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Research Conference 2000  


BAC's 6th Annual Research conference was entitled 'Opportunities and Challenges in 21st Century' and took place on 20 May 2000. It was held at the Weston Building, University of Manchester in association with The Counselling Research & Training Group, University of Manchester.  

Click here for an evaluation of this year's conference

Abstracts



Kate Anthony

Initution: University of Greenwich
Contact Address: 82 Tormount Road, Plumstead, London SE18 1QB
Email: kateanthony@aol.com 

ABSTRACT: Paper

Strand: Theoretical Issues and Communication

The Therapeutic Relationship within Online Counselling

In response to the growing need for a study of the phenomena of Online Counselling, this research provides a qualitative examination of the nature of the therapeutic relationship between the Counsellor and Client whose communication is conducted over the Internet.

Professional participants were recruited through an email inviting them to visit the researcher's website to learn about the project. These email addresses were found by 'surfing' the Internet for Counsellors who offer a service online. Participants are based 'webwide', that is, they are from the UK, USA, Australia and elsewhere. The study is also noting the possible differences between the orientations of the Counsellors and the type of Online Counselling they employ.

The clients of Online Counselling were recruited by a link via the websites of some of the Counsellors, inviting them to voice their experience. This ensured that they were not approached (causing a break in confidentiality).

After the initial communication via the researcher's Website, an email was returned by the researcher explaining the logistics of the interview. These interviews were conducted online via synchronous messaging, via AOL, ICQ or YAHOO (therefore being consistent with the experience of an online relationship) at the convenience of the respondent.

The Online relationship is one that needs scrutiny, not dismissal. The findings of this study will be presented and discussed in relation to a new theoretical orientation which involves the advent of the Internet.

Further information: www.onlinecounsellors.co.uk

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Christina A Birtwistle

Professional Role: Counsellor/Psychotherapist
Institution: General Practice and Liverpool John Moores University
Contact details: 50 Greasby Road, Greasby, Wirral, CH49 3NE
Email: christina300ab@aol.com

ABSTRACT: Poster

Clients' Perceptions of the Effectiveness of the Counselling Service within their General Practice Setting in West Wirral, Merseyside

In this small, local study the counsellor will research all the clients she has counselled in a GP's surgery, over the 9 months prior to the study. Clients are referred by all 9 doctors practising in the 3 surgeries belonging to this large Group Practice, situated in a suburban area in West Wirral, Merseyside.

All clients are asked, both at the beginning and end of their counselling, if they are willing to accept the postal-questionnaire, when their counselling is finished. They are told that they are not obliged to take part in the survey; they need answer only those questions with which they feel comfortable; they may withdraw from all or part of the study at any time, and whatever they decide, their treatment will not be affected in any way. Clients will not be asked for their names; addresses; ages; gender; ethnicity; occupation; or number of sessions, anywhere on the questionnaire, to ensure complete anonymity. It is hoped that such assurance will promote valuable, reliable and valid data. If clients do agree to participate, they are asked to sign a form, stating that they are willing to do so.

Comparison will be made between clients' perceived change in presenting problems after counselling, with perceived change whilst on the waiting list. Clients are asked if they would have preferred to meet with a male counsellor, at a different time, or in a different location. They are also asked about their perception of the counselling room, and qualities of the counsellor, as well as change in medication and use of doctor's time.

By following the clients' perspective, and obtaining a view from the 'inside' of those who have been on the receiving end of counselling, the researcher hopes to discover outcomes and benefits which were found to be helpful or unhelpful to the consumers of the Counselling Service.

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Helen Castle

Other Author: Tomeny M

Professional Role: Assistant Psychologist
Institution: Central Nottinghamshire Healthcare Trust
Contact details: Central Nottinghamshire Healthcare Trust, Southwell Road West, Mansfield, Nottinghamshire, NG18 4HH
Email: assist@hq.cnhc-tr.trent.nhs.uk

ABSTRACT: Poster

Primary Healthcare Counselling: are Client, Process and Counsellor Factors Related to Good Outcome?

Which treatment, with which kind of therapist, for what type of patient or problem are the crucial questions being asked in current psychotherapy research (eg, Leon et al 1999). Similar attention has not yet been addressed to identifying which clients are likely to achieve the greatest benefit from short-term counselling.

Research Questions:

  • Are client, process or counsellor factors related to good outcome?
  • Is it possible to predict who will achieve good and poor outcome with primary healthcare counselling?

Before and after counselling, clients were asked to complete the Brief Symptom Inventory and the General Health Questionnaire. Client demographics, process data and counsellor demographics and training details were also collected. During the study period complete sets of data were collected for 219 clients.

Several client, process and therapist variables were found to relate to good outcome. A comparison of clients who showed deterioration or no change at post with an equal number who improved the most on each measure was made. On at least one measure, the 'most improvement' group were significantly more likely to be female, younger, employed, rated as appropriate by the counsellor and seeing an older counsellor. The 'most improvement' group also tended to present with less severe problems compared to the 'deterioration/same' group. Clients moving from a clinical case to a non-case at post-counselling had significantly lower pre-levels of distress within the clinical case range, than those maintaining case status. Discriminant function analysis showed that knowledge of scores on a selected number of client process and counsellor variables at assessment, particularly presenting levels of distress, could be used to predict clinical outcome at discharge. Seventy-three percent of cases were correctly classified into one of the two clinical improvement groups.

Implications and recommendations are discussed, for example tailoring the referral guidelines to those who will benefit most, and providing guidance in appropriate referrals to other specialties.

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Sue Copeland

Professional Role: Senior Lecturer
Institution: College of Ripon & York
Contact Address: College of Ripon & York, Lord Mayor's Walk, York, YO13 7EX
Email: s.copeland@ucrysj.ac.uk

ABSTRACT: Paper

Strand: Ethical Issues and Counselling Relationships

Ethical Issues for Counselling Supervisors Working in Organisational Contexts

Research was undertaken to explore the dilemmas faced by counselling supervisors working in diverse organisational contexts.

A postal questionnaire had been used in the first stage of this research to gain a broad view of the dilemmas faced by supervisors working in organisational contexts. 45% of the supervisors who responded to the questionnaire volunteered to give an in-depth interview of up to one hour's duration. From that sample fourteen supervisors, working in diverse organisational contexts, were chosen to take part in an in-depth interview of an hour's duration. Initially, the organisational context in which they worked was unknown but subsequently they were found to work in the context of counselling agencies, industry, education and health settings.

When analysis of the transcripts was complete is was evident that dilemmas in supervision arose from:

  • Supervisors who had a dual role within the organisation
  • The organisation's lack of understanding about counselling and the supervisory process
  • The organisation's culture and the need for supervisors to be aware of its influence upon counselling and the supervisory process
  • The nature of the organisation's work
  • Parallel processes within the organisation
  • 'In-house' supervision
  • External supervision
  • Supervisory contracting within the organisation
  • Supervisor's reports to managers
  • Clinical responsibility
  • Confidentiality
  • Financial constraints and the use of time limited counselling
  • The referral process

Conclusions were drawn about the nature of the responsibilities held by the supervisee, supervisor and manager for the work undertaken within the organisation.

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Judy Crompton

Other Author: Purves D

Institution: Oxford Stress and Trauma Clinic
Contact Address: 7 Princes Street, Oxford, OX4 1DD
Email: judy.crompton@tesco.net

ABSTRACT: Paper

Strand: Medical Issues and Client Concerns

A Survey into the Prevalence of Post Traumatic Stress Disorder in a sample of the counselling population

Post Traumatic Stress Disorder (PTSD) does not appear to be solely a consequence of natural disasters or of war. Epidemiological research shows there to be a surprisingly high prevalence rate of traumatic events and of PTSD in the general population. It is also knows that PTSD has been shown to be significantly comorbid with many other psychiatric problems. There is, however, no information about the extent to which PTSD might act as a precipitating factor in the need to seek counselling.

Forty clients from a voluntary counselling organisation were given a short, structured clinical interview using the PTSD-I questionnaire. Results reveal that 62.5 per cent of the client sample had experienced symptoms of PTSD related to a specific event, and of those, 40% were diagnosed with current PTSD. The duration of symptoms for the current diagnosis group was 15.43 years. Only one of the sample gave a traumatic event as their reason for seeking therapy. It is suggested that PTSD may be a significant but under-diagnosed factor in whether a client will seek out or be referred for counselling.

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Ruth Duffield

Professional Role: Counsellor/Psychotherapist
Institution: Centre for Counselling & Psychotherapy Education
Contact details: 3 Albany Place, Egham, Surrey, TW20 9HG
Email: matt.duffield@virgin.net

ABSTRACT: Paper

Strand: Cultural and Gender Issues

Retirement - A Time for Self-Discovery?

Current attitudes imply that our identity is related to the work we do and existing literature focuses on the outer level of our lives in retirement, paying scant attention to the working of our inner life.

My heuristic research investigated the psychological effects of retirement and pre-retirement, brought about by age, illness and redundancy at different stages of the life cycle. The results could have social relevance for the counselling profession, at a time when the retired section of the community is expanding.

Information came out of a 'Conscious Retirement' workshop and a Co-operative Enquiry Group, using creative ways such as masks, spontaneous writing, drawing, inner dialoguing, and clay modelling to access unconscious thoughts and feelings. It was concluded that retirement might be a transformative event involving losses (death of false selves) and opportunities for creativity (birth of authentic selves). It was discovered that adapting to retirement might parallel the grief process in terms of loss and adjustment.

We noticed that work entailed reacting to the expectations of others whereas retirement required us to turn out attention inward, by responding to our own needs and remembering our spirit. When no longer distracted by work, there is more time available to reconnect with our innate nature. The conclusion was that retirement definitely was a time for self-discovery, specifically offering a fresh opportunity to discover who we really were, in response to our inner selves, rather than in reaction to the work expectations placed upon us.

Since results indicated the benefits to be gained, employers might consider allowing appropriate employees the time out to attend an experiential 'Conscious Retirement' workshop in order to help them make an easier transition to the next phase of their lives.

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Barbara Edge

Professional Role: Counsellor/Trainer
Institution: Chester College of Higher Education
Contact Address: 27 Egerton Drive, Upton, Chester, CH2 2JE

ABSTRACT: Paper

Strand: Spirituality

A Phenomenological Study of Clients' Experiences of Counselling in a Pastoral Setting


In this study four people were interviewed about their experiences of counselling in a pastoral setting. The setting is a Counselling Service which is one of the many projects under the auspices of the Church of England's Committee for social Responsibility.

Semi-structured interviews were used to obtain relevant information. The transcribed interviews were analysed in terms of the constant comparative method of qualitative analysis.

The analysis of these interviews reveal that the Christian context of the counselling experience was by far the most reflected on by clients. This study provides evidence that the accommodation of Christian beliefs and values within the counselling process was instrumental for therapeutic change to occur for these particular individuals. The quality of the counselling relationship was of central concern to all the participants in the study and clearly underpinned the therapeutic process. Counsellors were reported as being, open, friendly, caring people without pretentious expertise. Feeling safe and comfortable being accepted, and not being judged by the counsellor were reported as important aspects of the relationship and set the foundation for a positive therapeutic outcome.

As discussed, the aim of this study is not to propose any 'universal truths' about clients' experience. However, this glimpse into the subjective experience of clients provides valuable learning about the nature of counselling from the point of view of the client and raises some implications for the Diocesan Counselling Service and for the practice of the counselling profession in general.

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Dr Kim Etherington

Professional Role: Course Co-ordinator/Tutor
Institution: University of Bristol, Graduate School of Education
Contact details: 8-10 Berkeley, Clifton, Bristol, BS8 1HH
Email: K_etherington@hotmail.com

ABSTRACT: Paper

Strand: Ethical Issues and Counselling Relationships

Research with Ex-Clients: A Celebration and Extension of the Therapeutic Process

In this paper the author explores the role of narrative based research with ex-clients as an appropriate extension of the counselling process. Particular attention is paid t the process of clarifying the issues related to negotiating informed consent when working with ex-clients who are survivors of childhood sexual abuse. Issues concerned with power and control, ethics and safety are also re-negotiated in establishing research relationships in the light of concerns about dual relationships in counselling. This paper reflects on these issues within the context of conducting a collaboration research project which culminated in the publication of 'Narrative Approaches to Working with Male Survivors of Child Sexual Abuse; the Clients', the Counsellor's and the Researcher's Story' (2000).

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Malcolm Firth

Professional Role: Psychosexual Therapist
Institution: Psychiatric Social Work Educational Centre, University of Manchester
Contact details: Psychiatry Infirmary, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL
Email: mfirth@psy.cmht.nwest.uk

ABSTRACT: Poster

'Not Just Broken Willies: a Generic Perspective on Psychosexual Therapy'

The first 50 referrals taken on by a new, specialist practitioner in psychosexual healthcare in an inner city, hospital-based clinic illustrated a range of biological, psychological, inter-personal and environmental difficulties well beyond the specific sexual problems outlined at referral. The latter comprised familiar problems of desire, arousal, anorgasmia, vaginismus, ejaculation and erectile dysfunction. However, when examining case material over the four broader dimensions, it was apparent that the referred sexual problems needed to be contextualised within client's past experiences and current circumstances.

Although by no means discrete, the following difficulties additional to the referred sexual problems featured.

BIOLOGICAL: fertility, neurological damage, immaturity and aging, diabetes, heart and circulatory problems, side effects of medication, general health.

PSYCHOLOGICAL: post-natal depression, childhood trauma (including sexual abuse), recent trauma, sexual assault, clinical depression, anxiety disorders, alcoholism, severe mental illness, ethno-cultural factors, sexual and social role expectations, religion, mortality, educational needs.

INTER-PERSONAL: infidelity (current/past), sexual offending, new relationships, gender of therapist, sexual preferences (mismatch of).

ENVIRONMENTAL: employment (priority of), low income, social adjustment, daily occupation, social isolation, transport problems.

Of additional interest were the prevailing attitudes of men, which were often discrepant with those commonly presumed to be the case, as outlined by Zilbergeld in the late 70's. The study is descriptive and the method is by retrospective case review. Results are still being analysed.
The author concludes that:

1. A generic perspective can usefully inform the specialist focus on specific sexual problems

2. Counsellors in non-specialist services might more routinely enquire about sexual problems, with a view to appropriate referral on.

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Dr Royston Flude

Institution: University of Manchester
Contact details: Apartment 4, 10 Springfield Road, Altrincham, Cheshire, WA14 1HE
Email: roystonflude@compuserve.com

ABSTRACT: Paper

Strand: Theoretical Issues and Communication

Psychology vs Counselling - Different Sides of the Same Coin?

The role of the counsellor compared with the role of the psychologist is interesting in terms of their respective developmental routes. The Psychological framework has evolved from a Mental - Physical perspective which utilises the Cognitive Behavioural approach as one of the foundations of its therapies. On the other hand Counselling has evolved from a 'befriending process' which has been Spiritual-Emotional in its perspective and therefore have focused on the passive understanding of the clients values and feelings to allow them to move forward.

The writer would argue that true well being should come from an integration of these approaches to create the Third Way that harmonises and balances the active and passive to minimise fear and maximise trust and achieve both short-term and long-term therapeutic movement or change.

The development of effective and sustainable change requires the minimisation of fear, the reduction of helplessness and the maximisation of trust. The use of the FIN model, in conjunction with Jungian psychological archetypes and a Johari's Window conceptual framework of the known and unknown dimensions of hyper conscious, conscious and subconscious and how they relate to the individual's 'essence' and interaction with 'the world', has led to a new decision-making model to facilitate personal choices.

Furthermore, the challenge of decision-making in a framework of reality requires boundaries that have goals, check for realism, consider options and create a positive will to change. The resulting outcome must then be reviewed against milestones and criteria for success to create a 'learning embolism'. In may dimensions of life this new conceptual framework provides a vehicle for more effective personal decision making across cultures and alternative forms of therapeutic intervention.

Comparisons are made with recent research into the effectiveness of psychologists and counsellors in achieving therapeutic movement.

In conclusion, Counselling and Psychology are like two sides of the same coin with each having their own unique and valuable contribution, which cannot be sensibly separated and when considered in union, they maximise the chance of effective facilitation or 'helping' and sustainable therapeutic movement.

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David Goodlad

Professional Role: CAC - Chair
Institution: The National Association of Alcohol and Drug Abuse Counsellors (NAADAC) UK, www.12corefunctions.com
Contact details: South Manchester Centre for Psychotherapy, Wellington Terrace, 338a Wellington Road North, Heaton Chapel, Stockport, Cheshire SK4 5DA
Email: D.Goodlad@12corefunctions.com

ABSTRACT: Paper

Strand: Primary Care Issues and Practice Based Research

Core Counselling Procedures in Addiction/Medical & Multi-Disciplinary Settings

This study inquired as to the knowledge, skills and clinical1 attitudes of counsellors working in the UK addictions field, though not exclusively trained in it. In the current climate for evidence-based practice, counsellors are increasingly questioned regarding what it is they do, how they do it and why. The study explores attitudes toward a series of procedures that counsellors, with varying degrees of awareness, appear to have. These procedures, having been identified as essential to good practice by numerous academics, counsellors and institutions are observed as not being restricted by setting constraints, counselling theory/application, nor counsellor experience.

The following three key areas of investigation were included:

1. By using 'common language' to describe specific procedures in counselling, the researcher explored the intensity with which counsellors consciously make use of those procedures in practice

2. Through the use of set procedure, explore the feasibility of its use in describing how a counsellor practices, irrespective of the counselling approach used

3. Explore the existence of an already established clinical procedure, which might be readily accepted as a standard, by other clinical/medical, or related professionals.

Some findings were that an improved understanding towards clinical attitudes would only better serve those counsellors who need to communicate with other professionals as part of their normal practice. Further, supervisors of counsellors working within multi-disciplinary settings might also find these procedures useful in their practice. Finally, there needs to be a clear development of procedural attitudes used by counsellors, in order to maintain and improve responsible practice, not only for the well being of the client and addictions counsellor, but also for society as a whole.

1 The term 'Clinical' is used to describe the supervised and systematic gathering of client related information.

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Peter M Gubi

Professional Role: Lecturer and Director of Counselling Courses
Institution: South Cheshire College
Contact details: Social and Community Care, South Cheshire College, Dane Bank Avenue, Crewe, Cheshire, CW2 8AB
Email: p-gubi@s-cheshire.ac.uk

ABSTRACT: Paper

Strand: Spirituality

Prayer and Psychotherapy - an exploration of the therapeutic nature of Christian Prayer and its possible use with Christian clients in secular psychotherapy.

Brief description of research carried out:

Qualitative interviews were carried out with seven reflective, counsellor trainers who teach in British Universities. The use of thematic prompts enabled interviewees to explore their understanding of prayer, how it might be psychologically understood and used in the psychotherapeutic process, and what ethical considerations might affect its use. The data was analysed using Grounded Theory.

Brief summary of results:

How prayer is understood within the Christian tradition is explored. The literature search demonstrates that prayer is of psychotherapeutic benefit. Prayer is of covert benefit to psychotherapeutic practice as: a means of 'grounding' for the counsellor; a means of support; a way of understanding counselling, and as a way of upholding the client when away from the counselling environment. Prayer could be used overtly as: a form of meditation to reduce anxiety; a way of 'acting out' an issue; a way of expressing feelings from the heart to enable sensitisation and awareness of emotions to develop; a method of reformulation; a form of guided fantasy; a way of transcending the enormity of experience, and as a coping strategy away from the counselling environment. Prayer can be psychologically understood as: a form of attachment; a means of reducing anxiety; a method for dealing with the recognition of existential aloneness; a method of fostering a greater sense of self-worth; a completion of gestalt; a psychological defence; and as a cathartic process of venting emotion.

Implications and recommendations:

Prayer can have a place in secular psychotherapy with clients who are able to step back from the act of praying and reflect on their process. Attention must be paid: to the client's ability to be psychologically-minded; to the client's level of spiritual development; to boundary issues that might arise; to the impact on the counsellor/client relationship, and to minimise the imposition of the counsellor's belief system on the client. Prayer may be difficult to justify as a therapeutic intervention when a counsellor is held to professional account. Using prayer can be powerfully therapeutic with the 'right' client, but it is a risky intervention which needs further research to determine methodology.

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Nigel Hamilton

Other Author: Hiles D

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

ABSTRACT: Paper

Strand: Processes and Developments

Dreams as an Indicator of Spiritual/Personal Growth: Exploring a New Model

New research evidence to support a transpersonal model of human consciousness is presented. The original model was developed out of a study that monitored people's dream process during spiritual retreat (Hamilton & Hiles 1999). Dreams were found to map the state of consciousness being experienced.

The model proposes four basic stages during the process of transformation and seven possible levels of consciousness that can be attained. This paper presents the model in summary form along with examples of the dream material gathered on retreat. The model is then used to examine samples of a number of series of dreams recorded in the therapeutic setting.

The results of the dreams recorded in both the retreat and therapeutic settings are then compared. Research to date shows this transpersonal model clearly describing an innate structure of human consciousness on retreat where the environmental influence is minimal. The longer the retreat, the more clearly this structure reveals itself. However, in the therapeutic context, clients are constantly involved in their everyday lives and life issues. Whilst the latter is apparent in the dreams, it is still possible to observe the underlying archetypal structure of consciousness, which, if invited, can actively help clients deal with their life issues.

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Jan Hordern

Professional Role: Counsellor/Psychotherapist
Institution: Centre for Counselling & Psychotherapy Education
Contact details: Heath House, Head House Road, Woking, Surrey, GU22 ORD

ABSTRACT: Paper

Strand: Cultural and Gender Issues

Inner Masculine and Feminine in Relation to Soul, Spirit and Living Creatively

Qualitative research was undertaken in the heuristic style and from a transpersonal perspective. The study originated from the researcher's emerging sense of the importance of inner masculine and feminine in the spiritual journey and the exciting possibility of living creatively - living from soul.

Participants described how they worked with masculine and feminine figures from dreams, visualisations and meditations. Some were guide figures, some shadow, and others seemed to draw attention to the relationship between focused and diffuse consciousness. Focused consciousness was seen as masculine - uni-directional, concentrated and evaluative - and diffuse consciousness as feminine - multi-directional, receptive awareness.

Both men and women felt the call of the feminine was significant in their spiritual journeys. Participants also described living creatively as feminine in terms of receptivity to soul or spirit, with the urge to manifest being associated with the masculine aspect.

The researcher drew on a range of psychological, spiritual and scientific literature to create a synthesis of findings and theory. The concept of inner masculine and feminine was taken beyond Jung into the transpersonal. Evidence that male minds tend to be structured for focus, whereas female minds tend to be suited for diffuse consciousness operations, was explored, and the impact of patriarchal society considered.

As we move into the twenty-first century, there seems to be a swing back into the feminine, with a consequent rejection of much that is deemed masculine. The research shows the importance of the feminine in the spiritual path, but also suggests that a significant role of inner masculine and feminine figures is to show that, in order to live creatively, we need to be able to access both focused and diffuse consciousness.

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Colin Kirkwood

Professional Role: Senior Lecturer in Counselling
Institution: University Of Edinburgh
Contact details: Department of Community Education, Moray House, Institute of Education, University of Edinburgh, Holyrood Road, Edinburgh, EH8 8AQ
Email: colin.kirkwood@ed.ac.uk

ABSTRACT: Poster

Professional and Socio-Cultural Issues Arising from a Study of the Development of Counselling in Shetland

The study of the development of counselling in Shetland, which has now been completed and written up, is thought to be the first attempt to trace the growth of counselling in a society. It demonstrates the leading role of the voluntary sector and shows that counselling in Shetland grew in two waves, during the 1980s and 1990s. It has proved possible to give an exact picture of the scope, focus and volume of counselling in Shetland in 1998, but the attempt to portray an equivalent picture of the volume of counselling skills work, came up against the different perspectives on the meaning of the term 'counselling skills' held by counsellors and allied professionals. The author argues that the counselling/counselling skills distinction is no longer adequate, and needs to be replaced by a tripartite distinction between counselling, a counselling approach and listening and responding skills. He makes recommendations for counselling organisations, the counselling professional bodies, central government and for the direction of further research. As well as suggesting a way forward with regard to the statutory regulation of counselling, the research also focuses on the socio-cultural meaning of counselling, and in particular on its links with rapid technological change, changes in values and cultural norms, changes in the family, and large scale movements of population. In conclusion, the author argues that counselling needs to be presented not solely in terms of its private, personal meaning, but also in terms of its role as a popular social movement: an unpredetermined but not disorganised set of phenomena arising in (Shetland/British?) society in the rapids of unexpected and in some respects unwanted transformations.

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Danny C K Lam

Professional Role: Senior Lecturer/Cognitive Behavioural Therapist
Institution: Kingston University & St George's Hospital Medical School
Contact details: Faculty of Health and Social Care Sciences, Kingston University and St George's Medical School, 2nd Floor, Grosvenor Wing, Blackshaw Road, London, SW17 0QT
Email: danny.lam11@hotmail.com

ABSTRACT: Paper

Strand: Processes and Developments

Cognitive Behaviour Therapy, Disputing Dysfunctional Thoughts: From Subjectivity to Objectivity (and back again)

Cognitive behaviour therapy states that people are not disturbed by events but by the views/beliefs they take of them. However, in the eyes of the client, the belief that causes the emotional and behavioural reactions is both logical and rational. The client is often able to substantiate his/her 'rationality and logic' with evidence, due to the selective nature of his/her thinking process.

This paper illustrates how this evidence-based disputing model is developed clinically, guided by research. It is particularly useful and effective in disputing clients who are persistently holding on to their dysfunctional and irrational thinking. Their 'stubbornness' to change is often compounded by negative emotions. This model advocates the shift of disputing onto a different 'territory/ground' where the client can be facilitated to acquire higher, abstract and objective thinking, and at the same time his/her emotional level is susceptible to rational and logical arguments. The new thinking would act as a catalyst for the client to reflect on his/her dysfunctional and irrational thoughts.

The author illustrates and discusses, using case examples, conceptual and practical issues in shifting the client's dysfunctional thinking (subjective) into an objective one (different territory), at which rational and logical thinking related to the client's difficulties can be cultivated. The disputing is then back to the client' territory (dysfunctional and irrational thoughts) to further the process of disputing. This disputing approach from subjectivity to objectivity and back again - is found to be clinical effectively in working with emotional clients. Their negative and high levels of emotions often impede them from developing rational and logical thinking.

The content of this abstract is based on a paper published in the Advanced Journal of Nursing, which described it as 'important and original, and it should make a real contribution to the literature'.

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Professor David Lane

Other Author: Sadler P

Institution: Professional Development Foundation
Contact details: 21 Lime House Cut, 46 Morris Road, London, E14 6NQ
Email: david.lane@pdf.net

ABSTRACT: Paper

Strand: Theoretical Issues and Communication

Does Counselling Research Have Anything to Contribute to the Major Issues Facing Society?

Counselling and Society

At the first symposium of the European Association for Counselling the question was posed:

What contribution can we make as counsellors to the future of social policy and its affect on human lives?

The challenge was taken up by contributors and the contribution of counselling to issues facing 'Europe in Change' 1 including the nature of work, minority populations, violence, refugees and intercultural counselling were extensively discussed. The event demonstrated the extent and commitment of counsellors through Europe to issue of importance to social policy.

As we face the 21st Century the issues become more urgent and challenges counsellors as researchers. Al professionals have to respond to the demands of a rapidly changing knowledge based business and professional agenda. In knowledge driven economy success depends on individuals and organisations continuously updating their understanding. As counsellors we face the same need but also deal with the casualties of the process.

Social exclusion is recognised as the most pressing issue that is going to drive social policy for the future as the knowledge economy heightens the difference between those who do and do not have access to the knowledge that matters.

Counsellors will now be faced with clients who have more information than they do themselves, and who may well have looked on the Internet for key information before consulting their counsellor. Professionals will have no automatic rights to information. However, through communities of practice, professionals will have the ability to turn information into knowledge and useful expertise. It is such communities of practice that will drive the research agenda for the new century.

This paper will examine the use of a community of practice for developing research in the area of social exclusion. It will show how such communities can be effective and the value they add to traditional case led research.

1 Europe in Change: the contribution of counselling 1994 Erika Stern, David A Lane, Craig McDevitt, EAC

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Maria Lever

Professional Role: Palliative Care Counsellor
Institution: Salford Community Health Care NHS Trust
Contact details: Ordsall Health Centre, Belfert Drive, Salford, M5 3PP

ABSTRACT: Poster

Can The Concept of Professional Development Reconcile the Diverse World of Counselling and Nursing?

The aim of this MSc study in Psychology and its Applications was to explore whether Skovholt and Ronnestadt's (1992) model of counsellor and psychotherapist professional development can be generalised to expand current understanding of nurses' professional development. It was hypothesised that professional development is a key concept that can unite diverse fields such as counselling and nursing and therein lay the opportunities and challenges.

The study used a multi-method approach with community nurses completing questionnaires, semi-structured interviews and participating in collaborative enquiry groups. The qualitative method of grounded theory (Glaser and Strauss, 1967) was used to induce meaning from the data.

The study concluded that Skovholt and Ronnestadt's (1992) model can be used to understand nurses' professional development in community based palliative care as this type of nursing encompasses communication skills and emotional and psychological support which are reminiscent of the skills used by counsellors and psychotherapists. This study further identified that community nurses' perceptions of the care they offer to terminally ill patients can be linked to and is influenced by their level of professional development as defined by Skovholt and Ronnestadt (1992). Finally, the nurses in this study identified methods of enhancing professional development, including insight and reflective practice, which further supported the findings of Skovholt and Ronnestadt (1992). However, the study is limited by its small sample size and further research needs to be carried out to establish whether this model can be applied to nursing in other fields and settings.

he researcher is currently working with her Community Trust's Education Co-ordinator to disseminate the findings of this study and explore ways of incorporating the results to enhance community nurses' personal and professional development plans.

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Shirley MacDonald

Professional Role: Counsellor/Family Practitioner
Institution: Behavioural Support Service, Bolton
Contact details: 25 Fairlyn Drive, Over Hulton, Bolton, BL5 1HJ

ABSTRACT: Paper

Strand: Children and Young People

A Counselling Psychological Approach to the Treatment of Emotional and Behavioural Difficulties in Children and Young People

Children and young people today experience increasing difficulties in their lives. In addition to the usual inherent development stressors, they face changing family structures, cultural diversity and conflict, substance misuse, media influences, domestic violence and abuse.

Far too many children and young people are experiencing traumatic events at times when they are most vulnerable and least able to cope.

The aim of the paper is to provide delegates with examples and information about how Counselling Psychology is being applied as a treatment approach with children and young people who are presenting Emotional and Behavioural Difficulties (EBD). The service is provided by a Local Education Authority and is situated within a multi-disciplinary team, consisting of Behaviour Support Teachers, Behaviour Support Assistants and a Youth Worker.

This approach to treatment of children presenting EBS requires the therapist to be conversant with psychological theories related to childhood development - cognitive, physical and emotional and also with Counselling theories and approaches, in particular the Cognitive Behavioural and the Person Centred approaches.

The service which at present, consists of one full time therapist, has been in operation for a period of eighteen months. An evaluation of the approach after a year provided evidence of its effectiveness/usefulness.
The implications for future practice indicate the need for increased resources in this area of work. The therapist herself is committed to developing the use of counselling with children and young people who are suffering emotional problems.

It is hoped that early intervention and an introduction to the talking therapies will prevent children and young people from developing more complex mental health problems in adulthood.

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Isie C MacIntyre

Professional Role: Senior Research Associate
Institution: University of East Anglia
Contact details: C.A.R.E. University of East Anglia, Norwich, NR4 7IJ
Email: i.macintyre@uac.ac.uk

ABSTRACT: Paper

Strand: Counsellor Training

Counselling, Curricula and Embodiment

The range and diversity of counselling courses offered in the UK has rapidly increased since the 1980's (Wheeler 1999)1 however there is very little contemporary research on the curricula of counselling courses particularly in regard to wider contextual issues (McLeod & Machin 1998)2. This paper sets out to explore, through a case study, the implicit and explicit curricula of a Diploma in Professional Counselling. The notion of curricula that shapes this study is not a purely structuralist/functionalist notion it is the dynamic interplay between different facets of curricula which are the areas of focus. Therefore, it is not only the curriculum as shaper of subject matter or framing of individual experience but an analysis which reveals what kinds of engagement these different 'texts' have with each other and their expression may be traced in the student's learning.

Data was gathered in the form of researcher/participant experience, observations, course literature, recorded and transcribed semi-structured interviews, group discussion and informal ad hoc conversations. This case study approach offers a reflection of people and their actions within a context. The main objective of using this methodology is to trade breadth for depth and to use the case as a means for achieving an in-depth analysis.

The analysis of the data reflects a post-modern, post-structuralist approach with particular emphasis on the embodiment of the curriculum. McLeod and Machin focus on specific contexts, this study explores how these and other con/textural factors are expressed within the curriculum and relate to the students learning. How these 'texts' are shaped or discarded within the curriculum and the absence or presence inscribed on the student (Deleuze & Guattari 1984).

The paper concludes by exploring the implications these findings have for counselling theory and practice in particular how the curriculum reflects changes in the wider social context highlighting the relationship between counselling and society.

1 Wheeler S (1999) British Association for Counselling Journal, Vol 10, No 5

2 McLeod & Machin (1984) The context of counselling: a neglected dimension of training, research and practice, British Journal of Guidance & Counselling, Vol 26, No 3.

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Hannah Mackay

Other Authors: West W, Moorey J, Guthrie E & Margison F

Professional Role: Researcher
Institution: University of Manchester
Contact details: 111 Nicolas Road, Chorlton-cum-Hardy, Manchester, M21 9LS

ABSTRACT: Paper

Strand: Counsellor Training

Training In Psychodynamic-Interpersonal Therapy: Primary Care Counsellors' Experiences of Changing Their Practice

This paper concerns primary care counsellors' experiences of participating in further training. Seven counsellors were interviewed about their experiences of learning and applying a new model of therapy, the psychodynamic-interpersonal model. These interviews were analysed using grounded theory, a qualitative approach. Under the core category of 'changing counselling practice: applying the Pl model of therapy', data was organised into ten major categories: difficult feelings; new awareness; therapeutic identity; identifying reasons for choosing how to work; experiencing difficulties in adherence; attributing causes of difficulties; ways through the difficulties; understanding how change in practice occurs; changing interventions and specific other inputs. Changing counselling practice may require the counsellor to change aspects of their identity as a counsellor, and to go through difficult emotional experiences. Implications for ongoing training, and for the debate concerning purity vs eclecticism will be discussed.

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David Mair

Professional Role: Student Counsellor
Institution: Coventry University
Contact details: Student Counselling Service, Coventry University, Priory Street, Coventry, CV1 5FB
Email: djbm@bigfoot.com

ABSTRACT: Paper

Strand: Cultural and Gender Issues

Gay Men's Experiences of Counselling

Brief description of the research

A qualitative piece of research aimed at exploring common themes and issues arising from gay men's experiences of being in counselling or therapy. A small sample of fourteen men were interviewed (in person and by telephone) using a structured questionnaire, asking them to reflect on various aspects of their relationship with their therapist.

Analysis was made using the constant-comparative method, and significant/unexpected themes emerging formed the basis of the writing up of the findings of this research.

Brief summary of the results

Amongst the most significant/common points emerging were:

  • The men's experience of feeling 'silenced' in terms of their sexual orientation in the therapy with an assumed heterosexual
  • The common experience of needing to come to some conclusion about the counsellors' sexual orientation when no verbal communication was made about this, and the impact that these assumptions had on the therapy
  • The issue of internalised homophobia within the men interviewed (usually unconscious homophobia) which led the majority to state that working with a gay counsellor would be 'unacceptable' to them.
  • The way the men had scrutinised their therapists for signs of homophobia/prejudice, and how any suspected instances of this had impacted on the therapy.

Brief summary of the implications and recommendations

  • The issue of who is responsible in therapy for bringing up topics related to sexual orientation; in this sample, there was a feeling that the men were needing/waiting for some indication from their therapist that s/he was willing/able to do this
  • The issue of neutrality/affirmation, as seen from the clients' point of view
  • The need for counsellors to be aware of their own homophobia, and the possibility that their gay clients may also hold internalised/unconscious homophobia
  • The need to find a way to address homophobia within the client when appropriate
  • Implications for training of counsellors who are working with gay male clients
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Brenda Mallon

Professional Role: Counsellor/Author
Institution: Private Practice
Contact details: 7 Didsbury Park, Didsbury, Manchester, M20 5LH
Email: lapwing@gn.apc.org

ABSTRACT: Paper

Strand: Processes and Developments

Dreams, Counselling and Healing

This paper is the result of twenty years investigation into dreams and counselling. It includes material from clients, from over 900 self-selected women who completed questionnaires for my research for 'Women Dreaming' (1989 HarperCollins) and subsequently questionnaires and interviews with people who have experienced dreams in which they felt they had been 'healed' in some way. The sum total of the information collected forms the basis of 'Dreams, Counselling & Healing' to be published by Gill & MacMillan in September 2000.

Summary of Results

I found that many people experience dreams in which they feel 'healed' in some way be it physical, psychological or emotional. Within my counselling practice I have numerous examples of the problem-solving nature of dreams which enhance self-awareness and empowerment. In addition, working with dreams helps clients recognise the 'self-healing' dimensions that aid personal well being.

Summary of implications and recommendations

Counsellors who know how to use dreams as part of the therapeutic process extend their ability to effectively help clients. Many clients spontaneously bring dreams to the counselling session yet these are not dealt with as confidently as they might be, if they are addressed at all. By increasing counsellor awareness of the power of dreams in the counselling process we maximise our ability to assist our clients.

Additional comments

'A light in the darkness of mere being', for me encompasses the process of counselling and the therapeutic relationship on which it depends. Initially both client and counsellor are metaphorically, in the dark. The healing process illuminates 'the darkness of mere being'.

The journey taken together includes the world of dreams as well as recalled experiences of pain and psychological insecurity. The reality of day to day anxiety and suffering is the tip of the iceberg below which the world of dreams and the unconscious are submerged. In this sea the counsellor often needs to be the anchor that holds the steady line. By appreciating the vastness of the dreamworld, we can plumb the depths where danger lies, understand how it may be circumvented and even enjoy the beauty of the awesome territory in which we travel for counselling is a process not an arrival point.

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John McLeod (paper)

Professional Role: Professor of Counselling
Institution: University of Abertay Dundee
Contact details: School of Social and Health Sciences, University of Abertay Dundee, 158 Marketgait, Dundee, Scotland, DD1 1NJ
Email: j.mcleod@tay.ac.uk

ABSTRACT: Paper

Strand: Processes and Developments

Narrative Processes in Experiential Therapy

Although narrative perspectives have become increasingly influential in counselling and psychotherapy in recent years, relatively little research had been done into narrative processes in therapy. This paper reviews the finding from a series of narrative processes occurring in cases of experiential (person-centred, process-experiential) counselling and psychotherapy. The method of qualitative narrative analysis of therapy transcripts is described. This method has been applied to three full cases. Consistent themes across these cases are reported: building a storyworld, the cycle of storytelling, the story as an invitation to empathic engagement, the significance of metanarratives. The implications of these preliminary findings for further research, and for practice, are discussed.

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John McLeod (poster)

Professional Role: Professor of Counselling
Institution: University of Abertay Dundee
Contact details: School of Social and Health Sciences, University of Abertay Dundee, 158 Marketgait, Dundee, Scotland, DD1 1NJ
Email: j.mcleod@tay.ac.uk

ABSTRACT: Poster

A Systematic Review of the Research Literature on 'Counselling in the Workplace'

The British Association for Counselling has commissioned a systematic review of the research literature on 'Counselling in the Workplace', to be completed by end of June 2000 and published in autumn 2000. The purpose of the review is to promote good practice in this area of counselling, and to stimulate further research. The primary aim is to produce a comprehensive review of all English-language studies of workplace/EAP counselling. The literature search will encompass published items such as reports and dissertations. The search will consider material from a range of disciplines: counselling, psychotherapy, psychology, sociology, management studies, occupational health, trauma studies, health and safety, and will encompass controlled trials, qualitative studies, and case studies. Further information is provided in this Poster about the aims and scope of the Review, and how to contribute to it.

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John Mellor-Clark

Professional Role: Visiting Senior Research Fellow
Institution: Psychological Therapies Research Centre, University of Leeds
Contact details: PTRC, University of Leeds, 17 Blenheim Terrace, Leeds, LS2 9JT
Email: johnmc@psychology.leeds.ac.uk

ABSTRACT: Paper

Quality Evaluation for Continuing Professional Development and Practice-Based Evidence: Opportunities and Challenges

Counselling enters the 21st century with both opportunity and challenge to develop accountability, demonstrate worth, and enhance professionalisation. The agenda within the National Health Service over the next ten years will increasingly focus on demonstrated effectiveness, lifelong learning, and professional self-regulation. As evidence, quality, and standards are the new watchwords for rationalising and developing NHS service provision, all practitioners face steep learning curves that are set to make major impacts on Counselling training, counselling practice and counselling credibility.

Whilst it is tempting to think that these opportunities and challenges relate only to practitioners in medical settings, it is a logical supposition that the ramifications of the health service quality agenda will increasingly find their way into other service domains. Counsellors working in education, industry, the voluntary sector, and in private practice may all face similar opportunities and threats.

This paper aims to present a synopsis of the NHS quality agenda, explore three key ramifications for all counselling practice, and set an agenda for debate in a complementary workshop. The key issues for debate are presented in the following propositions:

  • Counselling accreditation and supervision are inadequate as the only 'quality assurance' mechanisms for counselling
  • Counsellors need to adopt the skills and attitudes for routine audit and evaluation of practice to meet the NHS quality agenda
  • The profession of counselling will be substantially enhanced in the 21st century by appropriate evidence of its strengths and identification of its weaknesses

The presentation will close with a brief introduction to the CORE System. This is the first standardised approach to audit, evaluation, and outcome benchmarking in the UK. Developed by a multi-disciplinary group of researchers and practitioners, components of the CORE System are now being used by over 150 psychological therapy services across health, education, workplace, and voluntary sector services.

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James O'Shea

Professional Role: Community Psychiatric Nurse/Counsellor
Institution: General Practice Surgery
Contact details: 61 Beacon Road, Rollerston-upon-Dove, Burton-upon-Trent, Staffordshire, DE13 9EG

ABSTRACT: Paper

Strand: Primary Care Issues and Practice Based Research

A Small Scale Audit-Survey of Time Limited Psychotherapy Practised within a GP Setting

A small scale study was carried out, over an eighteen month period, in a GP surgery in the Staffordshire area, to see if patients' symptoms improved and whether their contacts with their GPs fell after a course of Time Limited Psychotherapy. Out of sixty-five patients referred from their GPs to a male counsellor, fifty-two patients completed the full course of treatment. Their symptoms were measured pre and post Time Limited Psychotherapy using a recognised symptom checklist called the SCL-90-R. Paired sampled T-Tests were carried out on a computer software package (SPSS) and the results were reported. Patients' contacts were also monitored by use of computerised medical records, for a period of six months before and after treatment and compared for any reductions in contacts. Similar paired T-Tests were carried out and reported in this study.

The results show that patient contact drops significantly with the GPs. Gender is also seen as an important variable, showing GP contacts dropping more for women than men. The study highlights that there is significant symptom reduction in patients referred for Time Limited Psychotherapy. Interestingly, men's symptoms decrease more than women's. Women's symptoms reduce in every category except phobic anxiety. The results presented suggest that Time Limited Psychotherapy does reduce patient symptoms and GP contacts for patients and may be the treatment of choice for certain conditions. There is also tentative suggestion that brief therapies in general, are as cost effective as psychotropic drugs.

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Paula Pope

Professional Role: Senior Lecturer
Institution: Liverpool John Moores University
Contact details: School of Law & Applied Social Studies, Liverpool John Moores University, 1 Myrtle Street, Liverpool, L7 4DN
Email: p.m.pope@livjm.ac.uk

ABSTRACT: Paper

Strand: Children and Young People

A Field Work Test Kit for Youth Counselling

This research into youth counselling took place from January to March 2000 and involved visits to six different projects. The projects visited were the Blackburn In Partnership Counselling Project; Its Your Choice in Totton; Young Persons Advisory Service on Merseyside; Youth Line in Liverpool; Stepping Stones in Wrexham and the Cumbria Counselling Bank.

The key project worker in each organisation was interviewed using a basic questionnaire. The questions asked included enquiries about the history and structure of the project, statistics on service users, the roles of young people and adults within the project and examples of good practice within each organisation.

The researcher looked at the way each project offered its service to young people - is it youth-friendly? What part do young people play in the development of the service? How does the service you offer empower young people? What do young people say about the service you offer? Can you give two examples of good practice in the counselling service you offer?

The findings of the research have been incorporated into what I have identified as a fieldwork test kit for good practice in youth counselling projects.

The main characteristics of the field test kit are given below. Each will be supported by an example from the research findings.

1. background of research to identify the needs
2. Responsive and flexible service
3. Young people are active in the project
4. Procedures and frameworks and statistics
5. Account is taken of power and cross-cultural issues
6. Professionally qualified counsellors
7. Separate supervision for casework and management
8. Staff development and training
9. Service promotion direct to young people
10. Networking with other agencies

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Steve Potter

Professional Role: Director of a Student Counselling Service, Psychotherapist Practitioner and Trainer
Institution: University of Manchester
Contact details: Counselling Service, University of Manchester, Crawford House Precinct Centre, Oxford Road, Manchester M13 0QS
Email: steve.potter@man.ac.uk

ABSTRACT: Paper

Strand: Primary Care Issues and Practice Based Research

Aspects of Developing a Checklist of when it is Hard to Help in the Context of Counselling, Psychotherapy and other Professional helping relationships

As a team of 'research naïve' student counsellors we were keen to incorporate research into our practice. One key concern was promoting a more informed response to people seeking, or needing, help who were experienced as hard to help either by would be referrers or counsellors on initial contact. Using various small group research methods (consensus generation exercise, focus groups) we identified a checklist of factors contributing to the hard to help experience. We piloted this checklist to ascertain its effectiveness in identifying or clarifying hard to help situations. The process of practitioner based research which has some costs but many benefits, has raised philosophical questions and is ongoing. In this session participants will be invited to use the 'hard to help' checklist as part of a brief consensus generating exercise and reflect upon some of the benefits and challenges of practitioner based research.

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Nancy Rowland

Other Authors: Bower P, Mellor-Clark J, Heywood P, Hardy R and, Godfrey C

Professional Role: Head of Communication
Institution: NHS Centre for Review & Dissemination
Contact details: NHS Centre for Review & Dissemination, University of York, YORK, YO1 5DD
Email: nancy.rowland@excha.yhs-tr.northy.nhs.uk

ABSTRACT: Paper

Strand: Primary Care Issues and Practice Based Research

A Systematic Review of the Effectiveness and Cost-Effectiveness of Counselling in Primary Care

A systematic review was undertaken to assess the effectiveness and cost effectiveness of counselling in primary care by reviewing cost and outcome data in randomised controlled trials and controlled patient preference trials of counselling interventions in primary care, for patients with psychological and psychosocial problems considered suitable for counselling.

The review reports results from four trials of counselling in primary care. Data from the trials was statistically significant when pooled, but the clinical significance of the findings is unclear. Patients who receive counselling are more likely to have improved psychological symptom levels than those who do not receive counselling. Levels of satisfaction with counselling are high. There is tentative evidence to suggest that counselled patients are more likely to be considered recovered than non counselled patients. There is limited information about the cost effectiveness of counselling; one study reported no clear cost advantage with either counselling or GP care.

The four trials included in this review were all pragmatic trials of counselling in primary care. Despite their methodological weaknesses, they represent the reality of counselling in clinical practice. The evidence base will be extended by controlled trials of counselling which are nearing completion.

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Estelle Seymour

Professional Role: Counselling Courses Co-Ordinator
Institution: Solihull College
Contact details: 5 Victoria Street, Leamington Spa, Warwickshire CV31 3PU
Email: estelles@staff.solihull.ac.uk / es@daath.demon.co.uk

ABSTRACT: Paper

Strand: Spirituality

Towards a Pagan/Magickal Approach to Counselling?

With the influence of the transpersonal in psychology and the growth in respect for indigenous traditions in the helping professions, an emphasis on, or at least the inclusion of, the spiritual dimension in therapy is accepted in many quarters. Although much of the literature on the role of spirituality in psychotherapy is based in a Christian context, some draws from the Native American and Shamanic traditions, as well as the Eastern influences of Zen Buddhism, Sufism, Taoism etc. Paganism is said to be one of the fastest growing religions in the UK and is, arguably, the indigenous belief system of the British Isles. This study suggests that the Pagan worldview is as valid as that of other cultures, and should therefore, be given equal consideration. A small-scale study was conducted in the Pagan community to assess the need for a Pagan approach to therapy. Many Pagan psychotherapists and clients see no need for a specifically Pagan approach to counselling. All agree that incorporating a Pagan world view into clinical practice is beneficial. Some clients and potential clients expressed a desire for choice, just as other specific groups expect similar choices. This study argues for the inclusion of the Pagan worldview as one aspect of dimensions of spirituality in counsellor training and education.

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Christine Sherlock

Institution: Redbridge Healthcare Trust
Contact details: 12 Frating Crescent, Woodford Green, Essex, IG8 0DW
Email: chris@sherlock33.fsnet.co.uk

ABSTRACT: Poster

Experiences of Coping with Usher Syndrome

The study examined how people with Usher syndrome and their families coped at diagnosis, what support they had received and would have liked, and their experiences of counselling. Twenty-three questionnaires were completed by: 11 people with Usher, seven mothers, one sibling and four partners. Nine semi-structured interviews were carried out with: four people with Usher type 2, three mothers, one sibling and one partner. The researcher kept a reflexive log. The results were broadly categorised into the five areas of: diagnosis, support, counselling, relationships and coping. Analysis of the interview data resulted in the five areas of exploration being extended to seven core categories: diagnosis, impact, family relationships, support, adaptation, counselling and resilience and change which formed the basis of grounded theory methods and analysis. The main findings were:

  • overall dissatisfaction with the clinical disclosure of the diagnosis
  • support given by Sense was much appreciated by participants
  • peer support was an important requirement from 61% of participants and had coincided with the Sense's provision of a five year peer mentoring project for people with acquired deafblindness
  • recurring grief and depression were common features for the Usher person and their families
  • 20% of participants had experienced counselling which was viewed as beneficial, but 78% of participants had experienced difficulty accessing services locally or were not offered counselling
  • 55% of participants with Usher had requested home visits by an 'Usher aware' counsellor.
  • participants recognised that coping with Usher syndrome had 'changed them as a person' and many admitted to 'living in the moment' as a positive coping strategy. Such adaptation was interpreted in terms of Rogers' (1980) actualising tendency and Vygotsky's (Kozulin, 1990) theory of the emergence of compensation for the sensorily impaired person.

Future research could focus on the cause of resilience and whether it is linked to personality.

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Deborah Short

Professional Role: Psychotherapist and Counsellor, Supervisor and Trainer
Institution: Sherwood Psychotherapy Training Institute and North/South Derbyshire Health Authority
Contact details: The Sherwood Psychotherapy Training Institute, 30 Park Row, Nottingham, NG1 6GR
Email: psychsocialcare@infoofficer.netscapeonline.co.uk

ABSTRACT: Paper

Strand: Spirituality

Spirituality in a Secular Profession?

This paper is based on a research dissertation submitted for MA in Gestalt Psychotherapy in July 1999 entitled: 'An Exploration of Spirituality: Gestalt Practitioners' Experience of Spirituality within Psychotherapy'

The main research question was, what is spirituality? Sub questions were, how do co-researchers experience/perceive spirituality to enter into the process of psychotherapy? What is the experience of co-researcher's working with their client's spirituality? How does the co-researcher's own spirituality impact on the process of psychotherapy?

The study aimed to generate phenomenological and qualitative research that is principally descriptive. Four co-researchers were interviewed, their clinical and personal experiences/perceptions of spirituality gathered and a research design on grounded theory applied to analysis.

Key themes of relationship/connectedness, mystery and suffering emerged in terms of the meaning and experience of spirituality. The grounded theory to emerge was as follows:

A principle component of spirituality and central outcome of in-depth psychotherapy is a personal experience of greater interconnectedness and corresponding growth of moral sensitivity.

The following extract from the data was chosen to affirm the grounded theory:

"The more psychotherapy people do, the more work and commitment to work that people move through, at some point there comes a developing interest in the spiritual, the sense of connection and connectedness with something other than self, it may be that the outcomes of psychotherapy are more moral in a sense - how we react and relate to each other and developing our moral sensitivity as a consequence."

The findings raise the following questions:

  • How to manage the centrality of spirituality in a profession that is generally regarded as secular?
  • What value might there be in developing collaboration between psychotherapeutic and religious communities?
  • What are the implications of developing and making more explicit the interface of spirituality and psychotherapy?
  • Given the indication that the process of psychotherapy involves the spirituality of both therapist and client, what are the implications for training and continuing personal/spiritual development?
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Alan Sparkes

Other Authors: Evans R, Jordan N

Professional Role:  Psychotherapy Researcher
Institution: The Metanoia Institute
Contact details: 13 North Common Road, London, and W5 2QB

'First Clients' - A Further Step in Exploring the Potential of Self-Study CD-ROMS in Learning Counselling Skills

Workshop Outline:

'An invitation to experience an exciting form of interactive learning'.

At the BACP Research Conference 1999 we gave participants the opportunity to try out an experimental self-study CD-ROM called 'Developing Observational Skills' (or 'Devski'). Student trials of Devski in summer '99 demonstrated that it met its learning outcome objectives and that students were enthusiastic about it.

In this workshop we will report briefly on the data from those trials and invite participants to actively try out and discuss with us our latest series of CD-ROMs called 'First Clients'. You are warmly welcomed to engage in using the 'First Clients' CD-ROM and discuss your experience with us.

The First Clients series is aimed at helping beginner students who are about to start sessions with real clients. Each CD-ROM allows the student to follow a commentary on a 40-minute video of client/therapist session. The commentary is somewhat similar to the 'voiceover' on a conventional TV documentary and provides a blow by blow analysis of what is happening in the session from a specific theoretical viewpoint.

Each counselling session can have different multiple commentaries, thus a student can view a session from a variety of theoretical perspectives and be provided with a very rich learning resource. When she or he is viewing the video they can choose between perhaps six different commentaries on the session - each commentary being made from a different theoretical view or by a different expert.

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Jane Speedy

Professional Role: Lecturer in Counselling
Institution: University of Bristol
Contact details: Counselling Programme, GSOE, University of Bristol, 8-10 Berkeley Square, Bristol, BS8 1HH
Email: jane.speedy@bristol.ac.uk

ABSTRACT: Paper

Strand: Counsellor Training

The Story of Three Generations: An Exploration of the Changing Professional Attitudes, Cultures and Self-Descriptions of a Group of Counselling Educators and Trainers

This paper will draw extensively on the stories that counselling trainers and educators at the University of Bristol tell themselves and each other about how they construct their professional lives, values and identities; about how and why they manage the interface between therapeutic, educational and academic endeavours and about how they envisage the future. Using this very local and intimate knowledge base the author paints a picture of professional development for the British counselling industry in late 20th and early 21st centuries as 'life in the fast lane'. She uses her own story and the stories of her colleagues to construct cultural vignettes of three generations that have rapidly evolved over the last two decades: the pioneers, the entrepreneurs and the establish professionals.

The author makes use of narrative, life story and feminist epistemologies (or ways of knowing) and methodologies (or ways of doing) to construct a rich web of stories and conceptual maps of the territory she is concerned with exploring. Jane is herself 'of' the group she is researching and is a central character in the stories she is engaged with co-creating. If research is about 'them' and ordinary life is about 'us' then this is not a research paper at all. The author will argue for transparency, intimacy and connectivity as congruent, legitimate and ethical standpoints in counselling research and practice.

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Greta Stanley

Professional Role: Counsellor
Institution: Volunteer at Victim Support, Private Practice
Contact details: Preston Cottage, Brook Lane, Alderley Edge, SK9 7QQ
Email: margaret_m.stanley@virgin.net

ABSTRACT: Paper

Strand: Theoretical Issues and Communication

Different Tongues: The Experience of Counsellors/Psychotherapists in Britain who practise in English, where English is not their Mother Tongue

The global migration of counsellors and clients will increase steadily within the 21st century. People have more opportunities to choose their country of domicile, their places for education and work. A new language, English, has to be learnt in order to survive in Britain and it becomes the dominant language in people's lives. Immigrants and their second generation often face cultural conflicts and difficulties in communicating.

Eleven counsellors/psychotherapists, including myself, participated in this qualitative study using the grounded theory research method to explore the meaning of their experience. Participants were from European, Asian and East African backgrounds with 7 nationalities represented. Ages ranged from 25 to 54 years with a gender ratio of 10:1 in favour of female practitioners. The British work experience of the participants ranged from 1 year up to 27 years. Data were obtained through biographical questionnaires and in-depth taped interviews.

Findings revealed that culture and language, are not fixed, but can change with political, social and personal circumstances and events and impact on counsellors/psychotherapists and clients. The length of time lived in a different culture/language is important. It changes the perception and the way of expressing experience and emotions and creates a reversible change in the individual's identity. The experience and knowledge of different cultural backgrounds and languages enable counsellors/psychotherapists to bring a different element into counselling, they offer different perspectives and therefore more choices to their clients to help them expand their views of themselves and the world they live in to establish their identity.

Language implications must be part of a counsellor's/psychotherapists training. There are different interpretations and conclusions during communication depending on the cultural meaning and feeling of words, which are not as obvious as the difference in skin colour. Supervision, but more important, personal therapy, should be available to counsellors/psychotherapists from different cultural backgrounds in their mother tongues.

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Susan Sussman

Professional Role: Counsellor/Psychotherapist 
Institution: Centre for Counselling & Psychotherapy Education
Contact details: 3 Hope Cottages, Breakspear Road, Ruislip, Middlesex, HA4 7SE

ABSTRACT: Paper

Strand: Ethical Issues and Counselling Relationships

The Significance of Psycho Peristalsis and Tears within the Context of Transpersonal Counselling and Psychotherapy

This study represents an heuristic inquiry into the significance of psycho-peristalsis and tears within the therapeutic context, using a transpersonal approach to counselling and psychotherapy. The term 'psycho-peristalsis' refers to involuntary, intuitive gut responses, operating independently of digestion, and experienced in response to a range of internal and external stimuli; a phenomenon discovered by Boyesen (1970; 1972; 1975; 1985) working independently on bio-energetic principles previously established by Reich (1942; 1950; 1952).

The phenomena are examined in the light of bio-dynamic and counter-transference theory, recent anatomical findings concerning the enteric nervous system, and some natural healing principles. Central to the study is an understanding of changing attitudes and developing concepts regarding the client/counsellor relationship. The main focus of the research rests upon autobiographical material and qualitative data gathered from case-notes and semi-structured interviews with 4 client/co-participants. This is set against a background of quantitative data from an overall caseload of 92 clients seen within a 6-year period (1993-1998). The main themes of the study are those concerning:

1. The somatic experiences, associated emotions and perceived meanings of psycho-peristalsis, and the importance of 'gut' responses as diagnostic indicators

2. The association between psycho-peristalsis and tears, and their significance in relation to expanded states of consciousness and transpersonal development

3. The phenomenon of synchronicity of peristalsis

Eleven constituents of experience are identified as parts of a 'general constitutional structure of experience' (Denne & Thompson, 1991), 8 being considered 'invariant' and 3 more 'emergent' themes.

The study demonstrates the importance of psycho-peristalsis and tears within the counselling relationship. A central finding of the research concerns the gut's ability to 'pick up', at an apparently unconscious level, significant material that might otherwise have been over-looked. The evidence suggests wider implications also, providing possible clues to he process of unconscious communication and healing. The research adds an interesting psychological dimension to recent findings in the fields of neuroscience and cell biology which amount to the discovery of a 'second brain' in the walls of the small intestine (Gershon, 1998)

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Louise Taylor

Professional Role: Counsellor for Maternity Service/Lecturer/Tutor
Institution: Kingston Hospital Surrey, and Roehampton Institute, London
Contact details: 83 Grand Drive, Raynes Park, London, SW20 9DW
Email: louisetaylor@psychology-counselling.co.uk

ABSTRACT: Paper

Strand: Medical Issues and Client Concerns

An Analysis of the First Two Years of a Counselling Service Provided for Maternity Patients

In 1997 a counselling service was set up in the maternity department of Kingston Hospital, Surrey, primarily to provide emotional support for women who had miscarried. After two years, statistical and qualitative analyses were made of all data to establish the clients groups being referred and the effectiveness of the service.

The majority of clients were referred for miscarriage. Often the client's usual support system had failed to provide an appropriate response and therapy provided an opportunity for clients to express their pain, for the seriousness of their loss to be validated and have emotional support. When this could be accessed through family and friends (19%), clients often needed only one session. Other groups of clients required more sessions.

28% with a history of recurrent miscarriage were highly anxious, particularly the majority of these (64%) who were in their late 30s. 9.6% were pregnant but anxious because of a history of miscarriage; 7.6% had suffered other losses such as stillbirth, cot death, terminations and were at risk of depression; 39% already had a history of depression or other mental health problems. Other referrals included other health problems associated with pregnancy, still births, termination for abnormality, and one unexpected birth!

Five areas for future development of the service were highlighted:

1. support for partners
2. seeking out 'anxious pregnant', for whom support improves the chances of a successful pregnancy
3. early identification of clients most vulnerable to prolonged emotional disturbance
4. more sessions to cope with increasing referrals
5. more training for health professionals

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David Tune

Professional Role: Psychotherapist and Counselling Lecturer/Trainer
Institution: Private Practice and Freelance Training
Contact details: 23 Rectory Road, Wivenhoe, Essex, CO7 9EP
Email: david.tune@virgin.net

ABSTRACT: Paper

Strand: Ethical Issues and Counselling Relationships

The Therapeutic Use of Touch in Counselling and Psychotherapy

The research conducted to date is a pilot study, which forms the initial phase of work towards a PhD in Counselling studies.

The pilot study consists of a qualitative analysis of a small number of semi-structured interviews with counsellors and psychotherapists, which explore the possibility of touch in the practitioner's work. Practitioners from a range of theoretical orientations are being interviewed, and the pilot study is looking at 'social' (eg, shaking hands) and 'therapeutic' (specific techniques) touch in the counselling relationship. The pilot study will inform the development of a more structured interview with 30-40 practitioners later in the year. From this qualitative enquiry a structured questionnaire will be designed, which will be sent out to practitioners nationally at a later stage in the research.

The interviews at this stage are semi-structured, aimed at opening up a debate rather than narrowing down the focus of interest. There are however, certain areas of enquiry structured into the interviews. The reasons for using touch (of any kind) are explored, investigating a number of possible motivational influences.

Some themes that have emerged are around such issues as motivation for touching, and a difference between what form of touch is perceived as part of the counselling session. A discrepancy between theoretical orientation and practice, and whether touch is processed with the client in the session. Who initiates touch may have some relevance, and practitioners' responses to clients have provided some interesting data.

The general issue of processing touch, or the fantasy of touch by client or practitioner in supervision is also an emerging theme, and there are a number of other outcomes that have implications for the supervisory relationship that have started to emerge. It is very early to be making recommendations, however the issue of what is considered worthy of being taken to supervision and what is not in terms of touch is one area for further investigation.

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Frank Wills

Professional Role: Principal Lecturer in Counselling
Institution: University of Wales College Newport
Contact details: Allt-yr-yn Campus, PO Box 180, Newport, South Wales, NP9 5XA
Email: f.wills@newport.ac.uk

ABSTRACT: Paper

Strand: Counsellor Training

The Influence of Personal Belief Systems on the Counselling Training Experience: Examples from Training in Cognitive Therapy

Research Carried Out:

The author has been engaged in a longitudinal study of how students learn the use of Cognitive Therapy in counselling. He has been surveying and interviewing trainees before, during and after training. The inquiry has been particularly focused on how personal beliefs and attitudes of trainees influence the way they take up new ideas, especially ideas from Cognitive Therapy. Beliefs and attitudes have been assessed by using existing instruments, such as the Myers Briggs Type Indicator (MBTI), and open-ended interviewing. Trainee progress has been monitored and cross-referenced with survey results.

Results

The study is still in its early stages and the results given must be regarded as provisional indications. These at present time seem to be:

1. Certain kinds of beliefs and attitudes - for particular example, those regarding the benefits and deficits of structuring therapy - are crucial in determining how open trainees are to taking on ideas from Cognitive Therapy.

2. Competence in cognitive Therapy can, however, still be attained, when contrary beliefs and attitudes are held in only moderate form.

3. Training is more effective when it takes careful steps to establish the trainee's current beliefs and attitudes and monitors how these are able to assimilate new ideas presented in the training.

Implications:

There are strong parallels between the development of beliefs and attitudes in trainees and the developmental processes of Cognitive Therapy itself. In this sense, it behoves the training itself to be congruent with what it is trying to teach.

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Jeannie Wright

Professional Role: Staff Counsellor
Institution: Sheffield University
Contact details: Counselling Service, Sheffield University, Mushroom Lane, Sheffield, S10 2TS
Email: j.wright@shef.ac.uk

ABSTRACT: Workshop

Using Writing Therapy: Pen and Paper or Keyboard and Cyberspace

Outline of Workshop presentation

Preamble:

In various therapeutic models, forms of creative writing are used as an adjunct to face-to-face counselling. Whether by keeping an emotional diary, or writing letters, which are not necessarily intended to be sent, such 'writing therapy' has been found to enable the free expression of thoughts and feelings. (Bolton, 1999; Hunt and Sampson, 1998). The increase in the provision of on-line support, especially by the Samaritans in UK, suggests that the users of chat rooms and on-line counselling in this country are well aware already of the therapeutic potential of writing (BACP, 1999).

In the United States, large scale research has shown the physiological as well as psychological benefit of expressing the 'unspoken' in writing (Pennebaker, 1988, 1993).

Aim:

To explore with workshop participants the current research in writing therapy and to invite participants to experiment with writing about issues in their own lives, both professional and personal.

Format:

Experiential workshop for a maximum of 20 participants. The introduction will include an overview of current research in using creative writing exercises or 'writing therapy'in personal development, counselling and reflective practice. In a supportive environment and with confidentiality assured, participants will be invited to take part in short writing 'assignments' and to reflect on the experience.
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Martina Wright

Professional Role: Counsellor
Institution: Private Practice
Contact details: 210 Hagley Road, Hayley Green, Halesowen, West Midlands, B63 1EB
Email: martinawright@vigin.co.uk

ABSTRACT: Paper

Strand: Cultural and Gender Issues

Is 'Whiteness' Equaled to Sameness in the Therapeutic Relationship?

An investigative study on how the dilemmas of Irish/British identity might impact upon Counselling relationships.

There is significant evidence that of all the ethnic minorities living in Britain, the Irish have the poorest record of both physical and mental health (Cochrane & Bal, 1989 quoted by Greenslade, 1994).

Greenslade (1994) reported that Irish-born people in Britain, particularly those with both parents born in Ireland, have the highest rate, migrant or otherwise, of first and subsequent admissions to mental hospital of any immigrant group.

The rates for depression amongst Irish women are greater than the combined Afro-Caribbean and English female hospital admission rates, and double for English-born women in the same period. (Cochrane & Bal 1989 quoted by Greenslade, 1994).

Description of research carried out:

I conducted four in-depth interviews with second generation Irish people using an approach based on heuristics. It seems important to acknowledge that despite being a small piece of research this study provided a depth of insight in the life-world of four-second generation Irish people but does not tell the universal truth about all second-generation Irish people. The choice of participants was inspired by humanistic philosophy which claims that there is much to be learned from healthy, self-actualizing people. Implications for counselling relationships were explored taking into account transference/counter transference.

Summary of the results:

The findings indicate that there were similarities in the experiences of Second Generation Irish people.

The main category was of identity, and all portrayed feelings of ambivalence and contraindication.

All of participants posed the same question?

What can I call myself?

Implication and recommendations:

There seemed to be a strong need for the complexities of identity to be acknowledged within therapeutic relationships.

Counsellors need to have an understanding of the psychological consequences of colonialism and its impact on the counselling relationships. As counsellors our psychological development will be in some way shaped by our experience, history and by how we see ourselves and how others see us. With so much shared history, the Irish/English relationship has much pre-transference, it was a recommendation that this needs to be recognized and worked through.

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Dr Rania Argiro Zidianakiaki

Professional Role: Psychotherapist and staff grade Psychiatrist
Institution: Centre for Counselling & Psychotherapy Education
Contact details: 51 Methuen Street, Southampton, SO14 6FR

ABSTRACT: Paper

Strand: Medical Issues and Client Concerns

Applicability of Imagery in Psychotherapy with Adolescents Who Have Anorexia Nervosa

This is a qualitative research study with eight adolescents who had anorexia nervosa. It explores how imagery works in focused psychotherapy with them. It was conducted at MH hospital, an NHS inpatient adolescent psychiatric unit, using heuristic methodology.

For the purpose of this study, the first eight adolescents with anorexia nervosa who were admitted to the unit from November 1998 until February 1999 were approached and offered 12 sessions, focusing on the exploration of their thoughts and feelings using directive or spontaneous imagery or imagery connected to their disturbed feelings. Seven of them were girls and one was a boy.

The methodology was heuristic, as my main aim was to obtain qualitative depictions that were at the heart of the adolescent's experience of anorexia nervosa. A key element in the research process was also my own self-aware involvement as a researcher. It challenged me to rely on my own resources and to gather within myself the full scope of my observations, thoughts, feelings, senses and intuitions. In addition, the participants remained visible in the examination of the data and were portrayed as whole persons.

The main themes that emerged were:

1. The participant's formidable resistance to engage in a therapeutic relationship
2. Their massive fear of experiencing any feelings at all, especially anger
3. Separation from the mother
4. Lack of integration of their body into the core self
5. Loss of reflection
6.Anorexia was their silent scream

Overall it was found that imagery can facilitate their difficulty in expressing themselves and their core feelings. It can also highlight their inability to look at themselves or to see how false their way of being is. It equally provided a safer way for the 'thinkers' to project their feelings on the drawing or embody them into mental images, before they could even name them.

Further research with a larger sample should be carried out to look at a variety of cases in terms of the response to this approach and how that might relate with the phase of their process. Another factor for consideration was the number of sessions; they were thought not to be enough for the participant to develop and establish a therapeutic relationship.

 

 
       
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