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Research Conference 1999  


BAC's 5th Annual Research conference was entitled 'Counselling: Effects and Consequences' and took place on 22 May 1999. It was held at Hilton National, Leeds in association with Psychological Therapies Research Centre, University of Leeds.

Click here for an evaluation of this year's conference

Abstracts



Sarah Baldry and Stephen Goss

Institution: Student Services, Napier University
Contact details: 219 Colinton Road, Edinburgh, EH14 1DJ
Email: s.goss@napier.ac.uk

ABSTRACT: Poster

Information Technology: Effects And Consequences On Counselling

This poster has been developed from the findings of a Masters research project entitled 'The Use of Information Technology in Counselling and Psychotherapy'. The project analysed a wide range of existing papers on various uses of Information Technology (IT) within the mental health industry over the last three decades, and identified issues to be addressed by therapists who are providing a service to their clients in an increasingly IT literate age.

The very human activity of Counselling has had contact with IT, for some thirty years starting with the development of ELIZA emulating Rogerian therapy. Initially bespoke software was developed to provide direct therapy for specific conditions. However, in common with all walks of life, it is the communications possibilities provided by the technologies of telephone, video-conferencing, email and the Internet that is driving potentially awe-inspiring changes in mental health provision.

Technology has affected the two principal members of the Counselling relationship unequally. Findings have shown that, after some initial reticence, the clients perceive many advantages with services that can transcend conventional limitations of geography and time. Counsellors, however, are more aware of the disadvantages that mainly spring from the effects on relationship building caused by non face-to-face encounters.

This poster highlights the advantages and disadvantages of IT in Counselling to both clients and providers, and draws attention to the issues that result.

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Jill Brennan

Institution: North Manchester Healthcare, North Manchester General Hospital
Contact details: Delaunays Road, Crumpsall, Manchester M8 5RB

ABSTRACT: Paper

Strand: Working Together

Counselling In A Psychological Therapies Department - The Results Of A Two-Year Audit

An ongoing caseload audit of the work of a counsellor recruited into an established Clinical Psychology Department has been in progress since the post was filled in March 1997. The recruitment of a counsellor using an integrative approach was an innovation in a Department which specialises in Cognitive and Behavioural Therapies. Two years' data on counselling reflect the process by which integrative counselling has been incorporated into the range of psychological therapies offered by the Department's multi-disciplinary team to its widely ranging clientele. The presentation looks at the way in which audit was integrated with caseload management, and then explores the data, including volume and sources of referral, waiting list times, number of sessions offered and taken up, assessment issues, the nature of presenting problem at referral and assessment, length of contract and rates of re-referral within the time period of the audit.

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Helen Castle and Maureen Tomeny

Institution: Dept. of Clinical Psychology, Central Nottinghamshire Healthcare NHS Trust Head Quarters
Contact details: Southwell Road, Mansfield, Nottinghamshire, NG18 4HH

ABSTRACT: Poster

A Short-Term Counselling Service In Primary Health Care - Client Improvement And Satisfaction

Studies evaluating the effectiveness of Primary Care Counselling remain sparse, yet essential to a service of this nature. Reported positive outcomes from short-term counselling include reduced psychiatric symptomatology and psychotrophic drug usage. Principle weaknesses of several previous studies include a lack of standardised self-report measures and insufficient follow-up periods in which to examine the maintenance of psychological improvements.

Clients seen in the Primary Healthcare Counselling Service during October 1996 to May 1998 were asked to complete the BSI (Brief Symptom Inventory) and the GHQ (General Health Questionnaire) prior to counselling (PRE), on discharge (POST), and 6 months later (FOLLOW-UP), along with an evaluation questionnaire. The counsellors completed an audit form for each client at discharge.

Significant improvements in psychological health measured by the BSI and GHQ were found at post-counselling, and maintained at follow-up. At the 6 month follow-up a subjective measure indicated that 65% of clients felt they had changed for the better as a result of counselling, and no client perceived a change for the worse. The majority of clients expressed satisfaction with the Counselling Service on a number of subjective measures. Factors relating to client improvement and satisfaction are identified. Subgroups who did not improve as a result of counselling or who did not view the service as helpful are examined.

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Sue Copeland

Institution: College of Ripon & York St John
Contact address: 74 Millfield Road, York, 4023 1NQ
Email: s.copeland@ucrysj.ac.uk

ABSTRACT: Paper

Strand: Factors affecting Training and Supervision

The Dilemmas Faced By Supervisors Working Within Organisational Contexts

Initial research was carried out to investigate the dilemmas faced by supervisors working in diverse organisational settings.

A postal questionnaire was used to investigate the supervisor, their organisational setting and how they worked within it and their experience of the dilemmas faced in those diverse settings.

This was an exploratory study as the first stage of in-depth research of supervision in organisational settings and the statistics were mainly descriptive. The response rate was low (30.5%) due to difficulties in finding an accurate sample of supervisors who worked in organisational settings and who were prepared to answer quite a long questionnaire. However from the numbers received it was possible to isolate cases into three categories: counselling agencies, Relate and Health, Industry and Education as well as analysing all cases as a complete sample.

When analysing the results it was evident that there were differences for supervisors working in the categories of Health, Industry and Education from those of Counselling Agencies and Relate. These differences related to the following areas:

  • The supervisor's role within the organisation.
  • The attitude of management to supervision.
  • The fit of the culture of the organisation with the supervisor's attitudes and values.
  • The type of contract required by the organisation for the supervision.
  • The feedback to the organisation about the supervisees.
  • The origins of the supervisor's dilemmas.
  • The description of the supervisor's dilemmas.

The implications from these results are that although there are some differences in:

The nature of the contact that supervisors have with the organisation across diverse settings.

The dilemmas faced by supervisors within those settings, there is a need to educate supervisors about the need to take a flexible but nevertheless ethical approach to working in organisational contexts. There is also the need for them to take on a consultancy role where ever possible to educate the organisation about the counselling and supervisory process.

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Margaret Evans

Institution:Keele University
Contact address: 122 New Road, Bromsgrove, Worcester, B60 2LD,
Email: margaret.evans12@which.net

ABSTRACT: Paper

Strand: Counselling, Spirituality and Christian Belief

"Coming Out To Be Judged"

How do counsellors with a Christian commitment integrate their beliefs with their Code of Ethics and Practice in counselling gay-male and lesbian clients?

ABSTRACT
Thirty-one counsellors who identified themselves as practising, committed Christians, returned completed questionnaires which investigated how they integrate their Christian beliefs with their Code of Ethics and Practice in counselling gay-male and lesbian clients.

It was found that most counsellors believe they are offering acceptance, although responses to this questionnaire identified some participants' incongruence and some anomalies, of which they were apparently unaware. It appears that it is difficult for some counsellors to remain non-judgmental about perceived gay/lesbian behaviours.

Lack of knowledge of scholarly interpretation of the Bible was demonstrated by some respondents. While churches adopt an "official" approach to sexuality, some individuals within denominations appear to operate on an interpretation of their own, which may conflict with the "official" stance. Counsellors who took a rational stance in their understanding of the Bible and Christianity expressed more open and accepting views. Counsellors with a fundamentalist approach to the Bible appeared to be lacking in acceptance and unaware that they have a serious problem in offering the core condition of respect to their gay or lesbian clients.

Of the counsellors subscribing to the BACP Code of Ethics and Practice, a minority demonstrated a lack of compliance to the condition of respect and need to think through their position. The Code of Ethics for the Association of Christian Counsellors differs in that it limits the offering of respect to the client and emphasises undefined Biblical assumptions and a framework of Christian values, above those of the client. It may thus fall short of providing an adequate ethical framework for safe therapeutic care.

Recommendations are made for further research into counsellors' belief systems, and for issues of sexual orientation to be addressed in counsellor training, particularly with regard to self-awareness.

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Dr Ken Fisher

Institution: Bolton Institute of Higher Education
Contact details: Chadwick Street, Bolton, BL2 1JW

ABSTRACT: Paper

Strand: The Self

'Self-Disclosure Re-Visited: Disclosure Preferences Of Mature Students'

Sidney Jourard and his associates popularised self-disclosure as a subject for extensive, scientific inquiry in the early 1960s. The research abstracted here was designed to answer the question "What problematic issues concern mature students and to whom do they prefer to disclose these issues?".

Two null-hypotheses were formulated. These were, for mature students -

1. The number of self-disclosures will not be greater for mature male students than for mature female students

2. There are no gender-related differences in mature students' self-disclosure preferences and profiles

The research question was answered by means of a questionnaire survey that contained 22 problematic and 8 positive items and 10 disclosure targets (Partner, Male Relation, Female Relation, Male Friend, Female Friend, Male Tutor, Female Tutor, Male Counsellor, Female Counsellor and Others) and Nobody. The questionnaire was completed by 144 mature students (N = 44 male students; N = 100 female students).

Through analysing the questionnaire responses, it was possible to identify disclosure preferences and to compile disclosure profiles. The difference between the total number of self-disclosures made by male and female students was statistically insignificant (which led to an acceptance of the first null-hypothesis). However, there were statistically significant differences in male and female disclosing preferences and disclosure profiles (which led to a rejection of the second null-hypothesis). The differences were investigated by the researcher and 3 focus groups.

The most popular disclosure target for both male and female students was Partner. For females, the next most popular disclosure target was Female Friend while for males it was Male Tutor. For both males and females, Counsellors (Male and Female) were the least popular disclosure targets. At least 20% of males did not disclose on nine items and at least 20% of females did not disclose on eight items. The relative unpopularity of counsellors as disclosure targets is an aspect that warrants further investigation.

(If any researcher would like to conduct a follow-up study using the same questionnaire please contact Dr Ken Fisher at the above address, Tel (day): 01204 528851)

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Dr Royston Flude

Institution: Department of Education, University of Manchester
Contact address: Apartment 4, 10 Springfield Road, Altrincham, Cheshire, WA14 1HS
Email: RoystonFlude@compuserve.com

ABSTRACT: Paper

Strand: The Self

The Journey Into Work

The problem of long-term (more than twelve months) unemployment in the age group 18-24 is a major concern throughout the European Union. This group represents the role model for the younger generation and they are the parents of the next. This problem is at its worst in inner city areas where high social and economic deprivation exacerbates the negative side effects of crime, substance abuse, illness and teenage pregnancy.

Conventional models of Community Development have been largely unsuccessful, using a 'top-down approach', which tends to dissipate resources and encourages bureaucratic processes. An extensive review of Welfare to Work programmes has been conducted and this paper hopes to encourage lively debate and stimulate informed opinion. It is proposed to test the findings by using the innovative person-centred CASEPT Programme.

The CASEPT Programme is a person-centred modular initiative that works to 'switch the light on' inside each individual and facilitate self-determined change. This programme has already been piloted in Partington (a suburb of Manchester, England) and achieved sustainable employment for over 80% of the participants. A further pilot programme is being delivered in Moss Side & Hume (Manchester, England) to examine the impact of ethnic diversity and the reproducibility of outcomes. The CASEPT Programme provides a person-centred approach to change and recognises the unemployed person's journey, which for each individual will be different and that they may get stuck in 'helplessness'. It also recognises that service providers, that are mostly funded directly or indirectly from government raised taxes, must 'justify the benefits' they deliver. From the employer's perspective the major obstacle is to overcome the 'fear of failure' that might result from an inappropriate recruitment. Finally, there is a parenting journey to ensure ease of transition into the new environment and 'sustainable achievement'.

The CASEPT approach considers a pathological view of deprived communities and families, considering how 'inadequate parenting' may be linked with socio-economic and locational factors. Whilst the CASEPT Programme emphasises the need of the individual to become 'functional' and make personal decisions, it does recognise that there may be cycles of deprivation that have their roots in economic organisation that tend to reinforce marginalisation to create an 'underclass'.

These concepts have been drawn together in a mind map (Buzan, 1993) of the variables that impact on long-term unemployed people aged 18-24 in making effective and sustainable employment decisions. The CASEPT Programme is very effective at facilitating a group of disillusioned long term unemployed people in the age group 18-24 to operate as a team, re-establish self-worth and motivation and to be aware of their ideal career direction. The programme has also demonstrated that it is able to change negative behaviour patterns and actively encourage participants to seek and obtain work. The CASEPT programmesconsiders these four journeys (unemployed person, government, employer & parental) and uses a unique combination of interventions to achieve 80% employment within 12 weeks (4 weeks intensive & 8 weeks follow-up).

(Published by EPT, European Policy Forum, March 1999)

"The CASEPT Programme has been developed to facilitate long-term unemployed youth into employment. Further details may be found on our web site CASEPT.com and a copy of the complete study (548 pages) from Howdomado publishing at PO Box 214, Altrincham, Cheshire, WA14 3LJ at a cost of 100 plus 7.50 for postage and packing." All proceeds will be used to defray the research costs.

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Lynne Gabriel

Institution: College of Ripon & York St John
Contact details: 97 Carr Lane, York YO26 5HN
Email: gabriel@ogma.u-net.co

ABSTRACT: Paper

Strand: Effects and Consequences of Research on Counselling Practice

Speaking The Unspeakable: Dual Relationships In Counselling And Psychotherapy
Definition and terms

A dual relationship in counselling and psychotherapy is defined here as a situation where the therapeutic relationship exists concurrently, or sequentially, with another role or roles outside therapy. For ease of reference, the term duality is used to refer to dual relationships in counselling and psychotherapy, therapist to refer to either counsellor or psychotherapist, and therapy to either counselling or psychotherapy.

Abstract

The paper discusses a qualitative research project exploring client and therapist

experiences and perceptions of duality. The aim of the research is to develop a theory that can account for a range of dual relationship situations, advance our understanding of the phenomena, and suggest ways of working with duality. Preliminary findings from pilot interviews and some research issues encountered during this phase are presented.

Preliminary results from the pilot interviews are considered against professional perspectives on duality. Themes arising from the results, including issues of secrecy, shame, guilt, and confusion about duality; issues related to the concepts of transference and counter-transference; power and trust dynamics in the relationship; the emotional impact of duality, and ways of coping in dual relationship situations, are discussed. The phrase included in the title of this paper, 'Speaking the Unspeakable' is discussed through the concept of a duality taboo, and linked to issues of secrecy, shame and confusion about dual relationship behaviour. Preliminary findings suggest that where a therapist's knowledge, skills and abilities in ethical problem-solving, decision-making and self-reflexive practice are well developed, duality situations and dilemmas are more effectively and appropriately managed.

Research issues arising from the pilot phase interviews are discussed under two main headings:

confidentiality: including issues of informed consent, disclosing issues of a sensitive nature (eg, the topic may be perceived as 'dangerous territory' for a therapist to discuss), anonymity, and limits of confidentiality within the research interview context

role conflict: including researcher-therapist role conflict where the researcher is also a practising therapist, issues related to the moral principle of non-maleficence (eg: not harming research participants through, for example, developing a sexual relationship with them).


Examples from the pilot phase will be used to illustrate the above areas and consider ways of working with confidentiality issues and researcher role conflict. Codes of ethics, professional guidelines, and moral principles that underpin the activities of the helping professions are considered for their potential for resolving researcher / research dilemmas.

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Dr Jeremy E. Halstead

Institution: Dewsbury Health Care Trust & Huddersfield University
Contact details: Healds Road, Dewsbury WF13 4HS
Email: jeremyhalstead@bigfoot.com

ABSTRACT: Poster

PACE-31: The Development Of A New Measure Of Outcomes In Counselling

In recent years there has been an increasing acceptance among both psychotherapists and counsellors of the importance of the measurement of therapeutic outcomes. The demonstration of clinical effectiveness has an important role both as part of internal audit and in presenting the work of a counselling or psychotherapy service to the outside world. Clinicians seeking to demonstrate change have traditionally made use of instruments developed in research institutes such as the Beck Depression Inventory (BDI) and the Symptom Checklist 90. These instruments have a number of merits, including acceptable psychometric properties and wide usage allowing comparisons to be made among studies. In recent years, however, price rises and more assertive protection of copyright have made these instruments less adaptable to clinical settings.

The Psychotherapy and Counselling Evaluation measure (PACE-31) has been developed over a number of years with the specific intention of overcoming some of the difficulties encountered by these instruments and a desire to develop a measure more directly addressing change measurement in shorter term counselling and psychotherapy. PACE-31 was developed with a view to achieving specific psychometric properties. Achieving adequate psychometric qualities for a scale almost inevitably involves making compromises. Longer scales measuring a single symptom domain are likely to have higher internal reliability than shorter scales. Scales measuring more stable aspects of personality are likely to have greater test retest reliability but may be less sensitive to change. The aims in constructing the shorter scale have been:

  • To measure several symptom domains, while limiting the length of the overall scale.
  • To produce sub-scales that are internally reliable.
  • To produce sub-scales with adequate test retest reliabilility.
  • To produce sub-scales that are sensitive to change.
  • To produce at least one sub-scale that correlates highly with a reference scale. In this case the BDI

Preliminary development included analysis of earlier self-relatedness and distress symptom scales. These along with new items were used in the construction of a 64 item scale. This scale was administered together with the BDI to 106 clients (age mean =36.88 sd = 12.04, BDI mean = 26.77 sd = 11.60), referred by GPS for brief (six session) counselling by experienced counsellors. Sub-scales were derived on the basis of predetermined face validity and factor analysis. These mixed methods resulted in nine distinct sub-scales, and three combined sub-scales. These are: self-esteem, dissociation, numbness, depression 1 (self-destructive), depression 2 (pessimistic), anxiety 1 (general), anxiety 2 (phobic), apathy, and cognitive problems. The combined scales are: depression 1 and 2, anxiety 1 and 2, and dissociation and numbness. Measurements were taken of internal reliability, test retest reliability, correlation with BDI and effect sizes after five sessions of counselling.

Detailed results are presented for: internal reliability (range .65 to .88 median .79 for distinct, .80 to .87 median .81 for combined); and test retest reliability(.81 to .92 median .86 for distinct, .88 to .93 median .92 for combined). Correlations among sub-scales and between sub-scales and the BDI are reported.

Effect sizes for distinct and combined scales are reported.

Preliminary data from a partial replication study (N = 100) are presented. The figures for internal reliability are maintained or improved. This study also presents correlations of the sub-scales with the BDI-2.

PACE-31 has been shown to be a measure of severity of client symptoms that has good psychometric properties and is appropriate for use in brief counselling.

The more widespread adoption of this and similar measures will enable counsellors to counter criticisms that counselling is ineffective or that counsellors use unscientific methods to support their claims of effectiveness.

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Nigel Hamilton and Dr. David Hiles

Institution: Centre for Counselling and Psychotherapy Education
Contact details: Beauchamp Lodge, 2 Warwick Crescent, London, W2 6NE,
Email: info@ccpe.org.uk

ABSTRACT: Paper

Strand: Counselling, Spirituality and Christian Belief

Retreats, Dreams: New Transpersonal Research

A current research study is looking at the contexts of people's dreams whilst on a solo spiritual retreat. To date each subject is asked to record their dreams and relate them to the Retreat Monitor who visits them once daily to provide guidance, support and spiritual exercises during their retreat. These retreats vary from 10 days to 40 days in duration. The dreams are then examined after the retreat. A new qualitative research method suitable to this research context had to be developed that could be repeated, compared and contrasted in several ways so as to expose the invariant qualities present in the dream experiences and thus give a measure of objectivity to the research and its method. This included a careful sifting out of extraneous material and a repeated reviewing and re-digesting of the dream material presented.

Preliminary analysis of the dream material shows that the dreams are acting as an indicator of:

a) The stage of the process (of transformation) of the Retreatant,

b) Depth of consciousness reached (or degree of subtlety of consciousness achieved),

c) The personal issues / conflicts that were being worked through in the retreat process, and which gave way subsequently to the emergence of fresh human qualities, that previously lay dormant in the personality.

These results have so far shown the existence of at least seven subtle levels of consciousness. These were identified as landscapes in the dreams that had a particular set of qualities which matched the feeling of the subject at the time.

Surprisingly certain personal issues when resolved seem to facilitate the emergence of a particular subtle level of consciousness, whilst other conflicts reveal other levels of consciousness. Four main stages of the process have emerged, each earmarked by the dream material. The implications of this research for transpersonal counselling practice will be discussed, and the conclusions drawn so far are that:

i) There are other dimensions of the human personality that seem to have an existence independent of the waking, material consciousness and yet are linked to and participate in our personal lives,

ii) Dreams are a means of accessing these levels of consciousness.

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Vivien Hunot, R. Churchill, R. Corney, M. Knapp, H. McGuire, A. Tylee and S. Wessely

Institution: Health Care Evaluation Unit, St. George's Hospital Medical School
Contact details: Cranmer Terrace, London, SW19 0NE

ABSTRACT: Paper

Strand: What Works for Whom?

A systematic review of controlled trials of the effectiveness and cost-effectiveness of brief psychological treatments for depression

Depression is a common condition, with an estimated 20-30% of the adult population in the UK experiencing depressive symptoms at any one point in time. During the last two decades, a wide range of time-limited psychotherapy models have been developed and used within health care settings as an increasingly popular alternative intervention to antidepressant medication in the treatment of depression. This paper reports on the findings of a systematic review and meta-analysis which was conducted to assess and summarise all available evidence on the effectiveness and cost-effectiveness of brief psychological treatments for patients with depression. A comprehensive search strategy was employed to identify all published and unpublished randomised controlled trials or quasi-randomised controlled trials conducted in an outpatient setting, that compared theoretically underpinned time-limited psychotherapy approaches with one another or treatment as usual control group, and involved adult patients with primary diagnosis of depression. The main outcome measure was defined as change in depression system levels. In order to make comparisons between the psychotherapeutic models described and examined in the studies, psychotherapy models were categorised into psychodynamic, interpersonal, cognitive-behavioural and supportive groups. 64 trials were eligible for inclusion in the review, of which just under half reported sufficient data for meta-analysis.

Preliminary results from the meta-analysis, using odds ratios and confidence intervals calculated from dichotomous outcomes (clinical improvement versus no clinical improvement), indicated that all variants of brief psychological treatment were more effective in attaining recovery from depression than treatment as usual. A possible economic advantage for brief psychological treatments over treatment as usual was also indicated. Problems with insufficient data, potential publication bias, low scores on internal validity items and inadequate reporting of methodology limit confidence in the findings. A full report with further results from the review and meta-analysis has been submitted to the NHS R & D Health Technology Assessment programme for peer-review. The report will be available on the HTA website early next year, and results from the review will also be published.

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Prof. Keith Macrosson (author) Jane Chisholm (presenter)

Institution: Couple Counselling Scotland
Contact details:40 North Castle Street, Edinburgh, EH2 3BN

ABSTRACT: Poster

Couple Counselling Scotland
Client Service Surveys 1 + 2, 27 April 1998

Description of Research
Couple Counselling Scotland (previously Marriage Counselling Scotland) and its 14 local counselling services undertook two questionnaire based surveys in 1997 and 1998 to ascertain how clients perceived the organisation and the service offered.

The questionnaires were devised and piloted by Couple Counselling Scotland with external assistance. The evaluation of the responses was undertaken by Professor Keith Macrosson, Faculty of Business, University of Strathclyde.

Every client who came to see a counsellor in the week beginning 21 April 1997 was given an opportunity to respond at the end of a counselling session or return a questionnaire by post. A couple were asked to complete two questionnaires (survey 1 - 1997).

In addition, clients were asked to complete a separate sheet if they were willing to be contacted in one year to answer a following questionnaire. Over 50% agreed to be contacted (survey 2 1998).

Result of Survey

Clients were better able to cope with relationship difficulties than when they first entered counselling.

No conclusion could be drawn as to whether or not counselling affected clients needs for public funded services such as Health, Housing and Education.

Older clients, who perhaps have older children, believe that their children are affected more by their relationship problems than younger clients. They also believe that their children have been helped less as the result of their parents being in counselling, than younger clients.

Implication and Recommendation

The importance of monitoring the service from the client's perspective.

The need for more in-depth research on a number of the issues raised e.g. the effect of couple counselling on children.

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Elsa Muller Sala

Professional Role: Research Student
Institution: University of Strathclyde
Contact address: Dwarswateringkade 11, 2353 AA Leiderdorp, Holland
Email: basal@planet.nl

ABSTRACT: Poster

An Investigation of Parental Empathy Towards Young Children ages 1-5

An investigation of parental empathy towards young children (ages 1-5), aiming to provide some insight into the construct of empathy as part of (or absent from) parenting practices. In this study, empathy is defined in Rogerian terms as: 'the process of (as far as possible) assuming the internal frame of reference of the child, perceiving the world as the child sees it, perceiving the child itself as seen by the child, and communicating some of this empathic understanding to the child, without losing track of one's own emotional and cognitive state'.

Arguments are presented justifying this definition of empathy and to clearly differentiate empathy from sympathy, something few other researchers have done, judging from the literature.

A tentative hypothesis is that parental empathy can be related to, or can result from, understanding and acceptance of Rogers' Proposition V: "Behaviour is basically the goal-directed attempt of the organism to satisfy its needs as experienced, in the field as perceived" (Rogers 1951 "Client-centred therapy" p 491)

During the 'pilot-study' stage, parents' meetings were held at various Nursery schools in the Glasgow area to discuss joys and difficulties of parenting, discussions that were noted and taped. These comments and subsequent lengthy interviews with two different parents were discussed and analysed qualitatively and presented as case studies.

Currently, in the concluding stage, attempts are made to look at the role of empathy, in parental responsibility (including children's and parents' needs and rights) and parent-child interaction (including discipline or limit setting). In addition links are established between empathy and the concept of 'good enough' parenting. Tentative conclusions are likely to comprise the following points:

i) There appears to be more evidence of fearful parenting (with struggle, difficulties, conflict, isolation, dissatisfaction, uncertainty and worry) than of confident, relaxed parenting of young children;

ii) Empathy or the ability to respond empathetically to child and/or self facilitates smoother parent-child interaction;

iii) A greater sense of 'good enough' parenting, requiring a measure of self-awareness and self-empathy, is equivalent to greater parental confidence and enjoyment of parenting.

Finally, recommendations or suggestions for further research or dissemination are to be presented.

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Steve Page

Professional Role: Head of Counselling Service
Institution: University of Hull
Contact details: Hull, East Riding of Yorkshire, HU6 7RX
Email: S.J.Page@cnsv.hull.ac.uk

ABSTRACT: Poster

Qualitative Study Of The Experiences Of Members Of A Supervision Group Based Upon The Cyclical Model Of Counsellor Supervision

The Cyclical Model of counsellor supervision was first published in Page, S. and Wosket, V. (1994) Supervising the Counsellor, London. Routledge. It was applied to one-to-one supervision initially, so the purpose of this study is to explore the experience of the members of a counselling supervision group facilitated using this model. It is intended that some of the data and subsequent analysis will be included in a chapter on 'Supervising in Groups' to be included in the forthcoming 2nd edition of Supervising the Counsellor.

Five counsellors are taking part in a supervision group that meets for two hours per month from November 1998 - July 1999. Each participant had an individual semi-structured one-to-one interview prior to the start, and will have a further interview after the end of the group. Following initial contracting the supervision group sessions have a fairly typical format: contracting time and focus, presentation of material with feedback and discussion, closing with a short period of review. The facilitation model is one of collective participation. Supervisees (and supervisor) keep a journal of their experience of the group focussing on three perspectives:

  • As a supervisee (facilitator) within the group
  • As a member of the group
  • As a co-supervisor of the counselling work of other participants.

These journals are submitted after the end of the group in order to safeguard against a conflict between my roles as researcher and supervisor. There is to be an additional meeting of all participants to review the research process part way through the life of the group.

This will be research in progress at the time of the conference - hence poster presentation.

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Steve Potter

Professional Role: Director of the University & UMIST Counselling Service
Institution: The University of Manchester
Contact details: 5th floor, Crawford House, Precinct Centre, Oxford Road, Manchester, M13 9QS,
Email: councel.service@man.ac.uk

ABSTRACT: Paper

Strand: Working Together

Using The Core System Of Service Evaluation In A Student Counselling Service

The Clinical Outcome Routine Evaluation System which has been developed by the Leeds Psychological Therapies Research Centre and the CORE system group, has been used by the University of Manchester & UMIST Counselling Service for the past 18 months. The Counselling Service has a team of 8 experienced counsellors and 15 trainee or honorary counsellors working in the service. The service is mainly using cognitive analytic psychodynamic or general counselling approaches.

In this presentation I will discuss the data obtained so far, drawing upon 400 cases and tell the story of our learning, both from the individual use of the CORE form with clients and the general shift to a more evidence based and research literate approach in our service. I will raise some of the pros and cons we have found from using CORE and some of the practical and ethical issues involved.

Finally, I will look at the impact of the CORE as a catalyst for increased research awareness and research literacy and our own efforts to identify further research activities both in terms of outcome measures and investigation of the therapeutic process I shall also refer to the value of the link with the Leeds Psychological Therapies Research Centre and the importance perhaps of counselling services joining together to do a multi agency evaluation of effectiveness.

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Dr Suzanna Rose

Institution: West Berkshire Traumatic Stress Service, Erleigh Road Clinic, Erleigh Road, Reading, Berkshire, RG1 5LR
Contact details: Mulberry Mead, Winchcombe Road, Twyford, Berkshire, RG10 0AD
Email: suzanna.rose@virgin.net

ABSTRACT: Paper

Strand: What Works for Whom?

Psychological Debriefing And Evidence Based Practice

It has been suggested that giving people the opportunity to talk about a traumatic event in a structured way may prevent the development of a later disorder. A systematic literature search/review was undertaken of one-off psychological interventions following trauma. Only 6 randomised controlled trials were found and none of these were of group interventions. Of the six trials two studies associated the intervention with a positive outcome, two demonstrated no difference in outcome between intervention and non-intervention groups and two showed some negative outcomes in the intervention group. This review suggests that early optimism for one-off interventions including debriefing was misplaced and that there is an urgent need for randomised controlled trials of group debriefing and other early interventions. This review formed the basis of a new Cochrane Collaboration Review. Subsequently, a randomised controlled trial of psychological debriefing for victims of violent crime was undertaken.

We tested the efficacy of two brief interventions, education and psychological debriefing, designed to prevent adverse psychological reactions to criminal victimisation. 157 individuals who had been the victims of a violent crime within the past month were randomly assigned either to an education condition, to a psychological debriefing plus education condition, or to an assessment only condition. Education involved providing information about normal post-traumatic reactions. Debriefing involved in-depth probing about events, thoughts and feelings experienced during the crime. Subjects were recruited from police and hospital sources and interviewed in their own homes. 138 were followed up at 6 months, and 92 at 11 months. Outcome was assessed using a DSM-IIIR diagnosis of PTSD, the Post-traumatic Symptom Scale, the Impact of Event Scale, and the Beck Depression Inventory. All groups improved over time but there were no between-group differences. No evidence was found to support the efficacy of brief one-session interventions for preventing post-traumatic symptoms in victims of violent crime. When the data were examined predictively it was possible to identify the minority of victims who subsequently went on the develop PTSD and currently a brief screening instrument is being developed around these findings.

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Lesley Seddon

Professional Role:PhD Student
Institution: Applied Social Science, Lancaster University
Contact details: Vine House Cancer Centre, 22 Cromwell Road, Preston, Lancashire, PR2 6YB
Email: lseddn@premier.co.uk or lseddon@globalnet.co.uk

ABSTRACT: Paper

Strand: What Works for Whom?

Hoops, Hurdles & Hotspots: The Practicalities Of Cancer Patient Research

Research In Progress

The Comparative Efficacy of Counselling & Complementary Therapy on the Minimisation of Psychological Morbidity in a Population of Cancer Patients: A tentative and pragmatic first step towards systematic enquiry.

Abstract

The psychosocial needs of cancer patients have received much attention over recent years and indeed remain one of the key areas for investigation within the NHS National R&D Cancer Programme. This prospective study aims to investigate the comparative efficacy of counselling, relaxation and reflexology in a heterogeneous population of cancer patients in an attempt to ascertain what works for whom in terms of psychosocial intervention. Outcome comparisons will be made between treatment groups and also across specific patient variables with a particular focus on Self-Efficacy and Locus of Control to see how these influence outcome.

As the incidence and prevalence of cancer disease has increased so has the demand for psychosocial intervention within oncology and palliative care. In the broadest sense such interventions incorporate a commingled array of activity at the patient-professional interface and at the heart of this activity lies the goal of cancer patient adjustment and coping. Nurses, counsellors, doctors, and complementary therapists etc all play a significant role in the cancer patient's illness experience but more importantly the patients themselves often seek out complements and additions to their mainstream medical care.

Stemming from observations within community based cancer daycare facilities this current study has been developed as a pilot investigation which is investigating the outcomes of three therapeutic activities. Patients using counselling, relaxation or reflexology will be tracked and the outcomes of these groups evaluated. These services have been selected as they are commonly used by cancer patients across a wide range of disease variables and have a growing body of evidence to support their use along side conventional cancer treatment/care - especially in terms of anxiety management and helping patients cope with the demands of their cancer. These particular interventions may differ significantly in their methods but common to them all is the fact that they attempt to reduce or prevent psychological morbidity, enhance quality of life and augment subjective well-being irrespective of physical condition and disease status.

Amidst the current climate of 'Evidence Based Practice' this research, in trying to identify what therapy works best for what kind of individuals, could help centres align patient need and service provision thus making best use of available resources. Facilitating patient adjustment to cancer and helping patients to cope is nothing new in the world of holistic cancer care, yet the challenge of generating evidence which shows how these adjuncts to conventional treatment benefit certain patient groups and how their use by patients reduces the draw on NHS resources remains - the project is a direct response to this challenge.

In terms of methodology the design can be described as a pragmatic design that incorporates elements of scientific enquiry and also captures subjective experience. This paper is a discussion document as it is introducing research in progress rather than presenting data or making recommendations. The challenges of developing a methodology that can satisfy the demands of diverse professional groups, that can capture patient experience, appeal to the funding body and gain ethical approval across three NHS research and ethics committees are discussed.

Funded & Supported by a Studentship Award from NHS Executive North West R&D Directorate, October 1997 - October 2000.

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Jane Speedy & Dr Kim Etherington

Professional Role: Lecturers in Counselling
Institution: Department of Continuing Education University of Bristol
Contact details: 8-10 Berkeley Square, Bristol, BSS 1HH,
Email: Jane.Speedy@bris.ac.uk

ABSTRACT: Paper

Strand: Effects and Consequences of Research on Counselling Practice

Personal Development As An Intended Consequence Of An Experiential Counselling Research Training Programme.

Much of the literature of counselling research from both Britain and the United states explores the efficacy of research training programmes in terms of increased research and researcher knowledge and competency, of professional development for individual practitioners and of the advancement of 'evidence-based' practice. All are important and worthwhile endeavours.

On the rare occasions, however, that counselling researchers acknowledge their research as a tool for personal development, this is done in, at best a surprised and at worst a shamefaced manner, as if it were a completely unintentional by-product of a different enterprise with an altogether higher purpose.

This paper outlines an experiential, person-centred programme of counselling research training developed for the MSc programmes in Counselling and Counselling Training and Supervision at the University of Bristol. It explores some of the 'rich texts' and 'thick descriptions' collected from course evaluations and research conversations with former students and distils these into a fertile synthesis of moments of personal change, choice and 'searches for meaning' the synthesis, or summary being obtained by a heuristic, co-operative research process shared between students and course facilitators.

Our research findings are tentative, and might better be described as 'the story so far', form part of an ongoing, developmental process. This is, perhaps, a congruent reflection of a research training framework embedded within an integrative, developmental counsellor, education programme. Nonetheless, our current understanding would suggest that the strengths of counselling researchers in illuminating 'particular' and 'intimate' human experiences may also lead to significant, and particular moments of self-awareness and of understanding of self in relation to others and to contexts, systems and organisations. This holds particularly if this possibility of personal development is made explicit and encouraged as a legitimate research device but also as an expected research outcome, rather than as an accidental aspect of counselling research education.

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Dr Gillian Thomas

Institution: Royal Berkshire and Battle Hospitals NHS Trust
Contact details: 2nd Floor Thames Block, Battle Hospital, Oxford Road, Reading, Berkshire, RG3 1AG

ABSTRACT: Paper

Strand: Effects and Consequences of Research on Counselling Practice

"Counselling Research - What's The Use Of It?"

The proposal is to stimulate a discussion on the use of counselling research in the day to day work of counsellors. To provide a context, the research study undertaken by the presenter, "The place of counselling in the care of people affected by inflammatory bowel disease" (known as ibd) will be briefly described.

Emphasis will be placed on how the clients involved in the research used their participation as part of the therapeutic process, referring to taking part in the study as the means to achieving an aim held by many - that of helping others affected by ibd. Equally stressed will be how the presenter has used the knowledge of what the research participants stated as being particularly helpful about counselling and the counsellor's approach, in her continuing work with people affected by ibd.

This description is only intended to act as a springboard for discussion on how or if research findings, whether resulting from the practitioner's own research or that of others, can be translated into a more informed, more valuable service to clients.

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Dr William West

Institution: Counselling Research & Training Group, CEN, Faculty of Education, University of Manchester
Contact details: Oxford Road, Manchester M13 9PL
Email: william.west@man.ac.uk

ABSTRACT: Paper

Strand: Counselling, Spirituality and Christian Belief

The Challenge Of Qualitative Research Into Counselling And Spirituality

Researching counselling and spirituality using qualitative methodologies presents a number of challenges to the researcher which includes: defining what spirituality is, and its relationship to counselling; dilemmas around the role of the researcher including that of bracketing; and finally specific difficulties relating to spirituality - for example the ineffability of spiritual experiences. Drawing on two recent research studies by the author (West 1997, 1998) Moustakas' heuristics will be considered as one possible way of researching counselling and spirituality that addresses rather than avoids these challenges.

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Sheila Wetton

Institution: University Hospital, Aintree NHS Trust, The Department of Psychological Services,
Contact details: Lower Lane, Liverpool, L9 7AL

ABSTRACT: Paper

Strand: Working Together

Counsellors' And Psychologists' Attitudes About Working Together

The purpose of this study was to explore the perspectives of counsellors and clinical psychologists about working together and to compare the findings to the advantages cited in the literature. Specifically, attitudes towards integrated services, perceptions of role competency and function and employment circumstances between professions were compared. The design of the study included a postal questionnaire survey of psychology services within Merseyside and Greater Manchester and follow-up, semi-structured interviews of a selected sample of participants.

Results showed counsellors and clinical psychologists have positive attitudes about working together in order to sell a unified service, enable better integration and communication between professions, increase the knowledge diversity and variety of skills in the service, promote learning and understanding between groups and improve services to patients. Furthermore, psychologists can prioritise their work loads while counsellors, through their collaboration with clinical psychologists, can use clinical psychology's established influence within the National Health Service (N.H.S.) to increase its own legitimacy; reflecting findings in the literature. However, some inequalities between groups concerning employment circumstances, status and negative stereotypes about counselling where highlighted. Results suggested such differences can lead to tension and conflict between groups. Role ambiguities coupled with the 'goal posts shifting', so counsellors work more with clients with complex problems, in addition to job insecurities experienced by some counsellors, fragmented work environments and communication problems are all factors likely to contribute to work stress. In addition a minority of psychologists feared that counsellors may undermine their profession.

Interdisciplinary psychology services are recommended, but such inequalities and role ambiguities need to be openly addressed. A number of recommendations are proposed, including further the professionalisation of counselling and more research of counselling's effectiveness (of a more qualitative nature) to increase counselling's credibility in the NHS.

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Sue Wheeler and David King

Institution (SW): University of Birmingham, School of Continuing Studies
Contact details: Birmingham, B15 2TT
Email: S.J.Wheeler@bham.ac.uk

ABSTRACT: Paper

Strand: Factors affecting Training and Supervision

Supervision For Supervision: A Vital Support For Supervisors Or An Unnecessary Expense?

The BACP Code of Ethics for Supervisors requires professional counsellors supervising other counsellors to have regular access to consultative support or supervision related to their work as supervisors. There are no similar requirements for psychotherapists, psychoanalysts, clinical psychologists or members of other professions offering therapeutic interventions. Experienced counsellors and supervisors advertising themselves as supervisors in the BACP Directory of Counsellors were surveyed about their interpretation of this BACP requirement, their thoughts and feelings about it, and their practical experience of the supervision of their supervision. Information was also collected about the nature of the issues raised with their own supervision consultant and with supervisors to whom they acted as consultant.

At the time of writing this abstract, results are yet to be fully analysed, but early indications are that a wide range of issues are discussed in supervision and that the opportunity to discuss problems in supervision is welcomed. A further indication is that supervisors would be unlikely to seek supervision for their supervision if it were not a BACP requirement. Full results will be presented at the conference.

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Frank Wills

Institution: Counselling Studies, Department of Health and Social Care, University of Wales College
Contact details: NEWPORT, South Wales
Email: frank.wills@newport.ac.uk

ABSTRACT: Paper

Strand: Factors affecting Training and Supervision

The Use Of The Myers-Briggs Type Indicator (MBTI) In Research In Counselling And Psychotherapy

The Myers-Briggs Type Indicator (MBTI) was devised by Kathleen and Isobel Briggs to make the Jungian Theory of Psychological Types more easily accessible to non-psychologists. It identifies 16 basic psychological types, based on estimating personality characteristics such as Extraversion/Introversion, Feeling/Thinking etc. Researcher such as Debra Erickson in the USA and Rowan Bayne in the UK have used it as a way of determining various counselling preferences for both clients and counsellors.

I am particularly interested in the training of Cognitive-Behavioural Counsellors and the way that their training is influenced by pre-existing attitudes and beliefs, including those indicated by the MBTI. For example, there is some evidence that personality types with a preference for 'Thinking,' prefer Cognitive and Behavioural therapies. However, MBTI and Jungian theory might also be taken to say that such 'Thinking' types may tend to over-use cognitive strategies and, conversely, overuse emotional strategies. Aaron.T.Beck has made it abundantly clear that Cognitive Therapists will not be competent if they are not at ease at dealing with clients' feelings. I am interested to explore the full significance of these factors for trainees and trainers.

The MBTI, however, is not an entirely straightforward research instrument to use. There are some confusions regarding the meaning of the numerical strength of its dimension measures, which limit the statistical applications that can be used in relation to it. Additionally, interpretation of MBTI results require care as there are sometimes subtle interactive effects - for example, that some people who experience emotional hurt may in effect learn to put 'Thinking' 'up front'. These complications lead some critics to compare the MBTI to Astrology. This researcher, however, has found the MBTI very useful and, by the time this paper is delivered, will hopefully have yet more experience of its use in research to describe.

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Val Wosket

Institution: Counselling Studies, College of Ripon and York St John
Contact details: Lord Mayor's Walk, York
Email: v.wosket@ucrysj.ac.uk

ABSTRACT: Paper

Strand: The Self

Counselling Research And The Therapeutic Use Of Self

The research comprised an 18 month study of a counselling relationship with a severely depressed client. The qualitative study was intended to explore the therapist's use of self and to systematically uncover significant aspects of the client's covert experience. It was postulated that the therapeutic dialogue revealed only a small portion of a richer, inner story that was simultaneously being lived by both client and counsellor. The methodology involved guided, structured recall using sentence stems as prompts to promote counsellor and client reflexivity. Counsellor and client recorded separate reflections of each counselling session which were compared only after the therapy ended.

Data revealed important insights into what the process of change is like for a client. From the data provided it was possible to track the impact of the therapist's use of self upon the client. It was evident that structured session-by session reflections on the therapy by both counsellor and client provided a feedback loop into the counselling process that had an immediate impact on how it unfolded. The research process appeared to stimulate additional therapeutic opportunities as many of the client's disclosures and the counsellor's interventions were called forth by the act of research itself.

The study highlights the important learning that may be gained by counsellors who conduct research into their own practice. It is argued that research such as this can provide a unique forum for the counsellor's ongoing personal and professional development. The study also provides evidence that practitioner research can enhance therapeutic outcomes and the quality of the therapeutic process experienced by the client. The study suggests the significance of work that is carried out at the interface of therapy and research. It demonstrates how these two activities, rather than being divergent, can be complementary and thereby promote counsellor-client mutuality and reciprocity.

A fuller account of this research and the issues raised are to be found in: The Therapeutic Use of Self: Counselling Practice, Research and Supervision, by Val Wosket (London: Routledge 1999, ISBN 0-415-17091-5)

 
       
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