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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)

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.

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.

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?

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)

Dr Herbert Biggs

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.

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.

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.

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.

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.

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)

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.

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)

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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'.

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.

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.

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)

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.

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. </