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Research Conference 2004  


BACP's 10th Annual Research conference was entitled 'The World of Counselling Research' and took place on 21-22 May 2004. It was held at the Holiday Inn, London in association with American Counselling Association (ACA), Australian Counselling Association (ACA), International Association for Counselling (IAC), Irish Association for Counselling and Psychotherapy (IACP), The Kenya Association of Professional Counsellors (KAPC), Malaysia Counselling Association (PERKAMA), New Zealand Association for Counsellors (NZAC) and Psychotherapy and Counselling Federation of Australia (PACFA).

Click here for an evaluation of this year's conference

Abstracts



Mansor Abu Talib

Professional Role: Postgraduate student
Institution: University of Manchester / Universiti Putra Malaysia
Contact details: Educational Support & Inclusion, Faculty of Education, University of Manchester, M9 13PL
Email: mansorat@hotmail.com

ABSTRACT: Paper

Mandated Counselling: A Case Study In Malaysian Setting

Counselling can assist in the reduction of distressing psychological problems. However, few who experience significant distress or meet the criteria for a mental disorder seek counselling. The decision to seek counselling is a complex process. Malaysian and other South-east Asians are known to be passive and reluctant to seek counselling. Their key characteristics include dependence on a more powerful people, student respect for the teacher, everyone values authority, subordinates expect direction, and low individualism (Hofstede, 1994). In Malaysia, mandated or compulsory counselling is practised in schools, universities, rehabilitation centres, government and private agencies and in court-ordered cases. This includes compulsory referral of 'problemed', 'underperformed' and 'undisciplined' individuals. However, counselling has always been associated with voluntary participation. Thus making it compulsory is unethical as it could indicate a reduction of individual autonomy. Little has been written about mandated counselling in the eastern culture and also within the higher learning institution.

The aim of this case study is to understand the experience of reluctant students mandated to seek counselling. In-depth interviews were conducted with seven university students comprising of 18 two hours sessions. Data were analysed phenomenologically using Heuristic method (Moustakas, 1994). The descriptions illuminate that clients welcome the 'forced invitation' to enter counselling. The therapeutic effects of therapy overshadowed 'intrusion'. Since they were unable to ask for help, making it compulsory eased the resolution to seek counselling. They didn't feel alone in their emotional battle. They wished that the therapist would 'knock on my door' or say 'hi' in the corridor when their problem was at its peak. The therapist's social presence mitigates the conflict. Mandated clients could become counsellors' greatest advocates. Some cultural issues pertaining to counselling and the practice of mandated counselling in Malaysia will be discussed.

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Zainah Ahmad-Zamani

Professional Role: Lecturer in Counselling
Institution: National University of Malaysia
Contact details: Centre of Psychology and Human Development, Faculty of Social Science and Humanities, National University of Malaysia, Bangi, Selangor, MALAYSIA
Email: zainah@pkrisc.cc.ukm.my

ABSTRACT: Paper

Strand: Cultural Issues

Ambivalence Of Counselling Service: A Question Of Stigma?

The idea of seeking professional help for psychological and interpersonal problems is still relatively new in some societies in Malaysia. For many Malaysians who would stop short of viewing counselling as stigmatising, there may still remain a fair degree of scepticism about the value of counselling. This study seeks to explore the subjective experiences of ex- counselling clients toward counselling.

A qualitative method was used, with semi-structured interviews of 15 employees from a public sector organisation in Malaysia. The interviews focused on questions about the benefits of counselling, satisfaction with counselling services and changes and learning that take place after counselling.

Results indicate that the existence of a prevailing climate of 'stigma' for counselling clients still exists and seems to restrain them from seeking help. A contributory factor to such scepticism is the conflict between Malaysian cultural values and the psychotherapy or counselling process. This conflict may deter employees from utilising counselling help. With such ambivalence and stigma, it consequently becomes a challenge for counsellors in Malaysia to promote an environment and support for those seeking help to overcome the fear of being stigmatised. Implications for these situations are discussed.

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Ann Beynon

Professional Role: Education Consultant /Counsellor /Trainer
Institution: Independent
Contact details: 2 Chapel Yard, Higham, Derbyshire, DE55 6EH
Email: abeynon@britishlibrary.net

ABSTRACT: Paper

Strand: Supervision

Standing On Common Ground. Can A Counselling Model Of Supervision Support Teachers In The Creation Of Effective Learning Relationships?

This research grew from my work with the teaching staff of a primary school during the past four years. The paper considers the value of offering a counselling model of supervision to teachers, to enhance their personal well being and professional competence. I have offered the same counselling model of supervision to all six research participants over a four year period. Three participants are practising counsellors, working in a variety of settings and three are teachers, working in the same school; the narratives of their experience of supervision provided the data for this study.

Methodology

The approach to the research task is qualitative, using the narrative inquiry method to establish the comparisons and differences in the use and value of counselling supervision, as experienced by the two professional groups. All the participants completed an initial questionnaire, focusing on their experience of supervision; this served as preparation for the open-ended conversations with each participant.

Results

On a spectrum of supervision needs, the teachers and counsellors identified overlapping personal and professional needs, including the need for confidentiality, monitoring, reassurance and to be safely vulnerable.

Conclusion

Despite the differences in the culture and purpose between the two professions, these research findings establish that, in principle, a counselling model of supervision can have a significant value in meeting teachers' restorative and developmental needs. There are however major issues to be addressed if this model is to become established within the current organisational values and systems in education. A counselling model of supervision and its implementation appeared to be successful in this particular school, because of a unique set of circumstances and personnel; are there common factors that can be identified from this research study and transferred to other staff groups in other schools?

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Andrew Bickerdike

Other Presenters: Kirsty Hildebrandt and Lyn Littlefield

Professional Role: Clinical Practice Leader - Mediation
Institution: Relationships Australia (Victoria)
Contact Details: 46 Princess Street, Kew, Victoria, Australia
Email: abickerdike@rav.org.au

Abstract: Paper

Strand: Family Relationships

The Impact Of Attachment Style And The Attachment Response On Spousal Adjustment To Divorce And Separation

Introduction:

Divorce disrupts the attachment bond between spouses. Research suggests that the level of continuing attachment to the former partner relates to the level of emotional distress experienced after divorce (Bickerdike and Littlefield, 2001; Berman, 1988). Attachment theorists argue that the organization of the attachment system differs across individuals (Secure, Preoccupied, Dismissing-avoidant, Fearful-avoidant) and suggest that these prototypes are associated with individual differences in adjustment to loss. Differences in attachment style may also affect the nature of the attachment response to divorce. Research has not investigated the relationship of attachment style and persisting post-separation attachment, nor their potential influence on divorce adjustment.

Method:

221 clients undergoing divorce mediation/counselling participated in the study. Participants were administered questionnaires assessing adjustment to separation, initiator status, psychological distress, attachment style, level of attachment, and various personality traits (pre and post counselling and at follow-up).

Results:

Sequential regression analyses demonstrated that the attachment prototypes, level of attachment to the former partner and initiator status significantly predicted psychological distress at all three time periods. The level of attachment to the former partner had the greatest unique effect on psychological distress at Time 1 and Time 2, with the fearful attachment prototype having the greatest unique effect at Time 3.

Conclusion:

Individuals who are less attached or manage to decrease their level of attachment to their former partner may adjust more quickly and have less psychological symptoms following separation. Those with a fearful attachment style may find this difficult to do, particularly if they did not initiate the separation.

There was a trend for Pre-occupied attachment to be associated with higher levels, and Secure and Dismissing attachment styles with lower levels, of response to separation attachment. This pattern of association is as would be expected from attachment theory.

(References available from the authors)

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Dr Herbert Biggs

Other Author: Glen Guy

Professional Role: Senior Lecturer
Institution: School of Psychology and Counselling, Queensland University of Technology
Contact details: School of Psychology and Counselling, Queensland University of Technology, Beams Road, Carseldine Qld 4122, Australia
Email: h.biggs@qut.edu.au

ABSTRACT: Paper

Strand: Theory and Practice

Narrative Therapy And The Group Process

The small group is a powerful yet under-utilised medium for assisting people experiencing emotional and social difficulties in our community. However, much group work is typically structured using a psycho-educational focus in which professional workers organise the group agenda and present "expert" information and skills training to the participants. Participants are frequently positioned, quite often inadvertently, as passive recipients of understandings and beliefs and gain little from the dynamics of the group experience. In counselling dimensions and practice, an emerging synergy that has the potential for client empowerment and ownership is the melding of growth aspects of the group context with narrative therapy. Narrative therapy approaches assist people to deconstruct or understand and question how unsatisfactory or oppressive stories come to be incorporated in their lives. This study examines the applicability of particular processes of the group context in this contemporary counselling approach of narrative therapy by examining evidence articulated in video and video script from group counselling undertaken in community based support agencies. The paper extends potential conceptual links between the group process and narrative approaches particularly in the 'audiencing' of preferred alternative stories that can be identified in the person's life events and which can be explored and developed in a supportive and accepting group environment. The paper concludes with a number of suggestions for research and evaluation design of potential future programmes in narrative therapy in group contexts.

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Dr Selwyn Black

Professional Role: Lecturer in Counselling; Counselling practitioner/consultant
Institution: University of Ulster
Contact details: University of Ulster, Shore Road, Newtownabbey, Co Antrim BT37 0QB
Email: s.black@ulster.ac.uk

ABSTRACT: Paper

Strand: Client / Therapist Issues

Traumatic Countertransference: A New Conceptualisation of an Old Concept

Introduction: In the 'new paradigm' of psychotraumatology, there is little research with clinicians who have themselves become traumatised as a result of their work with traumatised clients. This research explored some of the processes that lead to changes in clinicians' frame of reference and ultimately their sense of identity because of traumatic countertransference.

Methods: The identity processes of a Critical Incident Response Team working in the aftermath of the Omagh bomb, were tracked over three phases using the Identity Structure Analysis (ISA) conceptual framework. Their identity structures were compared with those of a comparison group of clinicians of similar professional profile who had no involvement in that traumatic incident. A further comparative study was conducted with a surgical team from the County Hospital, Travnik, Central Bosnia, who worked together in the context of the Bosnian War (1991-1995).

Results: The results show that clinicians adopt different identity orientations in contending with their traumatic countertransference responses. They also show that unaddressed traumatic countertransference can lead to vicarious traumatic experience that may have long-term consequences. A new conceptualisation of traumatic countertransference is presented that explains what happens when clinicians have been influenced by the negative affect of their clients' traumata.

Conclusions: This research has self-care implications for practitioners, training implications for those proposing to work with traumatised clients, and potential implications for the way clinicians currently understand traumatic experience.

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Dr Tim Bond and Dr Jane Speedy

Professional Role (TB): Reader in Counselling and Professional Ethics (JS) Senior Lecturer in Counselling
Institution: University of Bristol
Contact details: Centre for Narratives and Transformative Learning Graduate School of Education, 8-10 Berkeley Square, Bristol, BS6 5BS
Email: tim.bond@bristol.ac.uk, jane.speedy@bristol.ac.uk

ABSTRACT: Workshop

Strand: Autoethnographic Research

Collective Biography

This workshop will enable participants to engage, together with the presenters, in a 'live' collective research study that will use writing as a means of narrative inquiry. The session will include a short introduction to the ideas and practices of writing 'collective biography'.

The authors are in the process of developing their own approaches to this (traditionally feminist) research method (see Haug,1987. Davies,et al,1997, Davies, 2000). They are currently engaged in experimenting with these embodied writing processes alongside the practices of witnessing, telling and re-telling stories that have emerged from the narrative therapies (see: Speedy, forthcoming).

Participants will have an opportunity to 'witness' and reflect on the author's writings and will be provided with a framework in which to sustain each other and to produce some of their own writing within a climate of 'collective creativity'.

This workshop will be a 'taster' rather than a full-scale research study, but there will be opportunities for enthusiasts to continue this project as an online community of writers and to complete collective biography that might subsequently be submitted for publication.

References

Davies, B (2000) (In) Scribing Body/ Landscape Relations, Alta Mira, Walnut Creek, Ca.

Davies, B, Dormer, S, Honan, E, MacAllister, N, O'Reilly, R, Rocco, S and Walker, A (1997) Ruptures In The Skin Of Silence: A Collective
Biography, In: Hecate: A Women's Interdisciplinary Journal 23 (1), 62-79.

Haug, F (1987) Sexualisation, Verso, London.

Speedy, J (forthcoming) 'Collective Biography', in: Speedy, J, Narrative and Life Story Approaches to Counselling and Psychotherapy Research, Palgrave, Basingstoke.

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Carina Ferreira Borges

Professional Role: Researcher
Institution: left blank
Contact details: Rua Gomes Friere, n o 197-3 o
Email: gdq@mail.telepac.pt

ABSTRACT: Paper

Strand: Theory and Practice

Effectiveness of A Brief Counselling Intervention For Smoking Cessation

Background: Health education methods for pregnant smokers have demonstrated better results than routine advice in pre-natal clinics. A review of evidence shows that the type of intervention (face to face advice being better than others), the type of intervenor (both physician and non physician counsellors better than either alone), the number of modalities used in the intervention, the number of reinforcing sessions and the duration of the sessions, are related with the success of an intervention.

The purpose of this study was to determine the extent to which a new type of intervention - brief psychopedagogical counselling - could be provided in a public maternity hospital by different care staff members (tested under typical practice conditions) and to evaluate the efficacy of the intervention methods.

Methods: A prospective, randomized pre-test - post-test control group design was used to evaluate intervention effectiveness. This study was conducted over a 5 monthly period from March to 31 July 2002, in a Public Health Maternity Hospital from the metropolitan area of Lisbon. Of the 1,994 women who presented for their 1st visit at the hospital during the study period, 355 (17.8%) were identified as current smokers. Smokers were not eligible for this study if they were 28 weeks or more pregnant, if they were changing to another prenatal clinic or if they showed signs of any mental or behavioural disorders. Women who reported having stopped smoking or that were 'uncertain' were excluded even if they had stopped the day before.

At first visit, 33 patients were randomly assigned to an experimental (E) group where they received the counselling brief intervention and 24 were assigned to a control (C) group where they received usual care. Smoking status was reported by self-report and confirmed by expired air breath at the first visit and at two months follow-up.

Results: Tobacco abstinence was reported by 40.7% in the intervention group compared to 8.7% in the usual care group (p=0.01) (OR=7.2). Using an intention to treat analysis the 2 months point prevalence abstinence rates were respectively 33.3% and 8.3% (p=0.02) (OR=5.5).

Conclusions: Psychopedagogical counselling seems to be a promising approach that can help women to stop smoking during pregnancy.

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Dr Ann Bowes

Professional Role: Psychoanalytic psychotherapist, senior registered counsellor and supervisor in independent practice
Institution: UKCP, UKRC, BACP
Contact details: 21, Canowie Road, Bristol, BS6 7HR
Email: ann@bowes21.fsnet.co.uk

ABSTRACT: Paper

Strand: Supervision

Evaluating Supervisor Training And Accreditation: What Are The Experienced Supervisees' Needs: An Exploratory Study

Introduction

This paper explores the low take up culture around supervisor training leading to accreditation, and what is implicit and explicit in therapists' attitudes and needs from supervision. It particularly focuses on the experienced supervisee, drawing as a case study on the responses from the experienced supervisors (who are also supervisees). The research enquiry grew out of an article in CPJ highlighting the low numbers of registered supervisors in contrast to the larger percentage of BACP registered counsellors.

Methods

A qualitative approach was used through the use of co-operative inquiry which involves researching with, not on, people and stresses the perspective and experiences of those with whom the research is conducted. It enables participants to explore and to develop the research question for themselves. The study was based on the responses to an email questionnaire to the membership of BAPPS. There were 25 responses. Members were asked to develop their responses to three questions, viz: Why are only a limited number of practitioners going forward to qualify as supervisors and seek accreditation, why do not more counsellors and therapists seek out qualified and registered supervisors and what supervision training have practitioners had and what do they need?

Results

The responses fell into themes, such as accreditation does not necessarily make a good supervisor or that finding a supervisor is a very personal business. However the methodology developed the research question which led to an awareness that there is a dissonance between the public and private needs of experienced supervisees, that is not covered by the use of supervision to protect the public.

Conclusions

Further research is needed to explore the implicit but masked needs of experienced supervisees.

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Dr Loretta Bradley

Other Presenter: Dr Doris Coy
Other Authors: Dr Tom Sexton and Dr Howard Smith

Professional Role: University Professor
Institution: Texas Tech University
Contact details: 9312 Raleigh Avenue, Lubbock, Texas, 79424, USA
Email: loretta.bradley@ttu.edu

ABSTRACT: Paper

Strand: Theory and Practice

Practice Research Network: A Research Tool

Introduction

In an era of increased accountability, there is a need to answer the following questions:

1. Who are professional counselors?
2. What services do professional counselors provide? and
3. Does counseling work?

Although these questions may seem simple, in reality they are complex questions. Researchers have stressed the need to answer these and similar questions (Lambert, 2001; Lambert, Whipple, Vermeersch, Smart, Hawkins, Nielsen, & Goates, 2002; Whipple, Lambert, Vermeersch, Smart, Nielsen, & Hawkins, 2003). To answer the above research questions, a Practice Research Network (PRN) was established by the American Counseling Association (ACA) with grant funding to study the practices and outcomes of counseling.

Methods

The research design includes two phases. In Phase 1, 603 counselors completed the National Counselor Questionnaire designed for this study, with the primary goal to identify the characteristics of professional counselors, aggregate-level characteristics of clients with whom the counselors work, and the type of treatments provided. Unique features of this research study resulted from data being collected through the interactive web-database developed for this study and data were provided by both practising counselors and clients. Phase 2 is in progress.

Results

The results indicate that counselors work in a variety of settings and that clients pay for services from a variety of sources. The clients presented a wide range of clinical problems. Couples problems were the most prevalent primary presenting concern followed by mood disorders and family problems. Secondary problems were also identified. The work of 43 counselors with 187 different clients over 1,239 counseling sessions provided data about the services delivered. Although counselors rated the counseling outcome as modest, the clients rated the outcome as very good (successful).

Conclusions

This research is the first to show that in counseling settings with professional counsellors, counsellors have treated a wide range of problems. Based on the responses of clients, counselling has been successful. Additionally, this research indicates that the PRN provides a new research tool for identifying "best practices" in counselling.

(Further references available from the author)

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Peter Bray

Professional Role: School Counsellor
Institution: Mangere College, Auckland
Contact details: 212A, Glenbrook Beach Road, R.D.1, Waiuku. New Zealand
Email: peterbray@www.com

ABSTRACT: Paper

Strand: Young People and Adolescents

The Implications of Stanislav Grof's Holotropic Theory on Counselling Adolescents

Introduction: Adolescents experiencing auditory and visual hallucinations, disorientation, delusions, extreme vulnerability and risk taking behaviours may be diagnosed as regressively pathological. Alternatively, if the adolescent maintains a capacity for adaptive decision-making combined with transformational insight then these experiences may be regarded as psycho-spiritual healing processes that Grof and Grof describe as 'spiritual emergency'. The challenge for counsellors is to identify spiritual emergency and its manifestations in adolescent clients.

Method: Core to this research is a rigorous analysis of Grof's Holotropic Theory and its application to counselling practice in the light of DSM-IV . Case study methodology is used to propose a hypothesis that provides a basis for the application of Grof's theory in clinical practice. Cases serve to illustrate that inner and outer experiences of holotropic phenomena, categorised as 'spiritual emergency', are triggered by experiences of grief and loss.

Results: Conceptual research indicates that there is a paucity of literature about the experiential role of spiritual processes during adolescent development. Evidence suggests that counsellor education needs to include greater acknowledgement of this area of client experience. These results are particularly relevant to counsellors with adolescent clients and pertinent to the understanding and application of diagnostic category 'Religious or Spiritual Problem', in DSM-IV , which includes elements of spiritual emergency.

Conclusions: The significant implications for counsellor education, practice and research suggest that counsellors and trainees, employing reflective practice, examine their own spiritual positions in order to understand the impact of spirituality on their clients. Future research might also include qualitative and quantitative analysis of links between adolescent development, grief and loss, non-ordinary states of consciousness, and the spontaneous orientation of the psyche towards healing.

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Gulfem Cakir and Gul Aydin

Professional Roles: (GC) Research Assistant (GA) Professor of Counselling
Institution: Middle East Technical University
Contact details: Middle East Technical University, Department of Educational Sciences, 06531 Ankara, Turkey
Email: gulfem@fedu.metu.edu.tr, gulay@metu.edu.tr

ABSTRACT: Paper

Strand: Young People and Adolescents

Ego Identity Status And Family Type Among Turkish Adolescents

Introduction:

In identity formation literature, the studies that investigate family variables have been given an extensive emphasis (Meeus W, Oosterwegel A, and Vollebergh W, 2002). Although there are many studies related to the influence of the parents' marital status on adolescents' psychosocial development and behaviour (Simons, Lin, Gordon, Conger and Lorenz, 1999), there is a paucity of research investigating the association of parents' marital status with the identity development of adolescents. This study examines differences in the identity status of male and female adolescents as a function of family type.

Method:

The sample included 403 11th grade high school students. Three hundred and sixty one of the participants were from intact families, and 42 were from non-intact families. The Turkish version of the Extended Objective Measure of Ego Identity Status (EOM-EIS-2) was used to measure the identity status of students. A 2 (gender) X 2 (intact- non-intact) MANOVA was applied to the identity achievement, moratorium, foreclosure and diffusion EOM-EIS-2 subscale scores of the students.

Results:

The result showed no significant main effect of family type, which indicated that the identity status of adolescents did not differ as a function of coming from intact or non-intact families. However, significant gender differences between the mean scores of male and female students were found in the identity foreclosure subscale.

Conclusion:

The results did not support the literature, which suggests that changes in the perception of adolescents about divorced parents may influence the identification patterns with the parent and internalisation of the parent's values, beliefs and goals. On the contrary, this result is consistent with some findings suggesting that identity achieved males from broken homes were not different from males from intact homes.

(Further references available from the authors)

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Dr Jocelyn Catty (paper)

Professional Role: Research Fellow, Mental Health & Psychodynamic Counsellor (FPC / BACP)
Institution: St George's Hospital Medical School
Contact details: Dept of Mental Health, Jenner Wing, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE.
Email: jcatty@sghms.ac.uk

ABSTRACT: Paper

Strand: Theory and Practice

'The Vehicle of Success': Theoretical and Empirical Perspectives on the Therapeutic Alliance in Psychotherapy and Counselling

Introduction

The importance of the 'therapeutic alliance' has long been recognised in psychotherapy, originally in psychoanalysis and subsequently in a range of other therapies. The amount of attention it has received in clinical theory, however, is in marked contrast to the wealth of empirical research on the subject.

Methods

This paper reviews the evolution of the concept of the therapeutic alliance in clinical theory and traces the development of empirical research on the subject in order to consider their implications for each other.

Results and Conclusions

Examination of the clinical and empirical literature gives rise to the following questions. First, is the alliance concept distorted when adapted by different therapies, or when translated into research instruments? Thus, how are the theoretical implications of quantitative research findings to be understood? Second, how we are to understand the apparent anomaly whereby its proponents have defined it as a 'vehicle' for treatment rather than curative, while empirical research increasingly associates it with outcome?

The paper argues that meaningful clinical or theoretical distinctions between different concepts may not be reflected in the empirical literature, so that it may be unable to illuminate some of the theoretical controversies, although its implications for theory demand consideration. Moreover, reviews that demonstrate an association between global scores of different measures may encourage us not to distinguish between them; whereas there is a clear need to establish the degree of conceptual fit between the model of therapy studied and the measure used. Finally, the paper argues that the empirical research misleadingly suggests a curative paradigm and has not yet answered the question of whether the alliance is mutative in itself or is a facilitator of other more important factors.

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Dr Jocelyn Catty (poster)

Other Author: Hannah Winfield

Professional Role: Research Fellow, Mental Health & Psychodynamic Counsellor (FPC / BACP)
Institution: St George's Hospital Medical School
Contact details: Dept of Mental Health, Jenner Wing, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE.
Email: jcatty@sghms.ac.uk

ABSTRACT: Poster

The Therapeutic Relationship in Psychiatry: A Conceptual Review

Introduction

Meta-analyses of the therapeutic alliance in psychotherapy have suggested that it is strongly associated with outcome. The concept is based on an extensive theoretical and clinical literature, much of it psychoanalytic. The therapeutic alliance or relationship has recently become of increasing interest in psychiatric services. In psychiatric settings, however, the validity of scales developed for use in psychotherapy is also unclear, while the concepts underlying measures developed for use in psychiatry are rarely articulated.

Objective

To determine the conceptual bases of measures of the patient-professional therapeutic relationship in routine psychiatric services.

Methods

We conducted a comprehensive literature search for references identifying instruments to measure the relationship between mental health patients and professionals in routine psychiatric services. For each identified instrument, data were obtained on: client group; setting; discipline of professional; rater; frequency of use and clinical outcomes against which the instrument was tested. The conceptual validity of the measures was reviewed, where 'conceptual validity' was defined as subsuming face validity, content validity and construct validity. This was done through review of the validation of the measure by the original authors and conceptual review, comprising a consideration of each measure in terms of the underlying theory, with recourse to psychoanalytic theory in the first instance.

Results

For each identified measure, we review evidence of conceptual validity testing by the authors, in the form of face validity, content and construct validity, and any conceptual discussion presented. We then consider the theoretical orientation of the measure, if articulated, and review the implications of the measure from a psychodynamic perspective in the first instance.

Conclusions

The implications of our findings for research and practice are considered, with recourse to the psychotherapy literature. Implications for use of the measures in psychotherapy and counselling are also examined.

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Norman Claringbull

Professional Role: Lecturer/researcher in counselling and psychotherapy
Institution: The University of Southampton
Contact details: New College, University of Southampton, The Avenue, Southampton SO17 1BG
Email: norman.claringbull@btinternet.com

ABSTRACT: Paper

Strand: Organisational Counselling

The Fourth Wave In Workplace Counselling - its Professional Specialisation?

Introduction

A 'Pilot Exploration' into the training currently available for Workplace Counsellors and the needs of their employers and clients indicates that major theoretical, research-led and practice-based developments could greatly benefit WP practitioners. This research is the beginning of an ongoing process that is targeted at creating a basis for a 'Workplace Counselling Specialisation'

Methods

a) A series of meetings was organised with some Employee Assistance Programme Managers and other relevant professionals.
b) A survey was undertaken of the actual nature and content of the current UK courses that claim to teach Workplace Counselling

Results

1) The Service Providers want counsellors who can:
a) Provide 'Added Value' counselling.
b) Use counselling methodology as a management tool.
c) Are 'business aware'
d) Acknowledge that the needs of the employer and the worker are equally important
e) Offer a wide range of psychotherapeutic and psychological services
2) The current WP training on offer falls far short of meeting these demands

Conclusions: There is a mismatch between WP training and the skills that 'WP Specialists' could and should be offering. In order to find a sound basis for the professional claims of the putative WP Professional, research is needed into: -

a) Organisational/contractual demands on the WP Counsellor.
b) Client and organisational types their implications for WP Counsellor development.
c) Ethical conflicts when there are conflicts between employee-needs and employer- needs.
d) Available models of Workplace Counselling: what new ones might be needed.

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Dr Mick Cooper

Professional Role: Senior Lecturer in Counselling
Institution: University of Strathclyde
Contact details: Counselling Unit, University of Strathclyde, 76 Southbrae Drive, Glasgow, C13 1PP
Email: mick.cooper@strath.ac.uk

ABSTRACT: Paper

Strand: Young People and Adolescents

Young People's Experiences of an In-School Counselling Service

Introduction

Recent years have seen a burgeoning number of counselling services established within schools, but how are these services experienced by the users themselves? This paper presents the findings of a mixed-method study that investigated young people's experiences of attending school-based counselling services in three Glasgow secondary schools.

Methods

First, qualitative, semi-structured interviews were carried out with twelve of the young people attending the counselling service. Key areas of exploration included the young people's expectations of counselling, how they experienced the counselling service, how important confidentiality and anonymity were to them, and how they thought the counselling service could be improved. Following transcription, the interviews were coded and analysed using NVivo. Second, all clients were asked to complete a post-counselling semi-structured questionnaire. This included a range of qualitative and quantitative items, assessing how helpful the clients felt the counselling had been; how they felt the counselling did, or did not, help them; and their views on how the counselling service might be improved. Qualitative responses were analysed using a basic coding procedure, whilst quantitative items were subjected to descriptive statistical analysis.

Results

Respondents expressed an overwhelmingly positive response to counselling, with over eighty percent saying that the counselling had helped them either 'quite a lot' or 'a lot'. Such levels of satisfaction contrasted strongly with many of their expectations of counselling: for instance, that they would be judged or instructed to lie down on a couch for 'analysis.'

A high proportion of the respondents said the counselling had helped them by giving them an opportunity to 'get things off their chest.' A similar proportion also identified 'being listened to' as the key therapeutic ingredient. Several of the respondents, however, also reported that receiving advice or instructions on specific self-help techniques (such as relaxation methods) was a key element in their therapeutic work.

Respondents varied greatly in terms of the importance of confidentiality. In a significant minority of cases, however, the knowledge that the counselling was confidential and anonymous was absolutely critical to their use of -- and ability to benefit from -- counselling.

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Dr John Court

Other Authors: Ilona Reid and Dr Peter Winwood

Professional Role: Program Director, Doctor of Counselling
Institution: University of South Australia
Contact details: School of Psychology, University of south Australia, Adelaide, SA 5000
Email: john.court@unisa.edu.au

ABSTRACT: Paper

Strand: Training and Development

Meeting The Transnational Challenge: Counselling Training In Hong Kong

Introduction: Since Hong Kong became a Special Administrative Region of China, an innovative counselling training program has been offered which in all essentials is the same as that offered in South Australia. The Master of Social Science in Counselling is designed for mature age students seeking to become professional counsellors, or, more often, to upskill within their existing profession. It is provided jointly by the University of South Australia and Hong Kong Baptist University. As part of a review of this program, the present study considers the transnational implications of taking a course derived from Western counselling, but strongly multicultural and transpersonal in emphasis, into a setting where Asian values and practices predominate. Teaching is provided by Australian staff offering intensive workshops, supported by local, trained tutors.

Methods: The student body is typically of mature age, and studying part-time. Statistical data from enrolment information have been analysed for 270 students from 2001-2003, to determine the suitability of the course in the Hong Kong context. They are supplemented by qualitative data derived from several cohorts (two or three per year with a maximum of 70 enrolments), course evaluation data obtained at the end of each course, and benchmarked against information from other university courses.

Results: Results include information from cohorts that have had to deal with the economic downturn in Hong Kong, as well as the outbreak of SARS. Retention rates, student expectations, satisfaction ratings and occupational fit all suggest that the translation across cultures is working surprisingly well. Student reflections on what works provide helpful insights.

Conclusion: A course providing generic counselling skills designed for one context can be taken successfully into a quite different, transnational context.

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Pamela Elmslie

Professional Role: MA Student
Institution: Ontario Institute for Studies in Education of the University of Toronto
Contact details: R.R. #5, Georgetown, Ontario, Canada, L7G 4S8
Email: pelmslie@aztec-net.com

ABSTRACT: Paper

Strand: Training and Development

The Effects of Counsellor Trainee's Family-of-Origin on the Process of Becoming a Counsellor

Introduction

Counsellor trainees undergo a considerable amount of stress throughout their learning process, much of which can be attributed to the process of change that occurs within themselves and in their relationships with others. A trainee's relationships with members of his/her family-of-origin can be affected by the trainee's process of becoming a counsellor. A trainee's family can have various reactions to the newly emerging counsellor which may contribute to the trainee's developmental stresses. To date, no attempt has been made to explore the process of how the family-of-origin influences the trainee's development. Knowledge of processes involved in counsellor development is deemed essential for the design and application of training protocols.

Objectives

The study aims to understand the nature of the effect that studying counselling has on a trainee's relationship with members of his/her family-of-origin and to investigate the role that such effects have on the stresses and challenges that confront the individual trainee in his/her process of development.

Methods

Middle East Technical University Using a qualitative format a sample (8-12) of counsellor trainees are participating in open-ended, semi-structured interviews. This research is being conducted from January to March 2004.

Significance of the Research

It is believed that personal life stresses have an impact on therapeutic effectiveness and that the formative stage of professional development is a crucial one with implications for future efficacy in practice. Studying the family-of-origin influences on counsellor trainees is thus expedient. A trainee's family-of-origin experiences can have an effect on his/her efficacy as a future practitioner, and it is hypothesised that the resolution of family-of-origin issues is a necessary prerequisite to effective counselling.

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Dr Kim Etherington

Professional Role: Reader in Counselling and Research
Institution: University of Bristol
Contact details: Graduate School of Education, University of Bristol, 8-10 Berkley Square, Bristol BS8 1HH
Email: k.etherington@bristol.ac.uk

ABSTRACT: Paper

Strand: Autoethnographic Research

The Impact Of Writing First Person Stories For Research

This paper reports on a study of the impact on participants who write first person accounts for research purposes. It is based on an on-going and follow-up study of people who contributed their stories for a collective auto-ethnography which became a book entitled 'Trauma, the body, and transformation: a narrative inquiry' published in 2003. It follows participants over the period from their first responses to my advertisement for contributors in CPJ in December 2001 to the book launch in October 2003 and shows how stories and experiences change over time.

Data used for this meta-analysis was gathered from: email and telephone conversations during the initial engagement; the writing phase; notes made of conversations with authors when we met and what they said at the book launch about the impact of seeing the published book.

The data shows how the process of writing and publishing personal accounts can provide healing, release and new insights. It can also be 'scary, disturbing and difficult'. For some people it became too difficult and they withdrew.

Ethical issues were concerned particularly with self-disclosure, anonymity and informed consent; and the emotional and physical impact of re-connecting with childhood trauma through writing and talking about it. The concept of continuous process consent is highlighted.

Other ethical concerns discussed are related to methodological issues, such as co-construction and ownership of the work.

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Beverley Flitton

Other Author: Professor Julia Buckroyd

Professional Role: Counsellor / Research Assistant
Institution: University of Hertfordshire
Contact details: Centre for Community Research, University of Hertfordshire
Email: b.flitton@btopenworld.com

ABSTRACT: Paper

Strand: Young People and Adolescents

Using the Piers Harris 2 To Measure the Self Concept of Children/Adolescents Who Attend a School for Complex Needs

Nationally it has been recognised that learning disabled young people may be at risk of developing mental health problems. With the introduction of the Special Needs and Disability Discrimination Act 2001, there is a need to ensure equal access to services for learning disabled young people. The growth of counselling in schools for children who are learning disabled is diminutive in comparison to the rest of the population. If counselling in schools for learning disabled children is to develop then a model for access and the effects of counselling have to be thoroughly researched and presented. This research is an ongoing study funded by The Diana, Princess of Wales Memorial Fund.

The participants in the study are children/ adolescents who attend a school for children with complex needs. The staff at the school selected thirty students aged between ten and sixteen years who they believed would benefit from counselling. Fifteen students received counselling in the first year and the remaining fifteen became the control group. In the second year the control group received counselling. The purpose of this study is to evaluate the effect of a person centred counselling intervention on the child/adolescent's self-concept. The study explores the perspective of the child/adolescent, teacher and teacher's assistant.

A major feature of the project has been the problems presented by the attempt to evaluate change in the students. This paper presents the issues raised by the use of the Piers Harris 2 instrument to measure the children/adolescents' self concept. The presentation will be an interactive session offering an opportunity for discussion of the strengths and weakness of the instrument including the significance of the preliminary findings.

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Dr Ewan Gillon and Morag Patten

Professional Role (EG): Director and Lecturer
Institution: ResearchWise and Glasgow Caledonian University
Contact details: Dr Ewan Gillon, ResearchWise, 7 Belmont Crescent, Edinburgh, EH12 6JE
Email: ewan@researchwise.co.uk

Professional Role (MP): Student Counsellor/Welfare Officer
Association for University and College Counselling: Chair of Research Sub-Committee
Institution: Heriot-Watt University, Edinburgh
Contact Details: Morag Patten, Heriot-Watt University, Riccarton, Edinburgh EH14 4AS
Email: M.I.Patten@hw.ac.uk

ABSTRACT: Workshop

Strand: Young People and Adolescents

The 2002/3 AUCC Annual Survey of Counselling in Further and Higher Education: Development, Implementation and Results

Introduction

The Association for University and College Counselling (AUCC) Research Sub-committee conduct an annual survey of counselling in further and higher education. The survey, which addresses both student and staff counselling, is sent to counseling services in all FE and HE institutions in the UK (over 700 in total). It receives an average response rate of around 20% (est. 160 replies), and is unique in offering a year-on-year 'snapshot' of the experiences and working conditions of counselors in FE and HE.

Methods

In this workshop we will consider the philosophy and rationale for the survey, from inception to present implementation. We will also explore the challenges of undertaking a national study, focusing on methodological issues linked to capturing valid and reliable data in a wide range of settings.

Results

The methodological issues highlighted will be explored in the context of the results of the 2002/3 survey. These results will be described in terms of their implications for highlighting key concerns at a national level. Particular attention will be paid to a number of key dilemmas faced by the AUCC Research Sub-committee in balancing the needs of various 'stakeholders' in the survey, as well as in addressing the requirement to raise important issues via media coverage of the research.

Discussion

The workshop audience will participate in addressing, in small-group format, a small number of questions linked to the future development of the survey. Feedback and discussion of general issues raised will conclude the workshop.

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Michael Goldman

Professional Role: Ph.D. Candidate
Institution: Ontario Institute for Studies in Education of the University of Toronto
Contact details: 252 Bloor Street West, 7th Fl. Toronto, Ontario, M5S 1V6

ABSTRACT: Paper

Strand: Cultural Issues

An Examination of Novice Counsellors and their Development of Empathy in Dealing with Individuals from Both Similar and Dissimilar Ethnic Groups

Introduction

Previous literature in the field of cross-cultural counselling has outlined the inherent problems when counsellors work with clients whose ethnicity or culture is unfamiliar to them. Increasingly, there are demands for additional knowledge about ways in which therapy could be more beneficial to ethnicminority clients whose needs are often unmet in the counselling environment. The purpose of this exploratory research was to help develop a broader understanding of some of the impediments to cross-cultural therapy. Specifically, this study analyzed the way in which ethnicity affects empathy in the therapeutic relationship. Empathy has been noted as a key component of counselling across a range of psychotherapeutic interventions.

Method

A qualitative, case study method was utilized with a sample of nine novice counsellors using semi-structured interviews. The sample included master's level psychology practicum students who were beginning their training as psychotherapists.

Results

Results suggest that empathy is affected by a number of factors in the counselling process, which include: avoidance of ethnic-related issues; similar/dissimilar moral values; the counsellors' sense of progress in therapy; the importance of creating cultural meaning within the therapeutic context; and the need to build a cultural history of clients to aid empathic development.

Conclusions

The study found that there are multiple factors that affect empathy, which were not necessarily related to cross-cultural issues. The implications of these results are discussed with regard to improving therapeutic strategies for novice counsellors.

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Dr Patricia Goodspeed Grant

Professional Role: Assistant Professor of Counseling
Institution: SUNY College at Brockport
Contact details: SUNY College at Brockport, 350 New Campus Dr., Brockport, NY 14420 USA
Email: pgoodspeed@brockport.edu

ABSTRACT: Paper

Strand: Client / Therapist Issues

Phenomenological Understanding of Experiences of Job Loss: Counseling the Unemployed

Introduction: When counseling the unemployed, I noticed that clients often presented with symptoms of depression and anxiety, problems involving time, space, relationships, belonging and social isolation. Existing research, focused on stress and coping models and/or physical and mental sequella, often attempts to predict employment outcomes, but was of limited value in helping me understand the meaning of the clients' existential crises. The goal of this research was to elicit experiences of job loss and unemployment for displaced workers in order to gain a better understanding of their dilemmas.

Methods: Personal meanings are constructed from within social, historical and personal histories, and have meaning only within that context. One cannot understand individual experiences and reactions to unemployment without also understanding the meaning that work has for that individual. Hermeneutic phenomenology privileges a contextual understanding of given phenomena. Data was obtained using a phenomenological long interview with nine participants over a one-year period, and analyzed hermeneutically.

Summary: Existential themes were patterned, experienced differently by gender and by availability of outplacement services. The existential role of outplacement had value far beyond the intended benefit of helping participants find new employment by compensating for primary meanings in work that had been lost with unemployment (social contact, time structure). In addition to its pragmatic function, it helped participants find meaning in the loss, and to re-evaluate the place that work had in their lives.

Conclusions: Implications for those who counsel the unemployed include acknowledging stress of job loss that often results in family problems, understanding the elements of an existential crisis, helping clients find new meaning, and timing of interventions. Early in the process of job loss, dealing with grief and loss is more important than finding meaning. Group discussion will follow.

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Jan Grant

Other Presenter: Margot Schofield

Professional Role: Associate Professor / Course Co-ordinator Master of Psychology (Counselling)
Institution: Curtin University
Contact details: Curtin University of Technology, GPO Box U1987, Perth, Western Australia 6845
Email: j.grant@curtin.edu.au

ABSTRACT: Paper

Strand: Supervision

Supervision after Training: Myth or Reality?

Introduction

The counselling/psychotherapy profession is unique in its tradition of ongoing supervision of practising professionals after training has been completed. Indeed, supervision is one way of ensuring accountability amongst professionals who practice behind closed doors with an increasingly complex client population. For some models of therapy and some professional associations, this is embedded in membership and practice requirements. However, it is unclear whether most counselling professionals continue with supervision once they have qualified, and what kinds of factors are associated with this decision. This research aims to describe factors associated with ongoing supervision among practising psychotherapists in Australia.

Methods

This study is drawn from a larger funded research and development project on self-regulation in the counselling profession. Part of that project included a 'First Workforce Survey' of the members of PACFA (Psychotherapy and Counselling Federation of Australia) Associations. PACFA is a federation of 41 counselling/psychotherapy associations across Australia, representing over 2,500 full clinical members and considerably more associate and student members.

Results

Data will be presented describing psychotherapists and counsellors who seek ongoing psychotherapy supervision, types of supervision engaged in, what the considered benefits are, what the levels of satisfaction are, why some do not continue, whether this is linked to factors such as specific models, levels of training, levels of personal therapy, work settings and types of clients.

Discussion

Questions will be raised about why ongoing supervision of professional practice has emerged in our profession but not others, what purposes it serves, and whether we have a unique contribution to make to other professions in our understanding of effective supervisory processes.

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Dr Dennis Greenwood

Professional Role: Director of Undergraduate Counselling
Institution: University of Surrey
Contact details: University of Surrey, School of Arts, Department of Adult and Continuing Education, Guildford, Surrey, GU2 7XH
Email: D.Greenwood@surrey.ac.uk

ABSTRACT: Paper

Strand: Counselling Specific Groups

Counselling/Psychotherapy With A Person Diagnosed With Dementia

Introduction

This paper examines a case study that focuses on a psychotherapeutic relationship with a person diagnosed with dementia. The account of the therapy demonstrates how preconceived understandings of what is meant by a term like dementia can impose on a therapeutic relationship. The nursing home setting is also seen to have exerted a significant influence on the therapeutic relationship. The methodology of this study examines the epistemology of case study method and identifies how this approach has been neglected as an effective means of counselling/psychotherapy research.

Method

After considering the implications of realism and idealism for research, a phenomenological-hermeneutic case study approach was designed for this research project. This method was constructed around the notes taken by the therapist following weekly meetings with a patient who was resident in a nursing home. The therapy lasted for just over three years.

Summary of the results

This case study provides some evidence for the potential of a therapeutic relationship with a person diagnosed with dementia particularly in describing how representative the therapist became of other significant relationships in the patient's life. However, the therapist experienced significant difficulties in working with this patient because of the imposition of the diagnosis of dementia. The label of dementia had been established at the outset of the therapy and the meetings taking place in a nursing home specialising in dementia care enforced the pre-understandings associated with the term dementia.

Conclusions

The case study described provides the basis for considering the implications of a diagnosis like dementia for counselling and psychotherapy and in particular demonstrates the potential imposition of such a diagnosis on a therapeutic relationship. These findings may have broader implications for counselling and psychotherapy with any group of patients that are identified by a particular medical diagnosis.

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Pamela Griffiths

Professional Role: Course Leader MSc Counselling in Healthcare and Rehabilitation / Lecturer
Institution: Department of Health and Social Care, Brunel University (PhD Student Birkbeck College, University of London and Tavistock Clinic)
Contact details: Dept of Health and Social Care, Brunel University, Borough Road, Isleworth, Middlesex, TW7 5DU
Email: pamela.griffiths@brunel.ac.uk

ABSTRACT: Paper

Using Case Studies As A Research Method To Understand Psychological Process

Case studies appear in law, education, history, medicine, psychology and administrative studies (Van Maanen, Manning and Miller 1993). Their purpose can include biographic study, clinical diagnosis, policy analysis and theory construction. In sociology in particular they have a long established position as a research method which reached a zenith with the Chicago School from 1916 - 1935 at the University of Chicago (Hamel 1993). Concerns about the method will be discussed and the more recent interest in the approach explored (Stake 1995, Cresswell 1998, Yin 1998, Fishman 2000, McLeod 2002). Their potential to enhance clinical practice will be examined. The difference between social science case studies and the case studies counsellors write in clinical practice will be identified as well as relevant ethical considerations. Illustrations of developing research through the use of case studies will be drawn from the presenter's study: 'Holocaust testimony as a form of remembrance'.

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Terry Hanley

Professional Role: Counsellor
Institution: Visyon
Contact details: 43a West Street, Congleton, Cheshire, CW12 1JY
Email: terry@visyon.org.uk

ABSTRACT: Paper

Strand: Client / Therapist Issues

Online Counselling: A Heuristic Study Examining The Emotional Depth Of Internet Based Relationships

Introduction

Offering counselling over the Internet is a steadily growing field, and needless to say there are many unanswered questions that surround its practice. Existing research suggests that individuals can develop relationships of a sufficient quality that therapeutic change can occur. This study attempts to give an experiential account of developing such relationships online and examines how the concept of emotional depth can translate to working with clients online.

Methods

This is a heuristic study in which the presenter initiated and entered into Internet based dialogues with five practitioners who have had experience of working with clients online. Each dialogue lasted a six-week period and consisted of communication via email, and in one case email and one-to-one chat facilities. The focus of each dialogue was 'online counselling relationships' but straying from the overarching theme was allowed and, at times encouraged. Following the six-week data collection period each partnership worked together to create a synthesis of their contact.

Results & Conclusions

This is an ongoing study that is to be completed by the end of January. At present the author has completed the six-week dialogues and is co-constructing statements that accurately reflect the experience of the contact.

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Jean Elizabeth Hanson

Professional Role: M.A. candidate
Institution: Ontario Institute for Studies in Education / University of Toronto
Contact details: c/o OISE/UT, 252 Bloor Street, West Toronto, ON, Canada, M5S 1V6
Email: jeanh@magma.ca

Abstract: Paper

Strand: Therapist Issues

Should Your Lips Be Zipped? How Therapist Self-Disclosure And Non-Disclosure Affects Clients

Introduction

When I was researching the ethics of therapist self-disclosure, I realized that non-disclosure had been assumed to be an appropriate, helpful technique; disclosure, if not actually a mistake, needed to be justified and rationalized. Also, although there were many theoretical articles and studies of therapists' beliefs, few studies actually asked clients how they were affected. This paper is based on a study about clients' perceptions of therapist disclosure and non-disclosure.

Methods

Eighteen people (16 women, 2 men) in two Canadian cities participated in this qualitative study. The participants were not undergraduates, and ranged in age from 24 to 57 years. The interview data yielded 157 instances of disclosure and non-disclosure, which were then coded and analysed according to helpfulness or unhelpfulness. The data were then analysed according to themes.

Results

Therapists' disclosures were twice as likely to be seen as helpful; conversely, non-disclosures were twice as likely to be seen as unhelpful. The greatest effects involved the alliance. Also, helpful disclosures fostered more egalitarian relationships, modelled skills, and normalized or validated clients' experiences. Unhelpful non-disclosures invalidated clients, inhibited their own disclosures, and set them up to manage the relationship by avoiding certain topics or issues. There were skills and skills deficits that were associated with both disclosures and non-disclosures.

Conclusions : Clients found self-disclosure to be a useful intervention, especially as a means of strengthening the alliance, and were more likely to find non-disclosure to be unhelpful. Disclosures and non-disclosures that were lacking in skill could have potentially serious negative consequences. However, when the alliance was already strong, even less skilled incidents could be integrated into the client's therapy experience. Therapists may find it useful to consider the skills needed and pitfalls involved when choosing to disclose or not to disclose to their clients.

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Margaret Hidderley

Other Author: Martin Holt

Professional Role: Community Macmillan Nurse Specialist
Institution: Southern Derbyshire Acute Hospitals NHS Trust
Contact details: Community Macmillan Nurse Specialist, Nightingale Macmillan Continuing Care Unit, 117A London Road, Derby, DE1 2QS
Email: margaret.hidderley@sdah-tr.trent.nhs.uk

ABSTRACT: Paper

Strand: Medical and Health

A Pilot Randomised Trial Assessing the Effects of Autogenic Training (AT) in Early Stage Cancer Patients in Relation to Psychological Status and Immune System Responses

Introduction

The study was undertaken to investigate the benefits of teaching cancer patients Autogenic training observed by the author in a previous Macmillan nurse post.

Autogenic training (AT) is a type of meditation usually used for reducing stress. This pilot study describes how AT was used on a group of early stage cancer patients and its effect on stress-related behaviours and immune system responses.

Methods

This was a randomised trial with 31 early stage breast cancer women who had received lumpectomies and adjuvant radiotherapy. The women were randomised into two groups. Group 1 received a home visit only. Group 2 received a home visit and two months' weekly Autogenic training tuition. At the beginning and end of the two monthly periods, the Hospital Anxiety and Depression Scale (HADS) and T and B cell markers were measured as indicators of changes in immune system responses and measurement of anxiety and depression.

Results

At the end of the study, of the women who did not receive AT, HADS scores and T and B cell markers remained similar. The women receiving AT showed a strong statistical difference for an improvement in their HADS scores and those women observed in a meditative state as opposed to a relaxed state were found to have an increase in their immune responses.

Conclusion

From the results of this study, it can be concluded that Autogenic training could reduce the women's experience of anxiety and depression following cancer, and also lead to improvement in immune system responses by the reduction of the effects of stress.

This study suggests AT as a powerful self-help therapy.

(References available from the author)

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Andrew Hill

Professional Role: Senior Lecturer in Counselling
Institution: University of Salford
Contact details: School of Community Health Sciences and Social Care, University of Salford, Allerton Building, Frederick Road. Salford, M6 6PU
Email: a.hill@salford.ac.uk

ABSTRACT: Paper

Strand: Counselling Specific Groups

Counselling Older People: Looking at the Evidence

A systematic scoping search has been commissioned by BACP in the field of counselling older people. Its purpose is to locate and provide a critical appraisal of evidence as to the effects, appropriateness and feasibility of offering counselling/psychotherapy to this cohort of people. This paper offers an overview of work in progress and discusses methodological difficulties in establishing an evidence base in this field. To date six electronic databases have been searched, ten journals have been hand-searched and an extensive search of the "grey" literature undertaken. Inclusion/exclusion criteria have been established to determine what should constitute relevant evidence and as a result 2646 references have been located of which 352 papers were identified for potential inclusion and eventually reduced to a final inclusion of 36 papers. Each of these has been critically appraised by two independent reviewers and the resulting summaries tabulated to form the findings of the project. Methodological issues in undertaking such a project focus particularly upon how to define counselling/psychotherapy when faced with a cornucopia of psychosocial treatments for older people, how to be inclusive of a variety of approaches to research and yet provide some kind of rigorous meta-analysis, and whether such projects should look beyond the narrow Cochraneapproach of assessing effects of treatment to address the acceptability of counselling/psychotherapy to older people and the feasibility of delivering such services in both community and residential settings. Future research into the evidence base for counselling/psychotherapy should seek to address such issues.

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Sophie Holmes

Professional Role: Psychologist - Family Therapist, Director of training
Institution: Swinburne University of Technology
Contact details: 9 Hamersley Crt., Mt Eliza., 3930 Melbourne, Australia
Email: sophie@williamsroad.vic.edu.au

ABSTRACT: Paper

Strand: Family Relationships

Exploring the Dynamic Thinking Processes of Family Therapists using a Novice/Expert Comparison

Introduction

This paper reports results from a study that is exploring the nature of expertise in Family Therapy. In general, few research studies have been published investigating Family Therapy as practised in a naturalistic setting, and in particular no studies appear to have been reported that have directly investigated what constitutes expertise in clinical practice. The discourse on developing expertise generally assumes that skills training, combined with theoretical education and clinical experience, will inevitably lead to a consistent high quality of practice. However, other research has suggested that either experience or skills training programs do not necessarily lead to improved quality of practice.

This research program directly investigates the question of what constitutes expertise in a naturalistic clinical practice, how this expertise shows itself, and how it develops. Key elements of this process are investigated by tapping into the dynamic thinking processes of Family Therapists with different levels of experience.

Method

The research was conducted by eliciting and comparing the dynamic thinking-in-action of novice and expert Family Therapists during a therapy session. From this comparison, patterns of therapist attention, reasoning, action, and intervention emerged, allowing an account of their dynamic thinking processes to be developed. Novices and experts were asked to view a video tape of a family interview that they conducted. Each therapist was then asked to recall his/her thinking at particular points during the therapy, using the Interpersonal Process Recall methodology developed by Elliot & Shapiro (1988).

Results

Using grounded theory, three robust major factors have emerged from the dynamic thinking process data; Relational Expertise, Expertise in Clinical Judgements, and Reflective Practice.

Conclusions

The qualitative analysis of their accounts and the comparison of the patterns of mind of highly skilled and novice practitioners has shed considerable light on the key processes that underpin knowledge-in-action of Family Therapists. This understanding can now be applied to courses of training and on-going supervision, to more effectively develop consistently skilful Family Therapy clinicians.

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Sally Hunter

Other Author and Presenter: Margot Schofield

Professional Role: Lecturer in Counselling
Institution: University of New England
Contact details: School of Health, University of New England, Armidale, NSW 2351 Australia
Email: sally.hunter@une.edu.au

ABSTRACT: Paper

Strand: Therapist Issues

The Shadow Side Of Empathic Connection: Therapists' Experiences

The importance of the therapeutic relationship has been well documented in the counselling literature. Most outcome studies focus on client, rather than therapist, outcomes for obvious reasons. However, there is a growing literature which describes the potentially negative impact on therapists of working with clients, especially those who are trauma survivors. This literature has been based mainly on quantitative studies, with very little rich description of the therapists' experiences of the impact of the therapeutic relationship itself.

This qualitative study examines therapists' experiences in the therapeutic relationship, both good and bad. It explores the nature of the therapeutic relationship from the therapist's perspective and draws out the enormous satisfactions of this challenging work, as well as the cost to the therapist.

The study was based on grounded theory methodology, using a convenience sample. Eight face-to-face, in depth, qualitative interviews were conducted between August 2000 and March 2001 with one male and seven female relationship therapists working in general counselling agencies in Sydney, Australia. It was not possible to look at gender differences but a purposive sampling strategy enabled us to explore differences between experienced and less experienced therapists.

Therapists described the enormous satisfactions of their challenging work: helping others, making a difference, seeing clients change, the privilege of involvement, personal gains, such as self-awareness, and spiritual growth. They also described the costs to them: being deeply affected by traumatic stories, feeling emotionally and relationally drained, becoming depressed or desensitised, and having their beliefs about safety and intimacy challenged. Therapists described the transformative coping strategies which they had gradually developed which included self-care, professional, and organisational strategies.

Implications for therapists and agency management, including recommendations to facilitate the development of effective coping strategies for the prevention of vicarious traumatisation will be discussed.

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Gail King

Professional Role: Lecturer in Counselling and Psychotherapy
Institution: University of Leicester
Contact details: Institute of Lifelong Learning, Vaughan College, St Nicholas Circle, Leicester, LE2 4LB
Email: gmk3@le.ac.uk

ABSTRACT: Poster

Career Development of Counsellors

Many more people undertake counsellor training courses than can expect to find regular paid employment. In an attempt to explore the question of ways in which graduates of counselling programmes use their training to develop their careers a two part semi structured questionnaire was sent out to 143 counselling students who had completed diploma level training and above in December 2003. To date (February 2004) 58 part one replies have been received and 48 part two replies.

Part one of the questionnaire concerned itself with questions relating to

  • Qualifications and experience prior to counselling training
  • Current counselling work (paid and unpaid)
  • Obstacles encountered in finding counselling work
  • BACP accreditation since finishing the course
  • Views concerning the course's preparation of trainees for counselling work

Part two focused on questions concerning

  • Teaching and supervision opportunities
  • Future training needs in respect of BACP accreditation; providing supervision and undertaking research.

These questionnaires are to be analysed using quantitative and qualitative methods and the findings and a discussion of them will be presented at the conference in May.

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Michael King

Professional Role: Professor
Institution: University College London
Contact details: Department of Mental Health Sciences, Royal Free & University College Medical School, Royal Free Campus, Rowland Hill Street, London NW3 2PF
Email: m.king@rfc.ucl.ac.uk

ABSTRACT: Paper

Strand: Sexuality and Counselling

Talking Therapy for Lesbian Gay & Bisexual People - Has it a Bad Press?

The relationship between lesbian, gay and bisexual (LGB) people and psychological & psychotherapy services has had an unfortunate history. Legal sanctions against male homosexual behaviour, together with prejudice against gay men and lesbians, rose to a peak after the Second World War and laid the foundation on which interest in psychological interventions to alter sexuality expanded rapidly in the 1960s and 1970s. This history means that many LGB people have had a well founded suspicion of psychiatry and clinical psychology. The conception of homosexuality as a mental disorder received wide acceptance by the public and fuelled much of the stigma and discrimination against LGB people. Although no longer a clinical diagnosis, there is evidence that professional prejudice against LGB people persists to some extent. This paper will briefly review the history of the LGB people and psychotherapy, before presenting quantitative and qualitative data on contemporary experiences of LGB people in counselling and psychotherapy services. New directions for research and the development of clinical services will also be discussed.

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Danny Lam and Julia Gale

Professional Role: Lecturers / Practitioners
Institution: Kingston University and St George's Medical School
Contact details: 4 Barons Hurst, Woodcote, Epsom, Surrey KT18 7DU
Email: danny_lam11@hotmail.com

ABSTRACT: Paper

Strand: Medical and Health

The Labelling Bias Effects On Clinical Judgements In Mental Health Professionals

Research suggests that mental health professionals are susceptible to labelling bias effects in their assessments of patients with psychological problems and that these effects may involve undue pessimism or even stigmatisation. An experimental study investigated the extent to which diagnostic information (related to borderline personality disorder) can influence mental health professionals' attitudes towards a patient's assessment and its implications for their treatment with cognitive-behavioural therapy (CBT).

The mental health professionals (n = 265) who participated in the study were mental health nurses, mental health student nurses, psychiatric approved social workers, clinical and counselling psychologists, and psychiatrists. The experimental manipulation used involved changing the content of the written information given as background to a section of video (ten minutes) of a patient undergoing an assessment for CBT for panic disorder with agoraphobia. Participants were asked to base their ratings exclusively on the section of video which they watched. Participants were randomly allocated to one of three background information conditions. Condition (a) was accurate information about the person's background and family details, and clinical details of the panic disorder with agoraphobia. Condition (b) was as (a), but with brief mention that it had previously been noted that they experienced some more general disturbance at a time of stress. Condition (c) was as (b), but with the addition of information that it had previously been suggested that they might meet diagnostic criteria for borderline personality disorder (BPD). Note that condition (b) could also imply this diagnosis.

Results showed that the diagnosis of borderline personality disorder is associated with mental health professionals making more negative judgements of the patient and the likely course of treatment and its outcome. Some of these effects further interacted with professional group and level of experience. Implications for clinical practice and professional training are considered.

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Phoebe Lambert

Professional Role: Counsellor
Institution: Independent
Contact details: 1 Fleet Lane, South Walsham, Norwich, Norfolk, NR 13 6ED
Email: lambert@phoebe42.fsnet.co.uk

ABSTRACT: Paper

Strand: Client / Therapist Issues

Client Perceptions Of Counselling: Before During And After

A number of counselling research studies have pointed to the under-researched area of client perceptions. My own personal experiences as a former patient/client continue to raise concerns for me in terms of the mystique of therapy, the stigma that is still often attached to seeking counselling and to the power differential. I detect these concerns in many of my own clients. In my observation of counsellor training there appears to be little attention given to these important issues. At the same time I am increasingly aware of the beneficial effects of counselling.

The purpose of my research is therefore to:

  • explore client perceptions of counselling before engagement in the process
  • explore client and counsellor perceptions of counselling during and after counselling and how these perceptions are modified and transformed
  • consider in the light of the findings what can be learned by providers, counsellors and trainers in order to inform the training and practice of counselling

The research is informed by thematic analysis within the methodology of hermeneutic inquiry using semi-structured, recorded and transcribed, 30 one-to-one interviews forming the basis of 6 case studies, carried out within a two year period. I am focussing on two user groups from each of the following categories within the regions of Liverpool, London and Norwich

  • University counselling services
  • Primary care
  • Voluntary sector

After completing the pre-counselling and mid-counselling interviews the emerging themes are: uncertain expectations of counselling; identity, desire for relief of suffering and improved well-being; peer, media and socio-cultural influences; person history influences; negative experience of earlier therapeutic interventions.

Further issues for discussion are:

How do we prepare people better for counselling in terms of raised awareness in the public domain, counsellor attitude and approach, and training of counsellors?

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Dr Pittu Laungani

Other Presenter: Dr William West

Professional Role (PL): Honorary Research Fellow
Institution: University of Manchester
Contact details: ESI, Faculty of Education, University of Manchester, Oxford Road, Manchester M13 9PL
Email: pillarsofsociety@aol.com, william.west@man.ac.uk

ABSTRACT: Workshop

Cross-cultural Therapy: Theory, Research and Applications

In this workshop we will discuss and argue (and hopefully 'fight over') several major but controversial issues related to understanding the nature of culture, cross-cultural and indigenous therapies. The following issues will be discussed in great depth

  • the nature of culture and cultural differences and multiculturalism
  • the Western myth of 'value free' therapy;
  • 'matching' clients and therapists in terms of race, ethnicity, gender
  • role of religion and spirituality in therapy;
  • cross-cultural variations in therapy
  • assessing the truth and validity of therapies

The workshop will draw on the authors' research, and clinical practice. The major aim is to generate an informed debate on the above areas.

The presenters themselves do not always agree with one another. For example Pittu Laungani believes that we carry our culture with us like a tortoise, its shell. William West, on the other hand, is noted for having a more post-modern perspective. However, both are committed to seeking to clarify their understandings and exploring and sharing their differences.

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Dr Courtland Lee

Professional Role: Counsellor Educator
Institution: University of Maryland
Contact details: University of Maryland, College Part MD
Email: c1191@umail.umd.edu

ABSTRACT: Paper

Strand: Young People and Adolescents

A Cross-Cultural Study of the Influence of Role Models and Mentors on Adolescents: Implications for Counselling with Youth

Introduction:

The purpose of this study is to investigate adolescents' perceptions of the role and impact of role models and mentors on their lives. A role model is operationally defined as an individual that a young person looks up to, emulates or would like to pattern his or her life after. A mentor is operationally defined as an individual who takes a young person "under his or her wing" and attempts to guide that youth educationally, occupationally, or in other aspects of life.

Methods:

A qualitative approach was used with structured interviews conducted with adolescents concerning their perceptions of the impact of role models and mentors on their lives. Young people were asked to identify their role models and mentors and list the characteristics of these individuals that made them significant in their lives. Interviews were conducted with youth ages 13-18 in Bolivia, New Zealand and the United States. One hundred and seventy five young people were interviewed in educational settings, community social/recreational settings, religious institutions, private homes, or other places where young people were likely to gather.

Results:

Young people identified a number of key individuals whom they admired as role models and that offered them guidance as mentors. Regardless of country or cultural context, parents and other family members were the most frequently identified as role models and mentors. Characteristics of those identified included being supportive, setting good examples and promoting education.

Conclusions:

The findings suggest that counsellors need to ensure that, whenever possible, role models and mentors are considered in counselling with adolescents. It is incumbent upon counsellors to have an idea of who it is that adolescents look to for help with problem-resolution and decision-making in their lives.

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Frances Mackay

Professional Role: University of New England
Institution: Lecturer in Counselling
Contact details: School of Health, University of New England, Armidale. NSW 2350, Australia
Email: fmackay@metz.une.edu.au

ABSTRACT: Paper

Strand: Therapist Issues

Sacred Stories: Counsellor Passion Narratives

Introduction: During the past few decades there has been a renewed interest in spiritual issues within the counselling literature, including the need for counsellor training and development in the area. While there has been research on aspects of counsellor spirituality, for example, counsellor values and worldviews, there has been little qualitative, narrative research on how their spirituality has developed. This paper is taken from a research project which focuses on how counsellors integrate their spirituality into their overall narratives of personal and professional development.

Methodology: A phenomenological, interpretive approach, using in-depth interviews, was used to elicit narratives of personal and professional development. Sixteen (seven male and nine female) counsellors, representing a range of spiritualities and work contexts, were interviewed. The data has been analysed and presented in three separate chapters: the first presents individual storylines around key metaphors or phrases used by the participants; the second provides group storylines based on shared themes; and the third focuses on liminal or transitional spaces in the narratives. A constructivist, narrative approach acknowledges that researcher and participants co-construct the findings, which are narrative presentations rather than representations of some objective reality.

Results: The idea of 'passion narrative', suggested initially by participants' use of phrases like 'finding my passion', emerged as a meta theme in the group data, weaving together a range of themes relating to the integrating of spirituality into personal and professional narratives. These passion narratives are stories of transformation, which, like the wounded healer paradigm, suggest a connection between wounding, creativity and healing. Victor Turner's (1969, 1990) liminal space and Winnicott's (1971) transitional space are also used as analytical and interpretive tools in reflecting on these narratives.

Conclusions: This research not only contributes to an understanding of counsellor and client spirituality, but also suggests a way of rethinking self-other dynamics that has more general relevance to counsellor education, development and practice, especially relating to the use of self in therapy.

(References available from the author)

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Karen L Mackie

Other Authors: Kathryn Douthit and Patricia Goodspeed Grant

Professional Role: Counselor Educator/Outreach Coordinator
Institution: University of Rochester
Contact details: Warner Graduate School of Education and Human Development, University of Rochester, Rochester New York, USA
Email: karen.mackie@rochester.edu

ABSTRACT: Paper

Strand: Training and Development

Teaching Awareness of Social Class Dynamics in Counselor Education: An Action Research Approach

Introduction

Awareness of counselor race, class, gender and ethnicity is key for professional growth and for effective multicultural practice, yet in the U.S. social class is seldom explored. This study investigates experiences of class positioning and boundary-crossing, usually unvoiced in counselor training, and discusses pedagogical methods which help uncover experiential, class knowledge as students encounter a culture-centred curriculum.

Summary of Methods

Participants (20) were pre-service, graduate students taking a first seminar in multicultural counseling at a research university. Corroborating data was also obtained from twenty (20) professionals, participating in concurrent professional development on this topic. The researchers employed an action research perspective to iteratively explore teaching methods useful in building critical reflection capacities that could lead to improved practice. Personal narratives and reflection statements from both students and professionals were analyzed for salient themes related to class issues. A weakness of the study is the preliminary nature of the data analysis whereas its action methodology constitutes a strength.

Summary of Results

Thematic analysis of all narratives revealed that explicit instruction to consider the dimension of social class is challenging, given the mystification of class dynamics in the U.S. Students and professionals from working class and poor backgrounds are challenged to tell shame-based stories, while middle and upper class individuals struggle to ascertain their invisible privilege. Class effects are also tightly interwoven with gender and ethnic dynamics.

Conclusions

Social class is a critical but difficult dimension of multicultural knowledge for U.S. counselors to engage. Specific early socialization and family of origin narratives appear to render class constructs most comprehensible to counselors. Training seminars can be designed to construct a healing process as well as develop this critical social consciousness.

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Peter Martin

Professional Role: Senior Lecturer
Institution: Whitelands College, Surrey Roehampton University
Contact details: Whitelands College, Surrey Roehampton University, Sutherland Grove, London, SW15 3DS
Email: p.martin@roehampton.ac.uk

ABSTRACT: Workshop

Strand: Therapist Issues

Unravelling The Soul: A Response To Witnessing Life Narratives

This participatory workshop is an activity set within the phenomenological paradigm, and particularly within narrative methodologies. Yet the impact of its inquiry is not restricted to these areas. It is about the consequences of research on the researcher.

The experience of research is always, in some sense, an experience of being a witness. This is so internally whether we are listening to a story or are responding at third-hand to processed data. The role of the witness is rightly subservient to the chief actor, the participant or what used to be called the research 'subject'. It is nevertheless important and an area of interest and learning in its own right.

In this workshop we shall be exploring this sense of self of the witness. We shall envisage this self as "soul" and ponder on how this felt entity is affected by the data it encounters in others. I will outline some aspects of narrative enquiry. I shall read you a narrative of a life event and invite you to be a witness to it, and to observe your own process as you do so. I shall invite you to tell each other about your subjective experience, and perhaps how this small incursion into your previous or sense of self modifies your 'soul'. We shall sum up our experiences in terms of phenomenological process and methodology.

Programme for workshop:

  • Brief introduction to narrative enquiry: the researcher as witness: the self as 'soul'
  • Workshop participants listen to a story with assigned roles as witnesses
  • Response from workshop participants to the story
  • Paired work on the effect of witnessing on the soul
  • Brief summary of the place of this exercise in phenomenology.
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Ruhani Mat-Amin

Professional Role: PhD student
Contact details: York St John College, Lord Mayor's Walk, York, YO31 7EX
Email: ruhanim@yahoo.com

ABSTRACT: Paper

Strand: Training and Development

Journey Towards Becoming A School Counsellor Is A Difficult Learning Journey: Counsellor Trainee' Experience In Malaysian School

Introduction: This study aims to explore the counsellor trainees' experience during the counselling practicum in the school environment. The trainees perform the counselling practicum after having gained knowledge and skills related to the role of school counsellor. The counselling practicum provides an opportunity to the trainees to apply their counselling knowledge and skills that have been learned during training at the university.

Methods: This is a qualitative research study. Ten counsellor trainees participated in the study. The data were gathered through a series of semi-structured interviews from February to May 2002, during a group of counsellor trainees performing their practicum. Each trainee was involved in three interviews, at the beginning, the middle and the end of the counselling practicum.

Results: The trainees demonstrate that they experienced difficulties in fulfilling the university requirements. Their stories manifested that they had to work hard in gaining cooperation from the pupils. All ten trainees indicate that they had difficulties in gaining the pupils' trust. In this regard, one trainee indicates that he had to explore a new strategy in getting the pupils to counselling sessions. Another trainee implemented a different strategy, which was force-referral of pupils to counselling sessions. This strategy was a way to fulfil the required sessions. The trainees also experienced difficult relationships with the school counsellor, teachers, Head Teachers, and the university supervisor. Four trainees indicate that they struggled to gain support of the school counsellor. Eight trainees demonstrate that they experienced difficulties in gaining guidance and support of the university supervisor.

Conclusion: Despite the challenges, the trainees indicate that they experienced the process of becoming school counsellors through practical experiences in the school environment.

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Dr Garrett J McAuliffe

Professional Role: Associate Professor of Counselor Education
Institution: Old Dominion University - Counselor Education Program
Contact details: College of Education, Old Dominion University, Norfolk, VA 23529
Email: gmcaulif@odu.edu

ABSTRACT: Paper

Strand: Training and Development

The Impact of Counselor Epistemology on Clinical Competence: Analyses of Counselor Interview Behavior and Reflections

The effectiveness of counselling lies largely in the person of the counselor, rather than in the techniques employed. A potentially powerful contributor to counselling outcome lies in the personal epistemology, or way of knowing, of the counselor. We particularly chose to explore the epistemological characteristics of counselor trainees in this study, because we have observed that some students of counseling have difficulty learning the complex skills and sensitivities that are required for the work. In this study, we sought to discover a possible relationship between (a) a counselor's general propensity with regard to knowing and (b) the same counselor's behavior in a counselling interview.

Toward that end, we chose a qualitative research method, in which we analysed thirty interviews conducted by beginning students of counselling. Those interviews were divided into those conducted by dualistic thinkers and those done by relativistic thinkers. Dualistic thinkers are defined as those who tend to rely on external authority for knowing, whereas relativistic thinkers see knowledge as a human construction that is created by communities. These two types of thinking were determined from participant responses on William Moore's Learning Environment Preferences inventory. A qualitative method was chosen because it can produce rich, text-based data that has potential for application.

We found dramatic differences between dualistic and relativistic thinkers in their helping interviews. Dualists' interviews were characterized by what we called 'conflating points of view,' 'superficiality,' 'automatization/ concreteness,' 'reductionism,' and unconsidered action.' In contrast, relativists showed 'empathic decenteredness,' 'perspicacity' (insight), 'metacognition,' 'tolerance for ambiguity,' and 'deliberated action.'

The five themes that were named for dualists and relativists offer a beginning map for testing a developmental counselor education, as instructors might explicitly target each of the five characteristics of relativists' interviews for learning.

In the session, key questions and findings will be presented visually and a paper will be provided. Participants will be actively engaged in a discussion of the implications of these trends for the selection and training of candidates for counselor education.

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Kevin McEvoy

Other authors: Dr. J. O'Hanlon, Consultant Anaesthetist, Pain Clinic, Mater Hospital, Belfast; Dr. M. Dempster, School of Psychology, Queen's University, Belfast

Professional Role: Training Officer for Counselling Services
Institution: The Queen's University of Belfast
Contact details: The Student Counselling Service, Student's Union Building, Queen's University of Belfast, University Road, Belfast. BT7 1NN
Email: kevin.mcevoy@queens-belfast.ac.uk

ABSTRACT: Paper

Strand: Medical and Health

Does Locus Of Control Influence The Choice Of Coping Strategies Among Clients Who Attend A G.P Practice Counselling Service And Those Attending A Chronic Pain Clinic?

Introduction: It has been shown that clients with an internal locus of control choose more active coping strategies to deal with illness (Gibson, S.J et al 2000.). We assessed the locus of control and coping mechanisms of clients attending a G.P. Practice and a Chronic Pain Clinic to investigate a link between these two factors.

Method: Following ethical committee approval, 88 clients referred for counselling by their G.P. (Group 1) and 50 clients referred by their G.P. to a Pain Clinic were recruited for the study (Group 2). Perceived locus of control was measured using The Multi-Dimensional Health Locus of Control Scale (Wallston, KA et al 1978) and coping strategies were measured by The COPE Scale (Carver, C. S).

Results: A MANOVA was used for the locus of control variables and the coping strategies separately. There was no statistically significant difference between the two groups on internal locus of control, but group 1 scored significantly higher on external and chance locus of control. Group1 clients scored significantly higher on avoidant coping strategies. There were no other differences between the groups in terms of coping strategies. Furthermore, bi-variate correlations indicated that those with a higher internal locus of control are significantly more likely to engage in acceptance-focused coping (r = 0.375, p =.006) and those with a higher external or chance locus of control are more likely to engage in avoidant-focused coping(r = .551, p<.001; r = .426, p = .002, respectively).

Therefore, Pain Clinic clients exhibited a more external and chance locus of control and thus experience problems in developing coping strategies. The relationship between external and chance locus of control and the inability to develop coping strategies may explain why chronic pain impacts to such an extent on our clients. That is, this group of clients expect a much greater degree of control from healthcare professionals.

Conclusions: We have demonstrated a relationship between locus of control and coping strategies in these two groups; however, further investigation is needed to assess how exactly locus of control, as a dimension of personality, influences the use of coping strategies and how this can influence therapeutic interventions. Also, these are valuable instruments in predicting how clients may respond to pain management.

(References available from the author)

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Isha McKenzie-Mavinga

Professional Role: Counsellor / Trainer
Institution: Goldsmiths College
Contact details: Department of Psychotherapeutic Studies, Goldsmiths College, New Cross, London SE14 6NW
Email: atttherapy@aol.com

ABSTRACT: Paper

Strand: Cultural Issues

Understanding 'Black Issues'. A Bridge Between Fear and Transformation

Introduction: This study came about as a wish to fill a gap in training and influence how issues about African and Asian heritage peoples are explored in the therapeutic process.

Method: Qualitative pluralistic action research seemed appropriate for the research theme whilst at the same time engaging with participants. The study was carried out within a 2 year counsellor training programme, using dual roles as trainer researcher. A naturalistic, participatory reflexive approach was used to present a series of workshops about the concept of 'black issues'.

Results: Trainees expressed fear and the need for safety within the process of understanding the concept 'black issues'. Participants got drawn into discussion on racism or looked to black people for the answers. Issues about white people in relation to each other or black people seemed threatening. Staff expressed concerns that their training did not equip them to facilitate students' exploration of black issues. Empathy was gained by making links to participants' cultural experiences. My own transformation as the only black course trainer was necessary to create safety in the process of 'not knowing' for both trainees and colleagues. A wish to influence has become a need to understand. Through this process my research question has evolved.

Conclusions: Findings demonstrate that greater awareness about 'black issues' creates greater understanding of diversity and transcultural process. The participatory research process has modelled an active practitioner role in the exploration of black issues. There is a need for theory, training materials and aware supportive facilitation to assist trainees with their concerns about engaging with black issues in the therapeutic process. The curriculum has benefited greatly from this input.

'Process is the analysts way of accounting for change' (Strauss & Corbin 1990. p143. In developing Effective Proposals Keith Punch Sage 2001)

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John McLeod

Professional Role: University Lecturer
Institution: University of Abertay Dundee
Contact details: Tayside Institute for Health Studies, University of Abertay Dundee, Dudhope Castle, Dundee, DD3 6HF
Email: j.mcleod@tay.ac.uk

ABSTRACT: Paper

Strand: Theory and Practice

A Narrative Social Constructionist Approach to the Interpretation of Significant Moments in Therapy

Introduction

A narrative perspective draws attention to the co-construction of meaning, through the use of language, by client and therapist participants in the work of psychotherapy. In addition, a narrative perspective suggests that the performance by clients of different forms of storytelling provides openings for the therapist for a range of therapeutic interventions. The aim of this single case study is to examine the co-construction between client and therapist of good moments within a case of humanistic therapy.

Method

The case consists of a twelve-session good outcome therapy, in which both client and therapist completed IPR interviews after the first, sixth and final sessions. All sessions were recorded. In this paper, a method of qualitative narrative analysis is used to identify the significance of specific narrative episodes in a session which was described by both participants as highly significant.

Results

The application of detailed micro-analysis to the transcript revealed that 'good moments' within the session were characterised by distinctive patterns of shared language use, which could be categorised as a 'language of authenticity'.

Conclusions

It is argued that the availability of client and therapist recall interview material enhances the possibilities for narrative analysis, by emphasising the improvised nature of storytelling performance. The implications for practice of these findings are discussed.

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Bonnie Meekums

Professional Role: Lecturer in Counselling
Institution: University of Leeds
Contact details: University of Leeds, Wakefield Campus, Barnsley Road, Wakefield WF1 5NS
Email: b.meekums@leeds.ac.uk

ABSTRACT: Paper

Strand: Autoethnographic Research

Developing Embodied Identities: An Autoethnographic Study of a Counselling Trainer

Introduction: There is a growing interest in the therapist's body as a source both of wisdom and of subjectivities (Etherington, 2003; Shaw 2003). This development is accompanied by methodological developments narrative inquiry. The present case study concerns a relatively new counselling lecturer based in a University department whose research emphasis is Education. The impetus for this inquiry emerged out of a required shift in identity, and considerations about how this shift was negotiated.

Method: The methodology is an autoethnographic case study of a counsellor trainer / researcher. The subject's developing identities are examined using journal and other archive material along with reflection and recall. The essential questions are: How did I get here? And what threads enable me to continue to construct an identity that I can feel comfortable with? Secondary questions include: How much of my journey so far has been purposeful and agentic, and how much serendipitous or unforeseen? What role has societal scripting played? What influences my decision making? What role does my body play in this process? How does the process of writing this story contribute to the ongoing construction of my identity?

Results: The story so constructed is one of an interplay between the forces of society and of the individual as agent. The individual is neither entirely passive nor completely unfettered in her development. While there is a fluidity to identity thus constructed there is also a narrative thread. The journey is one from wounded story teller to embodied counsellor to embodied trainer and researcher. The role of the body in this journey includes gendered stories, wounded body stories, powerful body stories, and ultimately the wisdom of the body as a source of knowing and of identity.

Conclusions: It is hoped that the results of this ethnographic study will form the basis of further research with therapists concerning their own developing identities, in particular focussing on the body as a site of identification and agency.

References

Etherington, K. (Ed) (2003) Trauma, the Body and Transformation: a Narrative Inquiry. London: Jessica Kingsley Publishers

Shaw, R. (2003) The Embodied Psychotherapist: the therapist's Body Story. Hove: Brunner-Routledge.

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Valerie Monk

Professional Role: Professional Doctorate Student at University Of Manchester
Institution: Counsellor In Primary Care, For EAP's and in Private Practice, Counsellor Trainer.
Contact details: Counselling Dept., School Of Education, University Of Manchester, Oxford Road, Manchester, M13 9PL
Email: val@creativeexchanges.com

ABSTRACT: Paper

Strand: Autoethnographic Research

A Mother's Experience of the Enduring Schizophrenic Illness of her Son

Introduction

In studying different paradigms of mental illness during the Professional Doctorate in Counselling, I reflected on my experience of being the mother of a son, now in his 30's, who was diagnosed as schizophrenic at 14 years old. Preparatory to my research with other mothers of children with enduring schizophrenic illness, I undertook a preliminary piece of auto ethnographical research, which considers the effects on my life and the impact on our family of having such a child. This initial study is part of a project that 'gives a voice' to those whose experience is often not well known or understood by counsellors or professionals in the mental health field.

Method

My own individual case study is explored by a heuristic process which involves:

  • my current perceptions of my experience at the start of the research
  • examination of my own journals, letters and other written material contemporaneous with the events described and recorded from my son's birth until his diagnosis
  • comparison with the limited number of personal accounts by other mothers 
  • targeted examination of the relevant professional and research literature describing and responding to family members at various points in the patient's life

Results

The study enabled me to 're-view' and find positives in my narrative, while discovering the pervasive-ness of the issues of guilt and responsibility, to face possible failures in nurturance as environmental triggers or even 'causes' and hold the dynamic tension between these and the standardisation and medicalisation of treatment approaches. The ethical issues facing a researcher in this field, with this methodology, has been an important focus of the study.

Conclusions

This study has already helped other mothers and equips me to do further research into their experiences. Other counsellors and mental health professionals may find it useful in informing their practice.

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Dr Roy Moodley

Professional Role: Assistant Professor
Institution: OISE/UT
Contact details: Ontarion Institute for Studies in Education, University of Toronto, 252 Bloor Street West, Toronto, ON, M5s 1V6
Email: roymoodley@oise.utoronto.ca

Abstract: Paper

Strand: Cultural Issues

A Hermeneutic Study Of Carl Rogers Counselling a Black Client

Introduction: Through the investigation and exploration of 'a single case study' of one of Rogers' own demonstration films, this enquiry hopes to generate multiple understandings of how person-centred therapy can be more inclusive of black and ethnic minority clients. Rogers suggested the need for a "meticulous analysis of the single case Ä as a source of emerging knowledge and generative hypotheses" (Rogers [1986] 2002:12). The video taped sessions: 'Carl Rogers Counsels an Individual - 'Right to be Desperate' and 'On Anger and Hurt' (Whiteley 1977) explored in this study were originally filmed in 1977. The films show a young black man in therapy with Carl Rogers. In this interview the client and Rogers attempt to uncover issues of race and culture in ways that reveal some of the complexities and difficulties inherent in a black client/white therapist relationship.

Method: A qualitative and quantitative analysis of the video sessions in which 30 scholars, researchers and practitioners from different counselling schools/approaches from Britain, Ireland, Belgium, USA, Canada and Australia interpreted the video sessions. Participants were offered a list of key areas to focus on when analysing the film, such as the nature of empathy between therapist and client, the quality and intensity of the therapist's attention to the client's communication on issues of race and culture, the consistency of the therapeutic approach when faced with difficult dialogues on race, and the researcher's subjective response to watching the film. Participants were selected on the basis of their research and scholarship in multicultural counselling and psychotherapy . The research was conducted between 2000 and 2003.

Results: The interpretations - both qualitative and quantitative - were wide ranging and explored on the one hand, the theory of client-centred therapy and its relevance to black and ethnic minority clients and on the other, critiqued the techniques of person-centred practice with minority clients. Quantitative analysis included 'Content analysis and clinical reflections', 'Uncharacteristic Directiveness' and 'Conversational analysis' while qualitative interpretations offered the more popular critical race discourse. Other responses included observations from social constructionist, humanistic-spiritual, post-colonial, and cultural perspectives. One third of the interpretations took the form of personal and private reflections, with one contribution reflecting on the personal-private narrative that unfolded around the particular client and his relationship with Rogers. One of the study conclusions is that the therapist's silence and avoidance of race and racial issues problematise the black/white relationship in therapy. In the analysis of this particular film the responses indicate that the process is clearly specific within the context of its own history and culture.

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Angie Naylor

Professional Role: Lecturer in Psychology
Institution: Edge Hill University College
Contact details: Psychology Unit, Edge Hill University College, St Helens Road, Ormskirk, LE39 4QP
Email: naylora@edgehill.ac.uk

ABSTRACT: Poster

Counselling for Children: Analysing Change in Non-Directive Play Therapy

Introduction:

There is a lack of research examining the process of therapeutic play and its outcomes for children. The aim of this study is to achieve a better understanding of the process and to examine change within non-directive play therapy, through the analysis of individual therapy sessions.

Method:

The study centres on the detailed case studies of two children's individual play therapy sessions over the course of 12 sessions, each lasting one hour in length, carried out by a qualified play therapist (having graduated from an approved British Association of Play Therapists diploma course). The therapist employed a non-directive approach. The research took the form of transcribed therapy sessions, which were a true and accurate record of the original data. Client confidentiality was addressed through concealment of identity. The qualitative case study design utilised a grounded theory approach

Results:

A grounded theory approach was adopted in order to draw categories from the data itself. In carrying out the procedure a qualitative data analysis package - NUDIST QSR was utilised, which allowed the data to be organised and managed into major categories and sub-categories. Findings indicated that several elements change in both context and value throughout the course of sessions. These include embodiment play; role-play; relationship with therapist; feelings of aggression; and attachment issues.

Conclusions:

The findings take into account the significance of the relationship between the therapist and child in non-directive play therapy and the process of therapeutic transition. The child indicates patterns of change throughout several key elements leading to the development of an initial therapeutic model of change.

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Dr Tajudin Ninggal

Professional Role: Director / Professor
Institution: Universiti Teknologi Malaysia
Contact details: Director, University Counselling & Career Centre, Level 3 DSI, Universiti Teknologi, Malaysia 81310, Skudai, Johor Bahru, MALAYSIA
Email: mtajudin@utm.my

ABSTRACT: Paper

The Asian Students' Adjustment to Acculturative Stress in the United States: Was Their College Life Normal?

This study examined whether there were differences in six acculturative stress themes among three Asian ethnic groups who were enrolled at one of the Mid-western universities in the United States during the winter, 2002 semester. The six acculturative stress themes investigated in relation to their demographic attributes were as follows, (1) Perceived Discrimination, (2) Homesickness, (3) Perceived Hate, (4) Fear, (5) Cultural Shock, and (6) Guilt.

A total of 230 respondents (female, n = 103 and male, n=127) representing the countries of Malaysia, China and India were selected through a process of systematic random sampling. Their age ranged between 18 and 35 years old. They took approximately 20 minutes to answer a set of 36 items in Likert format on the Acculturative Stress Scale for International Students (ASSIS) designed to measure international students' concerns on a variety of psychological issues related to their stay in a university environment outside of their home country. Two-Way Analyses of Variance (ANOVA) and Post hoc analyses using the Scheffe method were used to determine differences among the six acculturative stress themes. Twenty-four hypotheses were tested at an alpha .05 level of significance.

Important findings in this study included:

(a) Malaysian students experienced higher levels of stress on the majority of the six acculturative stress themes on the ASSIS than did the Chinese and Indian groups

(b) There were stress differences between students who were below 20 years of age and students who were above 26 years on all acculturative stress themes

(c) There were interactions between students' types of sponsorship and three types of academic major on Perceived Discrimination, Homesickness, Perceived Fear, and Guilt acculturative stress themes

(d) The study indicated an interaction among students' two types of residential settings and three socio-economic levels on the Culture Shock theme and

(e) The study found the Homesickness stress theme constituted the most concern among the three Asian ethnic groups enrolled at that Mid-western University.

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Elizabeth O'Donnell

Professional Role: Counsellor, Private Practice specializing in infertility
Institution: RPT Foundation Inc. Cleveland State University, Ph.D. candidate and post-graduate research assistant.
Contact details: Cleveland Ohio, USA
Email: lizzieodo@aol.com mindingmatters@aol.com

ABSTRACT: Poster

Art, Why Hath Thou Forsaken Me? When Creating A Child Is All You Want To Do

Literature Review and analysis of the social, cultural, economic, and intrapersonal impact of involuntary childlessness.

Introduction

Since the birth of Louise Brown in 1978 assisted reproductive technology (ART) has helped thousands of couples have their own, or some combination of, biological children. Although expertise around this discipline has improved, definitive empirical research remains almost exclusively the domain of science and medicine. However, procreation is not simply a function of biology. Children represent the propagation of 'self'.' Often held up as a symbol of cultural growth and prosperity, fertility is richness and richness extends good fortune. Bearing life is therefore not simply about having a baby. Historically, the literature points to numerous suspected psychological barriers to a woman's capacity to conceive. Although these theories are mostly debunked, the work of achieving pregnancy in sub or infertile individuals now finds itself almost entirely dependent on the knowledge of reproductive endocrinologists. This poster explores the variety of ways in which failed conception influences, reflects, manifests, and possibly defines the desire to give birth within a social, economic, cultural, and philosophical and physiological framework.

Methods

A comprehensive literature review was conducted across several disciplines that looked at the declared psychological, cultural, social, economic, and spiritual impact of involuntary childlessness. Both qualitative and quantitative data analysis is included which examine the relationship if any, between the socio-cultural, psychological and economic demand to have a baby as well as access to infertility services and third party reproduction. Exploration of the intra and interpersonal effects on treatment intervention and pregnancy outcome, are also discussed.

Results

ART continues to be a service predominantly addressed by the medical community. Features of involuntary childlessness that address social, psychological, and cultural concerns, although paid some attention in the literature, are not well integrated into research methodology and are therefore poorly considered as viable considerations in intervention. However, current literature in reproductive health and several other medical areas, points to a significant relationship between physical health and emotional, spiritual, and psychological well being. Given that all are impacted in the battle to conceive, further research that evaluates their effect and integrates the knowledge of a multi-disciplinary team, is vital.

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Denis O'Hara

Professional Role: Lecturer / Counsellor
Institution: University of New England, Armidale, Australia
Contact Details: 24 Ditmas St Wishart, Brisbane, Australia
Email: djohara@uq.net.au

ABSTRACT: Paper

Strand: Theory and Practice

Psychotherapists' Metatheories as Theories-in/on-action

Introduction: Although the existence of a gap between our theoretical claims and our practice of counselling is well established, the process of moving towards greater integration of theory and practice has received less attention in the research literature. This research investigates how therapists integrate over time, their respective theory and practice into a coherent personal metatheory.

Methods: The study was conducted using in-depth semi-structured interviews of five experienced therapists. Participants were therapists selected from across different professional counselling fields including: psychology, social work, medical and counselling. Each participant was interviewed three times over a period of 2-3 months, drawing on multiple methods for examining key issues. The first interview ascertained the therapist's perceived theoretical influences and espoused theories of practice. The second interview used an Interpersonal Process Recall approach via reflection on a video of the therapists' practice to explore the relationship between theory and practice. The third interview was structured around a diagram created by the therapists, which was a representation of their integration of the various theoretical approaches in their practice. The data were analysed through the use of grounded theory with a special focus on any theory/practice gap implications.

Results: The study found that examination of a theory/practice gap acts as a heuristic in identifying current personal metatheories of practice in the form of integration-in/on-use. There was evidence that a strong school focus limited metatheorising and consequent practice. Analysis also demonstrated that approaches to metatheorising and practice was as much influenced by personal issues and values as by professional education and training.

Conclusions: Significant implications for counsellor education and supervision emerged from this study relating to issues such as development of critical reflection, development in therapeutic efficacy, approaches to supervision and challenges to how integration is understood.

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Sara Perren (paper)

Other Presenter: Nancy Rowland 
Other Authors: Cath Snape, Lesley Jones & Nancy Rowland

Professional Role: Counsellor
Institution: Gillygate Surgery Research Practice
Contact details: Gillygate Surgery Research Practice, 28 Gillygate, York YO31 7WQ
Email: saraperren@hotmail.com

ABSTRACT: Paper

Strand: Medical and Health

Counselling - Why Not? A Qualitative Study of People's Accounts of Not Taking Up Counselling Appointments

Background: Counselling in primary care has increased considerably in recent years. In many services up to 20% of people do not take up a counselling referral. This raises questions about wasted resources and accessible provision of service.

Aims: To explore the reasons behind people's decision not to take up a counselling referral.

Method: NHS Primary Care counselling services in Northern England invited feedback from people who had been referred but did not attend any counselling appointments. Participants were interviewed by a researcher using semi-structured interviews. Interviews were tape recorded and data generated was transcribed and analysed by two researchers. We also utilised questionnaire responses from people who did not wish to be interviewed. The project was approved by the local NHS ethics committee.

Results: 43 people responded, 21 of whom were interviewed. Many people talked about the courage it took to ask for help. The referral itself was sometimes therapeutic as it legitimised their distress. The GP's response affected people's decisions. Length of waiting time and what happened during waiting was important. Some people had their own resources, which they used actively, seeking other sources of help; others were more passive, their lives changed around them.

Other factors that contributed to non-engagement were being referred in a crisis; lack of knowledge about counselling and mental distress; and concern about stigma and its impact on work.

Conclusions: Perceived waiting time was the most significant factor, but most people had a combination of reasons for not engaging. Support from the GP, information about the service and being given realistic information about waiting times may help people feel better able to access counselling services.

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Sara Perren (poster)

Other Authors: Cath Snape & Nancy Rowland

Professional Role: Counsellor
Institution: Gillygate Surgery Research Practice
Contact details: Gillygate Surgery Research Practice, 28 Gillygate, York YO31 7WQ
Email: saraperren@hotmail.com

ABSTRACT: Poster

The Impact of Research Results on Counselling Practice

Introduction

Unless research is translated into change in practice it remains irrelevant. Our qualitative study of people's accounts of not taking up counselling appointments had implications for the provision of service. We disseminated the research results to the counselling organisations involved. The main implications for practice were on provision of information to clients. This included information about:

  • The service and what to expect from counselling
  • How to cancel, postpone or rearrange an appointments
  • Alternative support, such as self-help literature and self-help groups

Letting people know that they are on the waiting list and how long they may wait, including a phrase that legitimises returning to the GP if necessary.

This small study aims to assess the impact of disseminating research on counselling service provision.

Methods

On completion of the research, all counselling organisations that took part were given written information outlining the research findings. Results were also presented at a 'Counsellors in Primary Care group' meeting.

Nine months after results were disseminated, questionnaires were distributed to those involved. The questionnaires aimed to assess any service changes that had been implemented in response to the study. We also sought reasons for continuation of the status quo.

As part of the initial study some counsellors had performed an audit of their DNAs and cancellations. These people were asked to repeat the audit so we could assess whether or not change in service provision had an impact on service uptake.

Results

Preliminary findings suggest some changes to service arrangements have been made.

Conclusion

This project aims to determine if a small study disseminated to relevant people has an impact on practice. If this is not the case some insight will be gained into why no change has occurred.

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Kathy Raffles

Professional Role: Independent Practitioner (Counsellor, Trainer, Supervisor, Consultant)
Institution: Kathy Raffles Counselling Services
Contact details: Kathy Raffles Counselling Services, The Basement, 6 The Crescent, Taunton, Somerset.TA1 4EA
Email: kathyraffles@onetel.net.uk

ABSTRACT: Poster

Finding A Way Through Crisis

The Effect of Personal Illness, Loss or Trauma on the Independent Practitioner's Practice: How Practitioners Manage the Effect of This With Regard to the Working Relationship

Introduction: This study, developed through personal experience, addresses a phenomenological issue. The aim is to promote dialogue, and to create a deeper understanding, within the counselling community of the specific professional, emotional, economical and theoretical issues highlighted due to the temporary cessation of independent practice.

Methods: A collaborative, reflexive process is being used drawing on narrative exploration held within Heuristic Inquiry. This qualitative approach is linked with Kolb's Experiential Cycle of Learning with emphasis on inter-relationships between phenomena and the Independent Practitioner. A training workshop of 12 Independent Practitioners, 'inexperienced' in the phenomena, has been held to formulate the research questions (What is happening?). Semi-structured interviews (What happened?) and Focus Group interaction (What does it mean?) with eight Independent Practitioners, 'experienced' in the phenomena, were subsequently conducted to answer the questions posed.

Results: All outcomes will be derived through research participants being actively and experientially engaged with the process of the Kolb Model. In exploring the phenomena through this model opportunity for ongoing change and development as a process will result. Data provided by the eight 'experienced' Independent Practitioners will contribute to the design of a new CPD training workshop (What shall I do as a result?) which will be delivered initially to the 12 'inexperienced' practitioners in April 2004 for their evaluation and feedback. This will then be incorporated and the workshop offered nationally as part of my organisation's CPD 'Professional Practice Issues' Training Portfolio. Research participants' knowledge, experience and ultimate action in relation to discovering new meanings in experiences will thereby enhance a new concrete experience (Kolb) for the counselling profession.

Conclusions: This study will encourage:

  • research participants engaged in Kolb's Model of Experiential Learning - a process-in-action experience à
  • research participants collectively involved in the design/production of a CPD training workshop and a book to be edited by the researcher
  • dialogue of professional practice issues within the counselling profession
  • a network of support when facing personal crisis for those working independently
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Dr Gella Richards

Professional Role: Chartered Counselling Psychologist / Senior Lecturer
Institution: The University of Surrey Roehampton
Contact details: The University of Surrey Roehampton, 'PATS', Whitelands College, West Hill, London SW15 3SN
Email: g.richards@roehampton.ac.uk

ABSTRACT: Paper

Strand: Cultural Issues

Perspectives Of The World Of Counselling From Former And Potential Black Clients

In the counselling literature, some material can be found that questions the 'psychological mindedness' of Black and ethnic minority clients (e.g. Jung, 1930). The current paper addresses this issue by investigating Black former and potential clients' attitudes towards counselling.

Areas such as what problems they would bring to counselling and the relevance of counselling in their world were researched. This involved the use of a self-completion semi-structured questionnaire. Participants were also shown photographic stimuli of Black and White female 'counsellors' and asked to indicate their preference. This was also explored in the questionnaire. In addition, contemporary issues in cross culture counselling such as ethnic matching and the use of counselling services by Black individuals were also examined.

This revealed a range of attitudes amongst this sample of Black participants with regards to their perceptions of counselling and how it fitted into their support network. These findings are then compared with previous research and counselling literature (Ponterotto, Alexander & Hinkston, 1988; Sue, 2000; Thomas, 2002; Tien and Johnson, 1994). They are also placed within the context of the so-called concept of psychological mindedness and the relevance of assuming that generally Black clients do not appropriately access or utilise the world of counselling.

Recommendations are made as to how counsellors can integrate both their world of counselling and the world of the Black client to enhance the therapeutic process, especially in relation to the current samples' understanding and expectations of counselling. For instance, both ethnic matching and cross-cultural counselling should be considered as equally viable counselling dyads for Black clients. This recommendation is based on the finding that not all Black participants stated a preference for ethnic matching in counselling. Their responses indicated that for some Black individuals the ability of a White counsellor to demonstrate multicultural counselling competencies when exposing the Black client to the counselling world was adequate, and this did not need to be coupled with a racially similar counsellor. This indicates that there are a range of therapeutic preferences and needs amongst the Black community.

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Maggie Robson

Professional Role: Director of the Centre for Studies in Counselling
Institution: University of Durham
Email: maggie.robson@durham.ac.uk

ABSTRACT: Workshop

Strand: Theory and Practice

Can Play Therapy be a Useful Therapeutic Approach with Children? A Case Study

Introduction: Increasingly, the importance of children's emotional health is being recognized in schools. Children do not achieve if they are distressed and their distress can lead to disruptive behaviour in the classroom. Play is a child's natural means of communication and it is central to the meaning making process of children. Winnicott, (1971) writes:

"It is by playing and only in playing that the individual child is able to be creative and to use the whole personality and it is only in being creative that the individual discovers the self".

Play therapy offers children a therapeutic intervention, which may be useful if they are excluded in some way from 'normal' functioning.

This paper presents a play therapy case study. 'Paul', aged 6, was referred for therapy because his long-term foster placement had broken down. He was displaying behavioural problems both in his foster home and at school. These problems appeared to have been triggered by the loss and rejection he experienced.

Method: Case notes were collected at the time of therapy and themes in the play identified. The themes emerging from a selected session are explored with reference to the available literature, to find possible explanations for Paul's behaviour and to see if the therapeutic relationship brought about any change in behaviour. In addition, there was an exploration of the possible effect on this behaviour of the therapeutic relationship.

Results: Play therapy appears to be helpful in promoting behavioural change

Conclusions: The paper describes the process of therapy, identifies some of the themes which emerged during the work and look at the implications for behavioural change from the work.

The paper concludes that play therapy appears to be helpful in promoting behavioural change and that it needs to be more available in schools. A short description of a play therapy initiative in County Durham Schools will be offered.

Audience participation is to be achieved through debate and group work following the presentation

Reference: Winnicott, D.W., (1971) Therapeutic Consultations in Child Psychiatry London: Hogarth Press: Institute of Psycho- Analysis

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Brian Rodgers

Professional Role: PhD student
Institution: University of Abertay Dundee
Contact details: Tayside Institute for Health Studies, University of Abertay Dundee,Dudhope Castle, Dundee, DD3 6HF
Email: brian.rodgers@abertay.ac.uk

ABSTRACT: Paper

Strand: Theory and Practice

Life Space Mapping: Development of A New Method for Investigating Counselling Outcomes

Introduction

Counselling outcomes are often measured in terms of standardised questionnaires. Though efficient for large numbers of participants, this method cannot capture the unique and subtle 'shifts' that clients often report when qualitative methods are utilised. Further, such questionnaires usually focus on the individual, missing the wider social implications of therapy. Previous research by the author (The Client at the Heart of Therapy, Rodgers 2002) has suggested that the experience of 'restructuring' during counselling may be a key requirement for clients who perceive their therapy to be successful. This paper will discuss the potential of researching this 'restructuring' in terms of a shift in the perceived life space of a client.

Method

Existing methods for exploring individual perceptions of social networks and life space were reviewed in order to develop a life space interview schedule, which can be used to enable clients to map out their perceived life space prior to commencing therapy and again on completion. Differences between these two maps are discussed with the participants at the end of counselling, including the role that therapy played in any change. This discussion is recorded and analysed.

Results

Preliminary results from a pilot study will be presented, illustrating change in the life space of one client over the course of therapy.

Conclusions

Life space mapping has the potential to gather rich, in depth narratives about peoples' experience of 'restructuring' that can occur in therapy. By inviting participants to reflect on this, new insights into this phenomenon may be possible. This method also offers an alternative to viewing counselling outcomes in terms of standard statistical data which may prove more sensitive to the client's lived reality, including their diverse social worlds.

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Margot Schofield

Other Author: Eric Hudson

Professional Role: Associate Professor in Counselling & Executive Director
Institution: University of New England & PACFA
Contact details: PACFA, PO Box 481, Carlton South VIC 3053, Australia
Email: mschofi2@pobox.une.edu.au

ABSTRACT: Paper

Strand: Supervision

Expertise In Counselling Supervision

Introduction

Clinical supervision has developed informally in Australia by experienced therapists translating what they have learnt as therapists to the supervision context. There has been limited opportunity for formal training in supervision and little research conducted. This study aimed to explore experienced counselling supervisors' perceptions of the essential elements of 'good' counselling supervision as a basis for developing training and practice guidelines.

Methods

The study used a phenomenological research method involving in-depth interviews with experienced counselling supervisors. Six supervisors, each with more than 20 years experience, from different approaches and contexts, were purposively recruited. Participants were asked to describe in detail two recent supervision sessions that they considered to be 'good' supervision sessions: one where they were the supervisee and another where they were the supervisor. They were then asked to reflect on the essential elements of good supervision experiences. Interviews were audiotaped, transcribed and analysed using grounded theory methodology.

Results

Five major themes were identified: improving client outcomes, promoting personal well-being of the counsellor, promoting professional development of the counsellor, creating a reflective space, and providing a safe and reliable relationship. The themes were then incorporated into a model to guide supervision training and practice.

Conclusions

The presentation will discuss the implications of the findings for the training and practice of clinical supervisors in Australia and then outline the next phase of research.

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Elspeth Schwenk

Professional Role: Workplace Counsellor & Supervisor
Institution: Independent Portfolio Practitioner
Contact details: Wiltshire
Email: elspeth@schwenk.me.uk

ABSTRACT: Poster

The Exploration Of Counsellor Development Within Workplace Counselling: Examining Key Milestones In How Practitioners Manage The Development Of Their Professional Career

Introduction

The basis and validity for this study lies in the reflexive, heuristic experience of practitioner-research in workplace counselling. Beyond training and continued professional development, little is available regarding career development through the stages of Novice, Apprentice, Journeyperson and Master-craftsman in workplace counselling. This study will explore how counsellors become self-aware regarding professional development, and proactive in the management of career progression; exploring the relationship between the historical pathway into workplace counselling and subsequent career aspirations.

Methods

This is a qualitative study, based upon heuristic research that incorporates the investigator's internal frame of reference and experience, journey of intuition and indwelling, while drawing upon the stories and experience of the research participants. From within the field of workplace counselling, eight (8) co-researchers will form a focus group based upon the four stages of development, and through a creative and experiential workshop generate research questions that will be explored by a sample of 12 research participants through semi-structured interview, and the inclusion of reflective documentation such as journals, and creative writing.

Results

This proposed area of research reflects an un-addressed area of counsellor development regarding career management and guidance. This study will explore this phenomenon and generate tools of reflection and development based upon the experience of the researcher and research participants representing the four-stage model of counsellor development.

Conclusions

This is a work in progress. A significant element of the study is the experience and journey of practitioner-based, reflective research, in addition to the practical contribution it hopes to offer the field of workplace counselling.

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Margaret Selby

Professional Role: Counsellor in private practice
Contact details: Ealing - London
Email: margandon@hotmail.com

ABSTRACT: Paper

Strand: Counselling Specific Groups

Working With Difference: Counselling The Dyslexic Client

After ten years as a practitioner I still dismissed dyslexia as a literacy problem with little importance in therapy. Events in my personal and professional life were to show me how wrong I was and led to the research question - 'How can an understanding of the inner-world of the dyslexic client enhance the counselling process?'

Methodology: - An heuristic inquiry was undertaken with four dyslexic counsellors as co-researchers. Their experience was presented in narrative form to provide a rich description of dyslexia. An analysis of this data was considered along with relevant literature and all that I had absorbed from the world of dyslexia to extract an understanding of dyslexia that would be relevant to counselling and psychotherapy. The literature search showed practically nothing has been written on counselling and dyslexia.

Findings: - All co-researchers had been humiliated by peers and/or tutors from within the counselling community. The complexity of dyslexia, and its wide variation of symptoms, keeps it a 'hidden' disability. The high proportion of adults assessed at university has led Grant (2000) to conclude the number of those undiagnosed, throughout society, will be higher than those with a diagnosis. As living with dyslexia creates high levels of stress (Miles & Varma 1995) and dyslexics are also subject to the more common stressors, I suggest many clients will be undiagnosed dyslexics. The visual thinking style of many dyslexics is much faster and wider than thinking in words (Davis1997). West (1991) has explained it is also metaphoric. How are we to enable verbal communication of this thought process? What is its impact on the experience of anxiety and trauma?

Conclusions - Conclusions and recommendations are from my own research. There are no previous studies to make comparison with and there is an urgent need for further research and to examine to what extent the counselling community is 'dyslexia aware' and 'dyslexia friendly'.

Dyslexia is a lifestyle with both inefficiencies and strengths. A comprehensive understanding and respect for its difference is necessary if we are to offer a safe therapeutic alliance where our dyslexic client can feel heard and be offered complete acceptance. This need and how it may be achieved will be illustrated by drawing on my client material and changes in practice.

(References available from author)

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Jenny Lukito Setiawan

Professional Role: PhD student
Institution: The University of Nottingham
Contact details: Flat 4, 25 Waverley Avenue, Beeston, Nottingham, United Kingdom, NG9 1HZ
Email: jennysetiawan@yahoo.com

ABSTRACT: Paper

Students' Willingness to Seek Counselling: An Indonesian Study

Being at a university is a major life change, which brings opportunities for young people to achieve their personal growth. However, at the same time, this also involves risks of suffering from distress. Therefore, some Indonesian universities provide a counselling service to help students deal with their problems in order to support their academic life. However, Indonesian students might not be prepared to seek help from a counsellor. This presentation will focus on: the level of willingness to seek counselling; and the discouraging and encouraging factors in relation to seeking counselling.

Both quantitative and qualitative approaches were adopted in this study, in order to give a fuller picture of issues under investigation. A questionnaire was distributed to 1,279 students. The students were from two private universities in Indonesia. This was followed by individual semi-structured interviews with students (n = 32) and with university counsellors (n = 4), and focus groups with students (n = 4 groups).

The results indicated that students perceived counselling positively at a superficial level, but did not necessarily accept the idea of receiving counselling within their own frame of reference, which was shown in the low level of willingness to seek counselling. The use of social networks was the most important discouraging factor from seeking counselling. Other discouraging factors at various levels, such as intrapersonal, interpersonal, organisational, and community were interrelated and contributed to the low take-up of counselling services.

The wide dissemination of information about the counselling service and the efforts to promote trust are strongly suggested to encourage students to seek counselling.

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Bernice Shooman

Professional Role: Counsellor/Lecturer in Education
Institution: Park Lane College; University of Leeds
Contact details: Leeds
Email: bernice@shooman.fslife.co.uk

ABSTRACT: Paper

Holocaust Testimony: Memory and Transgenerational Mourning

Introduction

This research investigated how testimony expressed by Holocaust survivors to The Shoah Visual History Foundation challenged or changed relationships and how persecution, sudden separation and death of significant loved ones reverberated into lives of 2nd generation. The inquiry examined whether survivors' experiences of testimony processes, focussed on recalling memories, resulted in restoration of self and explored unconscious transmission onto the next generation.

Methods

Phenomenological heuristic methodology, oriented towards capturing elements of individual human experiences, was used. This qualitative method achieved an integration of authentic descriptions of the phenomena experienced by three survivors and three 2nd generation co-researchers. The researcher was aware of her potential bias and subjectivity but contextualised her own experiences which lead to a more holistic study.

Results

Research findings emphasised important links between three related establishments where identification with other survivors empowered co-researchers. The results suggest that a therapeutic framework was provided for survivors when giving audio-visual testimony to the Shoah Foundation. The experience of containment, acknowledgement and validation gave great value to survivors, the essence of which was felt by 2nd generation family members. This combination of events elicited fresh roles for survivors as educators and their new self construct positively affected relationships with 2nd generation. Witnessing and being heard were central to aiding restoration and resolution.

Conclusions

The Holocaust survivor phenomenon influences the impact of history on modern day genocide, recent human tragedies and the plight of dispersed and displaced people. Tolerance of difference forms the basis for future research and further discussion.

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Liesl Silverstone

Professional Role: Fellow BACP, Trainer/Supervisor
Institution: Person-Centred Art Therapy Centre
Contact details: 17 Cranbourne Gardens, London NW11 OHS
Email: liesl.silverstone@btopenworld.com
Website: www.person-centred-art-therapy.com

ABSTRACT: Workshop

Strand: Theory and Practice

Art Therapy and The Person-Centred Way: Bringing The Person-Centred Approach To The Therapeutic Use of Art

Art therapy is a creative mode to keep us away from cerebral, verbal, judgmental processes and into the here-and-now world of imagination, intuition and inspiration. The paradox applies that by thinking less it is possible to know more. By making visible our images, we can tap into material from the subconscious which is denied to the forefront of our awareness, and gain valuable insights.

The person-centred non-directive approach, based on the belief that the individual is responsible and capable of self-determination, enables the client to discover the message of the image for her/himself, thus gaining self-awareness as well as moving towards a more autonomous way of being. By bringing the person-centred facilitative approach to images expressed in art-form, integration, growth and healing can occur at every level of development.

Liesl Silverstone is the originator of person-centred art therapy and wrote the first book on this approach, Art Therapy the Person-Centred Way. She has many years experience as a tutor, counsellor and art therapist.

After a brief introduction on background and therapy, Liesl will offer and facilitate an art therapy exercise. The Workshop will be experiential to enable the participants to discover for themselves the potential of person-centred art therapy. There will be opportunity for comments and questions.

Liesl believes that incorporating the non-verbal creative intelligence within the 'talking' therapies of counselling, training and practice, would greatly enhance the effectiveness of our profession.

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Sophie Smailes and Khatidja Chantler

Professional Role Sophie Smailes: Lecturer
Institution: Manchester Metropolitan University
Contact details: Department of Health Care Studies, Manchester Metropolitan University, Hathersage Road, Manchester M13 OJA
Email: s.smailes@mmu.ac.uk

Professional Role Khatidja Chantler: Honorary Research Fellow
Institution: Manchester Metropolitan University
Contact details: Department of Psychology & Speech Pathology, Manchester Metropolitan University, Hathersage Road, Manchester M13 OJA
Email: khatidja.chantler@lineone.net

ABSTRACT: Paper

Strand: Family Relationships

Deconstructing Experiences, Contexts and Understandings of Domestic Violence

Introduction

This research study sought to identify, model and evaluate support for South Asian, African/African Caribbean, Irish and Jewish women escaping domestic violence.

Domestic violence features heavily in counselling as well as many other health and social care settings. Many interventions fail to acknowledge the intersections of domestic violence and minoritisation and our intention was to highlight these gaps.

Summary of Methods Used

The study was jointly funded by the European Social Fund and the Manchester Metropolitan University and was based in the Women's Studies Research Centre. It was an 11month study completed in July 2002.

The approach used was qualitative and had three phases:

  • thirteen 1:1 organisational interviews with workers from domestic violence and related agencies and 26 secondary sources and contacts
  • twenty-five face to face in-depth interviews with women from the above cultural backgrounds
  • three support groups for women with experiences of domestic violence running over a period of two-three months.

Results

While the outcomes were wide-ranging and diverse we have chosen to focus on highlighting meanings and constructions of domestic violence. Our results clearly indicate that social, political, economic, gendered and racialised contexts influence the understandings of service providers as well as women experiencing domestic violence.

Conclusions

The privileging of physical violence is dominant in services, the legal framework and the accounts of women. This serves to render invisible emotional, sexual, psychological, financial and other methods of power and control, including immigration and the use of culture as regulatory mechanism for controlling women. Implications for practice include the need to broaden our conceptualisations of domestic violence, together with an attention to the intersections of the minoritisation of women.

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Bernice Sorensen

Professional Role: Psychotherapist / Supervisor / Trainer / Consultant
Institution: Metanoia Doctoral Candidate
Contact details: 9 Selwyn Avenue, Hatfield, Hertfordshire, AL10 9NR
Email: bernicesorensen@yahoo.com

ABSTRACT: Poster

The Drama Of The Only Child

Introduction

Despite the ever-increasing numbers of only children, there has been little research on the phenomena, most of which has been quantative. Of significance to my research is the recognition of the importance of siblings in personality development. My aim is to both co-create stories of female only children, and explore how the only child experience might be different to that of children with siblings.

Method

I am using an heuristic methodology and narrative analysis with reflexivity, to co-create my co-researchers stories. I have interviewed eight adult female only children, between the ages of 20 to 70 years, over a period of a year. These have been taped, in-depth unstructured interviews with on-going dialogues by either email or post. I now have eight life-stories depicting aspects of the only child experience.

Preliminary findings

My research to date has highlighted the various ways that only children have significantly different experiences in both child and adulthood to those with siblings. It appears that this typically creates difficulties in interpersonal relationships and self-image. Having a sibling provides concrete opportunities for psychic and social development in the form of specific intersubjective experience. These opportunities are usually absent for the only child growing up in a society characterised by a nuclear, rather than an extended family.

In a predominantly sibling society, being an only child is perceived as both a lack and an unfair advantage. As with any minority group, prejudices and stereotypes abound, many of which are negative and in my experience remain unchallenged by clients, counsellors or supervisors. This research is an attempt to inform and encourage therapists to move beyond the stereotypes by offering a deeper understanding of the experience of being an only child, not just in childhood, but also as someone living life from a minority perspective throughout their lifespan.

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Adriana Summers

Professional Role: Managing Director & Lecturer
Institution: anderson summers ltd & University of Manchester
Contact details: The University of Manchester, Oxford Road, Manchester and Friends, Meeting House, 6 Mount Street, Manchester, M2 5NS
Email: enquires@andersonsummers.com

ABSTRACT: Paper

Strand: Organisational Counselling

Clinical Effectiveness of Workplace Counselling

This study aimed to examine whether counselling was found to be clinically effective for employees accessing a workplace counselling or Employee Assistance Programme (EAP). Particularly, whether employees' symptoms changed as a result of a short-focused counselling intervention.

288 clients accessed the service however only 50% (144 clients) completed Goldberg's GHQ-28 at both the initial counselling and final counselling sessions. The fact that only 50% of clients completed the pre and post GHQ-28 was multifactorial, i.e. whether the counsellor considered it was appropriate to present the questionnaire to distressed clients at first meeting, whether the client attended their last scheduled session and whether counsellors were prepared to invite the client to complete the questionnaires.

The results showed that 83% of clients showed symptoms of psychiatric 'caseness', at their initial counselling session. By the end of counselling 70% were showing symptoms within the normal range. This suggests that the majority of people show a positive clinical response to focussed counselling. A smaller minority, i.e. with 3 or more presenting issues respond to up to an additional six sessions. Thereby significantly increasing an employee's well-being and reducing the potential of sickness absence.

This implies that: the majority of clients starting counselling have symptoms outside the 'normal' range and could have been sent for further assessment within a primary care referral system. Furthermore clients are often still at work and considered to be 'functioning' whilst experiencing symptoms.

The study was conducted within the financial services sector. The largest user groups were: administrative; professional and managerial. Females: were the largest group to access counselling; presented with one issue and fell into the 30 - 39 year age group. The second highest user groups were males between 40 - 49 years and females 20 - 29 years. The largest sub groups of presenting problems identified were: personal relationships; psychological; occupational and stress. This current study is being continued with a larger group study using some 500 employees.

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Maggie Turp

Professional Role: Tutor/Infant Observation Seminar Leader on MSc in Psychodynamic Counselling with Children and Adolescents, Counsellor/Psychotherapist in Private Practice
Institution: Department of Psychology, Birkbeck College, University of London
Contact details: Malet Street, Bloomsbury, London WC1E 7HX
Email: maggieturp@aol.com

ABSTRACT: Workshop

Strand: Theory and Practice

The Capacity For Self-Care: A Research Study Using Infant Observation Methodology

Psychoanalytic infant observation has contributed to training and professional development in the fields of psychotherapy, social work and health visiting for many years and is being developed as a CPD option for counsellors. The aim in training terms is an enhanced capacity to 'tune in' to the play of emotion and unconscious communication between the infant and primary carer(s) - an issue immediately relevant to the therapeutic encounter.

Use of infant observation as a research methodology is a more recent phenomenon. While developmental psychology research requires the infant to be in an alert active state, psychoanalytic infant observation allows us to see the infant 'in the round', in his or her home setting and in the context of his or her day to day relationships. We have the opportunity to observe joyful and hateful feeling states as and when they arise. It is a participant observation methodology where the observer's felt response is part of the 'data' under consideration. The experience of undertaking an observation and discussing observations in a seminar group has much in common with the experience of using countertransference responses as an instrument of understanding in the therapeutic encounter.

Research using psychoanalytic infant observation methodology will be presented. The aim of the research was to elucidate the early stages of the development of a capacity for self-care. Infant observation illuminated the detail of how an individual, in normal 'good enough' circumstances, moves from a position of extreme initial dependence on the care of others to one where he or she is able to attend appropriately to physical and emotional needs.

The relevance of the research to counselling and psychotherapy will be discussed. A good capacity for self-care, based on the successful internalisation of a good object, may protect and individual from the destructive and self-destructive tendencies involved in self-harming behaviour. Conversely, a poor capacity for self-care may leave the individual especially vulnerable to self-harming tendencies. These possibilities will be explored through discussion of clinical examples taken from Maggie's work and participants' work, as appropriate.

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Dr Andreas Vossler

Professional Role: Scientific Consultant
Institution: German Youth Institut
Contact details: German Youth Institut, Nockherstraße 2, D-81541 München, Germany
Email: vossler@dji.de

ABSTRACT: Paper

Strand: Young People and Adolescents

Adolesecents' Experiences In Counselling - An Explorative Study

This presentation reflects the experiences of young people in child guidance and family counselling in Germany. In evaluation research, the perspective of children and adolescents concerned was seldomly the subject of an investigation. In most studies in German-speaking areas, parents alone have been asked their opinion. Thus the paradoxical research situation arises that the actual target group is excluded from analysing process and result of the intervention.

To overcome this neglect, qualitative, semi-structured interviews were used to ask 17 young clients between the ages of 13 and 22 in an explorative study about counselling which had finished three to four years previously and its effects (follow-up history). The qualitative data were analysed through a "structured content analysis" approach. This method was thought to be most appropriate in order to draw out the participants own personal meaning of what they experienced during the counselling process.

The results show that adolescents often are insufficiently integrated in the processes that lead to the commencement of counselling and a formulation of the "counselling objective". Visiting the counselling centre was frequently associated with the young client's idea that counselling was to aid their discipline, and the counsellor was to be consulted as an "ally" of the parents in order to strengthen their position. Although most of the adolescents were overall satisfied with the help obtained, the interviews reveal that they partly felt excluded and insufficiently integrated into the counselling process.

These and other empirical findings are critically discussed in terms of the institutional conditions and methodical approaches which obstruct the involvement of children and adolescents in the counselling process. The concluding remarks include methodical options for a stronger orientation of professional behaviour towards facilitating participation of young people in counselling.

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Dot Weaks

Other Authors: John McLeod and Dr Heather Wilkinson

Professional Role: PhD student (full time)
Institution: University of Abertay Dundee
Contact details: Tayside Institute for Health Studies, University of Abertay, Dundee in collaboration with NHS Tayside, Dudhope Castle, Dundee, DD3 6HF Scotland
Email: 0014279@abertay.ac.uk

ABSTRACT: Paper

Strand: Counselling Specific Groups

The Value Of Post Diagnostic Counselling For People With Alzheimer's: Perceptions Of GPs and Old Age Psychiatrists

Introduction

The early diagnosis of alzheimer's disease means that people who have a high degree of insight into their cognitive impairment and likely prognosis, are being given a diagnosis. This can be traumatic and there is an opportunity for people at this stage, to be engaged in post-diagnostic counselling. This is not readily offered by the diagnosticians, although the merits of post traumatic counselling have been well documented in other areas of health care. This research explores the attitudes of consultants in old age psychiatry and general practitioners to the provision of counselling for this vulnerable group of people.

Method

A qualitative study, employing semi-structured interviews was carried out with 16 professionals and the sample was divided into equal numbers of both professional groupsã8 gps and 8 consultants in old age psychiatry in mid-Scotland. The sample included both male and female practitioners.

Questions explored whether they thought that this client group would benefit from counselling, identified barriers to using this type of service and enquired about the availability of counsellors in their area who were skilled in working with this client group. This research has been undertaken as part of a wider phd study into the psycho-social impact on patients and medical practitioners of a diagnosis of early dementia.

Results

Grounded theory analysis of the interview material showed the majority were open to post diagnostic counselling. The results showed a wide range and variety of understandings and views of counselling. Potential benefits were acknowledged while a number of practical barriers were highlighted. The meaning of counselling for diagnosticians was also found to be diverse.

Implications of these findings for the development of counselling services for these clients are discussed.

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Jeremy Weinstein

Professional Role: Senior Lecturer / Independent psychotherapist/researcher
Institution: London South Bank University
Contact details: Faculty of Health and Social Care, London South Bank University, Borough Road, London SE1 0AA
Email: weinstja@lsbu.ac.uk

ABSTRACT: Paper

Strand: Cultural Issues

Counselling as a New Ritual in Bereavement

Introduction

The research tracks two groups of London based bereaved: 1) Clients of a community based bereavement counselling service and 2) primary carers of former Hospice patients. It aims to provide insights into grieving, the role of counselling in this process and to locate the findings within the wider debates about the purposes and outcomes of counselling and mourning.

Summary of Methods

Mailed questionnaires with some respondents offering to have follow up individual interviews.

In the community based research 280 ex-clients were contacted, 89 (32%) responded and 9 had follow-up interviews.

In the hospice based research 50 individuals were approached, with a response rate of 50% and 9 follow-up interviews.

Results

Overall respondents are very positive about counselling. And a strong theme emerges of their tensions as they turn to belief based and culturally sanctioned customs to help them make sense of their loss. But aspects of contemporary life, e.g. a more individualised society, the retreat from organised religion, mean that these traditional rituals have lost their currency. Some respondents find creative ways to adapt the rituals. Others fill the psychological gap with bereavement counselling which takes on aspects of ritual based behaviour which, variously, compete with, complement and/or complete the work of more established rites of passage.

Conclusions

Conclusions are necessarily tentative given the small scale of the research. The research could be strengthened by 1) a more geographically and culturally diverse sample and 2) incorporation of the views of counsellors/psychotherapists.

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Dr William West and Dr Val Clark

Professional Role: Senior Lecturer in Counselling Studies
Institution: University of Manchester
Contact details: ESI, School of Education, University of Manchester, Oxford Road, Manchester, M13 9PL
Email: william.west@man.ac.uk

ABSTRACT: Paper

Strand: Supervision

Learnings From A Pilot Project Into Counselling Supervision

This paper draws on the authors' recent experience of piloting some qualitative research into helpful and hindering events in supervision. This project was supported with a small grant from the Faculty Research Development Fund. Counselling supervision sessions by 3 dyads of supervisor and supervisee were video taped. As soon as possible after the supervision both parties were independently invited to select helpful and hindering events which were then explored using IPR (Interpersonal Process Recall) in an audio taped interview. This paper presents the initial findings of this research using direct quotes from the interview transcripts which illustrate the value of IPR and of focusing on helpful/hindering events in supervision. It highlights the differing needs of the supervisee for example for help with a problematic client in contrast to the supervisor's need to feel good about how they supervise. Questions raised relating to ethics - how to deal with not 'good enough' supervision and methodology - the future direction of the project are considered.

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Sue Wheeler

Professional Role: Director of Counselling and Psychotherapy Programme
Institution: University of Leicester
Contact details: University of Leicester, Institute of Lifelong Learning, 128 Regent Road, Leicester LE1 7PA
Email: sw103@le.ac.uk

ABSTRACT: Paper

Strand: Training and Development

The Highs and Lows of Therapeutic Practice: Counsellors Reflect on Training and Experience.

Past students of two major counselling training providers were asked to complete the Development of Psychotherapists Questionnaire and a supplementary questionnaire devised for the project. The Development of Psychotherapists Questionnaire has been developed and widely used by a group of researchers and completed by thousands of subjects worldwide. It provides detailed information about training, personal therapy, practice experience and continuing professional development as well as eliciting information about career development and attitudes towards therapeutic work. The supplementary questionnaire explores experiences with clients and organisations providing counselling. This paper will provide details of various aspects of the findings of the project including the highs and lows of therapeutic practice. Some comparisons will be made with therapists in other countries and with different backgrounds such as clinical psychology or psychotherapy.

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Jeannie Wright

Other Author: Liz Sutton

Professional Role: Senior Lecturer / Practitioner
Institution: University of Derby
Contact details: Unit for Psychotherapeutic Practice and Research, University of Derby, Derby, DE3 5GX
Email: j.k.wright@derby.ac.uk

ABSTRACT: Paper

Strand: Training and Development

'A Diary Sort of Person' Counselling and Psychotherapy Students' Perceptions of Keeping A Learning Log And Writing For Reflective Practice

Presentation of research in progress

Introduction

There is very little published research into how 'writing for reflective practice' contributes to personal or professional development in the field of counselling and psychotherapy. The British Association for Counselling and Psychotherapy requires accredited courses to include a personal development component, but is not prescriptive about what or how. This study defines personal development as 'the consciously applied intention to change aspects of one's own life' (Daniels & Feltham, 2004).

Aim

  • To extend a survey of one cohort of students (Daniels & Feltham, 2004);
  • To represent some students' perceptions of keeping a Learning Log and 'writing for reflective practice from two qualitative studies;
  • To examine implications for facilitation of that writing process.

Methodology

Qualitative - data collected from 3 focus groups and 5 semi-structured interviews and analysed using Interpretative Phenomenological Analysis (Smith et al, 1999)

Findings

In progress - independent auditor still working on analysis. Some clear themes are emerging and the ongoing research will be illustrated by extracts from the focus groups and interviews with students.

Conclusions

The use of personal journals or learning logs has become a traditional part of initial and continuing professional development in counselling and psychotherapy. Suggestions about the substitution of such reflective and expressive writing for personal therapy in psychotherapeutic training and other implications for practice will be discussed.

(References available from the author)

 

 
       
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