results are high when compared with the study by Hoel & Cooper (2000) in which it was shown that 24.5% of employees had bullied and 45.2% observed bullying in the past five years. The study by Rayner (1997) showed that 53% of employees had been bullied at some time in the past. Several reasons might explain these results, firstly it is possible that CPs are more vulnerable to being bullied than other groups of employees. CP's are likely to approached for advice and support from employees who have been bullied during the course of their work. Thirdly, CPs are more aware of bullying and therefore more likely to label bad behaviours as bullying than other groups. Fourthly, it is possible that this was a biased sample. However, the issue of bias was partly addressed in the fact that the response rate for the CPs was 100% of those given the questionnaire and was representative of the CPs surveyed. Conclusions and implications These results suggest that there may be a need to revisit the construct of Post Traumatic Stress Disorder and consider whether there needs to be less emphasis on the situational factors and more on the subjective experience of trauma. Hoel, H. Cooper, C.L. (2000) Destructive Conflict and Bullying at Work, Manchester, UMIST Rayner, C. (1997) The incidence of workplace bullying, Journal of Community & Applied Social Psychology, 7, 199-208 Professional
Role: Lecturer ABSTRACT: Workshop A Reflexive Conversation About Researching Learning Across Cultures "All research beyond the banal begins in uncertainty, where action is unanticipated and anticipations are unrequited. We enter slippery, uncertain ground. Paths grow faint, the footing unsound. In real beginnings, we nearly always stumble, are misunderstood and lose our confidence or our way some of the time." (Charmaz & Mitchell, 1997 p.209) Definitions of reflexivity are unsettled but I am drawn to one offered by Hertz (1997) " to be reflexive is to have an ongoing conversation about experience while living in the moment." In this workshop I shall share the beginnings of my experience of ongoing conversations with international postgraduate students. As a higher education lecturer in counselling I want to be able to understand their stories of learning, how those stories are affected by being a member of a multicultural group within a specific teaching and learning culture. I also want to explore how my own learning story is changing as a result of my involvement with them. Those who write about the creativity of reflexive research (e.g. Douglas, 1985, Hertz, 1997) speculate about whether anyone who is engaged in the exploration of human beings should not have already undertaken a great deal of self-exploration themselves. As I enter the slippery, uncertain ground of my PhD, stumbling between losing my confidence and my way and having occasional glimmers of understanding, many questions are being raised for me. I would like to share some of those questions in this workshop. Questions such as: To what extent is my own counselling training and practice supporting me to have ongoing conversations while living in the moment - to be reflexive? How can I transform biases to bring about a social setting valued by all of us and move towards "cultural synergy"? (Cortazzi & Jin, 1997). How can I "build a bridge of mutual intercultural learning"? (Jin & Cortazzi, 1998) References CHARMAZ, Cathy & MITCHELL, Richard G. Jr. (1997) 'The Myth of Silent Authorship' in Rosanna Hertz ed. Reflexivity and Voice. Sage, Thousand Oaks, Ca. CORTAZZI, Martin & JIN, Lixian (1997) 'Communication for Learning Across Cultures' in David McNamara and Robert Harris eds. Overseas Students in Higher Education. London, Routledge. DOUGLAS, Jack (1985) Creative Interviewing. Sage, Beverly Hills, Ca. HERTZ, Rosanna (1997) ed. Reflexivity and Voice. Sage, Thousand Oaks, Ca. JIN, Lixian & CORTAZZI, Martin (1998) 'Dimensions of Dialogue: Large Classes in China. International Journal of Educational Research. 29 739-761 DAVID TUNE Professional Role:
Lecturer in Counselling/Psychotherapist ABSTRACT: Paper Dilemmas Around Issues of Touch In Psychotherapy An update of results from a pilot study on touch in psychotherapy, presented at the BACP Research Conference, Manchester in May 2000. Aim The study was conducted in order to explore and open up the debate on issues of touch, within the profession and between different counselling orientations. The work also forms the basis of research towards a PhD. Methods The approach uses a form of grounded theory, and the findings are presented from 24 semi-structured interviews with Counsellors and psychotherapists from different professional orientations over an eighteen-month period. The practitioners worked in a variety of settings and were all qualified for over two years to Diploma standard. The interviews focus on the reasons for using or withholding touch in the therapeutic relationship, the sort of touch when offered and whether the therapist was influenced by their theoretical orientation, professional guidelines or an intuitive response to the therapeutic situation at that time. Questions were also asked regarding the processing of touch issues in therapy and supervision, whether it actually happened or not. Findings The findings suggest there are many therapists who are following their intuitive feelings in regard to touch, and that this is not confined to any particular theoretical orientation. What has also emerged is that while most therapists in the study do touch in some ways sometimes, those who's training favoured the abstinence model or provided no debate on touch, were less likely to process it with their clients or their supervisor. Some differences in definitions of what is the 'therapeutic' or 'social' space, was also noted. Conclusions The implications regarding the therapist's struggles with this issue (in terms of conflicts between their orientation, intuition and ethical concerns), and the general theme of openness is discussed. Professional
Role: Lecturer/Researcher in Counselling ABSTRACT: Workshop What Do We Mean By Self-Harm? Research in progress will be described. It will be taken forward further at this event, through the consideration and discussion of: 1. 'qualitative leap' and 'continuum' models of self-harm 2. Culturally accepted self-harming activities (cashas), such as smoking and overworking 3. Clinical vignettes of situations that have arisen in the context of the counselling relationship and that may or may not qualify as self-harm. The aim of the research is to clarify the parameters of self-harm, particularly at the 'mild' and 'low visibility' end of the spectrum through consultation with practitioners working in the community. I am aiming for multi-disciplinary consultation and, to date, counsellors, psychotherapists, nurses, health visitors and social workers have taken part in the research. Following the presentation, participants in the workshop will be given two clinical vignettes to read and discuss in a small group. They will be asked whether the vignette they have considered in their view qualifies as self-harm and a count based on a show of hands will be taken. Findings to date are given below: behaviour in question, followed by percentage of participants seeing the behaviour as self-harm Apparently 'invited' accidents, major and minor, leading to chronic ill health and disability - 90% Neglected eczema (six months) and resulting skin infections - 95% Overriding of physical symptoms, leading to aggravation of R.S.I. and permanent disability - 80% Failures of self-care leading to a second unwanted pregnancy - 60% A period of open-ended discussion will follow, where workshop members will be encouraged to speak in their own way about the decision they have reached. At similar events conducted over the past two years, the question of what is meant by the terms 'mild' and 'severe' and how this can be judged has come up for discussion, as has the elusive nature of the line between 'normal' failures of self-care and impulsive actions and self-harm proper. Vignette One Rachel is a counsellor who is finding it impossible to control her workload. At her busiest times, she sees thirty clients a week. She also runs a small voluntary organisation and attends training sessions on budgeting, quality assurance and other organisational matters. She runs a training course on bereavement counselling and is a member of her local Community Health Council. At home, she is the main carer for two teenage children, one of whom has a medical condition that requires ongoing management. Rachel tells me that she sets no limits on the number of concessionary counselling places she offers. She finds herself unable to say no to 'needy' clients and is aware that this is linked to a neediness in her. Rachel sleeps fitfully - work matters go round and round in her head and keep her awake. A short while ago, her blood pressure became dangerously high and is now controlled by medication. Recently, she had a dream in which her family doctor told her that she had, at the most, five years to live. She awoke in great distress, thinking of her children and the loss and pain they would suffer when she died, then thought fleetingly that dying would be something of a relief.
compromised self-care; mild self-harm; moderate self-harm; severe self-harm Vignette Two Harry is a man in his fifties, being seen by a bereavement counsellor following the death of his mother. He has a history of falls, injuries, illnesses and childhood hospital admissions 'too numerous to mention'. In the course of eight months of counselling, he has cut himself twice, burned himself while cooking, sustained a scald, painfully stubbed his toe six times, trapped his fingers and cut himself by accidentally breaking an ornament that belonged to his mother. Harry describes four life threatening 'accidents', which have left him a chronic invalid, walking on sticks and virtually housebound. The first of these was a very serious car accident at age nineteen, in which a girl was killed. It happened shortly after the end of Harry's first sexual relationship, which Harry accused his mother of 'deliberately trying to sabotage'. Twelve years later, working as an engineer in a job his father had found for him, Harry electrocuted himself. Just before this, he saw his father's contemptuous face, thought 'I shouldn't do it' and then connected the wrong wires. At forty-three, Harry fell from his bike into the path of a lorry and sustained several fractures. Finally, eight years ago, he fell from a ladder that he knew had 'rotten rungs' and sustained a back injury 'that still gives him gyp'. At the time, he had been depressed, not caring what happened to him.
compromised self-care; mild self-harm; moderate self-harm; severe self-harm Professional
Role: Counselling Development Worker ABSTRACT: Paper Youth Counselling - What Do They Want? Aim: The Basement Project is a voluntary organisation providing support, advice and counselling to young people aged 16-30, in the Borough of Kensington and Chelsea. We have created a questionnaire survey to aid in the development of strategies to maximise access to our counselling service, to client groups who tend to be under represented: Black and ethnic minority youth; substance users; homeless; sex industry workers; gay, lesbian, bisexual and transsexual young people. As counsellors, we have made assumptions about the barriers which prevent young people accessing counselling, based on anecdotal evidence and experience of teachers, sexual health educators and counsellors in the field. We wish to have them challenged. The key areas of the questionnaire are: The relevancy of counselling services; 'acceptable' presenting issues; previous experience of counselling; making initial contact; the importance of who the counsellor is; accessing information about counselling. Methods: We have used a 34-question survey made up of multiple choice, comment on and 5 point likert scale questions. Trained volunteer peer researchers interviewed 103 respondents and these were completed over two weeks. The locations for the research include Youth clubs, Hostels, our own projects - The Basement Project and HIP, other specialist Projects/ organisations in the Borough as well as accessing the personal networks of the researchers. Strengths: One to one engagement with peers; a diverse range of respondents according to ethnicity and sexuality were canvassed. Weaknesses: Predominance of 16-19 year olds in the sample; representation was concentrated in the North of the Borough; cluster sampling means we can make fewer generalisations regarding the results. Findings: Diversity of preference in how young people want to access counselling literature, contact services, and have counselling according to ethnicity. Training and sexuality are important factors for client-counsellor matching, as is continuing counselling with the first counsellor seen face to face. Differences in attitudes and issues arise (eg family, drugs, sexuality), when assigning reasons for others to access counselling, compared to individual respondents' reasons. Conclusions: Clear indications for how to change operational/administrative procedures were elicited. Developing closer links with targeted clients groups in more intimate settings needs to follow, in order to further develop access. Professional Role:
Training and Development Adviser for a Social Services and Housing
Directorate in local authority ABSTRACT: Paper A Psychoanalytic Approach To Organisational Dynamics, As Applied To An Employee Counselling Service Aim: To explore effects of organisational dynamics on employee counselling provision within a public sector organisation. The research was carried out from a psychoanalytically oriented perspective. The study provided the basis for a dissertation towards an MA in counselling. Methods: Qualitative research methodology was used with an emergent design and a case study approach, primarily involving unstructured interviews, participant observation and field notes. Seven individual interviews and one small group interview were conducted. The research took place in a local authority over a one-year period. In this case study, employee counselling was provided on contract, using freelance counsellors through an occupational health service. Summary of findings:
Conclusions and implications: As this research centred on a single case study, it is not appropriate to extrapolate its findings to employee counselling provision in other organisations. However, a lack of research in this area implies a need for similar research elsewhere. Applying a psychoanalytic approach emerged as a useful tool to aid understanding of how processes become embedded and internalised within an organisation. Having undertaken this research, it proved relatively straightforward to apply the findings. This resulted in an action plan for the employee counselling service studied, with Recommendations directed towards increased effectiveness. Other Authors: Michael King, Margaret Lloyd, Peter Bower, Bonnie Sibbald, Sharon Farrelly, Mark Gabbay. Nicholas Tarrier, Julia Addington-Hall Professional
Role: Research Co-ordinator ABSTRACT: Paper The Talking Therapies Study: Reflections On Results And Opportunities For Working Together Aim To determine the comparative clinical effectiveness of usual GP care and two brief psychological therapies (non-directive counselling and cognitive-behaviour therapy) in the management of depression in primary care. Methods 464 patients aged 18 and over referred by GPs for depressive symptoms were recruited in general practices in Manchester and London. The study was a pragmatic randomised controlled design. Participants were allocated to brief (6-12 sessions) non-directive counselling, cognitive-behaviour therapy, or usual GP care. Therapy was conducted by BACP accreditable counsellors and BABCP accreditable clinical psychologists who were attached to participating practices. Outcome measures included depressive symptoms (BDI), general psychiatric symptoms, social function and patient satisfaction. Assessments were carried out at baseline, 4 and 12 months. Results Of 464 patients: 197 were randomised between the three treatments; 137 chose a specific treatment; and 130 were partially randomised. At 4 months, non-directive counselling and cognitive behaviour therapy reduced depressive symptoms to a significantly greater extent than usual GP care. There was no significant difference in outcome between the two psychological therapies. Patients and GPs valued the therapists. Conclusions The talking therapies are significantly more effective in reducing depressive symptoms than usual GP care in the short term. There are no differences between treatments at 12 months. Psychological therapy in primary care is effective in reducing depressive symptomatology in the short term. Could therapists and GPs work together more closely to benefit patient care? Professional
Role: Senior Lecturer in Counselling/Co-ordinator Counselling Programmes ABSTRACT: Paper 'Caught In A Story': A Discursive Analysis of Women's Narratives When Women Counsel Women. Aim: To explore the discourses used when women counsellors work with women clients and the impact of these on the frameworks employed to narrate the experience. Clients come to counselling because they have been unable to change and/or mediate between habitual discourses in ways that are satisfactory to them. By changing the discourses around a story, a client may live on-going aspects of it differently. Stories are freshly negotiated, within the relationship between speaker and listener, each time they are told. Stories in counselling achieve change via the relationship, defined and developed through language. Both feminist writers and narrative therapists have stressed the impact of social positioning on well-being. Women counsellors and clients are influenced in their work together by the cultural, social, political and gender understandings and expectations they have of each other and of their contexts. If women speak with a 'different voice', they also listen with 'a different ear'. Method: Discourses, from work with client and counsellor pairs, are tracked, through recordings of the counselling itself, counsellors' and clients' journals and communication with the researcher. Client change is evidenced in changes to the language used in and about the counselling. Similarly, because of the jointly negotiated processes, counsellors' discourses about themselves, as well as their clients, may alter. Preliminary findings: Brief data extracts will be presented to demonstrate how discourses denote and reflect: the relationship between counsellor and client; notions of self and other; theoretical frameworks that describe intra and interpersonal change; and the positioning of both counsellors and their clients within a broader social context. Conclusions: Responses from conference participants will help to shape the on-going nature of this work. WILLIAM WEST and MANSOR ABU TALIB Professional
Role: Senior Lecturer in Counselling ABSTRACT: Paper Some Cross Cultural Implications In Qualitative Counselling Research Aim: To explore how the culture of the researcher interacts with the data from a qualitative study into counselling and spirituality. Method: Eighteen counsellors and psychotherapists who were also members of the Religious Society of Friends (Quakers) were interviewed about how their faith impacts on their therapeutic practice. The findings of this qualitative heuristic study were presented at the BACP Research Conference in 1998 and subsequently published (West, 1998). The researcher was white, British, male, a counsellor and a Quaker. Five of the interview transcripts were randomly selected and given to a second researcher in 2001 who is Malaysian male, counsellor and Islamic. These interviews were analysed thematically and a commentary was written all without accessing the original analysis and published paper. Findings and conclusions: The two analyses will be presented and compared, the commentary explored and the implications for research will be considered including the role of the researcher and the cultural implications. Professional
Role: Senior Lecturer in Counselling ABSTRACT: Paper Evidence Based Supervision. What Do We Know? While a vast amount of research related to supervision has been conducted mainly in the USA, very little has found its way into the conversation, language, theory and practice of counsellors and psychotherapists. In response to this BACP have commissioned a systematic review of supervision research which summarises current research evidence and identifies significant gaps paving the way for future research. More than 4000 references to supervision were found of which about 1300 were deemed to be relevant to counselling and psychotherapy and approximately 400 reported original research projects. Supervision research reports were categorised under the following headings:
An overview of the findings will be presented. Professional
Role: Principal Lecturer in Counselling ABSTRACT: Paper Therapy Beliefs and Therapist Beliefs In Training For Cognitive Behavioural Counselling This report is part of a longitudinal research study on training in Cognitive-behavioural counselling. Although CBT itself has been very concerned to produce evidence of the effectiveness of the therapy, comparatively little work has been done on the effectiveness of CBT training. Whilst it has been argued that counselling skills are very helpful in doing good CBT (Wills, 2000), certain counselling beliefs, for example, in 'non-directiveness' may at times obstruct successful learning of CBT (Wills, 1999). The present study presents an interim report on the development of counsellors' beliefs and attitudes as they undertake CBT training. It finds that certain therapy beliefs - i.e., about how to proceed with therapy - can obstruct learning of skilled CBT practice. For example, if a trainee is unwilling to structure sessions because of the undesirability of 'directiveness', this makes it hard to achieve the kind of focused interventions that characterise CBT. Usually, however, students are able to be pragmatic enough to test out the limits of these therapist beliefs. When the beliefs are held 'religiously', however, they often combine with unhelpful 'therapist beliefs' to scupper progress and even block the achievement of competence. A 'therapist belief' (Padesky, 1997) may predict a negative outcome in therapy - for example, that the client will object to being structured and storm out of the session. The present findings come mainly from a longitudinal questionnair e survey of several cohorts of students undertaking CBT training. The author is now engaged in a series of qualitative interviews to explore the more subtle variations of this process - including understanding how negative learning experiences can be forestalled and/or overcome. Professional
Role: Staff Counsellor ABSTRACT: Paper Online Counselling: Learning From Therapeutic Writing - Reviewing And Applying The Research Aim: To review the research into therapeutic writing and assess how empirical findings from a range of studies could be translated into online counselling in a workplace setting (Wright, 2001). Method: Over a two year period, the literature into therapeutic writing from a range of disciplines was searched and reviewed (Wright & Chung, 2001). Definitions of 'writing therapy' were considered from the 'scientific' (Esterling et al, 1999) and 'humanities' (Hunt & Sampson, 1998) approaches. Only research studies that had been published in publicly accessible sources were included. Search strategies included the use of online databases and handsearching relevant journals. Findings: As this is a report of secondary research, findings are not available in the usual way. However, an online counselling service in the workplace (Kurioka, et al, 2001) was set up as a result of the search and the stages of this project will be reported (Wright, in press). Conclusions: The link between therapeutic writing and counselling using text-based methods via the Internet is clear (Collie et al, 2000). There is a well established research base for therapeutic writing and some of the findings from particular writing protocols can be translated into online counselling services (Lange et al,2001). Future Research: The urgent need for more empirical research in specific areas of online counselling (Goss et al, 2001) is evaluated. References Collie, K. R., Mitchell, D. & Murphy, L. (2000). Skills for online counseling: maximum impact at minimum bandwidth. In Bloom, J.W. & Walz, G. R. (Eds.) (2000). Cybercounseling and Cyberlearning: Strategies and Resources for the Millennium. Alexandria,VA: American Counseling Association, ERIC/CASS. Esterling, B.A., L'Abate,L.,Murray,E.J.,Pennebaker, J.W. (1999). Empirical foundations for writing in prevention and psychotherapy: mental and physical health outcomes. Clinical Psychology Review,19 (1):79-96. Goss, S., Anthony, K., Jamieson, A, Palmer, S. (2001). Guidelines for Online Counselling and Psychotherapy. Rugby: British Association for Counselling and Psychotherapy. Hunt, C. & Sampson,F. (eds.) (1998). The Self on the Page: Theory and Practice of Creative Writing in Personal Development. London: Jessica Kingsley. Kurioka, S., Muto, T. & Tarumi, K. (2001) Characteristics of health counselling in the workplace via email. Occupational Medicine, (51)7: 427-432. Lange, A., Van de Ven, J.P., Schrieken, B. & Emmelkamp, P. M. G. (2001). 'Interapy. Treatment of posttraumatic stress through the Internet: a controlled trial,' Journal of Behavior Therapy and Experimental Psychiatry,32(2): 73-90. Wright, J. (In press) 'Online counselling and psychotherapy - the story so far: Learning from Writing Therapy,' British Journal of Guidance and Counselling. Wright, J. (2001) 'Developing Online Counselling in the Workplace,' Counselling at Work Journal, 34, 4-6. Wright, J. & Chung, M.C. (2001) 'Mastery or mystery? Therapeutic writing: a review of the literature,' British Journal of Guidance and Counselling, 29(3):277-291.
ADAMS, K. (1996) Journal writing as a powerful adjunct to therapy, Journal of Poetry Therapy,10(1): 31-37. BOLTON, G. (1999a) The Therapeutic Potential of Creative Writing - Writing Myself. London: Jessica Kingsley. HOWLETT, S. & GUTHRIE, E.(2001) Use of farewell letters in the context of brief psychodynamic-interpersonal therapy with irritable bowel syndrome patients, British Journal of Psychotherapy, 18(1):52-67. LANGE, A. (1994) Writing assignments in the treatment of grief and traumas from the past. In: J. Zweig (Ed.) Eriksonian approaches, the essence of the story. New York: Brunner/Mazel. LANGE, A. (1996) Using writing assignments with families managing legacies of extreme traumas. Journal of Family Therapy,18: 375-388. PENNEBAKER, J.W. (ed.) (1995) Emotion, Disclosure and Health. Washington, DC: American Psychological Association. PROGOFF, I. (1975) At a Journal Workshop: The Basic Text and Guide for Using the Intensive Journal. New York: Dialogue House. RYLE, A. (1990) Cognitive Analytic Therapy: Active Participation in change. A New Integration in Brief psychotherapy. Chichester: John Wiley. SCHOUTROP, M.J.A., LANGE, A., HANEWALD, G., DUURLAND, C., & BERMOND,B.(1997a) The effects of structured writing assignments on over-coming major stressful events: an uncontrolled study. Clinical Psychology and Psychotherapy, 4,179-185. SCHOUTROP, M.J.A., LANGE, A., BROSSCHOT, J.F., & EVERAERD, W. (1997b) Reprocessing traumatic events in writing assignments: mechanisms, modes of processing and psychological physiological effects. Abstract. Psychosomatic Medicine, 59,83. SMYTH, J.M. (1998) Written emotional expression: effect size, outcome types, and moderating variables. Journal of Consulting and Clinical Psychology, 66(1) 174-184. VAN ZUUREN, F.J., SCHOUTROP, M.J.A., LANGE, A., LOUIS, C.M., SLEGERS, J.E.M., (1999) Effective and ineffective ways of writing about traumatic experiences: a qualitative study. Psychotherapy Research, 9(3): 363-380. |
||
|
