| bacp : research |  |
| HOME > RESEARCH > CONFERENCE ARCHIVE |
 |
||||
| PAGES | ||||
|
||||
|
||||
 |
||||
 |
||||
| JUMP TO SECTION | ||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
|
||||
 |
||||
 |
||||
| SIZE | ||||
 Click here to return to the default sized text Click here to view the page in a medium sized font Click here to view the page in the largest font, this is for use by people with sight disabilities |
||||
 |
||||
 |
 |
| Research Conference 2005 | ||
|
Click here to go to previous conferences by date Click here to go to previous conference abstracts by authorClick here for an evaluation of this year's conference 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. Friday opening presentation and keynoteProfessor Glenys ParryProfessional Role: Professor of Applied Psychological Therapies 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 LambertProfessional Role: Professor and Endowed Chair of Psychology 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 keynoteNancy RowlandProfessional Role: BACP Head of Research 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., RÃnnestad, 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 SchroderProfessional Role: Course Director 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.
AbstractsHilary AbrahamsProfessional Role: Honorary Research Fellow 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.  Steph AdamProfessional Role: Doctorate Student 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. Tim Bond and Dione MisfudProfessional Role: (TB) Reader in Counselling and Professional Ethics / (DM) Student Counsellor and Lecturer in Counselling 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. Nell BridgesProfessional Role: PhD student 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. Michelle Brooks and Stephanie DaviesOther Author: Dr Chris Evans Professional Role: Dramatherapist & Counsellor 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. Professor Julia BuckroydProfessional Role: Professor of Counselling / Editor of CPR / Director of Obesity and Eating Disorders Research Unit 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. Norman ClaringbullProfessional Role: Head of Counselling Studies 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:
Conclusions: This research is making a difference to Workplace Counselling by:
Dr Mick CooperProfessional Role: Senior Lecturer in Counselling 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. Marian CrowleyProfessional Role: Senior Lecturer 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. Dr Kim EtheringtonProfessional Role: Reader in Counselling and Research and Senior Research Fellow 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. Margaret Evans and Dr Paul McDonaldProfessional Role (ME): Counsellor Professional Role (PM): Director of Studies, University College, Worcester ABSTRACT: Paper Lesbian, gay and bisexual clients: relating to difference - some tensions Aims:
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. Sally Flatteau TaylorProfessional Role: Service Director 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:
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. Nollaig FrostProfessional Role: Teaching Assistant/PhD Student 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. Dr Lynne Gabriel and Professor Sue WheelerProfessional Role (LG): Lecturer and Practitioner Professional Role (SW): Lecturer and Practitioner ABSTRACT: Supervision Symposium Research in action: a focus group researching the difference supervision makes 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. 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:
Key outcomes will include:
Dr Cordelia GalgutProfessional Role: Counsellor/Researcher/Supervisor 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. Patricia Goodspeed Grant and Helena BoersmaProfessional Role (PGG): Assistant Professor 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. Dr Stewart GrantOther Author: Patricia Van Der Velde Professional Role: Consultant Clinical Psychologist 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'. Jan Grove, Maureen Smojkis and Alistair RossProfessional Role (JG): Lecturer in Counselling 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:
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 Harold HellerProfessional Role: Therapist in independent practice. 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. Joanna Heywood and Dave SaxonOther Author: Francesca Lemme Professional Role (JH): Head of Service Primary Care Counselling Professional Role (DS): Project Development Officer 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. Peter Jenkins and Dr Filiz PolatProfessional Role (PJ): Lecturer in Counselling/Research 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 Monika Jephcott and Jeff ThomasProfessional Roles: Chief Executive; Communications & Systems Director 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 Gill Jones and Anna StokesProfessional Role (GJ): Director 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. John LeesProfessional Role: Counsellor and Lecturer 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. Clare LennieProfessional Role: Lecturer in Counselling and Educational Psychology 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. 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. Jane Macaskie and Helen LaceyProfessional Roles: Counsellors 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:
How has the research made a difference?
Implications for research and practice:
Karen MackieProfessional Role: Counsellor Educator 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. Peter MartinProfessional Role: Programme Convener 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:
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. Jenny McBride and Kirstie-Ann McNaughtonOther Author: Jane Boyd 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 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. Barry McInnesOther Author: Shane Buckridge Professional Role: Counsellor/Service Manager 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. John Mellor-ClarkOther Presenters: Barry McInnes, Stewart Grant, Jenny McBride, Kirstee-Ann and Geoff Mothersole Professional Role: Director CORE IMS and Visiting Senior Research Fellow 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:
| ||