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Research Conference 2005  


BACP's 11th Annual Research conference†was entitled 'Research that makes a difference' and took place on 20-21 May 2005. It was held at Eastwood Hall, Nottingham in association with the Centre for Lifelong Learning. University of Birmingham.

Click here for an evaluation of this year's conference

Abstracts

Friday opening†presentation and keynote

Professor Glenys Parry

Professional Role: Professor of Applied Psychological Therapies
Institution: University of Sheffield, UK
Email: g.d.parry@sheffield.ac.uk

ABSTRACT: Friday opening presentation

Research that makes a difference

Research is often perceived by counsellors and psychotherapists as irrelevant to their work and inimical to their values. Many research findings languish unread having minimal impact on practice. Yet potentially research can empower clients, enhance the working lives of therapists, prevent harm, and improve the quality and outcomes of counselling. It can also provide ammunition in the fight for professional recognition and funding. How may these benefits be realised? Drawing on examples, I shall review factors that contribute to research making a difference, examining ways to embed research into practice and looking at research designs that improve applicability. In this way I hope to address the cartoon character Charlie Brown's excellent question, 'How can we fail when we're so sincere?'††

Michael J Lambert

Professional Role: Professor and Endowed Chair of Psychology
Institution: Brigham Young University, USA
Contact details: Brigham Young University, 272 TLRB, Provo, UT 84602 USA
Email: michael_lambert@byu.edu

ABSTRACT: Friday keynote presentation

Research that makes a difference: preventing negative treatment effects via measuring, monitoring, and feedback

About 8% of patients who enter psychotherapy leave treatment more dysfunctional than when they entered. In addition, it appears that a further 20-30% of patients do not realize any measured benefit from treatment. Research is presented that demonstrates that therapists are poor at predicting just who the failing patients will be, even late in the course of counseling. Methods aimed at reducing treatment failure will be presented. They include the use of a brief measure of symptomatic disturbance, interpersonal problems and social role functioning, that is given on a weekly basis. Expected treatment response (based on the course of 10,000 patients) is used to identify individual patients who are deviating significantly from a positive change trajectory. The questionnaire and decision rules based on expected treatment response are embedded in a newly developed software program (OQ-Analyst). The program permits administration through a handheld computer or paper administration with instantaneous feedback to clinicians, including an updated graph of patient progress in reference to normal functioning and the alarm system. The effects of giving this feedback to clinicians at each session of therapy are contrasted to treatment as usual (no formal feedback). In addition, experimentation with the use of measures of the therapeutic alliance, motivation and social support, which are provided to therapists, will be described. Results suggest that routine use of these procedures reduces treatment failure and increases positive outcomes for patients who are predicted to have a poor treatment outcome. Finally, a system for providing clients with feedback about their progress and therapists about the average outcome of clients in their caseload, relative to averaged outcomes across a large sample of therapists will be presented. The research program, as a whole, illustrates the feasibility of integrating research-based methods that enhance treatment outcomes in routine care.

Saturday opening†presentation and keynote††

Nancy Rowland

Professional Role: BACP Head of Research
Institution: British Association for Counselling and Psychotherapy
Contact details: BACP, BACP House, 35-37 Albert Street, Rugby, Warwickshire CV21 2SG
Email: nancy.rowland@bacp.co.uk

ABSTRACT: Saturday opening presentation

Research at BACP - does it make a difference?

Research department activity at BACP focuses on trying to make a difference. The central aims of BACP's research strategy are to develop a research culture within the Association - its members, divisions, committees and staff - and to contribute to the development of the evidence base for counselling and psychotherapy.

Developing and disseminating a knowledge base about counselling and psychotherapy is essential to the interests of the public, clients, the profession, service delivery and policy.

In reviewing activity in the Research Department over the last year, I will focus on what we are trying to do and describe how we have tried to further our strategic aims. I will also announce new funding and research initiatives for the year ahead.

I look forward to debating whether 'Research at BACP' does make a difference, and welcome suggestions on how we can have more impact.

References:

Orlinsky, D.E., R√nnestad, M.H. et al. (2005). How psychotherapists develop. A study of therapeutic work and professional growth. Washington D.C.: American Psychological Association.

Schroder, T.A. and Davis, J.D. (2004). Therapists' experiences of difficulties in practice. Psychotherapy Research, 14, 3, 328-345.

Biographical note:

Thomas Schroder is a chartered Clinical and Counselling Psychologist, and a UKCP registered analytic psychotherapist. He works part-time as an NHS Consultant in the Derbyshire Psychotherapy Services, and part-time as Course Director for the Doctoral Training Programme in Clinical Psychology at Nottingham University. His main research interests are in the areas of therapeutic challenges and the professional development of psychological therapists.

Dr Thomas Schroder

Professional Role: Course Director
Institution: University of Nottingham
Contact details: Mid-Trent Doctorate in Clinical Psychology Institute of Work, Health Organisations, University of Nottingham, William Lee Building 5-6 Nottingham Science and Technology Park, Nottingham, NG7 2RQ

ABSTRACT: Saturday keynote presentation

Interesting times with challenging clients. On listening to practitioner's experiences

The gap between researchers and practitioners of counselling and psychotherapy is frequently lamented, but difficult to remedy. Finding ways of bridging this gap has the potential of making a real difference to the field. One way of approaching this problem is to conduct research which is near to the experience of practitioners. The studies presented here focus on therapists'/counsellors' experiences of therapeutic challenges. One set of findings is derived from the International Study of the Development of Psychotherapists, especially from UK samples drawn from BACP and BABCP members. They focus on the difference that theoretical orientations make (or fail to make) on experiences of difficulties. Another set of findings is derived from in-depth studies of narratives provided by British and German-speaking practitioners. They focus on types of difficulties, their relationship to process, and to therapists' self-conscious emotions. The consequences of these findings are discussed, in terms of the potential of therapeutic difficulties for providing an integrative concept, which can make a difference to therapeutic practice.



Hilary Abrahams

Professional Role: Honorary Research Fellow
Institution: School for Policy Studies, University of Bristol
Contact details: 8, Priory Road, Bristol. BS8 1TZ
Email: Hilary.Abrahams@bristol.ac.uk

ABSTRACT: Paper

'We can never go home': loss, trauma and recovery in the refuge

Background: In any year, over 20,000 women and 28,000 children will shelter from domestic violence in refuges in England and Wales, yet little research has been carried out into the support they need. Providing services that are effective in helping women to recover from abuse requires greater understanding of the process which takes place during the refuge stay and afterwards, and the key areas where support is needed.

Aims: To ascertain the nature of the support needed and the factors which service users identified as facilitating recovery.

Method: This was a collaborative project, which used semi-structured interviews with past and present residents and workers, informal discussions and observation to produce an in-depth study of three refuges. I taped and transcribed 46 interviews, and carried out a systematic analysis based on the thematic framework which emerged from the data.

Results: Interim findings, presented at the BACP Research Conference in 2002, showed a complex picture of practical and emotional support needs and a process of recovery similar to that involved in bereavement. Further analysis has confirmed the centrality of loss for many service users and demonstrated the impact of domestic violence in dismantling the structure of everyday life, making recovery and social integration more problematic. Significant factors in facilitating this process included peer support, time to talk and be heard, and a respectful and empowering approach from workers, including appropriate use of practical advocacy, counselling and group work.

Conclusions: This study offers a framework of understanding that will assist practitioners and service providers in supporting women, bringing together the twin requirements of practical and emotional support. It gives women a way of making sense of their feelings and experiences, and of moving forward. Further research needs to be undertaken into longer-term support needs and to investigate the applicability of this model to other forms of domestic abuse.

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Steph Adam

Professional Role: Doctorate Student
Institution: Manchester University
Contact details: Educational Support and Inclusion, Faculty of Education, University of Manchester. M9 13PL
Email: cshrinkit@aol.com

ABSTRACT: Work in Progress Symposium

Therapists, clients and dreams - what next?

Background: Working with clients' dreams poses a particular challenge for therapists. The paradoxical nature of the reality of dreams can lure both therapist and client into a collaborative form of enquiry to interpret the dream meaning. This then may compromise the therapeutic process.

Aims: To explore the perceptions and experiences of therapists working with clients' dreams.

Method: A two hour focus group discussion with six female therapists and one female facilitator (also the researcher) explored issues for practitioners working with clients' dreams. Participants were interviewed using semi-structured questions. The discussion was recorded on video and audiotape, and will be transcribed and analysed using grounded theory.

Results: Preliminary findings revealed only one out of six therapists are confident about working with dream narrative. The reasons range from insufficient knowledge of the dream process, lack of a coherent theoretical model, and a pressure that the therapist should 'solve the mystery' of the dream.

Conclusions: The implications of this research into working with dreams for counsellor training, development and supervision are considered and recommendations for best practice are presented.

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Tim Bond and Dione Misfud

Professional Role: (TB) Reader in Counselling and Professional Ethics / (DM) Student Counsellor and Lecturer in Counselling
Institution: (TB) University of Bristol / (DM) University of Malta
Contact details: Graduate School of Education, 8-10 Berkeley Square, Bristol. BS8 1HH
Email: tim.bond@bris.ac.uk / dione.mifsud@um.edu.mt

ABSTRACT: Work in Progress Symposium

Investigating cultural differences: a methodological pilot of narrative inquiry using creative dialogue

Background: This methodological pilot grew out of a desire of two counsellors working in different cultural contexts to understand their cultural differences better, whilst developing a counselling training programme to be delivered in Malta by one of the counsellors with limited previous experience of Maltese culture.

Aims: One of the challenges facing counselling research and practice is how to engage productively with human difference? How can we understand the impact of cultural differences better in personally meaningful ways? How can we represent those differences in ways that relate to counselling practice?

Results: The outcome of this research is a dialogue using the techniques of creative narrative inquiry to represent the lived experience of communication across and about cultural differences. The methodology is an adaptation of writing as inquiry (Richardson, 2000), creative writing and narrative inquiry (Clandinin & Connelly, 2000) using email dialogue. The topics explored in this reading concern differences in identity, family systems, culture and their impact on personal values and sense of relationship.

Conclusions: The methodology that developed extends the range of ways of examining and representing cultural differences. The value of this approach will be a topic for discussion by the participants at the presentation. The dialogue and methodological discussion has been accepted for publication in Narrative Research on Learning: International and Comparative Perspectives (Symposium Books, 2005).

Dione Mifsud's contribution to the dialogue may be read by a workshop participant if he is unable to attend.

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Nell Bridges

Professional Role: PhD student
Institution: University of Bristol
Contact details: 8-10 Berkeley Square, Bristol BS8 1HH
Email: nell.bridges@bristol.ac.uk

ABSTRACT: Paper

Experiencing pressure to counsel unethically

Introduction: This research focuses on counsellors' struggles to adhere to ethical principles despite external pressures to do otherwise and relates such experiences to conceptions of self and personal life-story.

Method: Narrative inquiry is used with a small sample of six participants who were accessed through posters and fliers at conferences, university counselling departments and counselling agencies. Selection was on the basis that they had a significant and relevant experience that they were able to describe without disclosing confidential counselling material that could lead to a client being identified. Continuing relationships with participants allowed an ongoing process of informed consent as well as an iterative procedure where later stages of research built on earlier lessons.

Settings included voluntary sector, addiction rehabilitation, police counselling, education and personnel management. Sources of data include transcripts of narrative interviews (three with each participant) and extracts from journals and emails.

Summary of results: Results demonstrate pressure to breach a range of ethical principles often with inadequate support. This led counsellors to rely on non-counselling knowledge and contacts to guide their actions. Participants mostly referred to their difficult experiences having occurred at early stages in their careers. As such these findings are particularly pertinent for student and newly qualified practitioners.

Discussion points: Researching ethics demands rigorous research ethics. The procedure therefore includes participant checks of all transcripts, analysis, interpretation and re-presentation as well as an option for participants to withdraw consent at any time. Some respondents expressed interest but withdrew in the initial stage due to concerns that their story might be identifiable or that they may breach conditions of employment.

Conclusions/impacts: This research offers a resonant engagement with key ethical issues and challenges the counselling profession to reconsider the support given to practitioners dealing with such incidents in isolation.

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Michelle Brooks and Stephanie Davies

Other Author: Dr Chris Evans

Professional Role:†Dramatherapist & Counsellor
Institution: Barnet Learning Disabilities Service
Contact details: 313 Ballards Lane, North Finchley, London. N12 8LY
Email: michelle.brooks@barnet-pct.nhs.uk

ABSTRACT: Work in Progress Symposium

Psychological therapies for people with a learning disability - developing an outcome measure to fit the task

Background: Traditionally treatments for psychological problems for people with learning disabilities have involved behaviour management, skills training and medication. More recently clinical experience has shown the benefits of psychotherapeutic approaches, however, there is a need to build evidence to support this.

Aims: To adapt an outcome measure that evaluates the effects of psychological therapies for people with a learning disability. To develop this measure to reflect the experience of living with a learning disability and its' effect on psychological well being.

Method: We have chosen Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) as the measure to adapt. We are involving people with a learning disability in a Collaborative Research Group (CoRG) whose task will be to assist us in all aspects of the research. This requires us to pay close attention to all forms of communication to make their role meaningful and empowering, one that attempts to redress the power imbalance inherent in the relationship between us.

Conclusion: Initially we will be attempting to unearth the components of living with a learning disability by taping and analysing discussion with the CoRG, as the experts of their own experience. From this we will create questions that contain the 'authentic voice' of people with a learning disability. These will form the new domain of what we hope will become CORE-Learning Disability (CORE-LD). The new questions will be further discussed with a wider learning disability population within day centres, colleges etc, in order to increase generalisability.

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Professor Julia Buckroyd

Professional Role: Professor of Counselling / Editor of CPR / Director of Obesity and Eating Disorders Research Unit
Institution: Health Sciences Research Institute, University of Hertfordshire
Contact details: Centre for Community Research, Dept of Social, Community and Health Studies, University of Hertfordshire, College Lane, Hatfield, Herts. AL10 9AB
Email: J.Buckroyd@herts.ac.uk and julia.buckroyd@bacp.co.uk

ABSTRACT: Saturday opening presentation

CPR: What is it for? Who is it for?

Counselling and Psychotherapy Research (CPR) is a young journal and still developing. This talk offers the editor an opportunity to share her thinking on the direction she envisages for the journal in the near future. She will discuss the role of the journal in relation to the significant pressures from various sources including: the international and multi-disciplinary research community; NHS concerns; and funders and managers. She will then explore the needs of the practitioner community and the various roles the journal can take in relation to that constituency, including: transmission of information; awareness of new work; education in research methods; provision of a forum; and encouraging research. It is hoped that this exploration of these issues will be helpful especially to those considering submitting to the journal in the future.

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Norman Claringbull

Professional Role: Head of Counselling Studies
Institution: University of Southampton
Contact details: School of Social Sciences, The University of Southampton, Southampton. SO17 1BJ
Email: nwc1@soton.ac.uk

ABSTRACT: Paper

Making a difference to workplace counsellor training

Background: I previously argued (Claringbull, 2004) that there is a need to develop specialist training for Workplace Counsellors. Such training might contribute to the development of the 'Workplace Counselling Professional Specialist'. Subsequent research suggests that there is a demand for recognisable, postgraduate, Workplace Counselling qualifications. It also generated evidence-based suggestions for postgraduate Workplace Counsellor training objectives and indicated an emerging need to develop a new 'Stakeholders' Workplace Counselling Model'.

Aims and method: Group discussions were held with 38 members of the Employee Assistance Professionals Association, including 14 representatives from Employee Assistance Programme (EAP) Providers, about their needs in the development of recognisable Workplace Counsellor qualifications. Interpretative phenomenological analysis was used to explore the results.

Individual interviews were undertaken with seven EAP managers about how potential Workplace Counsellors could be identified whose abilities matched those managers' needs. Content analysis was used to investigate the data an action-research investigation into design/validation issues in Workplace Counsellor postgraduate training course provision was conducted in a major UK university.

Results: These investigations indicate:

  1. EAP providers want counsellor/practitioners who:
    a. Have a quality-assured, post-accreditation, training in Workplace Counselling.
    b. Are qualified/capable to work with clinical and non-clinical client populations.
    c. Have the proven specialist/interpersonal skills and organisational knowledge to deliver consultancy/advisory interventions for promoting psychologically/ emotionally healthy workplaces.
  2. EAP providers would much more value Workplace-Counsellor postgraduate training programmes in which they had some 'ownership' in the design and delivery.
  3. Significant, but resolvable, strains arise between academia and commerce about competing needs when designing postgraduate Workplace Counselling courses.
  4. A new Workplace Counselling model would be useful.

Conclusions: This research is making a difference to Workplace Counselling by:

  • Underpinning the design of a validated Workplace Counselling MSc
  • Promoting the ongoing development of a 'Stakeholders' Workplace Counselling Model'
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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 G13 1PP
Email: mick.cooper@strath.ac.uk

ABSTRACT: Paper

Counselling in schools: findings from an in depth, multi-method evaluation

Introduction: This paper presents key findings from an in depth evaluation of a person-centred counselling service in three Glasgow secondary schools. The main aims of the research were to identify: whether clients were satisfied with the counselling service; whether the service brought about improvements in their psychological well-being; and, the ways in which the counselling service might be improved.

Method: The research was carried out over a two year period and adopted a pluralistic design, combining pre- and post-counselling psychometric measures (Teen-CORE); client satisfaction questionnaires; surveys of pastoral/guidance teachers; in depth qualitative interviews with clients, pastoral teachers and counsellors; and a school-wide survey of pupils' attitudes towards counselling.

Results: Clients' levels of satisfaction with the service were generally high, with 88% of respondents stating that they were 'satisfied' or 'very satisfied' with the service. The evaluation also found significant reductions in levels of psychological distress (p <0.05) and positive evaluations of the service by pastoral teachers (8.47 on a one to ten scale of helpfulness). In terms of future challenges, the main issue that emerged was the need for greater communication between counsellors and guidance staff.

Discussion Points: The triangulation of data from a variety of sources heightened the reliability of the findings though, with a response rate of less than 100 percent, it seems possible that the findings are skewed in a positive direction.

Conclusions: The Evaluation Report from which these findings are presented (Cooper, 2004, published by the University of Strathclyde) has been described by Professor John McLeod as 'one of the most comprehensive and detailed attempts to explore the issues around school counselling and has made a significant contribution to the expansion of schools based counselling in Scotland'.

References:

Cooper, M. (2004). Counselling in schools project: An evaluation report. Glasgow: Counselling Unit, University of Strathclyde.

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Marian Crowley

Professional Role: Senior Lecturer
Institution: University of Central England in Birmingham
Contact details: University of Central England Faculty of Health and Community Care, Westbourne Road, Edgbaston, Birmingham B15 3TN
Email: Marian.Crowley@uce.ac.uk

ABSTRACT: Poster

Exploring the impact of clients' trauma on the trainee gestalt therapist: a phenomenological exploration

Introduction: There is growing literature on the effects of Vicarious Traumatisation on therapists and others who work with survivors of all types of trauma. Individuals working with client trauma experiences are becoming increasingly aware of the personal hazards of their work. Working with clients who have experienced trauma may evoke certain feelings or responses in the therapist.

Aims and methods: The aim of this study was to determine the extent to which therapists experience Vicarious Traumatisation, and the coping strategies used to deal with this. A phenomenological methodology was used to explore the experiences and coping strategies of six Gestalt trainee therapists and their work with trauma clients. Data was analysed with the aid of NUD*IST software computer package.

Results: The following themes emerged: impact of working with clients on the trainee; motivation to work as a therapist; supervision; training; and trainees coping strategies. It also revealed that all too often the cost of working with clients can be traumatic. The results have highlighted the importance of further exploring the impact on the therapist. Therapists who work with traumatised people require ongoing support; just as no survivor can recover alone, no therapist can work with trauma alone.

Conclusions: The risk of Vicarious Traumatisation on therapists cannot, and should not, be underestimated. The therapist's reactions, unless understood, contained and brought into awareness may lead to disruptions in the therapeutic alliance. The lack of insight into this phenomenon by the trainee therapist may have a huge impact on emotional and psychological health.

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Dr Kim Etherington

Professional Role: Reader in Counselling and Research and Senior Research Fellow
Institution: University of Bristol
Contact details: University of Bristol, 8-10 Berkeley Square, Clifton, Bristol BS8 IHH
Email: k.etherington@bristol.ac.uk

ABSTRACT: Paper

Understanding substance misuse: a life story approach

Short introduction: Substance misusers commonly disclose unprocessed trauma/abuse in treatment settings. Although often understood in terms of 'coping' there is little research that shows how people understand links between substance misuse and childhood experiences. This paper shows how counselling discourses have helped one woman make those connections.

Method: Life story methodology provides a full account across the length of a life whilst focusing on one particular aspect of lived experience. The data for this paper was gathered through an interactive interview that focussed on social, economic and gendered influences, showing how drug addiction occurs within the context of a person's life. It is one of a group of six stories gathered for a larger study.

Results: This presentation depicts the life of one woman's journey from 'drug addict' to 'drugs worker' and shows how counselling discourses have influenced her changing sense of identity.

Discussion points: By separating the person from the problem we can obtain a view of the person's relationship with the problem, thus enabling participant and interviewer to challenge notions of disease and pathology that might limit a sense of agency and power. By focusing on how experiences are interpreted by individuals within families, peer groups and institutions we can challenge some of the dominant cultural stories of 'addiction' and 'drug addict' and create new, perhaps more hopeful stories.

Impact: Stories make a difference by providing insiders' views of the richness and complexity of peoples' lives, in their own words, and make knowledge accessible to practitioners, clients and policy makers. The approach used for this study views substance misusers as 'experts' who can inform professionals about their needs and strengths.

This research is funded by the ESF and commissioned by the Southmead Drugs Project.

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Margaret Evans and Dr Paul McDonald

Professional Role (ME): Counsellor
Institution: University College Worcester
Contact details: Bromsgrove, Worcester UK
Email: margaret.evans@clara.co.uk

Professional Role (PM): Director of Studies, University College, Worcester
Institution: University College Worcester

ABSTRACT: Paper

Lesbian, gay and bisexual clients: relating to difference - some tensions

Aims:

  • To explore Lesbian, Gay and Bisexual(LGB) clients' perceptions of their counsellor;
  • To include clients where this is an issue in their families (i.e. parents);
  • To triangulate in a larger research study which will inform counsellor training.

Methods: Respondents were recruited by advertising and 'snowballing' from the LGB press, the counselling world and agencies, (e.g. FFLAG) and Pink Parents. Open-ended questionnaires explored clients' experience. 58 completed questionnaires, selected from a total of 62 (47 female, 15 male) were subjected to qualitative thematic analysis rooted in grounded theory, verified by four other researchers.

Results: Two thirds (38/58) of respondents felt they had a positive experience from their counsellor(s). Nine respondents felt theirs was negative; others expressed ambivalence. Tensions were evident around areas of difference such as sexual orientation and disclosure of this by client or counsellor. Some clients expressed frustration at being treated 'the same' as heterosexual clients, others did not want to be 'special'. Clients also raised counsellors' knowledge of and sensitivity towards LGB issues.

Conclusions: Participants described positive or negative experiences of counselling, dependent upon assumptions made by both client and counsellor, and counsellors' sensitivity and knowledge of sexual minority issues. Counsellors need to understand the implications of growing up LGB, and wary of making assumptions about, or focusing too much on, LGBlifestyles. The counselling world is taking this challenge seriously.

Future research: Linked research is ongoing and the results will be used to inform National Relate training.

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Sally Flatteau Taylor

Professional Role: Service Director
Institution: The Maypole Project
Contact details: The Maypole Project, 203-205 High Street, Orpington BR6 0PF
Email: sallytaylor@themaypoleproject.fsnet.co.uk

ABSTRACT: Paper

Between the idea and reality: a client-focussed study exploring the counselling experiences of bereaved people who sense the presence of the deceased

Background and introduction: Within bereavement there is a continuum of theories; from the idea of grief processing through stages to the relinquishment of relationships to the deceased, to those identifying ways in which bereaved people continue relationships to the deceased. For 50% of bereaved people this is shown to be through sensing their presence. This raised the question; which theories are perceived to be most helpful when integrated into counselling bereaved people?

Methodology: A qualitative research methodology was used to explore the narratives of bereaved clients who had sensed the presence of the deceased, including taped semi-structured interviews to focus on participants' stories of the death, and subsequent counselling experiences. Tape transcripts were condensed into themes and analysed. Gatekeepers made initial contact to ensure initial confidentiality, and that research criteria were met.

Results: The 10 participants (9 women, 1 man - white British) were from a wide range of backgrounds and experiences of death, and had 21 experiences of counselling. 3 themes were identified:

  • 12 counsellors were perceived to have dismissed or deflected their client's sense of presence.
  • 5 counsellors did not facilitate any exploration.
  • 4 counsellors facilitated full exploration.

Conclusions:

80% of the counselling experiences of participants in this research were perceived by them as unsatisfactory, and their experience of sense of presence of the deceased to have been dismissed, deflected or absent. An equal dissatisfaction was expressed at not having been facilitated in exploration of the 'new' reality of their world. This leads to the conclusion that a 'good enough' basis for counselling bereaved people may be more than the sum of any one theory.

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Nollaig Frost

Professional Role: Teaching Assistant/PhD Student
Institution: Birkbeck College
Contact details: School of Psychology, Birkbeck College, Malet Street, London WC1 7HX
Email: n.frost@bbk.ac.uk

ABSTRACT: Poster

Taking the other out of mother: a qualitative study of the transition to second time motherhood using narrative analysis

Background: Individuals frequently tell stories to impose meaning on their lives. This is particularly so when they have undergone important changes or when they perceive breaches between their real and ideal selves. These may also be times when they choose to enter counselling or therapy. An understanding of narrative approaches to listening to and hearing stories may enhance therapeutic practice.

Aim: To gain insight into individual perspectives of women making the transition from being a mother of one child to being a mother of two.

Method: Semi-structured interviews are used to interview four women from approximately six months pregnant with their second child until the child is nine months old. With the participants' consent, the interviews are tape recorded for transcription and analysis.

Discussion: The text is analysed for form and content using formal and informal approaches. Labov (1972) and Gee's (1991) formal linguistic approaches examine language by asking audience questions (what? who? then what? and so what?) and apply five levels of fine grained analysis. Informal approaches recognise difference by, for example, looking across the narrative for circularity and multiple endings (Gergen, 1992) or identifying poetic passages (Riessman, 1993). Becker (1999) suggests that this demonstrates that not all stories follow convention and thus challenges ways of listening.

Conclusion: The analysis allows alternative meanings in narratives to be identified. The narrator's words and meaning-making are privileged over story telling conventions. Rather than dismiss or ignore stories that are more chaotic or have hidden meaning, this research illuminates them. Understanding this may help therapists and researchers to consider their ways of hearing so that meanings otherwise lost can be understood. This enables research and practice to focus on ways of looking beyond the basic plot and on the listener's role in the narration, to better hear clients' stories.

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Dr Lynne Gabriel and Professor Sue Wheeler

Professional Role (LG): Lecturer and Practitioner
Institution: York St John University
Contact details: York St John University College, York
Email: l.gabriel2@yorksj.ac.uk

Professional Role (SW): Lecturer and Practitioner
Institution: University of Leicester
Contact details: University of Leicester
Email: sw103@leicester.ac.uk

ABSTRACT: Supervision Symposium

Research in action: a focus group researching the difference supervision makes
Research question: What difference does supervision make?

Please note: The focus group will involve up to 12 individuals, either supervisors or supervision researchers, who will be recruited by the group facilitators across the course of the conference. A few individuals will have the opportunity to nominate themselves on a 'first-come first served' basis. Up to 9 people (maximum number) are welcome to attend as observers only.
Background: The BACP's (Wheeler, 2003) scoping review of supervision research identified the lack of UK research. In response to this and feedback from membership, BACP's recently formed Supervision Working Party (SWP) has a brief to develop research in supervision. Both researchers are members of the working party and in forming the focus group at the BACP Research Conference want to engage in research to inform the work of the SWP, as well as making a contribution to the UK supervision research base.

Method: Focus group (1.5 hrs: taped). The focus group method will enable facilitated and focussed, yet unscripted discussion. It will be recorded for transcription and analysis to identify key themes that arise in the group discussions. The overall time frame is: 10 minutes preparation and 80 minutes for focussed discussion and debriefing.

Aim: In forming the focus group, the researchers will provide a context in which participants can explore in depth, critical incidents associated with supervision.

Examples of the type of questions/prompts that will be used in the focus group discussions include:

  • To what extent supervision inhibits my reflective practice and the development of my internal supervisor?
  • What I couldn't possibly tell my supervisor is...
  • What difference would it make to my practice if I didn't have supervision?

Key outcomes will include:

  • Participation in action research through attending and contributing to the focus group discussion
  • Rich data for qualitative analysis
  • Development of contemporary and provocative narratives on supervision status, content and process
  • Generation of research questions for quantitative, systematic inquiry.
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Dr Cordelia Galgut

Professional Role: Counsellor/Researcher/Supervisor
Institution: Self-employed
Email: cgalgut@insight99.plus.com

ABSTRACT: Poster

Lesbian clients' experiences of counselling and therapy

Background: This research explored 24 lesbian women's experiences of counselling and psychotherapy with practitioners espousing a variety of theoretical orientations.

Aims: The broad aim of this research was to ascertain the accuracy of claims that services offered to lesbians were falling short of a satisfactory standard. This aim was conceived because both previous research and anecdotal reports spoke of prejudice and pathologisation amongst therapists and a general lack of awareness of the needs of lesbians in therapy.

Method: A qualitative method of enquiry was used and a semi-structured interview format was adopted. In-depth questions were asked about participants' experiences of the process of therapy and the counsellors and therapists they saw. Data was then transcribed, from which compilations of emerging themes were done. From these, diagrammatic representations were created, which were used to write up the results.

Results: The results revealed seven themes which were defined as major (80% + response from participants) and on the basis of these results, conclusions were drawn and suggestions made about how services offered to lesbians by practitioners could be improved. For example, the particular need for explicitness from therapists, within the counselling relationship, was raised by all the participants, with the importance of therapists disclosing their sexuality mentioned by 83%. Also, 96% were concerned about heterosexual therapists' lack of awareness of lesbian lifestyle and culture, stressing the need for therapists to examine their own attitudes to lesbians, and highlighting the relationship between practitioners espousing positive attitudes to lesbians and a successful outcome for them in therapy.

Conclusion: These results, therefore, both confirm and augment the findings of existing U.K. research in this Professional counselling and psychotherapy organisations need to take note of the findings of this research, as do trainers and trainee practitioners.

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Patricia Goodspeed Grant and Helena Boersma

Professional Role (PGG): Assistant Professor
Institution: SUNY College at Brockport
Contact details: 350 New Campus Drive, Brockport, New York, USA 14420-2918
Email: pgoodspe@brockport.edu

ABSTRACT: Paper

Understanding obesity from the inside: lived experiences of participants in a weight loss clinic

Introduction: Despite the growing body of scientific research on obesity, there has been very limited success in the field of weight management. Given the magnitude of the problem, it seems evident that the current state of knowledge has not successfully captured some of the core issues faced by individuals, particularly deeper emotional factors.

Aims: The aim of this research was to understand the lived experiences of individuals struggling with obesity and weight loss.

Method: Van Manen's hermeneutic phenomenology guided this study of 11 adult men and women with long histories of obesity and weight loss attempts who were enrolled in a hospital weight loss clinic over a 6-month period. Lived experience is captured from a stream of consciousness through in-depth interviews, transcribed verbatim and analysed for themes. Meaning is co-constructed by the researcher and participants, applying hermeneutic analysis to interpret meaning from within the social context.

Results: Participants felt frustrated by their multiple failed attempts at weight loss, and exploitation by commercial programs. Identified themes included histories of stigmatization, childhood abuse, learning to use food as control, compulsive tendencies, and a cycle of emotional eating. Conceptions of the self and body image were tied to successful or failed attempts at weight loss.

Conclusions/impact: Deep emotional issues were a significant factor in sabotaging weight loss efforts. Participants wanted practitioners to know that losing weight is much more difficult than restricting food intake and exercising more. They experienced more success when programs included a personalized comprehensive program that included a physician, dietician, exercise physiologist, support group, and counseling interventions. Several participants entered therapy as a result of insights obtained through the interview process.

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Dr Stewart Grant

Other Author: Patricia Van Der Velde

Professional Role: Consultant Clinical Psychologist
Institution: Dumfries & Galloway NHS Board.
Contact details: Department of Psychological Services & Research, Francis Grove, Nithbank, Dumfries D1 2SA
Email: SUGrant@dg-primarycare.scot.nhs.uk

ABSTRACT: CORE Workshop Paper 2

Making sense of CORE system data: attrition, effectiveness, concordance and service delivery

Introduction: The paper describes a number of small studies conducted within our service using CORE and data from other sources to answer questions about our effectiveness. Questions included: how many and at what stages are clients dropping out of the system before the end of therapy?; how effective are we with the clients who complete therapy?; do clients and therapists agree about effectiveness?; and how can we improve data collection?

Methods: A one-year sample of our CORE data (1135 clients) was investigated and compared with data from our Psychological Management System. This yielded information on attrition effectiveness and concordance.

To improve data collection we set up two 'focus groups', one comprised of therapists who had collected the most data and one comprised of those who had collected the least data in the sample time period. Data collected from the six-week period following the groups was compared to the same six-week period from the previous year.

Results: The service loses contact with 23% of clients before the end of therapy. Although this number seems high this compares favourably with national benchmarks. 67% of clients demonstrated clinical and/or reliable change on the CORE outcome measure. There were interesting differences between clients' and therapists' perceptions of effectiveness. Conducting the focus group did have an effect on data collection.

Conclusions/impact: Services need to pay attention to the discrepancy between the number of clients they are referred and the number completing therapy. A systematic investigation of individual effectiveness can be built into supervision. High yielding data collection needs to be worked at and cannot be assumed to be happening 'automatically'.

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Jan Grove, Maureen Smojkis and Alistair Ross

Professional Role (JG): Lecturer in Counselling
Institution: University of Birmingham
Contact details: Centre for Lifelong Learning, Weoley Park Road, Birmingham University B29 6LL
Email: j.a.grove@bham.ac.uk

ABSTRACT: Paper

The relationship between learning styles and theoretical orientation in counselling training

Background: The learning styles of trainees have been researched in various helping disciplines with some interest in learning styles from the perspectives of counselling trainers (Dryden & Feltham, 1994; Connor, 1994). However, the experiences of counselling trainees have been under researched. Information from two cohorts from the three programmes (psychodynamic, integrative and brief solution focussed therapy), exploring influences on choice of theoretical paradigm was examined.

Aims: To explore trainee counsellors' choice of training, influenced by prior learning experiences and preferred learning styles.

Method: Completion of a Kolb Learning Style Inventory and a questionnaire identifying learning experiences resulting in 97 completed questionnaires analysed using qualitative and quantitative methodology.

Results: Using a chi squared test, learning styles and choice of course could not be shown to be associated. However, the patterns in the two cohorts were similar and if this were repeated in a third cohort then the overall result is likely to achieve statistical significance. Using grounded theory key categories emerged relating to specific learning experiences: negatively where the subject was taught with little opportunity for participation, and positively relating to group factors and group composition, and the opportunity to risk or experiment in a safe environment.

Significant themes emerged relating to the motivation for choice of course:

  1. meet personal needs (including self-awareness and personal growth)
  2. meet the needs of potential clients
  3. address their professional development
  4. the theoretical content of the course
  5. range and application of skills
  6. place of research and evidence based practice.

Significant variations between courses and learning styles emerged in each of the categories. Further data will be collected and analysed.

Conclusions: The interim results have impacted on the range of teaching methodologies and a review of selection processes. Joint research enriches team members through creatively working together across theoretical orientations.

References:

Dryden, W., & Feltham, C. (1994). Developing counsellor training. London: Sage
Connor, M. (1994). Training the counsellor. London: Routledge.

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Harold Heller

Professional Role: Therapist in independent practice.
Institution: Independent
Contact details: East Middleton Farm, Middleton St George, Darlington DL2 1AY
Email: harold.heller@virgin.net

ABSTRACT: Paper

What makes supervision effective? An interactional model

Background: The study (ongoing PhD) emerged from dissatisfaction with my own supervision experiences. As a supervisor I seemed to rely on a mixed bag of counselling theory supported by memories of good models; as a supervisee, I often felt passive and perplexed.

Aims: To illuminate the supervision process by seeking to explore underlying patterns and processes. I therefore developed an analytic set of categories to classify both supervisors' interventions and supervisees' responses. Patterns of intervention and response are assessed against a range of variables, such as theoretical orientation; quality of narrative and commitment to specific strategies, roles and styles. A major hypothesis has been to compare generic models of supervision, with those that derive from and are modelled on specific therapeutic approaches (often styled isomorphic models).

Methods: The methodology involves detailed analysis and decoding of transcripts of supervision sessions, using the Interactional Grid (4 Modes x 6 Strategies), together with the Rating Scale for Supervisees' responses. This allows a qualitative profile to be drawn up depicting the affective and cognitive development of the session. The narrative content of sessions is analysed and mapped against this profile.

About half of the planned total of 50 supervision sessions have been transcribed and coded. Half of these are a longitudinal series of the author's supervision with five therapists. The remainder comprise samples from different schools of practice (CBT; psychodynamic; integrative).

Results/conclusions: The Interactional Grid has the potential to be both a diagnostic and a developmental tool for supervisors. It scans the supervision dialogue to help explicate the habits and styles of supervisors and the strengths and limitations of different approaches to supervision. Results to date suggest that this process can discriminate critical patterns and key transitions in supervision, can indicate which interventions may be most helpful or limiting, and under what conditions. The analysis also captures patterns which characterise different models of supervision.

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Joanna Heywood and Dave Saxon

Other Author: Francesca Lemme

Professional Role (JH): Head of Service Primary Care Counselling
Institution: Sheffield Care Trust
Contact details: Clinical Psychology Northern General Hospital, Herries Road, Sheffield, S5 7AU
Email: joanna.heywood@sct.nhs.uk

Professional Role (DS): Project Development Officer
Institution: Sheffield Care Trust
Contact details: Specialist Psychotherapy Service, 299 Glossop Road, Sheffield S10 2HZ
Email: david.saxon@sct.nhs.uk

ABSTRACT: Paper

Who drops out? A quantitative study using CORE returns to investigate the predictors for non-completion of a primary care counselling contract

Background: A common issue for primary care services nationally are the group of clients who attend for an assessment interview, but then 'drop-out' before completing the offered counselling contract. The personal and resource implications of this behaviour may be large, with one third of clients of the service under study ending contact in this way. A number of suggestions have been forwarded regarding predictors of this behaviour, but little evidence has been gathered.

Aims: To establish a research quality database of Clinical Outcomes in Routine Evaluation Outcome Measures (CORE-OM) returns. To use that data to assess whether unplanned endings were systematically related to features assessed within the CORE-OM and Therapy Assessment Form. To review the implications for service delivery.

Method: This is a retrospective pragmatic study using routinely collected CORE returns gathered over 38 months from 13 counsellors working for 27 GP Practices in 2 Sheffield Primary Care Trusts, a population base of 250,000 patients. A research database on 1310 clients (aged 16 to 84) was established. A priori hypotheses were developed regarding unplanned endings. The data was transported to SPSS for statistical analysis of profiles. One example of a hypothesis tested was that the lower the congruence between the CORE-OM measure of risk and the counsellor perceived level of risk, the greater the risk of an un- planned ending.

Results: Initial analysis showed insufficient positive correlations to build a reliable profile of a 'drop-out' client. None of the a priori hypotheses developed from the literature were supported.

Conclusions: Analysis of the statistical data is currently continuing, however, there was no one client group that the service was reliably failing to engage. Proposals in the literature regarding the demographic or symptomatic profiles of 'drop-outs' are not supported.

The research gained Ethics approval from North Sheffield Research Ethics Committee and Clinical Governance Approval, and Funding from Sheffield Health and Social Research Consortium.

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Peter Jenkins and Dr Filiz Polat

Professional Role (PJ): Lecturer in Counselling/Research
Institution: University of Salford
Contact details: Directorate of Counselling and Psychotherapy, Allerton Building, University of Salford, Frederick Road, Salford M6 6PU
Email: P.Jenkins@salford.ac.uk

ABSTRACT: Poster

Counselling provision for young people in secondary schools in England and Wales

Background: Counselling in schools is currently provided by a wide range of organisations.

Aim: To carry out a survey of counselling provision for individual therapeutic counselling for pupils within secondary schools in England and Wales.

Method: A postal questionnaire was sent to a large random sample of secondary schools and to the population of LEAs in England and Wales. The questionnaire produced quantitative and qualitative data, analysed using SPSS for Windows.

Results: Responses were received from 607 schools (28% response) and 39 LEAs (22% response). The low response rates may reflect the lack of an easily apparent contact person, or a low priority given to providing information on this topic.

The findings need to be treated with caution, but suggest that three-quarters of secondary schools provide some form of individual therapeutic counselling via a patchwork of agencies. Patterns of referral and of confidentiality vary significantly. Funding is mostly from within the school budget. The survey reveals both a high level of support for counselling-related provision, but also the existence of a significant body of opinion within schools opposed to the development of counselling within the secondary school system.

Conclusions: The survey provides useful information about counselling provision in a fast developing and strategic sector. The weaknesses are the possible conflicting role definitions of counselling and global responses to key questions.

Potential impact: The research provides a snapshot of change, at a time when counselling in schools has received high profile government backing. This feeds into the debate about future services for children, regarding counselling provision within extended schools. In terms of practice, it identifies complex patterns of provision, and the need for this to be well-integrated within schools.

Funding: Grant of £10,000 from University of Manchester Research Support Fund

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Monika Jephcott and Jeff Thomas

Professional Roles: Chief Executive; Communications & Systems Director
Institution: Play Therapy UK
Contact details: Fern Hill Centre, Fairwarp, Uckfield TN22 3BU
Email: jefferyht@yahoo.co.uk

ABSTRACT: Poster

Making a difference with children: development of a quantitative research system for practitioners

Background: Surveys show that 20% of the UK's children have emotional and behaviour problems and 10% have mental health problems. The use of play therapy to alleviate these problems is an emerging discipline which is expected to grow rapidly due to government measures such as the Children's Bill and the NSF for Children's and Young Persons Health.

The efficacy of therapeutic play has been demonstrated through the use of outcome measures such as the Goodman's SDQ and others. However practitioners of therapeutic play use a combination of non-directive (child led) and directive based interventions and many 'tools' including art, drama, movement, music, sand play and therapeutic storytelling. There is no practice based evidence showing the relative effectiveness of each of these tools compared to the presenting problems.

Aim: To develop practise based evidence for play therapy.

Methods: A continuing programme of collecting data for practice based evidence and clinical governance was started in 2000 by PTUK using the Goodman's SDQ as the prime measuring instrument. The programme encountered similar problems to those experienced in the early implementation of CORE: attrition in the completion of post therapy measures, the inefficiencies of paper based systems and the motivation of the therapists to use the data.

PTUK requires its practitioner members to apply the principles of clinical governance. The decision was taken in early 2004 to develop a system (CMCGS) to integrate case management, clinical governance and research functions since much of the data collected is common. CMCGS is designed to export anonymous data to SEPACTO the UK's national database of play therapy clinical outcomes. Quantitative research data is derived as a valuable by-product of practice data. The design is based on well established management information systems principles, the comparison of potential, activities and results. The intention is to enable every practitioner to become a researcher. The system is currently in Beta testing.

Results: Work is in progress but the programme is intended to make a difference at two levels:

1. Improve individual and collective practice
2. Increase the credibility and adoption of play therapy and therapeutic play through improved practice based evidence

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Gill Jones and Anna Stokes

Professional Role (GJ): Director
Institution: Counselling Online Limited
Contact details: 1 Whitworth Lane, Milton Keynes MK5 8EB
Email: gilljones@campusonline.org.uk

ABSTRACT: Work in Progress Symposium

An online study to develop a framework for obtaining ongoing feedback from online clients

Background: As online counselling develops in the UK feedback from online clients is both desirable and necessary if best practice is to be achieved. This study seeks to encourage online counsellors to request regular feedback from their clients by developing a framework which can be used after every therapeutic encounter.

Aims: To develop a feedback framework which can be used regularly by online counsellors with their online clients.

Method: Counsellors who had completed some training with Counselling Online Ltd. were invited to discuss their views on feedback/evaluation using semi-structured interviews. These exploratory interviews were held in private chatrooms and the transcripts were analysed by the two researchers. A pilot research framework was subsequently developed and offered to a group of online counsellors who volunteered to use it for a two-month period. The researchers then asked the counsellors to provide data about their usage of the research framework and to evaluate it using a questionnaire. Further interviews would be held as necessary to clarify and/or augment their answers. Following analysis of these questionnaires and interviews a final research framework would be developed.

The researchers will discuss initial findings, with a view to modifying the framework further if necessary.

Conclusions: If a research framework is simple and effective it is more likely to be used by counsellors on a regular basis for ongoing feedback of their work.

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John Lees

Professional Role: Counsellor and Lecturer
Institution: The University of Greenwich
Contact details: The School of Health and Social Care, The University of Greenwich, Southwood Site, Avery Hill Road, London SE9 2UG
Email: j.lees@gre.ac.uk

ABSTRACT: Paper

Developing the research base of the counselling and psychotherapy profession

Background and Aim: The counselling and psychotherapy profession is a relatively new profession which is developing its research base. This investigation aims to contribute to the development of this research base.

Method: The method comprised three cycles of research based on the principles of transformatory reflexivity. First, an analysis of the methodological orientation of the research disseminated within the therapy profession in recent years in such journals as Counselling and Psychotherapy Research. Second reflection on the findings in the light of therapeutic theory. Finally, the construction of a hypothesis for the development and transformation of the research base of the profession.

Results: There is a tendency for the profession to be colonized by orthodox methodologies from sociology, psychology, social psychology and medicine. Second, analysis of these findings on the basis of Maslow's hierarchy of needs showed that the process of colonization is understandable and necessary for the survival and development of the profession. Finally, supplementing such methods with transformatory research methods based on the principles of clinical practice will create a healthy balance and further develop the identity and self-actualization of the profession. However, the findings arose out of a subjective interpretation of the data which constitutes a major weakness of the study.

Conclusion: A pluralistic balance of methodologies within the profession will further the aims of the BACP as stated in the Counselling and Psychotherapy Journal. Orthodox methodologies will strengthen the standing of the profession within society and promote counselling and psychotherapy as an efficacious method of therapeutic change. Transformatory research methods based on the principles of therapeutic practice will enhance the quality of clinical practice by encouraging practitioners to reflect on their work more rigorously as a result of promoting research awareness. The combination of both methods will enhance the work of the profession making a positive contribution to its future development.

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Clare Lennie

Professional Role: Lecturer in Counselling and Educational Psychology
Institution: Manchester University
Contact details: School of Education, University of Manchester, Oxford Road, Manchester M13 9PL.
Email: clare.lennie@manchester.ac.uk

ABSTRACT: Paper

The role of personal development groups in counsellor training

Background: Counselling training courses in the U.K. widely employ personal development groups as a method for developing the self-awareness of trainees. However, these groups are under researched and, possibly, poorly understood.

Aims: The research aimed to investigate the relationship between the personal development group and developing self-awareness, to learn something more of the experience of the group for counselling trainees.
Methods: Focus groups were used with a cross-section of 88 trainees of counselling (from the start of the Certificate training to the end of the Diploma), to identify factors that contributed to developing self-awareness in the group. Responses were used to develop a questionnaire measuring the trainees' perception of their own self-awareness (Connor, 1980) and the extent to which the contributory factors were felt to be present in their current Personal Development Group (the 'comfort fit').

Results: Trainees were more comfortable in the Personal Development Group at the start of their training and less comfortable at the end, no clear relationship was established between a better 'comfort fit' and increased self-awareness.

After further reflection, a second heuristic stage of the research attempted to uncover 'what was not being said' in the research and the Personal Development Group. Grounded theory analysis of focus group data, from a further cross-section of trainees, indicated a core category of inclusion and exclusion of the Self in groups (the counselling community, the Personal Development Group, the research focus group and the resulting 'refresher' group) and in the process of research.

Conclusions: The research focus groups acted as a 'refresher' for some trainees, facilitating their work in the Personal Development Group and are discussed in terms of communication in groups both in counselling training and research. Implications of the findings relate to issues of pluralism, researcher positioning and methodological stance in counselling research.

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Jane Macaskie and Helen Lacey

Professional Roles: Counsellors
Institution: Leeds Counselling (WPF)
Contact details: Leeds Counselling (WPF), Leeds Bridge House, Hunslet Road, Leeds LS10 1JN
Email: j.f.macaskie@leeds.ac.uk; helen.lacey@leedscounselling.org.uk

Abstract: Poster

Staff support: making a difference in schools

Introduction: This research evaluated two pilot projects run by Leeds Counselling (WPF), offering workplace support to school staff.

Research question: What difference does it make to the functioning of school staff to have a support service provided by an independent counselling agency?

Methods: 26 service users and 22 non-users completed CORE forms and qualitative questionnaires. Support workers and supervisors contributed to a focus group discussion. Semi-structured interviews were conducted with the head teachers. Qualitative data were analysed using grounded theory. CORE data were analysed using CORE System software to generate pre-and post-therapy scores and scatter graphs showing a range of outcomes.

Results:

  • CORE results showed a significant group of staff above clinical cut-off on pre-therapy measures; reduced scores were obtained post-therapy for most service users.
  • Questionnaires and interviews showed key themes including improvement in functioning, the importance of independent support and the contribution of group work to team building.
  • Focus group findings included the need for modifications by staff support workers to the therapeutic frame.

How has the research made a difference?

  • Both schools decided to continue the service.
  • 'Preventative' support was valued alongside crisis intervention.
  • These projects encountered resistance to acknowledging emotional needs, which ran counter to the prevailing culture. The findings enabled this resistance to be challenged.
  • The work challenged practitioners to work with different boundaries and to attend to organisational dynamics and clients' work with disturbed children. An understanding is evolving of how the dynamics of staff support differs from traditional counselling.

Implications for research and practice:

  • This contributes to thinking in an expanding area of community provision undertaken by Leeds Counselling (WPF). A longer-term outcome study is suggested.
  • Further research is suggested on the relevance of staff support for the reflective practice of school staff.
  • Practitioners' experience suggests a need to evolve a theoretical description of staff support.
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Karen Mackie

Professional Role: Counsellor Educator
Institution: University of Rochester
Contact details: Warner Graduate School of Education & Human Development, University of Rochester, Rochester, New York, 14627, USA
Email: karen.mackie@rochester.edu

ABSTRACT: Paper

Keeping faith: the negotiated professionalism of counselors in higher education work contexts

Introduction: Negotiating professional role in context of salaried employment takes on intensified salience for counsellors since it competes with core ideological commitments related to the work of helping clients.

Aim: This research attempts to bridge understanding of the counsellors' subjective focus on therapeutic work with their embeddedness in the challenging realities of institutional employment. My intent has been to explore how employment constructs and reconstructs counsellors' professional identity and agency in on-going and situated ways, as an aspect of theorizing specific features of therapeutic professionalism.

Methods: In depth interviews which inquired about counsellors' perceptions and enactments of their professional activity were conducted over a twelve month period with 40 counsellors in four year colleges in New York. Interviews were transcribed verbatim and analyzed for content categories and themes using grounded theorizing as the data analytic framework. Analysis proceeded inductively using the constant comparison approach to first understand the lived experience of the informants and then to generate preliminary theoretical constructs that might add a recursive dimension to the data interpretation.

Results: In response to interview protocol questions, counsellors identified resource constraint, increased constituent demand, forced role narrowing, economic efficiencies and leadership emphasis, as factors requiring active negotiation to preserve core professionalism. Tactical coping strategies, characterized by gender, career stage and training socialization also appeared.

Conclusions: This research uses qualitative study of counsellors' experience enacting their professional work to construct a preliminary, case based challenge to prevailing understandings of professionals and professionalism. Recognizing the dynamics of therapeutic professionals as employed workers and the negotiated nature of professionalism has implications for developing critical consciousness among counsellors about threats to professional sustainability without appreciation of systemic contradictions.

Discussion Point: While the perceptions and tactics of these counselling professionals are interpreted in detail, the manner in which therapeutic practice with clients is impacted as a result can only be inferred from the data at this point.

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Peter Martin

Professional Role: Programme Convener
Institution: Roehampton University
Contact details: Whitelands College, Roehampton University, Holybourne Avenue, London SW15 4JD
Email: p.martin@roehampton.ac.uk

Abstract: Workshop

Supervising troubled counsellors

Background: A key figure in the management of therapist crisis would seem to be the supervisor. But is this always the case? This workshop addresses the question "what is the nature of, and the value placed upon supervision during therapist crisis?"

Aims: Active exploration by workshop participants of these issues, based upon heuristic research of the presenter (Martin, 2001). This present inquiry indicates that:

  • While continued work with clients often provided a place of refuge from the life crisis for the counsellor, the supervisor has only a limited role in his or her estimation;
  • Dealing with practicalities, the influence of spiritual beliefs, and the importance of more therapy is more important;
  • The orientation of the counsellor affects expectations of the supervisor.

Practical implications concern the supervisor's residual role in relation to the supervisee. Simple applications of ethics and of "fitness for practice" are unhelpful. Rather, a co-operative endeavour is required in which the two partners reach a revised intersubjectivity. Such conscious intersubjectivity mediates the therapist's safe stance in relation to his or her client. Further research should include an expansion of the methodology of heuristic inquiry. The question is whether this phenomenon is not for "essence", but for the location of creative intersubjective meaning for the supervisor, the therapist and the client during times of personal crisis.

Workshop activity: Exploration of how conflicting forces such as personal need and ethical commitment to the client can be acknowledged and used by the skilled supervisor in facilitating a new intersubjectivity. The received wisdom that the normative and restorative roles of the supervisor are the most significant in this situation is questioned.

Conclusion: The workshop will end with a series of provocative questions that the therapist can use to shake rigid thinking when they next need to support a distressed counsellor in an ethical, sensitive and professional way.

References:

Martin, P. (2001). The therapist as a person. Counselling and Psychotherapy Journal, 12, (December No. 10): pp.10-12.

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Jenny McBride and Kirstie-Ann McNaughton

Other Author: Jane Boyd
Professional Role (JM): Consultant Clinical Psychologist
Institution: Cardiff & Vale NHS Trust
Contact details: Psychology and Counselling Department, Whitchurch Hospital Whitchurch, Cardiff CF14 7XB
Email: Jenny.McBride@CardiffandVale.wales.nhs.uk

ABSTRACT: CORE Workshop Paper 3

Using CORE data in clinical supervision: an initial exploration

Question: What are the main themes which emerge from counsellors and supervisors in relation to introducing the results of individual practitioner CORE outcomes in supervision?

Introduction: Our service has been using the CORE system (Clinical Outcomes in Routine Evaluation) to evaluate its primary care provision since June 2000 and has used CORE-PC. To date we have a total dataset of over 4,500 clients; several practitioners have expressed interest in receiving personal feedback on their past and future contribution to therapeutic outcomes comprising the overall service profile.

Method: Themes in introducing CORE data in supervision were identified from a focus group meeting which included representatives of the service and audit structure. Questions arising from the themes were identified and used in three focus groups comprising of:

1. Supervisors
2. Counsellors who 'opted -in' to use of CORE in supervision
3. Counsellors who 'opted out' of using CORE in supervision

Using an informal qualitative analysis approach, participants were asked to offer their views on predominant themes identified using a SWOT grid as a framework for responses.

Results: Results will be presented from the three focus groups in the form of a SWOT grid which will represent views from those engaged and not engaged in using CORE data in the supervision process.

Conclusions: The results will also inform the design of a questionnaire to include all practitioners' views. This will inform best practice through a pioneering process of supported individualised practitioner self-audit. The process is inherently client-centred in introducing systematic feedback in supervisory practice and sharpening the focus on client reported outcomes. It is anticipated that this will improve effectiveness of service delivery.

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Barry McInnes

Other Author: Shane Buckridge

Professional Role: Counsellor/Service Manager
Institution: Royal College of Nursing
Contact details: 20 Cavendish Square, London W16 0RN
Email: barry.mcinnes@rcn.org.uk

ABSTRACT: CORE Workshop Paper 1

Using CORE system to make a difference to service management and development: an experiential account

Introduction and aims: The Royal College of Nursing counselling service has used the Clinical Outcomes Routine Evaluation (CORE) system to evaluate its provision since 1999, and CORE-PC since 2001. To date we have a dataset of around 2,500 clients. This paper presents an experiential account of the development of our use of the CORE system data and addresses the question:

What impact has the systematic collection and analysis of service quality evaluation data had on individual practice and wider service delivery?

Method: CORE system data has been used since 1999 to monitor overall service performance and quality. Since 2001 counsellors have been equipped with CORE-PC software, allowing access to their own and service performance data. Data are now routinely analysed to monitor service quality and track changes over time, and key quality indicators are benchmarked both internally and externally to assess service and individual practitioner performance.

Results: Analysis of CORE system data has highlighted a number of key areas of service strength and weakness. These have included differences in client and counsellor rated levels of risk, and variations across practitioners in areas such as session attendance, therapy endings and client change. These findings have informed changes in the service's approach to risk management and a more systematic framework for service quality improvement, including development of quality targets and use of CORE data in counsellor appraisal and development.

Conclusions: Use of CORE system data has led to changes in service delivery and its approach to service quality. This process is ongoing, and has presented challenges for both practitioners and the service manager. Routine evaluation of this type, however, has the potential to influence individual practice and service delivery positively, to the benefit of practitioners and clients alike.

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John Mellor-Clark

Other Presenters: Barry McInnes, Stewart Grant, Jenny McBride, Kirstee-Ann and Geoff Mothersole

Professional Role: Director CORE IMS and Visiting Senior Research Fellow
Institution: CORE IMS and University of Leeds
Contact details: CORE IMS, 47 Windsor Street, Rugby, CV21 3NZ
Email: john@coreims.co.uk

ABSTRACT: Overview of CORE Workshop

Using CORE to make a difference to service delivery, management and continuing professional development

Introduction and aims: This workshop presents a panel of four papers that collectively profile and explore the impact of introducing the CORE System on service delivery, management and supervision. Drawing on the combined experience of four senior NHS managers over the last five years, and from data for over 11,000 clients, a series of interlaced question explore:

  • The impact of introducing CORE as a routine clinical outcomes information system on practitioners and managers
  • The challenges exposed by routine clinical outcomes data
  • The potential utility of routine clinical outcomes data in practitioner/supervisor relations
  • The potential utility of routine clinical outcomes data in practitioner/manager relations - given the right environment

Whilst each paper is designed to stand alone for those that want to dip-into one of the range of pluralistic accounts, the richest yield will be for those that follow these managers' experiences as they unfold over the course of the day.

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Nicky Mitchell

Professional Role: Counsellor
Institution: University of Portsmouth
Contact details: Counselling Service, Dept. for Curriculum and Quality Enhancement, Nuffield Centre, University of Portsmouth, St Michael's Road, Portsmouth. PO1 2ED
Email: nicky.mitchell@port.ac.uk

ABSTRACT: Work in Progress Symposium

Attitudes towards computerised cognitive therapy (CCBT) self-help for depression amongst a student population

This study will examine the relevance to university students of a computerised cognitive-behaviour therapy (CCBT) self-help package for the treatment of mild to moderate depression. It aims to identify individual differences in students' attitudes towards CCBT, namely in its credibility, acceptability, the likelihood of it being used if depressed and its comparative popularity.

CCBT self-help packages have been used within the NHS by people with difficulties including depression, panic attacks and bulimia nervosa. Preliminary outcome studies have been conducted but little information exists on users' attitudes to CCBT, whilst these may be significant to uptake and outcome. Use of CCBT within Higher Education has not yet been documented. The notion of 'stepped-care', where less intrusive, accessible treatments such as self-help are offered first to people with milder difficulties, may be relevant within Higher Education. Increasing numbers of distance-learning students may also point to the potential helpfulness of CCBT, if available remotely. Most students have access to computers and many may already use the Internet to source mental health information. CCBT may be credible to many students, may add quality control to the sourcing of such information, and may overcome some current barriers to accessing help.

Attitudes towards an intervention may be related to factors such as personality, learning style, cultural background, gender, and information about the intervention. This study will explore possible relationships between (a) health locus of control, (b) self-efficacy, (c) learning style, (d) attitudes towards seeking psychological help, and attitudes towards CCBT. It will also examine which of these variables best predicts a favourable attitude to CCBT. The aim is for 100 students to complete questionnaires measuring these variables. 20 of these students will then be given a brief demonstration of a CCBT CD-ROM, before attitudes are again measured, in order to measure any effect of such exposure on attitudes towards CCBT.

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Geoff Mothersole

Professional Role: Consultant Counselling Psychologist
Institution: Adur Arun and Worthing Primary Care Counselling Service
Contact details: Dept of Psychology, 16 Liverpool Gardens, Worthing. BN11 1RY
Email: geoff.mothersole@wshsc.nhs.uk

ABSTRACT: CORE Workshop Paper 4

Using CORE data in service management: creating the right environment

Introduction, Aims and Methods: Our service has been using the Clinical Outcomes Routine Evaluation (CORE) System to evaluate its primary care counselling provision since 2000, and has used CORE-PC since April 2002. Todate we have a dataset of around 3,000 clients.

For the past two years we have been exploring ways of using CORE System data to make a difference to overall service quality, particularly in the areas of enhanced risk assessment and performance monitoring. We have implemented a number of action research methodologies including focus group sessions, questionnaire studies, and pilot innovations to explore ways of engaging practitioners with the data generated by the CORE-PC system.

Results: Following an initial CORE System data presentation profiling trends in the development of our service quality, results will be presented to sequentially explore:

  • Counsellors' experience of using CORE and our in-house risk guidelines
  • the use of CORE in professional development and performance management
  • influential factors in the creation of a service culture that is conducive to productive use of CORE data
  • the central importance of appropriate leadership, ownership and stakeholder relations.

Conclusions: Our experience suggests that CORE can be a central tool in service management, and that it has great potential in providing data for reflection and professional development. Care needs to be taken over the way that it is introduced and used.

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Angie Naylor

Professional Role: Lecturer and Counsellor
Institution: Edge Hill College of Higher Education
Contact details: Edge Hill College of Higher Education, Dept. of Social & Psychological Sciences, St. Helens Road, Ormskirk L39 4QP
Email: naylora@edgehill.ac.uk

Abstract: Poster

The concept of change in therapy: a play therapy case study

Introduction: The research explores the concept of change within a non-directive play therapy setting. The process of change itself is a difficult concept to define or explain and within the field of play therapy this is especially under-researched. The research question evaluates the emotional and behavioural changes in a child from the beginning to the end of therapy.

Method: The method is of a qualitative case study design, focusing on a 9-year-old female who attended play therapy over the course of 12 sessions, following family difficulties. A grounded theory approach was adopted in order to draw categories from the transcribed sessions themselves. 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.

Results: Findings from the grounded theory analysis indicated that several elements change in both context and value throughout the course of sessions. The child indicates patterns of change throughout several key elements including elements of play, aggression, attachment and relationship with therapist.

Conclusion: 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. This research hopes to provide the basis for a future model of therapeutic change. Clearly, greater understanding of this concept will inform and improve practice and training, and will educate wider communities.

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Sue Parker Hall

Professional Role: Psychotherapist & Lecturer
Institution: Cornwall
Contact details: 25 Spernen Close, Carbis Bay, St Ives, Cornwall TR26 2QT
Email: sueparkerhall@btconnect.com

ABSTRACT: Poster

Presenting models of anger and rage and their impact on therapists

Background: Anger and rage are issues which therapists can struggle with both personally and professionally. I have developed models to support discussion and understanding of these phenomena and the choosing of appropriate interventions.

Aims: Research question was 'how do my models of anger and rage impact on therapist's understanding of these phenomena and influence their practice?'

Methods: In order to explore the research question I ran a one day 'Anger, Rage & Relationship' workshop for therapists and used qualitative methods to understand its impact. Data used for analysis were the end of workshop verbal feedback and structured evaluation questionnaires of fifteen participants, three of whom were later interviewed using a partly structured interview inviting them to reflect on each of the 6 models and an unstructured part to reflect on wider issues.

Results: Themes that emerged were: that all the models introduced were useful or very useful, a rare opportunity for frank discussion about the issues featured strongly; becoming clearer about therapist's personal relationship with anger and rage; and how this impacts on practice, relational approach as reassuring and a simple response to what had previously been thought to need complex interventions and unprocessed personal rage was identified.

The three post workshop interview participants generated examples of using the models in their practice. One therapist shared the 'positive aspects of anger model' with a client who immediately then connected with hitherto unexpressed anger; one therapist had utilised the concept of 'cold rage' which enabled her to be more patient and warmer with her client; and the third therapist kept in mind the 'processing old resentments' model which supported her client to connect with underlying hurt.

Conclusions: The models support therapists to explore and analyse personal experience and client work, and support them in formulating interventions. Also helpful though, was the opportunity to discuss these issues frankly with others.

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Dr Sue Pattison

Professional Role: Director of Counselling Programmes, Lecturer, Counsellor and Counselling Supervisor
Institution: University of Newcastle upon Tyne
Contact details: School of Education, Communication and Language Sciences, University of Newcastle upon Tyne, Joseph Cowen House, St Thomas Street, Newcastle upon Tyne NE1 7RU
Email: susan.pattison@ncl.ac.uk

ABSTRACT: Paper

Making a difference for young people with learning disabilities: a model for inclusive counselling practice

Background: The prevalence of mental health problems in young people with learning disabilities and the need to conform to human rights legislation form the backdrop to this research study.

Aims: To identify how inclusive counselling is of this client group; to gain insight into inclusive and exclusive practices; to identify strategies to increase inclusivity and to put forward a model for inclusive counselling practice.

Method: Mixed methodology provides quantitative and qualitative data: this research included a survey of counsellors (n=396) listed in the BACP Directory (2001) and a series of semi-structured interviews (n=15). SPSS was used to analyse the quantitative data and a thematic approach using techniques from grounded theory was taken to analyse the qualitative data. The hypothesis tested was that counsellors can increase the inclusion of young people with learning disabilities in their practices.

Results: Results indicate four levels of inclusivity (never, rarely, sometimes, often) and that inclusion is a process. Six indicators of inclusive counselling are identified and used to build a model for inclusive counselling practice: a proactive approach to inclusion; a focus on building relationships; operationalising equal opportunities policies; inclusive initial assessments; adopting flexible and creative approaches to counselling and training and awareness raising.

Conclusions: The hypothesis that counsellors can increase their levels of inclusivity regarding this client group is upheld. The implications for research and practice are to acknowledge the exclusive nature of the profession and address the issue of inclusion through training, professional development and further research in the field. The model for inclusive counselling practice is put forward as a tool for assessing existing counselling practice and as guidance for counsellors and policy makers in increasing inclusivity of young people with learning disabilities in mainstream counselling. The model will also form part of a further research study.

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Rosanne Pearce

Professional Role: Counseller
Institution: The Holistic Centre
Contact details: The Holistic Centre, 5A Devonshire Road, London W4 2EU
Email: rpfisco@aol.com

ABSTRACT: Paper

Therapeutic risk-taking: an investigation into the role and effects of risk-taking by counsellors in the therapeutic process, with emphasis on the person-centred approach

Background: Mearns, Thorne, Merry, Schmid and others have alluded to the treacherous waters around the core condition of congruence. Yet, as these and other writers have also suggested, we are most helpful when we are risking ourselves as individuals in the relationship.

Aims: To explore the nature and effects of therapeutic risk-taking to see if there is a correlation between the levels of risk in the interaction between client and counsellor and evidence of a thriving relationship which is perceived by both as being 'fully alive' and empowering for the client.

To identify types of risks being taken; to explore the perceived effects and consequences of the risks described and the motivations for them and to investigate counsellors' attitudes to risk-taking in relation to their own personal and professional development.

Methodology: A qualitative study over one year combining phenomenological and hermeneutic approaches. Primary data was obtained from semi-structured interviews with eight counsellors (Person-Centred or Integrative) in a variety of organisational/agency settings. Interviews were tape-recorded and transcribed.

Results: Whilst the research highlighted some pitfalls encountered by counsellors when taking risks with conveying congruence, it also showed that a critical moment of risk-taking often led to a more authentic relationship in which the client reached a deeper level of revealing. Variables impacting on the process included the level of trust established in the ongoing relationship, and the immediate level of contact at the moment of risk-taking. All participants felt that risk-taking was an element which had either been ignored or actively discouraged during training.

Conclusions: The research identified critical variables which can provide a relational map to assist counsellors in meeting the challenge of navigating the therapeutic waters around achieving and conveying congruence.

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Dr Abdul Malek Rahman

Other Author: Nazariah Ab Samad

Professional Role: Lecturer
Institution: Counselling Department, Universiti of Pendidikan Sultan Idris
Contact details: Universiti Pendidikan Sultan Idris, Tanjong Malim, Perak, Malaysia 35900
Email: a.malek@upsi.edu.my

ABSTRACT: Paper

The effectiveness of cognitive behaviour group counselling on bullies amongst the secondary schools students in Malaysia

Aims: The incidence of bullying is a serious phenomenon among secondary school pupils in Malaysia. We conducted an experimental study to assess the effectiveness of structured group counselling, using a phenomenological-cognitive behavioural approach, on pupils who were bullies. Two types of group counselling were developed, 'the weekly group counselling' and 'the marathon group counselling'. The effectiveness of group counselling in reducing bullying behaviour was measured using four self-report scales related to bullying behavior, empathy, aggressiveness and self-esteem.

Methods: The subjects (n = 48), comprising of Form 2 and Form 4 pupils, were randomly assigned to two Form 2 and two Form 4 experimental groups and two wait list control groups. Subjects were administered the pre- and post- tests for the four self-report measures. Treatment consisted of weekly group counselling and marathon group counselling. Altogether experiment group subjects received 11 counselling sessions of two-hours duration per session, over six weeks.

The treatment focussed on developing new belief systems and building empathy through cognitive restructuring and role-play. Statistical analyses used to analyse the experimental data were, Multivariate analyses of covariance-Mancova, and Post Hoc-Tukey.

The Mancova was used to analyse the data for the pre and post-tests, with the pre-test data serving as the covariates and the post-test data serving as the variates. The Post Hoc-Tukey was used to analyse the differences in the treatment's effects between the two types of group counselling. The significant level was set at .05.

Results: The study showed that the cognitive behaviour group counselling based on the integrated model of phenomenological-cognitive behavioural approach was significantly effective in: i) reducing the bullying behaviour and aggressiveness of all the subjects; ii) increasing the empathy of all subjects; iii) increasing the self-esteem of Form 2 subjects. However, it had no significant effect in increasing the self-esteem on Form 4 subjects.

Conclusion: Groups counselling can help reduce bullying while increasing the empathy of bullies.

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Christine E Ramsey-Wade

Professional Role: Trainee Counselling Psychologist
Institution: School of Psychotherapy and Counselling
Contact details: Regent's College, London
Email: chriserw@ukonline.co.uk

ABSTRACT: Work in Progress Symposium

On being a university student in therapy: student client views on how therapy can help

Background: Historically, the client's experience of therapy has not featured centrally in psychological research. Research into student mental health shares this past bias towards the practitioner's viewpoint. While some research has been carried out into the process and outcome of therapy within some university counselling services, more is needed.

Aims: This study aims to explore further the experience of undergoing therapy, as well as the experience of undergoing therapy and a university degree at the same time. Specifically, this study will seek to discover students' views on what impact, if any, undergoing therapy while studying has on their efforts to adequately complete their degree.

Method: In order to capture the students' experiences, a qualitative, phenomenological research design has been employed. Eight co-researchers with experience of undergoing therapy while studying for a degree are being recruited by letter for semi-structured interviews. The interview material will be analysed using Interpretative Phenomenological Analysis, in order to ensure that the distilled themes remain true to the participants' material.

Results: Themes which have already arisen from the first four interviews are around driving factors and obstacles to seeking therapy, how clients feel therapy works, their experience of therapy, its outcomes, and how therapy assists students with their studies. This presentation will provide more detail on the themes that emerged from the interviews as well as describe further the design, analysis and results.

Conclusions: Possible implications from this exploratory study for practice within university counselling services and for our understanding of how therapy works generally will be discussed.

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Andrew Reeves

Other Authors: Sue Wheeler and Ric Bowl
Professional Role (AR): PhD Researcher/Counsellor
Institution: University of Liverpool / University of Birmingham
Contact details: University of Liverpool Counselling Service, 14 Oxford Street, Liverpool
Email: A.Reeves@liverpool.ac.uk

ABSTRACT: Paper

Training counsellors to integrate suicide risk assessment into the counselling process: developing and evaluating training resources

Introduction: UK policy surrounding mental health development and service delivery emphasises the need for practitioners to respond effectively to suicidal clients. Targets have been set to reduce the numbers of completed suicides by one fifth by 2010. Thus therapists need to be competent and confident to assess suicide risk with vulnerable clients. However, how or whether therapists are equipped by their core training experiences to undertake such assessments is unclear (Reeves et. al., 2004).

Aims: A one-day training workshop was designed for counsellors to focus on therapeutic and practice considerations when working with suicidal clients. This study evaluated the usefulness of that workshop to determine how counsellors could be supported in their work through the use of time-limited training.

Method: Twelve workshops were presented which were attended by 118 counsellors across a range of practice settings. All participants completed a written evaluation immediately following the workshop whilst 59 counsellors participated in semi-structured group interviews four months later. Verbal data was transcribed and analysed by the principal researcher using a qualitative thematic analysis. Inter-rater reliability was tested by a second researcher not otherwise involved in the project.

Results: The results indicated that counsellors felt more able to integrate suicide risk assessment skills into their theoretical framework following time-limited training. Experiential learning rather than formal teaching was preferred, which allowed for exploration of personal and professional responses to suicide. Learning points included the implications of organisational policy on practice, record keeping, self-care and ways of exploring suicide with vulnerable clients.

Conclusions: The study highlighted implications for the development of organisational policy regarding suicide and the place of social policy within a therapy teaching curriculum. Differences in how theoretical orientations view assessment within therapy and how that influenced approaches to working with suicide risk were noted. Time-limited training on suicide appeared to be of significant value to participating counsellors.

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Barbara Richards†

Professional Role: Director of Counselling Course
Institution: University of Reading
Contact details: School of Health and Social Care, Bulmershe Court, University of Reading, Berkshire RG6 1HY
Email: b.m.richards@reading.ac.uk

ABSTRACT: Work in Progress Symposium

When two worlds collide: the emotional impact upon professionals of working with suicidal people

Introduction: This project constitutes my PhD and is work in progress. Little is known about the effect upon professionals in the front line of caring for suicidal people. Psychoanalytic understandings may inform the practice of some mental health teams, however, there is a 'knowledge gap' regarding the psychological impact of such work upon professionals such as GPs, ambulance staff, nurses, hospital doctors and police officers. These people are regularly called upon, as a part of their job, to respond to suicide and suicidal people. What this does to them remains unknown, but it may be that we see some of the effects in terms of ill health, depression etc. Greater knowledge may enable professionals to be better prepared; to have greater understanding with regard to the difficult feelings that are evoked within them and to know how to take care of themselves in a psychological way.

Methods: Gaining ethical approval to work with the five professional groups named above has been a feature of this research to date and has raised issues with regard to the feasibility of research within the NHS in particular. A questionnaire has been developed for the purpose of the research. This has been piloted amongst a small group from each of the five groups and following this it has been circulated to 415 participants overall. A second phase will consist of more in-depth exploration of a smaller number of case studies.

Results: Analysis is at a very early stage and is in progress.

Results/Conclusions/Impact: It is hoped this work will inform policy development with regard to the training and support of professional groups in the sample, and other groups involved in similar work, and to assist professionals in their own reflection upon their experiences.

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Dr Gella Richards

Professional Role: Chartered Psychologist
Institution: University of Roehampton
Contact details: University of Roehampton, School of Human and Life Sciences, Whiteland's College, Holybourne Avenue, London SW15
Email: G.Richards@roehampton.ac.uk

ABSTRACT: Paper

Effective counselling and therapeutic cross-cultural relationships

Background: Whilst recognising that ethnic matching should be available for ethnic minority clients, there is growing material to suggest that many cross-cultural counselling dyads can be of benefit to ethnic minority clients. Such a dyad can have beneficial effects for both counsellor and client and in some cases can be more effective than ethnic matching.

Aims: To report on preliminary findings on cross-cultural counselling outcomes and to compare these with therapeutic outcomes when ethnic matching occurred.

Method: An independent design was used which compared the counselling outcome for ethnic minority clients who received ethnic matching and those who received cross-cultural counselling (independent t-tests). The retention rate (i.e. length of time in therapy for their clients) of both ethnic minority counsellors and White counsellors was also compared as was premature termination of their clients from ethnic minority and White ethnic groups (n=104).

Results: The results showed that there were no significant differences between ethnic minority counsellors and White counsellors in their ability to retain ethnic minority clients. In addition there was no difference between the two groups of counsellors (Black and White) in the rate of premature termination of counselling amongst their ethnic minority clients.

Conclusions: This research has made a difference because it qualifies much cross-cultural counselling research that seemed to indicate that ethnic-matching provided the most effective conditions for ethnic minority clients. These results demonstrate that there are White counsellors who are able to apply their skills in the therapeutic relationship to provide an appropriate therapeutic service when working cross-culturally. Hence one of the clinical implications is the need to identify the components that contribute to the 'extra-something' skills that enable certain White counsellors to work effectively in cross-cultural therapeutic dyads.

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Dr Maggie Robson

Professional Role: Lecturer in Counselling
Institution: Keele University
Contact details: Keele University, Keele, Staffordshire ST5 5BT
Email: m.a.robson@psy.keele.ac.uk

ABSTRACT: Work in Progress Symposium

What is the experience of personal development groups?

Introduction: As a counsellor trainer I have always been fascinated by the power of the personal development group (PD) in enhancing self-awareness and self-exploration. For some students, the PD group appears to be the most powerful experience of their counsellor training. For others they never really seem to understand or engage in its purpose. This research proposes to capture the experience of being a member of a PD group and will ask participants to reflect upon this experience.

Method: Two PD groups have agreed to keep a journal of their experiences in PD from January to March '05. One group is a Certificate group in their first year of counsellor training (no.=16 (including 3 facilitators)). The second group are first year Diploma students in their second year of counsellor training (no.=9 (including a facilitator)). These present groups were formed in September '04.

The journals will be collected and the data analysed following Interpretive Phenomenological Analysis (IPA) guidelines (Smith, 2004) by:

  • Looking for themes: reading the transcript many times and making notes on what is interesting or possibly significant in what the respondent has said
  • Connecting the themes: writing emergent themes down and looking for connections between them
  • Checking the clusters against the manuscript: themes are checked in the transcript to make sure that they are true to the original source material
  • Produce table of themes: The clusters of themes are given a name and details of where they can be found in the transcript
  • Continuing analysis with other cases.

Results: In progress

Discussion: Evaluation of the methodology and implication of results for counsellor training.

Conclusions/impact:

  • How has this research made a difference
  • Do the results of this study make a difference to how we use PD groups in training settings?
  • What are the implications for practice and research?
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Alistair Ross

Professional Role: Counsellor & Trainer
Institution: Centre for Lifelong Learning, Birmingham University
Contact details: Centre for Lifelong Learning, Weoley Park Road, Birmingham University B29 6LL
Email: j.a.ross@bham.ac.uk

ABSTRACT: Paper

The nature of spirituality in contemporary British counselling and psychotherapy

Background: Spirituality has emerged as a significant area in counselling and psychotherapy in Britain, seen in contributions to the Counselling and Psychotherapy Journal.

Aims: To explore how counsellors and psychotherapists describe their spiritual understanding and what factors contribute to their spirituality.

Method: Three conferences of counsellors, psychotherapists and pastoral carers completed a questionnaire identifying six definitions of spirituality and 36 categories of spiritual experience. One hundred and seventy questionnaires were distributed and fifty-two returned. The variable response rates of participants at each conference (28%, 32% and 37%) could be explained by the length of time the researcher was at the conferences.

Results: The results were grouped according to theoretical orientation and show that at least 50% of person-centred and psychodynamic counsellors adhere to 'a specific belief system in a Divine Being that can be encountered in a direct way leading to spiritual growth or wholeness'. This figure rises to 74% for integrative counsellors. A detailed analysis of categories of spirituality is currently underway to provide a more nuanced picture of spirituality.

Conclusions: This research indicates that a large percentage of counsellors have a spiritual belief in a Divine Being. This helps explain why spirituality has become a significant area for counselling as a profession, where spirituality is seen as an issue of difference that needs addressing. Theoretical orientation does make a difference and a significantly larger percentage adopting an integrative therapeutic belief system suggest that someone with spiritual or religious belief system may adopt a therapeutic belief system in which there is room for a degree of integration. Further research with a larger sample and higher response rate would add to these initial findings and contribute to the wider debate within counselling about spirituality.

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Lindsay Smith

Professional Role: Joint Head of Programme
Institution: College of York, St John
Contact details: Counselling Studies College of York, St John Lord Mayor's Walk, YorkYO31 9JX
Email: 1.smith2@yorksj.ac.uk

ABSTRACT: Paper

The listening project. A quantitative study: what effect does listening to individual children have on learning?

Background/Aims: Developing listening skills is a focus for primary educators as a contribution to educational success. This study examines how these skills are learned and how a child's experience of being listened to may contribute to their development.

Methods: Voluntary individual, half-hour listening sessions with a Listening Partner were offered with parental permission to 35 children of 5 - 11 years for ten weeks. The adult listeners were third year undergraduate Counselling students, all of whom had a two year grounding in Counselling Theory & Practice and a minimum of 100 hours of counselling skills training. Educational progress and behaviour was measured against a control group. The study used quantitative methods to analyse results using standardised tests and teacher assessments. The college research committee gave ethical approval.

Results:

  • Eleven per cent of children in the participant group disclosed a child-protection issue that required follow-up. This level of disclosure was unprecedented in the school and there was no similar disclosure from the control group.
  • Teachers assessed 40% of the participant children as improved in talking and listening in lessons. Average scores in the standardised listening test, and in progress scores in Maths Reading and Writing were higher than in the control group.
  • Results and teacher assessments of effects on relationships, behaviour and talking/listening in peer group indicated no change in these areas of development.

Conclusions: The focussed attention of a trusted adult enabled children to communicate more effectively notably disclosing child protection issues. Developing the counselling skills of adults in school may protect children better. Increasing the opportunities for children to experience being listened to positively affected their educational achievement. Skilled listeners have a significant effect on children's learning and well being.

This research was funded by the College of York St. John Research & Enterprise Group.

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Dr Jane Speedy

Professional Role: Senior Lecturer
Institution: University of Bristol
Contact details: Graduate School of Education, University of Bristol, 8-10 Berkeley Square, Bristol BS8 1HH
Email: jane.speedy@bristol.ac.uk

ABSTRACT: Paper

Consorting with gargoyles: the place of mythical creatures in methodological innovation and the creation of research training environments

Introduction: Arts-based methods continue to make inroads into the domains hitherto regarded as 'social science'. There is a growing tradition of fictionalised research, particularly within educational settings, not least as a means of re-presenting research that would not otherwise become available within public domains (e.g., Clough, 2002). This paper is presented within the genre of 'creative scholarship' and is an account of the author's interest in the gargoyles that first appeared in her life when she began to work at one of the UK's leading research universities. This relationship paralleled the author's development as a researcher, writer and scholar.

Overview of methods: Two short narratives are used as illustrative data. One describes the changing shape and position of gargoyles within the author's counselling supervision practice over time and one depicts a creative relationship with time, space, place and narrative that was sustained by the gargoyles who infiltrated a recent research text on 'comparative learning narratives' (Speedy, forthcoming) and allowed the unsaid and the unsayable to gain a fictional voice.

Results: These stories illustrate the ways in which mythological characters can open windows onto territories that researchers would not normally inhabit. Magical, marginal creatures perhaps adhere to different research frameworks. In particular they may indulge in eavesdropping and gossiping and interfering with other people's data and presentations. They may also have scant regard for everyday assumptions about time, space and the pull of gravity. In this way, gargoyles and others can extend research conversations within counselling and psychotherapy settings.

Conclusions/impact: The paper concludes with recommendations about the value of reverie within research and research training climates and the place of magical and mythical creatures in cultivating such environments.

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Dr Jane Speedy, Becky Midwinter and Jane Nott

Professional Role (JS): Senior Lecturer
Institution: University of Bristol
Contact details: 8-10 Berkeley Square, Bristol BS8 1HH
Email: jane.speedy@bristol.ac.uk

ABSTRACT: Workshop

Definitional ceremony: A collaborative counselling research methodology?

Aims: In this workshop we will explore and demonstrate the use of definitional ceremony and outsider witness practice (taken from the narrative therapies) as a form of collaborative research. In so doing we would hope to broaden the range of participatory research methods available to counselling practitioners and to 'trouble the edges' between research and practice.

Methods: The session will begin by briefly situating and describing these practices (of telling stories in conversation, listening to witnesses retelling the stories from different positions and then re-generating what has now become a 'thicker description') as a participatory research method.

The presenters will then conduct a (brief) collaborative inquiry. This 'live' research will reflect on Becky Midwinter's MSc research on the passing-on of trauma. The audience will be invited to position themselves as witnesses to the conversation and, as such, to participate in the re-telling of the stories that they witness. The original story-teller will then (briefly) reflect on these further stories.

For the final part of the session the presenters will lead an informal discussion about the experience of witnessing and being witnessed, and about the possible uses of this form of counselling research, particularly in relation to remembering, memory work and the passing-on of trauma.

Some possible research questions:

  • How effective might this form of inquiry be, with respect to the eneration of complex, tentative, partial and situated research studies?
  • What kinds of investigations would best be served by the introduction of 'witnessing' as a form of collaboration or co-research?

References:

Midwinter, R. (2004). Through someone else's eyes: An auto-ethnographic insight into the passing-on of trauma. Unpublished MSc thesis: University of Bristol.

Speedy, J. (2004). Living a more peopled life: Definitional ceremony as inquiry into psychotherapy outcomes. International Journal of Narrative Therapy and Community Work, 3: pp. 43-53.

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Sheila Spong

Professional Role: Senior Lecturer in Counselling
Institution: University of Wales Newport
Contact details: School of Social Studies, University of Wales Newport, PO Box 180, Newport, Gwent NP20 5XR
Email: sheila.spong@newport.ac.uk

ABSTRACT: Work in Progress Symposium

Ideas of influence: counsellors and their influence on their clients

Introduction: This study explores ways in which counsellors talk about the influence they have on their clients. The idea of influence in counselling is problematic and this study comes out of an interest in finding out more about how counsellors manage the tensions between 'influencing' and 'not-influencing'.

Methods: Six groups of counsellors (27 people) from a range of contexts and theoretical traditions met to discuss a number of counselling issues and scenarios. Their conversations were analysed using a form of discourse analysis.

Results: I will present preliminary results of the analysis, showing how the counsellors in the study framed influence as positive and negative, acceptable and unacceptable, inevitable and alarming, and considering what this might tell us about counselling.

Discussion points: Discussing influence in counselling raises questions about the values implicit in counselling, and the interplay of these with any value positions the client and the counsellor bring to the relationship. I hope that the people who come to this paper will enter into the debate about the value base of counselling and how this impacts on our clients.

Conclusions: I suggest that 'influence' in counselling is an area that is difficult and uncomfortable for counsellors but which is crucial to understanding the way we construct our practice. The results discussed here may help clarify some of the conflicting ideas that form part of the discourse of counselling.

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Faith Stafford

Professional Role: Senior Lecturer, Counsellor, Supervisor
Institution: University of Wales, Newport
Contact details: University of Wales, Newport, Allt-yr-yn Campus, P.O. Box 179, Newport NP18 3Y
Email: Faith.Stafford@newport.ac.uk

ABSTRACT: Poster

Too academic or not too academic - the importance of context in counsellor training

Introduction: This research was prompted both by the White Paper on Higher Education, which emphasises widening participation and the growing number of counselling courses seeking university validation.

Aim:

  1. To conduct a pilot study to ascertain how students and tutors see the value for counselling courses being linked to a university or being independent, and to assess the potential for further research.
  2. To encourage debate regarding how counselling training may develop in response to external pressures and public perceptions.

Method: An opportunistic sample of 17 students and tutors, from within and outside universities, completed qualitative and quantitative questionnaires. Volunteers were: participants from a workshop; tutors from a university programme; tutors on an FE course and six of their students and a supervisee who tutors for an independent organisation. There was no formulated hypothesis and no reference to literature was made until the survey was analysed. An internal academic research committee funded the project.

Results: 15 people responded from six types of participant groups. The data was analysed by coding each answer according to the aspect identified in the response given. Four categories emerged: Standards, Resources, Structure and Ethos/Values. The consensus indicated that while standards and resources are perceived as the main benefits of linking training to a university, freedom of structure and appropriate ethos /values were seen as the greatest advantages of independence.

Conclusions: Although the data from this small and unrepresentative sample must be treated with caution, the findings suggest that a larger study would be worthwhile. The methods used allowed participants to identify the categories of greatest importance to them. A further study could use these categories in a more focused and comprehensive analysis where participants prioritise them according to significance. Such information would benefit training institutions and the profession in seeking to influence policy regarding training for regulation of counselling and counsellors.

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Steve Theiler

Professional Role: Counsellor and Lecturer (Psych)
Institution: Swinburne University of Technology (Lilydale Campus)
Contact details: Swinburne University of Technology (Lilydale Campus) Melba Ave, Lilydale, Australia 3140
Email: stheiler@swin.edu.au

ABSTRACT: Poster

An investigation of maladaptive themes represented in early childhood memories, their relationship to current psychological difficulties and the value of revealing these themes early in counselling

Background: Themes found in early childhood memories have been associated with indicating the main issue/s affecting a client in counselling that might otherwise be difficult to verbalise (Fowler, Hilsenroth & Handler, 1995). Maladaptive themes, also referred to as schemas (Young, 1990), are conceptualised as accumulated knowledge, affect and perceptions of oneself, others and the environment (Epstein, 1994).

Aims: To explore a number of maladaptive themes represented in early childhood memories and to examine whether certain themes are related to people who are currently reporting high levels of maladaptive perceptions of themselves and others.

Method: Early childhood memories (915) were collected from 249 university students in Melbourne during class along with a self-report measure of maladaptive perceptions of self and others (YSQ-S; Young, 1999). Students were asked to write down two of their earliest memories and then one of their father and one of their mother. Two postgraduate students rated the memories for representations of maladaptive themes. The ratings of the themes from the memories were analysed in conjunction with people's current self-reported measures of maladaptive perceptions of self and others.

Results: Relationships were found among a small core of maladaptive schemas (themes) represented in early childhood memories and high levels of current self-reported maladaptive perceptions (schemas) of self and others. The findings indicated that maladaptive themes of 'disconnection and rejection' and 'perceiving the environment to be unsafe', were significant indicators of people who self-reported currently having high levels of maladaptive themes of self and others.

Conclusion: The implications of this research for counselling are that themes that are revealed from early childhood memories during the intake session can alert the counsellor to crucial information that underlies their client's difficulties that might otherwise be difficult and time-consuming to access.

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Sarah Turner

Other Authors: Dr Christine Bennetts and Dr Cheryl Hunt

Professional Role: PhD Student
Institution: Exeter University
Contact details: University of Exeter, Department of Education and Lifelong Learning, Heavitree, Exeter EX1 2LU
Email: sarah.k.turner@exeter.ac.uk

ABSTRACT: Poster

Counsellors' experiences of personal and professional change in HIV and AIDS counselling

Introduction: No known studies have addressed the effects on counsellors of working with HIV positive clients. This qualitative study asks the question 'do counsellors who work with HIV positive clients experience any personal and professional changes as a result of their client work, that other counsellors do not generally experience?'

Methodology: Qualitative semi-structured interviews were used to gather data from two cohorts of counsellors. These consisted of a group of 19 counsellors who had had one or more significant experience of working with HIV positive clients, and a group of 20 counsellors who had had no experience of working with these clients. Data were analysed using a Grounded Theory methodology, which produced a theory of counsellor change for each group. The theories were compared and similarities and differences noted.

Results: Taken together, the theories detail numerous ways in which all counsellors might change, both personally and professionally as a result of their client work. However, counsellors who work with HIV positive clients are more likely to address their own death and, in some circumstances, work within more flexible boundaries than those counsellors who do not work with this client group.

Conclusions: This research has made a positive difference to participants by the use of interviewing as a way of fostering reflectivity in terms of counselling practice and relational impacts, and, as such, has implications for student counsellor training and ongoing supervision. In addition, it highlights the potential importance of flexible boundaries in HIV and AIDS counselling.

Further research will focus in more depth on the ways in which counsellors who work with HIV positive clients address their own death as a result of their client work.

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Jeremy Weinstein

Professional Role: Senior Lecturer
Institution: London South Bank University and in private practice, London
Contact details: 21 Parklands Road, London SW16 6TB
Email: jeremy.weinstein@care4free.net

ABSTRACT: Work in Progress Symposium

Personal and professional responses to bereavement: how the personal experience of bereavement resonates in the work of counsellors/psychotherapists

Background: In the award winning Italian film 'The Son's Room' (Moretti, 2001) there is a moving depiction of the impact on a psychotherapist of the accidental death of his son. Watching the film I was struck by the fact that, while the details may differ, we all of us, as counsellors and psychotherapists, have either dealt with our own bereavements or live in anticipation of the loss of those close to us. Yet this area has been little addressed in the literature.

Aims: Consequently, this research explores this important and under-explored area by seeking the responses of both experienced practitioners and counsellors in training on bereavement and its impact on their counselling practice.

Methods: Questionnaires were circulated to both experienced practitioners and counsellors in training. There were Likart scale questions asking for various responses to identified areas of interest with space allowed for fuller responses. There were also focus groups based on the questionnaire for both groups.

Respondents were asked about their:

  • personal experience(s) of bereavement
  • the effect that this may have on their choices of potential clients and on client work
  • whether, as practitioners, they feel equipped in this work by their training, core theory(ies) and their religious/spiritual beliefs, or lack of them
  • where, as practitioners, they go for their support.

Results: The research is on going. Preliminary results suggest a variety of responses underlined by the often unexpectedly powerful impact on practitioners of bereavement, their own and that of clients. Many respondents felt they had had to learn 'on the job' and have not felt grounded by their core theory and training.

Conclusion: The need for practitioners to be better trained and supported through the grieving process.

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Dr William West

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

ABSTRACT: Work in Progress Symposium

Researching spirituality - the methodological challenges

Introduction: Researching counselling and spirituality from a qualitative perspective presents challenges to the researcher that are relevant to other research topics, but are perhaps more clearly visible in this context. These include: situating the researcher in the research process; researcher's reactions to the data - conscious and unconscious; choice of methodology; data analysis and how to write up the research.

Focus: How we position ourselves in relation to our research topic has an impact on our choice of methodology and data analysis. Our value systems determine what research questions we ask and how we ask them.

I will draw on my research (West, 2004) in which seven practitioner-researchers shared their reactions to five qualitative interview transcripts randomly selected from 18 interviews I did with therapists who were also Quakers (West, 1998). Thematic analysis resulted in three main themes: researchers' religious and spiritual reactions to the data; researchers' reactions as therapists; and researchers' reactions to the interviews and the interview processes.

Discussion: The notion of bracketing seems to deny we have a stance and operate in a cultural context. I will argue for 'critical subjectivity' (Reason, 1981) and acknowledge that gender, self and soul, in Denzin's (1989) phrase, 'filters knowledge'. The discussion will explore what words mean especially in relation to spirituality; the role of counter transference reactions in the researcher and their impact on the data, and how these ideas apply to the therapy relationship and the research relationship. I will review methodological choice in the light of these issues.

Conclusion: I remain convinced that there is no objective stance possible in relation to researching counselling and spirituality, that researching human beings is a human science activity, that data is contextualised and cannot be understood without recognising the role of the researcher and their interactions with those researched. These conclusions have implications for quantitative studies and for counselling practice.

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Professor Sue Wheeler and Tom Schroder

Other Author: Stephen Goss

Professional Role (SW): Director of Counselling and Psychotherapy Programme Services NHS Trust
Institution: University of Leicester
Contact details: Institute of Lifelong Learning, 128 Regent Road, Leicester LE1 7PA
Email: sw103@leicester.ac.uk

Professional Role (TS): Consultant Clinical Psychologist, Derbyshire Mental Health.

ABSTRACT: Paper

Does accreditation make you rich? This and other tales of counsellors and therapists

Background: The Psychotherapists Questionnaire has been developed and widely used by an international group of researchers chaired by David Orlinsky and Helge Ronnestad, and completed by more than 7000 respondents 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 views of self-development.

Aims: To explore the experience of BACP members working as counsellors: their pay and working conditions and the effect of the work on the life, health and wellbeing.

Method: 1500 BACP accredited counsellors and 1500 non-accredited, but active BACP members were invited to complete the Development of Psychotherapists Questionnaire. A total of 687 replies were received.

Results: This paper will report various aspects of the findings of the project including ways in which counsellors describe themselves, their job satisfaction, salaries, stresses and coping strategies. It will also highlight some differences between accredited and non-accredited counsellors, as well as between men and women.

Conclusion: Accredited counsellors earn significantly more than non-accredited counsellors. There are numerous other differences. Given that the British accreditation system has a weak evidence base, this British sample of counsellors and therapists may provide valuable information to support decisions that have been made intuitively. Competent professional practice is essential for the welfare of clients and the credibility of the profession. This research has the potential to influence future policy on registration, training and other professional issues.

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Frank Wills

Professional Role: Cognitive Therapist / Trainer
Institution: University of Wales Newport
Contact details: 7 St Matthews Road, Cotham, Bristol BS6 5TS
Email: Frank@fretwork.freeserve.co.uk

ABSTRACT: Paper

Crossing continents: learning a therapy model from the perspective of another

Introduction: Persons et. al., (1995) and others have speculated on the influence of other therapeutic modalities on training in cognitive therapy. Generally, such adherence does not appear to obstruct learning cognitive therapy. These studies, however, were limited by excluding any assessment of cognitive therapy competence. This study addressed this gap.

Method: This longitudinal study followed three successive trainee cohorts (n=59). It measured their cognitive therapy values at pre-course, end of course and one year follow-up. It explored the nature and change in their therapeutic values and assessed competence, using an adapted version of the Cognitive Therapy Scale (Beck & Young; 1988). It interviewed trainees who had reached the one year follow-up stage (n=24).

Results: The study found that few trainees began training with cognitive therapy values. Half the trainees preferred person-centred counselling. Person-centred trainees, however, took longer, compared to the other trainees, to develop cognitive therapy competence. They found particular difficulty with structuring cognitive therapy sessions, especially at the start of sessions - e.g., agenda setting. Qualitative analysis of interviews revealed that one obstruction was that trainees frequently developed rigid self-instructions about how they thought they were supposed to learn. Once they were able to modify these statements, learning typically proceeded more smoothly.

Conclusions: Most of the trainees were followed over a period of two to three years, allowing confidence in the shape of their reported development. The study would have been strengthened by having more access to their on-going practice, but this would have cut down the numbers involved and might have led to idiosyncratic conclusions.

This study suggests that it may be unwise to underestimate the influence of therapeutic ideas when training across models. Unexamined differences appear to delay learning. More optimistically, however, these differences can be overcome by using therapeutic principles: exploring and sometimes modifying trainees' frames of references regarding the training process.

 
       
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