British Association for Counselling and Psychotherapy

   
corner
L
L
L
L
L
L
L
L
L
L
L
L
corner
corner
>
>
>
>
corner
 
corner
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
>
corner
corner
small fontClick here to return to the default sized textsmall fontClick here to view the page in a medium sized fontsmall fontClick here to view the page in the largest font, this is for use by people with sight disabilities
corner

   
Research Conference 2006  


BACP's 12th Annual Research conference was entitled 'The consumer and counselling research' and took place on 19-20 May 2006. It was held at Glasgow Marriott Hotel, Glasgow in association with The University of Strathclyde.

Click here for an evaluation of this year's conference

Abstracts

 

Friday opening address and keynote

John McLeod

Professional Role: Professor of Counselling
Institution: University of Abertay Dundee
Contact details: Institute of Health Studies University of Abertay Dundee
Email: j.mcleod@abertay.ac.uk

ABSTRACT: Friday opening address

Research into the outcomes of counselling and psychotherapy: refocusing the debate

Investigation of the outcomes or effects of counselling and psychotherapy has remained a key focus of research activity within the profession since the 1950s. The importance of this domain of research has been heightened by the adoption of evidence-based practice policies by health providers in the U.S.A, U.K. and elsewhere. In the main, the trend has been for research that has been carried out into therapy outcome to have consolidated around the use of randomised controlled trials (RCTs) as a preferred methodology, in which the effectiveness of different therapy models is compared using a comparison of pre- and post-therapy scores derived from standardised questionnaire measures. However, in recent years, the work of Bruce Wampold, Drew Westen and others, has suggested that the vast investment of time, money and effort into this kind of research has failed to provide a secure knowledge base that meets the needs of users and audiences of research. The key issues that have emerged within this debate will be briefly reviewed. A number of solutions to these issues have been put forward, including adoption of a practice-based evidence approach and accumulation of pragmatic case study evidence. The advantages and disadvantages of each of these research strategies will be outlined. It is argued that the counselling and psychotherapy community in the U.K. needs to decide where it stands in relation to the debate over outcome research. The important question of who are the consumers of outcome research needs to be addressed - up to now, this domain of research has been dominated by the perceived requirements of policy-makers, rather than other research audiences. Finally, it is suggested that it is essential for the profession to engage in deeper reflection, analysis and inquiry into the concept of outcome. Almost all of the research that has been carried out into the effects of counselling and psychotherapy has operationalised outcome as change in therapist/researcher-defined categories (such as depression or anxiety). It is likely that inquiry into user-defined outcomes has the potential to generate a new type of knowledge that would be of value to multiple audiences.   

 

Professor Paul Salkovskis

Professional Role: Professor of Clinical Psychology and Applied Science/Clinical Director
Institution: King's College, London Institute of Psychiatry/ Centre for Anxiety Disorders and Trauma, Maudsley Hospital
Contact details: Department of Psychology (PO Box 077), Institute of Psychiatry, Kings College, London, De Crespigny Park, Denmark Hill, London SE5 8AF
Email: P.Salkovskis@iop.kcl.ac.uk

ASBTRACT: Friday keynote

Giving people what they want; empirically grounded psychological therapy

The future development of talking therapies may be a simpler matter than it seems. Service users will play an increasing role in deciding how services are deployed, and which types of therapy continue to be offered. At present, there is a bewildering range of approaches, and those not only those wishing seek therapy but also those who wish to offer it may find it problematic to decide which to choose.

Evidence-based approaches have clarified although not entirely solve this issue. Although the drug metaphor embodied in pure evidence based approaches has been helpful when applied to psychotherapy, it has also been misleading particularly in terms of developing and refining brief psychotherapy. It is proposed that good psychotherapy is a skillful blend of clinical art and clinical science. The approach is particularly well characterised by the concept of "empirically grounded psychological therapies", implemented in ways which allow the patients to participate in the choice of treatment. It is proposed that giving people what they want needs to involve helping them engage with evidence-based patient choice as a type of shared decision making.

These principles are illustrated in the context of the highly successful application of cognitive approaches to the understanding and treatment of anxiety disorders. The importance of specificity in understanding treatment and training of therapists will be illustrated using research findings and clinical examples. Implications of the research described will be considered. These include the value of formulation-based (rather than diagnosis-based) approaches and the need for the development of dissemination and stepped care models. The difficult issue of inertia in those currently practicing psychological therapies will also be addressed. It is concluded that a profession which prides itself on helping people to change should be able to identify its own need for change and react accordingly.

 

Saturday opening address and keynote

Mick Cooper

Professional Role: Professor of Counselling
Institution: University of Strathclyde
Contact details: Counselling Unit, University of Strathclyde
Email: mick.cooper@strath.ac.uk

ABSTRACT: Work in Progress (abstract for joint presentation - also see John McLeod)

Establishing a counselling research clinic in the UK based on a pluralistic model of therapeutic change

Abstract: Within the vast majority of counselling and psychotherapeutic paradigms - as well as research programmes - therapeutic change is accounted for by just a handful of processes: for instance, the correction of dysfunctional cognitions. However, the research and practice of the newly-established Tayside Counselling Clinic (a counselling centre in which clients have an opportunity to participate in a range of research protocols), starts from a very different basis, and one more in tune with a post-modern zeitgeist: that therapeutic change can happen via a plurality of diverse and non-exclusive pathways.

Having introduced this 'pluralistic' model of therapeutic change, the paper suggest that the process of counselling and psychotherapy can be broken down into a series of inter-related collaborative activities: (i) understanding the underlying problem in living that has lead the person to seek therapy; (ii) identifying what the person wants - their goals for therapy; (iii) agreeing on specific therapeutic tasks that would be necessary for the achievement of these goals; and (iv) selecting and implementing appropriate methods that will enable these tasks to be carried out. What happens at each of these stages has the potential to be linked to a multiplicity of elements at the other stages. For instance, a client's goal may be to 'like myself more', and this may be achieved by a range of tasks - for instance, identifying negative self-beliefs or behaving in ways which are known to bolster self-esteem - each of which may be achieved through a variety of methods.

Therapeutic implications of this model will be discussed, but the main focus of the presentation will be on the potential that this model has to provide a radical new grounding for counselling and psychotherapy research. This is because it provides an opportunity to move beyond 'macro-level' analyses of how certain methods relate to certain outcomes, and instead allows for the 'micro-level' analysis of which methods can be used to achieve which tasks, which tasks help to achieve which goals, and which goals help in the overcoming of which problems - an analysis which is best undertaken through in-depth qualitative research. This process will be illustrated through data from a recent study into young people's experiences of counselling in schools.

 

John McLeod

Professional Role: Professor of Counselling (JM)
Institution: University of Abertay Dundee
Contact details: Institute of Health Studies University of Abertay Dundee
Email: j.mcleod@abertay.ac.uk

ABSTRACT: Work in progress (abstract for joint presentation - also see Mick Cooper)

Establishing a counselling research clinic in the UK based on a pluralistic model of therapeutic change

One of the main reasons why counselling and psychotherapy research in the U.K. has lagged behind developments in the U.S. and Europe is because of the lack of dedicated research clinics. Not only do such clinics provide a unique opportunity to examine therapeutic processes and outcomes in an intensive and controlled way but they can serve as a hub of research activity, drawing together and strengthening a community of counselling and psychotherapy researchers. This paper will present the first-hand experiences of a group of academic-practitioners who have recently established a major new counselling research clinic in Dundee: The Tayside Centre for Counselling. The paper will discuss a range of practical issues involved in the setting up of such a clinic, including:

  • obtaining funding
  • arranging suitable accommodation
  • manualisation of practice
  • recruiting trainee counsellors
  • liaising with GP surgeries
  • managing the project
  • ensuring that research is informed by a user perspective
  • the relationship between the clinic and the wider professional community - for example, how to allow access to methods and data
  • the relationship between research, and providing a counselling service
  • research priorities - what are the most important questions to be pursued?
  • the value of adopting a pluralistic counselling model, rather than carrying out studies that compare different approaches to therapy
  • the ethics and morality of carrying out randomised trials
  • advantages and disadvantages of team-based research
  • the role of BACP in promoting research clinics.

The paper will also discuss key issues surrounding the development and implementation of research protocols, introducing the Clinic's first major research initiative: an in-depth qualitative study of therapeutic outcomes. This presentation will be of particular value to researchers and practitioners interested in the possibility of setting up a counselling and psychotherapy research clinic. 

 

Professor Liz Bondi

Professional Role: Professor of Social Geography and Co-Director of Counselling Studies
Institution: Institute of Geography (School of GeoSciences) and Counselling Studies (Sch of Health in Social Science)
Contact details: Geography, The University of Edinburgh, Drummond Street, Edinburgh EH8 9XP and Counselling Studies, School of Heath in Social Science, The University of Edinburgh, Teviot Place, Edinburgh EH8 9AG
Email: liz.bondi@ed.ac.uk

ABSTRACT: Saturday Keynote

Filling gaps or feeling gaps? Dilemmas for counselling researchers in an age of consumption

Research is often described and justified in terms of filling gaps in knowledge. The idea that counselling research responds to a variety of consumers is consistent with this point of view. Participating in this model of research brings benefits to counselling research but it is also fraught with dangers. This paper explores some of the ensuing dilemmas faced by counselling researchers. In so doing it argues for an approach to research that holds in mind the practice of counselling, including the insights it offers about the tension between filling and feeling existential gaps.  



Joe Armstrong

Professional Role: Lecturer in Counselling
Institution: Tayside Institute for Health Studies
Contact details: Tayside Institute for Health Studies, Dudhope Castle, Dundee, DD3 6HE
Email: joe.armstrong@abertay.ac.uk

ABSTRACT: Paper

Finding a voice: a qualitative study exploring the meaning and experience of becoming a volunteer counsellor

Background: Volunteer counsellors contribute significantly to the delivery of psychological therapy in Britain and other countries as well. This raises questions about, among other things, how volunteer counsellors develop competence and awareness, and the type and level of training and supervision required to achieve good client outcomes.

Aim: To explore a group of volunteer counsellors' experiences of training, entering practice and client work during their first year of practice.

Method: Eight minimally trained/experienced volunteer counsellors working within a voluntary sector mental health agency were interviewed for approximately one hour at the end of their first year of counselling practice. Interviews were semi-structured, tape-recorded and transcribed and analysed using a grounded theory approach.

Results: The meaning/experience of becoming a counsellor, entering practice and client work was constructed through five main categories: "resonating"; 'expressing and inner voice'; 'learning a language'; 'engaging in helping/therapeutic conversations'; and 'experiencing and resolving dissonance'. These main categories were contained within an overarching core category, 'finding a voice', a metaphor which denotes a process of discovery that references the person's initial encounter with counselling or helping 'in the broadest sense' and subsequent quest to achieve an identity as a counsellor.

Conclusions: "Finding a voice" can be regarded as a process that (volunteer) counsellors engage with in an effort to express 'self-as-counsellor'. The extent to which individuals 'find a voice' relates to them being able to establish a framework for practice within the context of the agency's expectations and culture, and which also accommodates their aspirations, motivations, needs, values and personal philosophy of life/helping. This process involves the experiencing of and successful resolution of dissonance or emotional conflicts in order to continue to engage in volunteer counselling and develop an identity as a counsellor 'the cycle of engagement'. These findings have implications for the selection, training and support of volunteer counsellors.

back to top

Liz Ballinger and Dr Jeannie Wright

Professional Role (LB): Senior Lecturer
Institution: Nottingham Trent University and Manchester University
Contact details: School of Education, University of Manchester, Oxford Rd, Manchester M13 9PL
Email: Liz.ballinger@ntu.ac.uk

ABSTRACT: Work in progress symposium

Does class count: what significance do counsellors attach to social class?

Research rationale: Both researchers identify themselves as coming from working class backgrounds and as holding a personal and practice-based interest in social class. Wider studies confirm the continuing significance of class in shaping life-style and life chances and, hence, its potential importance to the counselling process. This sits alongside our perception that class is accorded little interest in counselling texts and research, an impression confirmed by a review of British counselling literature.

Research design: The first stage of the research process involved an invitation to interested counsellors to join a Co-operative Inquiry Group to explore their perception of the significance of social class. This method was chosen as it reflected the researchers' priorities in terms of:

  • Facilitating a collaborative, non-exploitative research process
  • Enabling the development of an organic, evolutionary research process
  • Creating a climate for an exploration of subjective experience and understanding.

Following two introductory meetings, a series of six meetings took place, three fitting into the 'project' and 'encounter' phases of the research cycle, the final three into the 'making sense' and 'encounter' phases. Nine counsellors participated. The three 'project' and 'encounter' meetings of the inquiry group were recorded on audio-tape. The research process has continued subsequently in collaboration with Nottingham Women's Counselling Project and counselling students at Nottingham Trent University.

Sample: Purposive: Invitations to the Co-operative Inquiry Group were sent to interested counsellors in the East Midlands using informal networks.

Results/findings: Findings took the form of agreed descriptions of group experience distilled from the tapes and personal learning statements. These focussed on the continuing significance of class in intrapersonal and interpersonal relating, as well as its significance for counselling. Financial and cultural barriers to access were highlighted. Issues such as the use of language were also raised.

Conclusion: Class continues to be an under-acknowledged topic for discussion and research in counselling.

back to top

Jane Balmforth

Professional Role: Counsellor
Institution: University of Strathclyde (MSc student)
Contact details: c/o RSAMD, 100 Renfrew Street, Glasgow G2 3DB
Email: jane@nickwrightplanning.co.uk

ABSTRACT: Paper

Clients' experiences of how a perceived difference in social class between counsellor and client affects the therapeutic relationship

Background: There is already a body of research on how differences between counsellor and client such as race, gender and sexual orientation affect the counselling relationship; social class is a dynamic in the counselling relationship that has received less attention. I am a middle class person, very aware of my mixed middle/working class background, which was my motivation for choosing a class-related study. I am also aware that I bring my class background to the interviewees and to the research as a whole.

Aim: This is a qualitative research project to explore how clients felt a perceived difference in social background had affected their relationship with the counsellor. As a person-centred counsellor I wished to focus on the clients' lived experience of this difference, using a phenomenological study and definition of class. The research has received ethical approval from the University of Strathclyde.

Method: Counsellors and trainee counsellors were sought who had experience of being a client and felt they were a different social background to their therapist. Six participants identified themselves as working class and perceived their counsellor to be middle/upper middle class. Participants were interviewed either by phone or face-to-face using semi-structured interviews. The interviews were tape-recorded and the data transcribed. A thematic analysis was then carried out of the data.

Results: Themes that have emerged so far include clients feeling disempowered, having no connection with the counsellor and withholding parts of themselves in the counselling relationship because of feeling judged. Education, dress and accent were some of the factors that triggered feelings of shame connected to social class and meant the client did not feel able to be him/herself in the relationship with the counsellor.

Conclusions: In these clients' experiences the perceived difference in social background had a powerful effect on the counselling relationship. There were unresolved and unspoken issues of power, and a lack of awareness from the therapists of a working class frame of reference that prevented the clients from feeling accepted and able to develop in counselling. There may be wider aspects of how class is dealt with in therapy for counsellors to consider.

back to top

Emma Barnes

Other Author: Dr Kim Etherington

Professional Role: Research Assistant
Institution: University of Bristol
Contact details: University of Bristol, 8-10 Berkeley Square, Bristol BS8 1HH
Email: ejbarnes@aol.com

ABSTRACT: Paper

Problematic drug users' identity construction through relationships and group affiliation during use and recovery

Background: Identity reconstruction within addicts' narratives is seen as being an integral part of the recovery process (Baker, 2000). This paper looks at the development of an 'addict' identity and what clients who have been prescribed methadone tell us about the influence on their changing sense of self and identity of relationships with the people in a community drugs project (other service users, the counsellors they work with individually and in a group setting, and other members of staff). The therapeutic importance of relationships between client and counsellor is well known: this study extends that thinking to include other service users and other drug workers.

Research design: One to one semi-structured interviews and a group interview were carried out in a community drugs project to gain an understanding of the lived experiences of drug use and attempts at recovery. Interviews were tape-recorded, transcribed and then thematically analysed individually by three researchers, who then jointly negotiated the final themes. 22 current and previous clients of a community drugs project in Bristol were approached either by their counsellor, by letter from the project, by 'word of mouth' from other clients or by the researcher at drop-in sessions at the project. Participants were at various stages of recovery and whilst all had a history of poly-drug use over several years, it was their use of heroin that was the focus of their methadone treatment.

Results/findings: Drug subculture group identification initially fostered a sense of belonging for marginalised individuals, but increasingly problematic use had negative effects on relationships, with both non drug-users and other users, and having few supportive relationships led to feelings of isolation. This, coupled with a perceived social stigma, reinforced an 'addict' identity. Counselling sessions, group work and user involvement at the project fostered feelings of connection with others, with clients seeing themselves as actively contributing members rather than just service users. Positive relationships with staff members and the formation of mutually helping relationships with other clients aided self-esteem and led to the adoption of an identity based on a shared norm of staying drug free rather than drug use.

Conclusions: The findings highlight the importance of the social and personal changes that occur through positive relationships formed within a drugs project and the value of user involvement in enhancing engagement and a feeling of agency over treatment.

Reference

Baker, P. L. (2000). I didn't know: Discoveries and identity transformation of women addicts in treatment. Journal of Drug Issues. 30, 4, 863-881.

Commissioned by the Southmead Drugs Project and funded by the European Social Fund.

back to top

Ginny Bates

Professional Role: Counsellor
Institution: Inner Care Primary Care Mental Health Team
Contact details: C/o Inner Care Montpelier Health Centre, Bath Buildings, Montpelier, Bristol BS6 5PT
Email: ginny@riseup.net

ABSTRACT: Paper

What's in a name? A narrative inquiry into the relationship between addiction and identity: implications for counselling 'addicts'

Research Question: This study explores the interplay between dominant discourses of addiction and personal narratives of identity in making sense of the experience of addiction.

Research Rationale: 'Every era has a particular configuration of self, illness, healer and technology; they are a cultural package.' (Cushman, 1995: 7) The 'cultural package' that constructs addiction as a behaviour that is 'out-of-control' and 'a disease', is considered through the lens of social constructionism. This study aims to provide a socially, culturally, historically and politically situated account of drug addiction and 'thick description' (Geertz, 1979) of the experience of being 'addicted'.

Research Design: The above issues are co-researched with a former heroin addict, using an individual case study/life story interview to produce a situated account of addiction. Subsequent interviews explored themes relating to addiction and identity arising from the life-story. The researcher is situated within the research by the inclusion of her own personal and professional stories relating to addiction. The researcher invited members of a self-help group for former problematic drug-users at a local drugs agency, to participate in the study. The participant who responded is a white European male, aged 40. A poly-drug user since his teenage years, he became addicted to heroin in his thirties. He was abstinent from heroin for two years.

Results/Findings: Eight hours of interview time generated 30,000 words, which were transcribed and re-presented as co-produced stories in stanza form. It is argued that the participant's personal and local narratives mediated the influence of dominant discourses of addiction on the meaning he ascribed to both the experience of addiction and its claims on his identity.

Conclusions: Addiction is discussed as a socially mediated process. It is suggested that dominant discourses of addiction can give rise to expectations of helplessness in relation to drugs. (Davies, 1997) Alternative metaphors are discussed from narrative therapy. Counsellors are encouraged to pay close attention to issues of identity and to privilege local and personal knowledge over expert knowledge in relation to drugs and addiction.

References:

Cushman, P (1995) Constructing the self, constructing America: a cultural history of psychotherapy Reading, Mass; Addison-Wesley

Davies, J. (1997). Drugspeak: the analysis of drug discourse. Amsterdam: Harwood Academic.

Geertz, C. (1973). The interpretation of cultures: selected essays. New York. Basic Books

back to top

Dr Loretta Bradley and Dr Bret Hendricks

Professional Role: Professor and Chairperson
Institution: Texas Tech University
Contact details: Texas Tech University, College of Education, P.O. Box 41071, Lubbock, Texas, 79413-41071
Email: loretta.bradley@ttu.edu

ABSTRACT: Paper

Music therapy techniques in treatment of adolescent depression: A cognitive behavioural study

Research Question: Music listening techniques paired with CBT will be more effective than CBT techniques alone when treating adolescent depression. Additionally, since school attendance and academic achievement are correlated with depression, these areas would be improved through reduction of depressive symptoms.

Research Rationale: One in ten adolescents is depressed and research does not indicate positive outcomes of treatment. Counsellors need strategies which motivate adolescents to actively participate in psychotherapy. Because music is an ever-present part of adolescents' lives, it was hypothesized that music listening could be integrated into a group for treatment of adolescent depression. Further, it was hypothesized that all participants would be positively motivated to complete treatment if they took part in the development of a parent education program about adolescent depression.

Research Design: The independent variables for the study were age, grade level and gender. The dependent variables were measured depression, school attendance and academic achievement. Treatment and control groups used journaling, mood identification, discussion of irrational beliefs and anger management strategies in a group counselling format. The treatment group additionally listened to self-selected music identified by group members as helpful in positively altering moods and discussed ways each member used music in his/her daily life as a coping strategy. The treatment group was assigned music listening as daily homework and each member was asked to keep a journal of the music that he/she listened to. 106 participants were referred by school counsellors in the Southwest US. Treatment took place over 11 weeks (weekly groups of 2 hours); 52 in the treatment group / 54 in the control group with random assignment. 103 participants were Anglo-American. 49% were female. Treatment and control groups were divided respectively into four therapy groups.

Results: 100 participants completed the study and participated in the parent education class after 11 weeks of treatment. All participants (control & treatment) showed significant reductions in depression, with the treatment group indicating dramatically lower levels of post-test depression, improved school attendance and academic performance.

Conclusions: The use of music therapy techniques provided a valuable addition to the CBT treatment. Participants in the treatment group showed stronger results in all areas. Music listening techniques are simple and cost effective for any counsellor to use. Additionally, the completion rate for all participants seemed to be positively enhanced by the participant development of a parenting programme dealing with teen depression.

back to top

Dr Jill Brennan

Professional Role: Counsellor
Institution: Manchester Mental Health and Social Care Trust
Contact details: Department of Clinical Psychology, North Manchester General Hospital, Central Drive, Crumpsall, Manchester M8 5RB
Email: jill.brennan@nhs.net

ABSTRACT: Workshop

Exploring psychological therapies contexts through stakeholder mapping: A pragmatic approach

This workshop is intended primarily for practitioner case study researchers, although it may be of interest to anyone who wishes to reflect systematically upon a therapy context. It aims to share with participants an imaginal process of exploration and notation of the social context of examples of psychological therapy, through stakeholder mapping processes developed as a means to conceptualise context in two unpublished pragmatic case studies. Participants are encouraged to bring and work through an example of a therapy context familiar to them.

The mapping exercise will be illustrated from the above-mentioned study settings in the NHS and voluntary sector. It is hoped that this exercise will stimulate discussion, e.g. of the influence of stakeholder communities on research and practice, and of the use of stakeholder matrices as an (as yet crude) preliminary conceptual tool. Discussion may be recorded and summarised in the workshop report to be submitted for publication.

The workshop will include:

  • A brief introduction to stakeholder theory
  • An analysis of who the stakeholders are in an act of psychological therapy?
  • Identifying and mapping immediate stakeholders, along with 'stakeholders in stakeholders', interest communities, rhetoric, values and goals
  • Locating research in relation to stakeholder interests
  • And translating the above into research.

References:

Fishman, D. (1999). The case for pragmatic psychology. New York/London: New York University Press

Stoney, C. and Winstanley, D. (2001). Stakeholding: confusion or utopia? Mapping the conceptual terrain. Journal of Management Studies 38:5, 603-626

back to top

Chris Brown

Professional Role: Counsellor/Psychotherapist, Supervisor & Counsellor Trainer
Institution: Lewisham College, London
Contact details: Room B215 Lewisham College, Lewisham Way, London SE4 1UT
Email: christine.brown@lewisham.ac.uk

ABSTRACT: Paper

The therapeutic relationship: what relevance and impact does 'the other characteristic' have to and on the therapeutic process?

Background: It has become apparent through recent published works (e.g. Norcross, 2002) that it is the quality of the therapeutic relationship, not the therapeutic model which is most pivotal to a successful therapeutic outcome for the client. Toward the end of his life Carl Rogers wrote about a phenomenon he experienced during his client work which he named 'the other characteristic' - a phenomenon which arose from a profound relational connection to his clients (Rogers, 1980). The above raises questions about the nature of the therapeutic relationship, and requires an explanation of its essence to clients and potential clients.

Aims: To explore and describe the components and nature of 'the other characteristic', and to discover how and when it arises during the therapeutic relationship, to what effect and to shed more light on the therapeutic relationship in general.

Method: Six person-centred therapists were chosen to be interviewed based on their length of experience. These therapists were both male and female and were local service providers with a wide range of clients. The interviews were semi-structured and audio taped, then transcribed and phenomenologically analysed using the Duquesne Method (Moustakas, 1994). The research was approved by the University of East London's Ethics Committee.

Results: The main conclusion indicates that 'the other characteristic' is often experienced by the participating therapists during the therapeutic alliance. The findings also illuminate both the individually experienced and commonly experienced elements by which 'the other characteristic' may be recognised. In addition the research shed light on when 'the other characteristic' arises and its impact on the therapeutic work and relationship in general.

Conclusion: The research findings allowed the researcher to postulate a definitive description of 'the other characteristic' as: 'unplanned moments of profound, defenceless connection between client and therapist which stand out, experientially and perceptually, among other moments of connectedness. Moments in which the deep visceral and sensory understanding of the therapist for the client's perceptual world will bring about a felt sense of organic union within the therapeutic alliance - which in turn will earnestly assist the client in his/her movement toward actualized-self'.

References:

Norcross, J. C. (2002). Psychotherapeutic relationships that work. Oxford University Press.

Rogers, C. (1980). A way of being. Boston/New York: Houghton Mifflin Company.

Moustakas, C. (1994). Phenomenological research methods. London: Sage.

back to top

Professor Julia Buckroyd

Professional Role: Director, Obesity & Eating Disorders Research Unit/Editor CPR
Institution: University of Hertfordshire
Contact details: Health Sciences Research Unit, University of Hertfordshire, College Lane, Hatfield AL10 9AB
Email: julia.buckroyd@bacp.co.uk

ABSTRACT: Workshop

A Writers' Workshop: Getting your work published in Counselling and Psychotherapy Research (CPR) Journal

Do you have a research article you have started writing (and stopped and started and possibly stopped and started yet again) with the aim of submitting for publication in an academic journal? If so, and you would like some sound advice on how to go about writing your article and giving it the best possible chance of publication, then why not join our 'writer's workshop' at the research conference?

The writers' workshop is for those new to writing for academic journals and advice will also be available for the more experienced author. Those new to writing for academic journals are often unsure about the expectations, practices of peer-review and what counts as a good academic paper. This often results in many authors being disappointed when their paper gets rejected. If you want to get your research published in an academic journal, in particular in CPR, then this workshop is for you. Professor Julia Buckroyd, Editor of CPR, will take delegates through all the stages of writing and submitting a paper for CPR, providing information on how to best write a paper that is more likely to be accepted for publication. Julia will cover topics such as:

  • The vision for CPR
  • What counts as research for CPR
  • How to structure a paper
  • Necessary ingredients of a paper
  • Presentation of the paper
  • What happens to your paper after you submit it
  • Topics of particular interest

The workshop will include a formal presentation on the above issues, followed by discussion and debate, whereby those attending will have the opportunity to ask questions about their own work and get some useful hints on how to best write for academic journals in general. Bring along any draft papers you have started as Julia will also provide a Q&A session offering immediate feedback on your work.

back to top

Dr Khatidja Chantler

Professional Role: Lecturer in Social Work
Institution: University of Manchester
Contact details: University of Manchester, School of Nursing, Midwifery and SocialWork, Coupland 3, Oxford Road, Manchester M13 9PL
Email: Khatidja.Chantler@manchester.ac.uk

ABSTRACT: Paper

Attempted suicide and self-harm (South Asian women): policy and practice

Research Question: The research explores to what extent mental health policy and provision, with a specific focus on attempted suicide and self-harm, addresses the needs of South Asian women experiencing such distress.

Research Rationale: There is an overall national policy context of reducing suicide and undetermined injury by 2010 (Our Healthier Nation) and the National Service Framework for Mental Health makes the prevention of suicide one of its key priorities. Raleigh's research (1996) indicates that suicide is high in young Asian women (15-24 years) compared to other ethnic groups in the UK. Evidence illustrates unequal treatment of black people within the mental health system (e.g. Fernando, 1991). Much of this literature overlooks the specific experiences of minoritised women, as does much of the literature on mental health and women (Aitken, 1996).

Research design: A qualitative study based on feminist/anti-racist principles, using semi-structured interviews with different stakeholders in Manchester. 64 people participated: 18 interviews with mental health workers (eg GPs, counsellors, social workers); 8 interviews with senior managers of mental health services; seven interviews with South Asian women survivors of attempted suicide/self-harm; and 31 South Asian women in four focus groups. Interviews were analysed using a thematic approach. Key issues are located within recent government mental health policy: 'Women into the Mainstream' & 'Inside Outside'. These are explored for their ability, or otherwise, to respond to the needs of South Asian women experiencing this form of distress.

Findings: Poor understanding of the issues experienced by South Asian women, primarily the ways in which state practices (e.g. mental health policy and immigration practices) impact on mental distress, and the privileging of culture over gender.

Conclusions: Action is required at multiple levels to impact positively on South Asian women's mental health. Interventions are needed in national mental health policy, immigration law, increased visibility of South Asian women's needs in service planning and delivery and staff development.

References

Aitken, G. (1996). The present absence/pathologized presence of black women in mental health services.

In E. Burman et.al (Eds.), Psychology discourse practice: From regulation to resistance (pp. 75-95). London: Taylor & Francis.

Fernando, S. (1991). Mental health, race & culture. Macmillan in association with MIND Publications.

Raleigh, S. V. (1996). Suicide patterns & Trends in People of Indian Subcontinent & Caribbean Origin in England & Wales. Ethnicity and Health, 1 (1): 55-63.

back to top

Dr Samantha Chromy

Professional Role: Lecturer
Institution: University of Bristol
Contact details: University of Bristol, Graduate School of Education, 8-10 Berkeley Square, Bristol BS8 1HH
Email: sam.chromy@bris.ac.uk

ABSTRACT: Paper

Sexual behaviour problems in sexually abused children: psychological, behavioural and victimization characteristics

Research Question: Is there a difference between sexually abused children who exhibit sexual behaviour problems and sexually abused children who do not exhibit sexual behaviour problems, in their psychological, behavioural and victimization characteristics?

Research Rationale: Childhood sexual abuse is perpetrated not only by adults, but also by children. Many adult and adolescent offenders began perpetrating or displayed sexual behaviour problems at young ages, including pervasive, age or developmentally inappropriate and abusive behaviours. Sexual behaviour problems appear to be one of the most common after effects of sexual abuse. Counsellors and those in the helping professions are in a position to help facilitate early treatment and prevention. This research aims to provide information that may help such professionals identify those at higher risk of sexual behaviour problems.

Research Design: This quantitative design was based on a retrospective chart review of the clinical records of a sample of sexually abused children. The sample was divided into two groups - those with sexual behaviour problems and those without. The groups were compared on a number of variables regarding their psychological, behavioural and victimization characteristics, using statistical analysis procedures.

Sample: The sample for this study was 125 children aged 4-12 years old who had received services at a counselling centre specializing in the treatment of sexually abused children in Florida.

Results / Findings: The study identified a number of characteristics that differed significantly between the groups - sexually abused children with and without sexual behaviour problems. The characteristics identified included the presence of assaultive behaviours, encopresis, the frequency of abuse and age of onset of abuse. The children with sexual behaviour problems presenting increased frequencies of these behaviour, and were abused with more frequency with a younger age of onset than the children without.

Conclusions: The study identified a number of characteristics that differed significantly between sexually abused children with and without sexual behaviour problems. It hopes to add to a body of developing research that will help to identify children at particularly high risk of the negative sequelae of abuse, including sexual behaviour problems.

back to top

Angela Clark

Professional Role: Counsellor/Supervisor
Institution: Winchester Bereavement Support
Contact details: Cornerstones, Fairfield Road, Shawford, Winchester SO21 2DA
Email: midgeresearch@yahoo.co.uk

ABSTRACT: Paper

'Who's there for Lucy?': Counselling for children of single parents with drug and alcohol problems

Rationale: This research attempts to investigate the availability of care, support and counselling for children of single parents with drug and alcohol problems and the affect of this availability on the parents' ability to undertake addiction recovery programmes.

Aims: This enquiry arose from my attempts as a counsellor to find care and counselling for Lucy, aged six, and her sister, aged eight, when their mother started on a drug and alcohol recovery programme. I couldn't find any organisation or person in the statutory or voluntary services offering help or advice. I was surprised that the recovery unit did not seem to consider the children of a single parent to be relevant to their service, compared to bereaved children for whom there is a network of organizations. I decided to explore the experiences of other parents in a similar situation.

Method: It was difficult to find people to take part - addicted parents are very reluctant to be identified for fear of having their children taken away. I advertised in the Big Issue and had responses from volunteers by phone, text, email and/or letter, all from women as no men responded. The data collection was taken from responses from emails and letters, as well as taped interviews that were undertaken with three women. The data were analyzed for patterns and emerging themes.

Findings: The impact on these women and consequently their children of poverty, physical and mental health problems, self-image, abuse, isolation and bereavement, emerged as common themes. There is limited availability of any sort of care or counselling for these children. Some recovery units admit children with their mothers but only three out of eleven admit both parents. The number of recovery units for substance abusing women with children does not seem to reflect the number of women with substance abuse problems.

Conclusion: Where does the provision for substance abuse rehabilitation fit in to the political agenda? It seems the lack of adequate provision for mothers, children or families is in contravention of the Children's Act 2004 and if 'every child matters' there needs to be the political enthusiasm and funding to make this happen.

back to top

Delia Edwards and Marjorie Reid

Other Authors: Barry Burnett, Hillary Tooze, Loretta Reynolds, Sonya Roach & Su Connan

Professional Roles: Trainee Counsellors and 2nd Year Higher Professional Diploma Students
Institution: Lewisham College, London
Contact details: c/o Chris Brown, Room B215, Lewisham College, Lewisham Way, London SE4 1UT
Email: christine.brown@lewisham.ac.uk

ABSTRACT: Poster

Are there any links between 'Obsessive Thinking' and the subsequent development of bulimia, if so, can these links be used as an early indicator of the condition to inform potential sufferers?

Background: Whilst studying the current literature on bulimia, an article on a condition called 'Pure O' (obsessive thinking) was discovered. This article suggests that such obsessive thinking is a prelude to the subsequent development of bulimia. No such link is to be found in the DSM IV, which raises the question does such a link actually exist; if so, can 'obsessive thinking' be diagnosed as an 'early warning indicator' to potential bulimia sufferers?

Aims: To explore if there are any links between the condition called 'Pure O' and the subsequent development of bulimia, and if so, to identify these links so that they might be highlighted to potential bulimia suffers.

Method: We limited the study to a small research project consistent with the phenomenological research approach, therefore, statistical data will be absent from our findings and generalisations will be made using the Duquesne Method (Moustakas, 1994). Two separate questionnaires were devised: one for clinicians and one for sufferers which focused on inquiring about the thinking patterns of clients and sufferers (respectively) before the onset of bulimia. The sample of respondent sufferers and clinicians were recruited through the Eating Disorders Association (EDA). Both sufferers and clinicians were sent the relevant questionnaire by post via the EDA. These questionnaires were returned directly to the researchers.

Initial Results & Conclusion: Initial results indicate that bulimia sufferers show signs of obsessive thinking patterns before the onset of the condition. No conclusions have yet been made; the completed questionnaires are still being analysed and it is the aim of the researchers to present the qualitative results whilst also proposing a hypothesis on whether an identifiable link exists (as outlined above).

This research has been undertaken to fulfil, in part, the requirements of the City & Guilds Higher Professional Diploma in Counselling @ Lewisham College, London, under the Supervision of Chris Brown MA. and Arike. Stan Grant MA. Approval from an Ethics Committee was not obtained, however, the research was conducted following the BACP Ethical Guidelines for Researching Counselling & Psychotherapy (Bond, 2004).

References:

Moustakas. C. (1994). Phenomenological Research Methods. London: Sage.

back to top

Jane Edwards

Professional Role: Counsellor, Trainer, MSc student.
Institution: University of Strathclyde
Contact details: Simpson House Drugs Counselling Service, 52 Queen Street, Edinburgh EH2 3NS
Email: jane@edwardsjane.wanadoo.co.uk

ABSTRACT: Poster

Being a person-centred counsellor in a postmodern context: a qualitative study of the influence of postmodernism on person-centred counsellors

Rationale: The work of philosophers who are associated with postmodernism has been influential in the social sciences in recent years and in some schools of psychotherapy. This study was conducted to expand on existing research by looking at the influence of postmodern ideas on a sample of person-centred counsellors. The study provides counsellors with possibilities of what they may take from postmodern ideas to use in their practice.

Research design/sample: The study involved conducting semi-structured interviews with seven counsellors, including three academics, trained to at least Diploma level in the person-centred approach. All are practising counsellors except one of the academics who is a practising counsellor trainer. None identified themselves as practising postmodern therapy. Recruitment was through advertising in journals, email circulars, and three academics were approached individually. The aim was not to gain a representative sample, rather purposive sampling was necessary to identify counsellors who had reflected on issues related to the research question. In-depth questions included the participants' understanding of postmodernism, and how it had influenced their thinking about counselling theory and their practice. Interviews were transcribed, and stages of analysis, including immersion, categorisation and phenomenological reduction of the data completed.

Findings: Themes included the significance of narrative, identity as socially constructed and awareness of how power is constructed and operates in society, as well as power within the therapist-client relationship. Participants identified the concept of the loss of grand-narratives as leading them to look beyond a particular counselling theory to explain how they work and what they believe counselling to be. The limitations of the study include sample size, and different understandings of postmodernism.

Conclusions: The study enabled exploration of the impact of postmodern ideas on a small sample of counsellors' thinking and practice. Participants suggested that postmodern ideas lead them to re-think the place of theory in their understanding of their work. Possible areas for further research include focusing on the influence of postmodernism on counsellors who were trained in other schools of psychotherapy.

back to top

Christine English

Professional Role: Psychodynamic Counsellor
Institution: The University of Reading
Contact details: School of Health and Social Care, The University of Reading, Bulmershe Court, Woodlands Avenue, Woodley, Berkshire RG6 1HY
Email: c.l.english@reading.ac.uk

ABSTRACT: Paper

An exploration of the meaning of addiction through an analysis of the countertransference experience of psychodynamic therapists working with drug or alcohol addicted clients

Background: Drug and alcohol misuse are grave social problems, yet preferred treatment modalities, such as substitute prescribing and relapse prevention education, are perhaps used in response to a need to alleviate the social costs of substance misuse. These then tend to focus largely on the symptoms of underlying psychological distress at the expense of an exploration of its causes. This qualitative research sought to consider the possible 'meanings' of addiction through an exploration of the experiences of psychodynamic therapists working with addicted clients. It was felt that such research could inform counselling practice with drug and alcohol addicted clients.

Research design: Letters inviting participation in the research were sent to a purposive sample of 120 psychodynamic practitioners, selected from the registers of the UK Council for Psychotherapy and the British Confederation of Psychotherapists. 36 therapists responded with nine agreeing to participate in the research. Nine semi-structured interviews were tape-recorded and transcribed, and analysis was informed by the ideas of immersion, categorisation, phenomenological reduction, triangulation and interpretation (McLeod, 1994:89-90).

Findings: Data analysis revealed several common themes in work drug and alcohol clients: relationship difficulties, use of primitive defence mechanisms, narcissistic vulnerability, and inability to cope with psychic pain. Common countertransference responses to work with this client group included a sense of meaninglessness about therapy, wishing to terminate therapy, and a sense of 'contamination' by the toxicity of the addicted clients' material.

Conclusions: Several possible 'meanings' of addiction were revealed: drug and alcohol addiction as a defensive withdrawal from reality, a turning away from unsatisfactory relationships and an attempt by a weak ego to tolerate or avoid psychic pain. It is hoped that a greater understanding of the common psychological difficulties of the drug or alcohol addicted client, and the countertransference they may evoke, could enable practitioners to work more successfully with this growing group of consumers of counselling.

Reference:

McLeod, J. (1994). Doing Counselling research. London: Sage.

back to top

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

Narratives of identity: from 'recreational drug user' to 'druggie'

This paper addresses issues of identity construction among people who have misused drugs and invites counsellors, psychotherapists, researchers and workers in the drugs field to notice how traditional psychological and socio-cultural notions of identity formation (Erikson 1968; Mead 1934; Vygotsky 1978) might shape their responses to clients' life stories.

The paper focuses on two of eight life stories gathered as part of an ongoing narrative inquiry. The inquiry was commissioned by a community based drugs project that provides free counselling for abuse/trauma survivors in recognition of the frequency of such histories among clients using the methadone, outreach and other drug services provided. It uses parts of the two life stories to address the question: what can we learn from a person's story about how they change their view of themselves as 'someone who occasionally would take drugs at the weekend', to being 'a druggie'.
The stories are analysed using narrative analysis to show how narrative and identity are not separable but, instead, constitute one another, and how, by using narrative approaches, new identities can emerge as the teller moves actively between private and public, personal and cultural, past and present. It also adds to the growing awareness of the therapeutic value of qualitative (particularly narrative) methods for research.

The work suggests that counsellors working in the drugs field who position themselves firmly within modernist notions of self and identity might miss opportunities to enable clients to re-story their lives in ways that can allow the emergence of healing connections between their historic childhood trauma and subsequent drug misuse. By focusing on the question 'Why?'- a question often discouraged during counsellor training - we can invite clients to make sense of their lives and drug misuse in ways that do not re-inforce internalised negative and stigmatising stereotypes based on concepts of identity as fixed and 'damaged'. Instead they can restore 'the valued sense of who they are, the preferred sense of identity or personhood' that Michael White (2004: 47) refers to as 'a sense of myself', which can then become 'the foundation for a rich story development of the person's life'.

back to top

Sally Flatteau Taylor (paper)

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

The Maypole Dance: developing a support service with and for families with a child/children with life limiting/life threatening illnesses

Background: The Maypole Project, created in 2003, provides flexible, holistic, family centred emotional support - from psychotherapy to a "listening ear" - to families with a child with illnesses which are life threatening/life shortening. This unique service pattern and philosophy has been developed from a foundation of research and experience of previous service provision to families with children with cancer, and its evaluation by families and health professionals. The aim of the project is to enhance this service by weaving existing research of supporting families in loss and bereavement into service delivery, as well as by integrating the families' ongoing evaluation of service received.

Research Methods: The user perspective is gained by invitation to all families referred to enter into research, participating families sign consent forms. The methods used are completion of evaluation forms and focus groups. The questions raised in both methods are in two sections. Firstly, relating to the structure of the support - referral, place, timing, etc, and secondly, the content of the support - therapy or listening ear, ability to relate to key worker, ease of talking through issues. The information gained forms a cyclical process - information gained is analysed and comments fed back into the service provision. Ethical approval was gained from a steering committee and external supervisor.

Results: Twelve evaluation forms were sent with eight returned and two focus groups held with 12 families attending. Responses have been positive. From the viewpoint of the structure of the Maypole Project they note the benefits of support received from diagnosis onwards and their ability to "dip in" to support as and when needed. Regarding the content of support, some families benefit from counselling, whilst others appreciated speaking to "almost a friend". All families felt able to talk about all issues. Recommendations of the service to other families was highlighted, which is reflected by an increase in families self-referring. Delays in referral to the service and issues with other services i.e. communication with health professionals were also noted.

Conclusions: This ongoing research confirms that flexible ongoing and holistic support is of great importance to families who, from diagnosis, suddenly find themselves being "fitted" into a medical world. The cyclical process of this research also enables regular reflection on practice and allows "fine tuning" of the service. The need is highlighted for future research across other interconnected services.

back to top

Sally Flatteau Taylor (poster)

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: Poster

Between the notion and the act - some realities of putting a research study into practice

Background and Introduction: In a recent research study into the counselling experiences of bereaved clients who have sensed the presence of the deceased (Flatteau Taylor 2002), an assumption was made that, in today's economic climate of high demand on funding where evidence of best practice is essential, counselling service providers would work to enabling research through safe and confidential access to their previous service users. This was not the reality of putting the study into practice, and this paper explores this question; What difficulties were found in engaging "gatekeepers" to access previous service users?

Methodology: Loss and bereavement is a sensitive issue and it is important to create a safe structure within which participants would feel able to recount their stories. (The findings of participants' experiences recounted in interviews can be found in Between the Idea and the Reality (Flatteau Taylor, 2005)). In gaining ethical approval, it was agreed to engage counselling service co-ordinators to act as "gatekeepers" to address letters to previous service users requesting a response to the researcher, thus holding their anonymity from the study until they chose to participate. The findings of these approaches is detailed below:

Key Findings: The findings highlight some significant issues; 12 approaches were made and three agencies participated. Of the negative responses, four agencies said "yes" and then "no". Reasons given for this were; non-approval by ethics committee & management committee. Three co-ordinators insisted on a full explanation of what "sense of presence" meant as an issue for bereaved people, before the research began.

Discussion: Tension is highlighted between the need for research and difficulties in accessing participants, which, if we need to provide more "proof" of what works in counselling in future will become more essential. There was an interesting contrast between the three co-ordinators who required an explanation of sense of presence, and the 10 interviewees who all talked of their experience without needing or wanting an explanation. This may parallel to the findings of the main study where the majority of counsellors did not work with their clients sense of presence as the natural and normal experience they described.

back to top

Kevin Friery

Professional Role: Clinical Director
Institution: Right Corecare
Contact details: Right Corecare, 3500 Solent Business Park, Whiteley, Fareham, PO15 7AL
Email: kevin.friery@right.com

ABSTRACT: Work in progress symposium

Employee Assistance Programmes: who is the customer?

Background: For many people, access to counselling is through their Employee Assistance Programme (EAP). This potentially introduces a new dynamic into the counselling relationship and raises the question of the nature of the customer from a number of angles. The research question is 'who is the customer and what is s/he buying?' This question is addressed to both the employer (purchaser of EAP) and the counselling clients (user of EAP).

Aim: The aim is twofold: firstly, to develop a clearer understanding of the identity and needs of the counselling customer from the purchaser and user perspectives, and secondly to identify the issues that users bring to sessions thus identifying the profile of service users.

Research Design/Sample: All customers (employers) who use Right Corecare EAP services (n>200) were asked to complete a questionnaire which included items identifying the reasons they had purchased an EAP. To date, responses exceed 50 but the survey is currently ongoing. In addition, a whole-sample (n= 5877) analysis was made of every client who had accessed face-to-face counselling in 2005 through Right Corecare's EAP programme. The quantitative methodology was the most simple - count every case and log each presenting problem.

Results: Whilst this is research in progress, results continue to emerge. Perhaps unsurprisingly, relationships and loss featured highly in the issues that were presented. Organisational change was a feature in certain clusters but, interestingly, there were organisations which went through great changes without this being reflected in the counselling referrals, leaving a question about what leads change to become an issue in counselling.

Conclusion: It is too early to be definitive about the conclusions of this research, but it is already emerging that there are differences between the employer as customer and the service user as customer. When we discuss the customer in counselling, it is often assumed that we are talking only of the service user whereas this research suggests we are meeting the needs of more than one customer, and understanding this is essential in developing services that meet the needs and expectations of all our customers.

back to top

Audrey Gachen and Patti Wallace

Professional Role (AG): Psychological Counsellor
Institution: Roehampton University
Contact details: Postgraduate Studies, School of Human and Life Sciences, Roehampton University, Whitelands College, Holybourne Ave, London SW15 4JD
Email: mscresearch@onetel.com

ABSTRACT: Paper

The consumers' voice: feeling or not feeling respected during hospitalisation: what counselling and psychotherapy have to learn from the psychiatric-inpatient experience

Aims: To explore individuals' experiences of feeling respected during psychiatric hospitalisation and to consider implications for outcome and for counselling/ psychotherapy practice.

Background: This study is rooted in the researcher's own experiences of feeling/not feeling respected during psychiatric hospitalisation. Previous research has considered respect as one of a number of elements of care (eg, Rose, 2001); this study is the first UK qualitative research to focus specifically on the concept of respect.

Research design: This qualitative study interviewed eleven individuals about their psychiatric inpatient-care. Data incorporated experiences in 17 hospitals/units, across 21 wards. Interviews were semi-structured and data were analysed using a model of Grounded Theory.

Results: In line with Rogers' thinking (1965, as cited in Farson, 1977) the data indicate that an individual's perception of whether or not they feel respected communicates to that person a sense of their value as a human being. This in turn impacts on self-esteem and potentially on outcome. The environment of the ward, the quality of patient/staff interactions, and individuals' sense of involvement in their treatment emerged as key themes. Although experiences were predominantly negative, occasions on which individuals felt respected were reported as having an enabling and lasting impact.

Conclusions: The psychiatric inpatient-unit is often perceived as an inappropriate arena for counselling/psychotherapy. Inpatient psychiatry, therefore, generally remains a disconnected realm to which we 'refer on', and yet, in reality, the seeds of extreme psychological disturbance can be present in our day-to-day client work. This study highlights the universality of human need and challenges the myth of an inpatient/outpatient divide. This research also highlights that a knowledge and application of basic Rogerian principals and fundamental psychodynamics by ward staff would significantly improve inpatient-experience. Areas for future research include closer links during psychotherapy training with inpatient-psychiatry, and training of ward staff in basic Rogerian and psychodynamic principles.

References:

Rogers, C. (1965). A humanistic conception of man. In R.E. Farson (Ed.), (1977). Science and human affairs. California: Science and Behavior Books Inc.

Rose, D. (2001). Users' voices. London: Sainsbury Centre for Mental Health.

back to top

Barbara Gerber, Donna Dunlop, Karen Smith and Lorraine Conway

Other Author: Sandy Kemp

Professional Role (BG): Psychotherapist
Contact details: 6 Erskine Road, Whitecraigs, Glasgow G46 6TQ
Email: gerberkb@aol.com

ABSTRACT: Paper

A quantitative study into whether the use of CBT self help materials could lead to a reduction in stress and anxiety scores and development of coping skills in year 11 school pupils

Background: Research has suggested that CBT self help materials are helpful in developing coping skills for anxiety. 24,000 teenagers are admitted to hospital each year having utilised unhelpful coping mechanisms; our aim was to see whether self help materials could help school pupils develop helpful coping mechanisms.

Aims: This investigation explored whether the use of CBT self help material results in reducing anxiety and depression scores in Year 11 school pupils.

Method: Renfrewshire Association for Mental Health (RAMH) provide counsellors in two of East Renfrewshire's seven secondary schools, a relatively high achieving area in the South East of Glasgow. We worked with one of these secondary schools. Sixty children from Year 11 were assessed before and after the experimental period. Half were randomly assigned to the control and half to the experimental group. We produced and presented four self-help booklets during four school periods. We utilised Beck's Anxiety and Depression Scales as our scoring tools. We scored before and after the experimental period.

Results: We utilized a Wilcoxon Statistical test for related designs. The control group for both anxiety and depression scores suggested no statistical difference between the scores before and after. However, there was a significant reduction in both the depression and anxiety scores in the experimental group in this same period. The results supported our hypothesis 'the use of CBT self help materials could lead to a reduction in stress and anxiety scores on a rating scale, and lead to the development of coping skills in Year 11 school pupils'.

Discussion: We believe the promotion of a universal school based CBT programme, designed to prevent depression and anxiety in adolescents could be effectively implemented in the school environment. This fits with the objectives of both the Children's Scotland ACT 1995, which provides for local authorities having a duty to safeguard and promote the welfare of children in need, and with NSF objectives.

back to top

Mary Glover

Professional Role: Counsellor and Psychotherapist
Institution: Dept Clinical Psychology, Birmingham Children's Hospital
Contact details: Birmingham, B4 6NH
Email: mary.glover@bch.nhs.uk

ABSTRACT: Paper

Researching sensitive issues with vulnerable groups: shame in adolescence as an exempler

Research Question: How can counsellors and psychotherapists conduct research on sensitive subjects with a vulnerable group?

Research Rationale: Focus groups are cited as an effective approach in counselling and psychotherapy research, however, there is limited research that examines using focus groups for sensitive topics and the literature does not report on group dynamics. The aim of this study was to explore differences in reported shame between adolescent renal patients and a healthy group of adolescents (matched for age, ethnicity and gender) and consider these differences in focus group dynamics.

Research Design: A questionnaire survey compared reported shame in the two groups (no modification was made to the pilot of the quantitative research protocol). The qualitative investigation, utilising interviews and focus groups, was designed to provide an in depth understanding of the aetiology of shame and how this influences individuals' behaviour during a focus group. No modification was made to the semi-structured interview schedule, however, a pilot of a focus group exposed flaws in utilising a moderator's stance with adolescents and the approach was modified. At the end of each session notes were made on the group dynamics and the audio taped discussions were transcribed, summarised then given to participants for feedback. A total of eleven participants aged 12- 16 years participated in two series of focus groups.

Results: Shame is associated with being defined as part of an 'out group', which is brought into sharp focus in adolescent peer interactions. Focus groups are an appropriate means of enquiry with vulnerable clients, but only when the group leader has significant therapeutic skills.

Conclusion: In this study it emerged that significant therapeutic skills were needed in order to support the focus group enquiry. All the participants remained keen group members but acted out shame. This raises the possibility that researching sensitive issues with vulnerable clients should be conducted by competent therapists who understand issues of transference and counter-transference. This study indicates that counselling and psychotherapy research is needed in order to explore how the moderator role in a focus group needs to be developed in order to examine sensitive issues with vulnerable clients.

back to top

Terry Hanley

Professional Role: Lecturer in Counselling/ESRC Funded
Institution: University of Manchester
Contact details: ESI, School of Education, University of Manchester, Oxford Road, Manchester M13 9PL
Email: terry.hanley@manchester.ac.uk

ABSTRACT: Paper

An investigation exploring the potential challenges and opportunities that surround the development of online counselling services for young people in the United Kingdom

Background: Services for young people should be relevant and accessible to those seeking support. Within the UK precedents for the provision of successful mediated youth counselling have been set by telephone services such as ChildLine. With these points in mind, and with the acknowledgment that the Internet is steadily becoming a 'majority technology', youth counsellors need to be prepared for a move to online counselling.

Aims/Method: This study aimed to pool together the views of a small group of counsellors with an interest in online counselling to explore the perceptions that they held regarding the development of such services for young people. To do so an online asynchronous focus group was set up and hosted for a one-month period to create a dynamic dialogue regarding the topic. A grounded theory analysis of the forum transcripts was used to make sense of the data generated.

Findings: Findings displayed that the participants in the study accepted the potential of the medium for offering therapy; this particularly related to reaching groups of young people who would not ordinarily use a counselling service. They also suggested that there is a need for online counselling services to be regulated and good practice to be promoted.

Conclusion: The Internet has great potential for the development of easily accessible and relevant counselling services for young people. However, caution should be heeded before jumping headlong into such uncharted territory. This paper ends by raising a number of questions that potential service providers should consider when developing a service of this kind. It also discusses the challenges of regulating such a varied and dynamic medium. Some suggestions for the minimum requirements of counsellors working in this field are made.

back to top

Andrew Hill

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

ABSTRACT: Paper

Developing an evidence base in counselling and psychotherapy: methodological issues encountered in a systematic review of counselling older people

Research Question: What are key methodological issues in developing an evidence base for counselling and psychotherapy?

Background: Central to the theme of the consumer and counselling research is the notion of evidence. All consumers view research findings as potential sources of evidence to shape policy and guide action. From the results of a systematic review of research into counselling and older people (Hill and Brettle, 2004) methodological and quality issues are discussed with reference to developing an evidence base in counselling and psychotherapy.

Method: Six electronic databases were searched and 10 key journals hand-searched. Reference lists of relevant studies were searched to identify further relevant studies. Forty-seven studies met the inclusion criteria and formed the body of research to be reviewed. Each paper was critically appraised by two independent reviewers and a summary of each study agreed. The summaries were organised into a table to facilitate analysis and the results presented in a narrative report.

Results: CBT was the most commonly-researched intervention. Of the 47 included papers only seven were studies carried out in the U.K., the majority being North American. Twenty studies were randomised controlled trials and a further 12 were pre- and post-test outcome studies. There were nine systematic reviews, one survey, one mixed-method study, one statistical analysis of case notes and just three qualitative studies. The process of critical appraisal identified a variety of methodological issues relevant to the question of what constitutes evidence in counselling and psychotherapy.

Conclusions: To generate a viable evidence base there is need for research to be carried out by U.K. counsellors on U.K. populations, in U.K. health and social care settings and using routine counselling approaches. Rather than focus on 'laboratory-type' efficacy research, there is a need to generate practice-based evidence by researching the effects of counselling in naturalistic settings. Pragmatic research designs will be needed to meet the exigencies of such settings. As a consequence, systematic reviews which have to date used the RCT as gold-standard for good evidence will need to take a more pluralistic and inclusive approach to hierarchies of evidence. The paucity of well-conducted qualitative research suggests that these methods are under-recognised and could usefully contribute to the evidence base.

Reference

Hill. A., and Brettle, A. (2004). Counselling older people: a systematic review. Rugby: BACP.

back to top

Carol Holtom

Professional Role: Counsellor
Institution: Consulting & Clinical Psychology Services, NHS Ayrshire & Arran
Contact details: Counsellor in Adult Psychological Therapies Service, CCPS, Pavilion 7, Ayrshire Central Hospital, Kilwinning Road, Irvine KA12 8SS
Email: Carol.Holtom@aapct.scot.nhs.uk

ABSTRACT: Paper

Telecounselling to Arran: a qualitative analysis exploring client experience

Research Question: To explore the experience of clients engaging in person-centred therapy through the medium of telecounselling; the effect of the telecounselling environment on clients and how the telecounselling environment affects the therapeutic process.

Research Rationale: Since 2003 videoconferencing has been used by Consulting and Clinical Psychology Services, NHS Ayrshire & Arran, to provide person-centred counselling during the winter months to clients on the Isle of Arran. Although evidence suggests that it is possible to build therapeutic rapport and a working alliance when delivering CBT via this medium, there is a dearth of evidence concerning a person-centred approach. Since the client-counsellor relationship is the vehicle of therapeutic change in person-centred therapy, it is important to discover if there are elements of this distance technology which prevent relational depth.

Research Design: A semi-structured interview format was used. The interviews were recorded, transcribed and analysed by the researcher using grounded theory methodology. The research design received ethical approval from the local NHS Research Ethics Committee and from the University of Abertay, Dundee.

Sample: Ten (nine females and one male) of the 11 Arran clients who had engaged in counselling via telelink between September 2004 and April 2005 were interviewed by a research assistant regarding their experience of engaging in counselling via the medium of videoconferencing. Five had experienced a mixture of in-person and telecounselling and five had had an introductory in-person session followed by telecounselling.

Results/Findings: The central category which emerged was 'engaging with the technology, a journey of transition'. Within this there were four major categories, each containing sub-categories: 1) wondering how this can work; 2) needing a safe space; 3) adapting to the medium; and 4) discovering that therapeutic process is unimpeded. Half the participants (n=5) felt that the medium itself reduced the discomfort of speaking of difficult matters.

Conclusions: Despite its limitations, it would appear from this study that, provided a 'safe space' is created, it is possible to offer clients an engagement at relational depth through the medium of videoconferencing in an NHS setting and that the videoconferencing medium may be advantageous for some clients.

back to top

Vee Howard-Jones

Professional Role: University Lecturer
Institution: University of Salford
Contact details: University of Salford, Frederick Road Campus, Frederick Road, Salford M6 6PU
Email: V.S.Howard-Jones@salford.ac.uk

ABSTRACT: Poster

Coping strategies utilised by patients when undergoing and waiting for MRI scan test results

Research Question: How do pituitary patients manage any stress related to their MRI scans?

Research Rationale: In January 2005 the Department of Health produced a white paper "Supporting people with long term medical conditions". As part of this initiative an "Expert Patient Programme" has been introduced, with the intention of helping people living with long term or chronic medical conditions to become more knowledgeable and empowered regarding their condition and their interaction with the NHS. This research supports this initiative by looking at a patient group with a long-term condition who regularly undergo what can be distressing diagnostic tests known as MRI scans. Initial communication with pituitary patients reveal that they are eager to talk about how they cope with waiting for an MRI scan, undergoing the procedure and waiting for the results. The research will identify the counselling/psychotherapy options available to this particular group. Participants will also be asked how they have accessed counselling/therapy if appropriate, and if they have not, what alternative support systems they have used. The research will look at the accessibility and availability of counselling/psychotherapy services for this client group.

Research Design: The research design will use ethnographic qualitative methodology and there will be a triangulation of research methods. Participants will be part of a number of national focus groups and there will also be national questionnaires.

Sample: The sample is purposive in that a particular group - those with a pituitary condition who are part of a National Pituitary Organisation - have been approached for their participation. The National Pituitary Foundation has endorsed this research and has advertised for participants of the research via their conference, their website and their newsletter.

Results/Findings: Through a thematic analysis of focus groups and questionnaires the researcher will identify how patients, and those close to them, cope with MRI scan procedures. The research intends to identify the most effective types of counselling/psychotherapy for this target population.

Conclusions: Conclusions from the findings will identify how best the helping professions can support people who undergo tests, the results of which may alter their lives significantly. I will conclude from the findings what are the most effective ways of offering emotional support to this client group.

back to top

Gillie Jenkinson

Professional Role: Counsellor and Psychotherapist
Institution: The Sherwood Institute in partial fulfilment of MA in Gestalt Psychotherapy / Sheffield Rape and Sexual Abuse Counselling Service / Private practice specialising in working with ex-cult members
Email: gilliepsychotherapistukcp@hotmail.co.uk

ABSTRACT: Poster

Does psychotherapy/counselling help ex-cult members recover from an abusive cult experience?

Background: There is virtually no reference to recovery from an abusive cult experience in the psychotherapy/counselling literature and ex-cult members (ex-members) report a lack of understanding by therapists. This raises questions as to the effectiveness of established approaches.

Aims: To explore what helps ex-members recover, whether the participants sought psychotherapy/counselling and whether it helped. The researcher chose a phenomenological qualitative research design and conducted semi-structured interviews with a sample of eight individuals who identified themselves as ex-cult members. The size of sample was chosen because qualitative research emphasises processes, meanings and how reality is constructed, and is typically smaller in number to quantitative research. The research aimed to begin to give this consumer group a voice in the profession.

Results: The data and findings were split into two sections; internal processes and contexts in which recovery occurs. These findings provide valuable insight into the recovery process from an ex-member's point of view. A number of themes emerged including; education about the cult experience; reconnecting with pre-cult personality; learning to trust again; relationship - an antidote; and reconnecting with 'normal' life. The findings highlight that specialist work is needed with ex-members.

Conclusion: Whilst a number of therapies were mentioned (including Gestalt, Psychoanalytic, Person-centred, Cognitive, Crisis intervention, Family Therapy, Pastoral Counselling and Psychiatric) it was clear that they were only marginally helpful in aiding recovery if the therapist did not regard the cult experience to be an issue.

The outcome of the research is, therefore, a challenge to the profession to include this consumer group. I propose that further research into specialist therapy approaches and services needs to be developed to meet their needs, as well as training for therapists and specialist supervision.

back to top

Dr Janet Johnson

Professional Role: Counselling Psychologist, Co-ordinator of Counselling Services
Institution: Pontypridd & Rhondda NHS Trust and in Independent Practice
Contact details: Psychology Dept, Pontypridd Mental Health Clinical Day Services, Woodland Terrace, Maesycoed, Pontypridd CF37 1DZ
Email: janet-m.johnson@pr-tr.wales.nhs.uk

ABSTRACT: Paper

The therapeutic relationship in primary care: using client accounts to inform debates of how to enhance the delivery and practice of counselling

Research question: Can client accounts inform debates of how to enhance the delivery and practice of counselling?

Research rationale: Counselling is included in NICE guidelines as a treatment of choice in primary care for those experiencing mild to moderate symptoms of depression and/ or anxiety. Whilst there is a literature that focuses on evidence-based practice, this study seeks to explore client accounts of primary care counselling in order to inform debates of how to enhance the delivery and practice of counselling.

Research design: Following ethical approval, 23 clients were interviewed by the researcher some months after completion of their counselling. Individual semi-structured interviews were analysed using a thematic analysis.

Sample: Participants had been referred in one of two managed primary care counselling services, covering 17 GP practices, which offered structured/ brief counselling. Counsellors were accredited, or of accreditable standard, and had undertaken training in differing therapeutic approaches.

Results/Findings: Clients disclosed a wide range of life issues that had preceded their referral for counselling, and their experience of a variety of counselling interventions. Clients also spoke of their appreciation of the ability to negotiate the spacing and ending of the counselling sessions, the perceived competence of the counsellor, and the physical location of the counselling. Eleven of the 23 had also received therapeutic interventions in other settings. They offered contrast narrative to illustrate helpful and unhelpful factors.

Conclusions: The findings suggest that no one form of counselling will suit all clients and, therefore, to offer only a single approach will inevitably fail to meet the needs of some clients. It is suggested that counselling provision in this setting needs to be flexible in its approach and that counsellors need to be able to offer interventions from a range of therapeutic approaches. Other issues are discussed, such as recognising and addressing counsellor-client 'fit', and the timing of the counselling in the client's life process.

This paper is based on PhD research funded by ESRC at Cardiff University.

back to top

Anthony Jordan

Professional Role: Primary Care Counsellor
Institution: WSHSC NHS Trust
Contact details: AAW Primary Care Counselling Service, 16 Liverpool Gardens, Worthing, West Sussex BN11 1RY
Email: tonyjordan@lineone.net

ABSTRACT: Paper

Do the benefits of time-limited counselling endure?

Background: Time-limited primary care counselling is now widely available. With the advent of routine clinical audit systems like CORE it is possible to monitor and report on the effectiveness of such services. The data shows substantive evidence of the benefits of counselling based on pre and post measures; but how well does this endure?

Aim: To follow-up clients known to have gained reliable and clinically significant improvement from time-limited counselling (6-12 sessions) to investigate 'durability of benefit' in the medium term.

Method: 108 ex-clients of an NHS primary care counselling service are followed up 9-16 months after completion of counselling. A CORE-OM and a custom questionnaire are used as dual, repeated measures of outcome. The follow-up measures are compared with previous pre/post data gained at the time of therapy. The project was approved by the local NHS ethics committee.

Results: The mean pre-therapy CORE-OM score of 64 had fallen to 21 by the end of counselling; the study found that at follow-up, the mean level had risen to 30. ANOVA testing found the rise to be significant although still well below the nationally established benchmark for clinical cut-offs (i.e. 41 for men & 44 for women). 72% of cases remain below the cut-off. Effect size between pre and follow-up was found to be large (ES=0.73). The custom questionnaire found clients' perception of 'durability of outcome' was good, and strongly associated with the CORE-OM follow-up measure. In those that relapsed, no association could be found with amount or type of therapy, clinical issue, time to follow-up, age or gender.

Conclusions: Durability of outcome was found to be good and in agreement with clients' own perception of lasting benefit to them. In the minority that relapsed, no specific factors could be identified.

The research was hosted by West Sussex Health & Social Care NHS Trust and supervised by Roehampton University.

back to top

Peter Kemp

Professional Role: Counsellor
Contact details: 7 Durham Court, Sunnyside Road, Teddington TW11 0SL
Email: p.kemp@talk21.com

ABSTRACT: Poster

What issues might arise from being ill with M.E. and can counselling help?

Aim: To discover, using an on-line survey, whether counselling can help people with M.E./C.F.S.

Method: Respondents completed online surveys. In order to take part, they had to have access to the internet and online patient support groups, and/or to organizations or forums which publicized the research.

Data: Respondents with M.E./C.F.S who received counselling (n = 97) rated the value of exploring various items in counselling. These included issues relating to their illness, psychodynamic and existential items and efficacy items such as 'counselling helped'. Learning items were also included, e.g., 'I learned to explore my feelings'. Respondents provided subjective ratings of some counsellor qualities, such as compassion, patience and so on.

Respondents with M.E./C.F.S who want to receive counselling (n = 37) rated how useful they think it would be to explore issues in counselling (including items listed above) and how importantly they rate counsellor qualities. Respondents with M.E./CFS who don't want counselling (n = 36) provided data regarding their reservations/objections. Respondents with M.S. who received counselling (n = 48) completed a similar questionnaire to people with M.E. Respondents submitted >30,000 words as comments.

Analysis: Qualitative data was progressively analysed for themes, key words and phrases. The research includes 115 illustrative quotes from respondents. The research includes references from 85 published sources and a literature review of 35 textbooks and published research.

Quantitative data was analysed using numerous sort criteria in Microsoft Excel and converted into graphs illustrating the data and trends. Analysis of data according to respondent demography showed little difference from overall results.

Results: Those respondents with M.E./C.F.S. who rated efficacy items high, appear to value work and learning achieved in counselling. For many this included issues specific to having M.E./C.F.S. Respondents who rated these issues high often rated their counsellor's qualities highly and in particular trusted the counsellor.

Respondents who rated efficacy items low sometimes thought that their counsellor did not understand their problems. They often rated work and learning items lower and had less trust in the counsellor. They sometimes rated their counsellor's qualities lower and some perceived 'psychologizing' of their illness.

back to top

Dr Kathryn Kinmond and Mrs Lisa Oakley

Professional Role: Senior Lecturers in Psychology
Institution: Manchester Metropolitan University
Contact details: MMU Cheshire, Crewe Campus, Crewe Green Road, Crewe, Cheshire CV1 5DU
Email: k.kinmond@mmu.ac.uk and L.R.Oakley@mmu.ac.uk

ABSTRACT: Paper

'It really is time we all woke up and smelt the coffee'. Issues for counselling spiritual abuse

Research Rationale: Spiritual abuse has been defined as 'someone using their power within a framework of spiritual belief or practise to satisfy their needs at the expense of others' (Hall, 2003:33). Recent research has demonstrated that it is also a form of abuse that affects many people in the U.K. Yet survivors comment upon a lack of understanding and support in today's secular society. It may be difficult for some to seek counselling for spiritual abuse with someone they may feel does not empathise with a core construct of their self. Certainly, it is acknowledged that a counsellor's lack of faith should not impact upon the client-practitioner relationship. Rather, if the essential 'core conditions' are created a therapist's lack of faith should be irrelevant. Yet, it can be argued that practically, some individuals may be hesitant about revealing the pain of abuse they fear may not even be recognised as abuse. Two factors that negated participation in counselling were fear and perceived counsellor lack of specific knowledge. This provides the rationale for the study.

Research Design: A qualitative study using a narrative methodology was conducted. Ten narratives were taken from individuals who had experienced spiritual abuse in the U.K. These narratives were analysed using interpretative phenomenological analysis.

Sample: The opportunity sample consisted of 10 individuals, from different denominational contexts holding a range of church positions, who had experienced spiritual abuse in the U.K. None of the participants had received counselling.

Results/Findings: Participants noted a lack of understanding of spiritual abuse together with a perceived absence of counselling support.

Conclusions: There is a need for a detailed understanding and acknowledgment of spiritual abuse. There is also a need for open dialogue within counselling practise about spiritual abuse. In this way clients may feel empowered to seek therapy from suitably informed counselling practitioners. The awareness raising of cultural and diversity issues has made counsellors more effective in supporting clients from different backgrounds. Similarly, raising awareness and knowledge of spiritual abuse may inform practice.

back to top

Phoebe Lambert

Professional Role: Independent Counsellor
Contact details: 58 Battersea High Street, London SW11 3HX
Email: pjlambert@btinternet.com

ABSTRACT: Paper

Client perspectives on counselling: a hermeneutic approach

Aim: This four year study investigated the under-researched area of client perspectives on counselling: how clients perceived counselling before, during and after counselling and how such perceptions evolved.

Background: As practitioners we often assume that we know and understand the client's perspective. Yet for many clients there remains a mystique surrounding counselling and uncertainty about what it entails.

Method: Drawing on my professional contacts in Liverpool, London and Norwich I sought client and counsellor research participants from six settings within the user groups of university counselling services (London, Northern and Eastern England), the voluntary sector (Norwich) and primary care (Norwich and Norfolk). Using an interpretive hermeneutic framework based on thematic analysis I carried out 30 half-hour interviews. These were semi-structured, one-to-one, recorded and transcribed and related to counselling periods lasting from six weeks to 18 months. Eight client participants agreed to be interviewed at the pre-counselling stage, of whom seven were interviewed early on in counselling and six after completion of counselling. Their own counsellors were also interviewed during and after counselling and as close as possible to their client's interviews.

Ethical approval was gained from the participating agencies and the Norwich NHS Research Ethics Committee.

Results: At the outset all eight client participants were experiencing distress and urgently seeking counselling. Six were uncertain about the nature of counselling and what to expect. Six referred to stigma associated with peer influence and experienced varying levels of confusion about specialist language and duration issues. Seven believed that counselling should be widely available and one requested greater responsiveness to cultural diversity. Six desired advice. All completing client and counsellor participants experienced the researcher interventions as useful in highlighting the client perspective and similarities and differences in the client-counsellor viewpoint, and in facilitating dual review of counselling.

Discussion: The research results raise key issues for practitioner consideration. These include wider client involvement in counselling research and policy-making; preparatory sessions for intending clients; training modules addressing the client socio-cultural perspective and issues of power and control underlying the value systems of the main counselling theoretical approaches; and the importance of networking and information sharing within and across user groups.

back to top

John Lees

Professional Role: Senior 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

Reflexive research, counselling practice and the consumer

Introduction: Most counselling and psychotherapy practitioners traditionally work in an introspective and reflexive way. However, the current emphasis on public accountability in the form of evidence-based practice and discussions about regulation also require an outward-looking approach to clinical practice which demonstrates the value and efficacy of the work. This inquiry looked at the impact of these developments on practitioner work.

Aims: The inquiry had two aims. First, to look at existing practitioner skills and examine how they prepared practitioners for the current demands which are made on them by society. Second, to see how it is possible to both maintain the integrity of the traditional reflexive discourse of therapy practice and meet these outer requirements.

Method: The research adopted the clinical case study method based on a single case study. The data was drawn from my experience of supervising an experienced general practice counsellor, who had given written consent. The data was collected retrospectively from memory and brief session notes. It incorporated four cycles of analysis with an emphasis on narrative analysis (Polkinghorne, 1995) and critical reflexivity (Freshwater and Rolfe, 2001). The research was limited by researcher bias, selectivity of data and the limits and distortions of memory.

Results: The principal result showed that the supervisory process exhibited 'dissociative' defences characteristic of trauma. In relation to the two aims, it was not possible to determine whether this was due to the impact of discourses relating to accountability or some other cause, or a combination of causes. But it did demonstrate how the discourse of practitioner reflexivity can add to the discourse of accountability in a way that can be fruitful for both (e.g. developing epistemological breadth).

Conclusion: The research was addressed to three primary groups - practitioners, clinical trainers/supervisors and health professionals. It demonstrated that practitioner reflexive methods can produce knowledge of value which supplements the knowledge produced by the dominant accountability discourse. However, in view of the fact that the impact of the dominant discourse on clinical work remains hypothetical, it is suggested that further research is conducted to examine this issue.

References

Freshwater, D., & Rolfe, G. (2001). Critical reflexivity: a politically and ethically engage research method for nursing. NT Research, 6(1): 526-537.

Polkinghorne, D. (1995). Narrative configuration in qualitative analysis. In J. A. Hatch and R. Wisiewski (Eds.) Life History and Narrative. London: The Falmer Press

back to top

Maureen Mason

Professional Role: Counsellor Trainer/Lecturer
Institution: Cornwall College
Contact details: Social Sciences, Social Work and Health Professions, Penhaligon Building, Pool, Redruth, Cornwall TR15 3rd
Email: maureen.mason @cbs.ac.uk

ABSTRACT: Work in Progress Symposium

Will your counselling training course help me get a job?

Research Question: This is the first part of a larger study, funded by a teaching fellowship from the University of Plymouth through the HELP CETL national initiative. It examines which factors improve students' employability and what improvements could be made, on an HE level BACP accredited diploma, delivered in two locations in the South West.

Background: Most students undertaking a diploma are hoping to gain employment in counselling. How well will their course prepare them? What factors are most helpful in reference to employability? There is a lack of research enabling tutors to help students prepare themselves for employment . Guidance as to what constitutes 'good practice' seems to be a matter of opinion.

Method: The study uses mixed methodology yielding qualitative and quantitative data. Questionnaires were sent to all (110) students who had successfully completed the Diploma, asking them to rate those aspects of the course which had been helpful in promoting their employability, on a rating scale of 1 (least helpful) - 10 (most helpful). They were also asked to identify factors that they would like to have seen included. The questionnaires were followed up by focus groups (n=10), which were videotaped and transcribed and analysed by two researchers. The next stage of the study will use semi-structured interviews with employers and further former students.

Findings: Fifty seven out of 110 questionnaires were returned (51%). Fifty (87.5%) respondents were counselling in either a full-time, part-time or voluntary capacity. In helping students gain future employability respondents rated client work and placements highly (9+). Supervision, personal counselling, the course reputation and academic aspects of the course were also scored as helpful (7.5 and above). Focus groups participants also identified networking as important in gaining employment. Respondents would like to have seen more emphasis on a number of professional aspects, and also on job seeking and transferable skills.

Conclusions: Graduates perceive that BACP requirements for placements help them gain employment and that HE level courses can give them an advantage in the job market. Personal counselling and academic experience contribute to professional confidence. Courses could do more to support students e.g. new developments in the HE sector on 'personal development planning' and work based learning may be helpful.

back to top

Denise Meyer

Professional Role: University Counsellor
Institution: Charlie Waller Memorial Trust
Contact details: Charlie Waller Memorial Trust, Mead House, Bradfield, Reading RG7 6HU
Email: denisemeyer@btinternet.com

ABSTRACT: Paper

Therapy beyond the counselling room - social constructionist action research to develop a student-focused self-help website for depression

Aim: To spread therapy 'beyond the counselling room' by using action research to co-create a comprehensive self-help website perceived as relevant and helpful by a representative student user group, and as clinically valid by a professional expert group.

Rationale: Nearly half of depressed people never access professional help (NICE 2004). Young men, a high suicide-risk group, in particular are often reluctant to seek help. The internet is a potential help medium accessible to young people, but a review of available depression-focused sites found little in-depth self-help information.

Research Design: This action research, within a social constructionist framework, aimed to produce a multi-layered account of depression with a view to positioning website users with empowering perspectives and strategies, while challenging barriers to help-seeking. An evaluative action research spiral was used to analyse and act upon specifications and ongoing feedback from stakeholders; public health guidelines; students; student focus group commentary; and final expert group commentary.

Sample: Thirteen students, chosen from 20 applicants to represent diverse demographics and depression experiences, attended semi-structured interviews to elicit 'coping' narratives. Ten interviewees then formed an ongoing email focus group. Triangulation was provided by other project stakeholders: the funding charity steering group (including heads of university counselling services); the university which provided programme/ethical approval; and the expert group (psychologists/psychiatrists) offering clinical validation.

Results/Findings: In addition to the central coping narratives, the student group contributed to the developing site in several stages, passionately debating diverse details of format and content and in turn informing accommodation of steering and expert group feedback. The final site at www.studentdepression.org has nearly 100 pages of information and self-help resources cross-referenced with personal narratives, providing a rich, complex account of how depression may be tackled and resisted.

Conclusions: Both student and expert groups were impressed with the final site quality and usefulness. Collaborative development with user-group representatives is likely to have produced a far richer, more accessible and more comprehensive resource than via counsellor authorship alone.

Reference:

National Institute for Clinical Excellence. (2004). Clinical Guideline 23 Depression: management of depression in primary and secondary care.

back to top

Sandra Moore

Professional Role: Ex Director/Volunteer counsellor
Institution: The Leicester Counselling Centre
Contact details: The Leicester Counselling Centre, No 1 Lodge, Victoria Park, London Road, Leicester LE1 7RY
Email: SMoore9845@aol.com

ABSTRACT: Paper

Voluntary sector therapy: has inadequate research resulted in a misunderstood and underutilized resource?

Background: Most counselling contacts in Britain every year are made through voluntary sector agencies (Armstrong & McLeod, 2003). Given the inability of the NHS to meet current demands for psychological therapies, many argue that the voluntary sector should offer even more. Little recent research has been done in this field, meaning there is inadequate 'evidence'. This study seeks answers to questions such as what sort of client presentations are voluntary sector practitioners able to work with, how effective is their work and what level of training have they had?

Method: A generic, county-wide, not-for-profit counselling centre staffed by over 60 volunteer counsellors and a small paid staff was studied. CORE Therapy Assessment Forms (practitioner completed) and Outcome Measure Forms (client completed), collected between July 2000 and June 2005, provided data on presenting problems and levels of distress; Outcome Measure Forms (OMFs) from clients ending during the same period were used to measure outcomes; and the centre's volunteer counsellors were asked to complete questionnaires describing their training.

Results: The 1,491-strong CORE database showed that the most common presenting problems at the centre were the same as those for the CORE National Database for Primary Care Counselling. 1,480 clients completed OMFs at assessment: the proportion below the CORE clinical cut-off level was low relative to national comparators. Ending OMFs, completed by 396 of the 601 clients ending during the period, demonstrated good outcomes compared with other therapy services. All 43 currently active volunteer counsellors returning questionnaires had considerable training in therapy, 74% already holding diplomas or better, and many having years of experience.

Conclusions: This study suggests that therapeutic work comparable to that being done within the NHS can be done in the voluntary sector, with good results and by appropriately trained practitioners. More research in this field is needed and would be in the interests of clients and local and national mental health policy-makers.

Reference:

Armstrong, J., and McLeod, J. (2003). Research into the organisation, training and effectiveness of counsellors who work for free. Counselling and Psychotherapy Research, Vol 3 No. 4.

back to top

Brigid Morris

Professional Role: Research and Development Worker
Institution: The Women's Therapy Centre
Contact details: The Women's Therapy Centre, 10 Manor Gardens, London N7 6JS
Email: brigidm@morrisb.fslife.co.uk

ABSTRACT: Paper

Women's views of psychoanalytical psychotherapy: qualitative research carried out at the Women's Therapy Centre, London

Research Questions: Can an organisation providing psychoanalytical psychotherapy gain useful information about the process and outcomes of therapy from its clients?

Research Rationale: All health and social care organisations, including therapy providers, are now required to provide evidence that their interventions are effective (evidence based practice) and that they are responding to the feedback of their clients (service user involvement). To date psychoanalytical psychotherapy providers have rarely sought the in-depth view of their clients regarding their experience of therapy.

Research Design: In-depth interviews with past clients of the Centre were carried out by two female researchers. The interviews were audio-taped, transcribed and then analysed using the Framework approach.

Sample: Seventy six past clients of group and individual therapy at the Centre were approached. All these women had left the Centre during a pre-identified one-year period. Forty seven of these women were located, agreed to take part and were interviewed.

Results/Findings: Women with positive experiences of therapy as well as those who were unsatisfied took part in the interviews. The analysis of the transcripts highlighted: the reasons why women initially sought therapy, what helped women engage with the "hugely challenging" process of therapy, why some women decided to leave therapy early, the wide range of ways in which many of the women benefited both internally and externally, and that women's time at the Centre was usually part of a wider personal journey of moving towards greater psychological well being or "healing".

Conclusions: Psychoanalytical psychotherapy can equip women with sustainable emotional "tools and skills" that can help reduce mental health symptoms and enable them to progress in their lives. Clients can eloquently describe, in lay language, what takes place in psychoanalytical psychotherapy and whether or not they feel they benefited from the experience. Client-focused qualitative research can provide useful information for a wide range of 'consumers' of research: future clients, therapists, other health and social care professionals, funders and policy makers.

The research was funded by the Big Lottery Fund with additional assistance from the Feminist Review Trust.

back to top

Seamus Nash

Professional Role: Psychotherapist and PhD Student
Institution: The Counselling Unit, University of Strathclyde, Jordanhill Campus.
Email: seamusnashphd@yahoo.co.uk

ABSTRACT: Paper

A qualitative exploration into counsellors/psychotherapists' use and understandings of the term 'person-centred'.

Background: This is part of a PhD study researching practitioners' understanding, meanings and employment of the term 'person-centred'.

Aims: It has been recognised within the person-centred approach to counselling and psychotherapy that there exists externally a proliferation of misinterpretations and misrepresentations about the nature of this modality (Mearns and Thorne, 1988; 2002). The research looks at practitioners' understandings of person-centred theory and how this is manifested in their individual practice.

Method: This is the first part of a PhD research project utilising a phenomenological and qualitative methodology. Fifteen respondents (out of 22 who responded) were recruited nationally who had undertaken a counselling/psychotherapy training labelled as 'person-centred'. Participants were interviewed both face to face and by telephone, using a semi-sturctured interview process. The interviews were recorded using both tape and mini-disc. The data generated was transcribed and analysed using NVIVO qualitative software. The project was approved by the University of Strathclyde Ethics Committee.

Results: Many of the respondents talked about their decision to train within the person-centred model which they linked to their life or 'ethical' stance. The respondents also emphasised the political aspects of a person-centred practice. The term 'person-centred' was held in a uniform manner by the respondents and significantly, the concept of 'a way of being', underpinned their practical applications. The research showed that the respondents did feel that misinterpretations concerning the approach are still apparent. This was linked to deficits on training courses. Respondents felt that their understanding and application of their unique interpretations of person-centredness had a solid grounding in theory. Various aspects of theory were elaborated upon and some were noticed as central to claiming of 'person-centredness', notably the actualising tendency and a renewed vigour in terms of the centrality of the relationship.

Conclusions: A practitioner's definition of 'person-centredness' was a central pillar to their practice. From this a practitioner's understanding of person-centred theory is also vital to how they understand themselves as 'person-centred'. These research findings are the first stage of an in-depth study.

References:

Mearns, D. & Thorne, B. (1988). Person-centred counselling in action. London: Sage
Mearns, D. & Thorne, B. (2002). Person-centred therapy today. London: Sage.

back to top

Sue Parker Hall

Professional Role: Lecturer in Counselling
Institution: Cornwall College
Contact details: Cornwall College, Pool, Redruth, Cornwall TR15 3RD
Email: sueparkerhall@btconnect.com

ABSTRACT: Poster

Grasping anger by the tale: therapists (discussing their experiences as client) identify specific interventions which helped and hindered their processing of anger

Research Question: Which specific counselling interventions supported the expression and processing of anger and which undermined that process?

Research Rationale: I explored whether issues of anger and rage are helpfully supported by qualities of relationship and interventions which validate anger, encourage its expression and subsequently attend to, the often many, layers of unprocessed life experience which can lie beneath it; in contrast to the mainstream cognitive interventions, usually referred to as 'anger management' programmes.

Research Design: Therapists participated in two un-facilitated reflecting teams lasting 2.5 hours and told stories about their personal and professional experiences with anger. The narrative research method reflects the researcher's belief that bringing the stories which lie beneath anger into a respectful relationship is efficacious. This was combined with the researcher's immersion in the process and data, a heuristic approach, which led to a creative synthesis in the form of four models for supporting therapeutic work with anger.

Sample: Sixteen local therapists were approached who consider themselves to work at 'relational depth', seven volunteered to take part (six female and one male).

Results/Findings: Interventions which facilitated anger being heard in a non-defensive way, especially when aimed at their therapist directly, emerged as important to all participants. The most common failing was therapist inability to hear their anger through practices of discounting, minimising, rationalising and, most unpopular of all, interpreting; 'cushion bashing' was found unhelpful by one participant. Four models emerged which tentatively exemplify 1) how a therapist's unresolved story around the issue of anger eclipsed work with a client; 2) some possible developmental stages in therapists' practice when working with client anger; 3) anger as a protection for other vulnerable feelings; and 4) some possible stages of anger surfacing in the counselling relationship.

Conclusions: Research participants' therapists inhibited the healthy expression and processing of anger through unhelpful interventions. Where their therapists were non-defensive, listened to their anger and conveyed their empathy, participants identified that considerable healing occurred. Significant personal and professional development is implicated if therapists are to work successfully with anger and rage issues.

back to top

Dr Sue Pattison and Ms Antoinette Corr-Jack

Professional Roles: (SP) Lecturer/Supervisor/Counsellor, (AC) Head of Guidance and Counselling Unit
Institution: University of Newcastle UK/Department of State for Education, Guidance and Counselling Unit, Gambia.
Contact details: University of Newcastle upon Tyne, School of Education, Communication and Language Sciences, Joseph Cowen House, St Thomas St. Newcastle upon Tyne NE1 7RU
Email: susan.pattison@ncl.ac.uk

ABSTRACT: Work in Progress Symposium

Gambian children as consumers: how effective is school counselling for female students in the Gambia?

Background: Counselling is high on the agenda for the Department of State for Education in the Gambia, supported by policies relating to Third World development nationally and across Sub-Saharan Africa.

Aims: The aim of this paper is to present emerging results from a research project to evaluate school counselling for female students in the Gambia.

Method: This study adopts a quasi-experimental approach to evaluate the effectiveness of school counselling (one to one) in the Gambia, along with collection of qualitative data to enrich the study. The sample consists of females aged 12-16 years across 10 urban and 10 rural secondary schools drawn opportunistically from the six regions of the Gambia. The data collection tool is the CORE-YP v1 administered for collection of before and after data. Data is analysed using the Young People's Core Scoring system and the SPSS software package. Qualitative data is analysed thematically using techniques from the grounded theory approach.

Results: This paper will present emerging results, which will be reported nearer to the conference date. However, initial feedback from the project shows that children feel less alone, more able to cope with their difficulties, less likely to self-harm, less tense and anxious, less upset and less irritable following counselling. They also feel more optimistic about the future and able to share their feelings with others. Head teachers find the counselling provision useful in terms of knowing how to help distressed children and 'holding' strong emotions related to difficult family and social circumstances. School counsellors are positive about their interventions and provide case study examples supporting children's responses to the CORE-YP questionnaires.

Children have responded positively to invitations to talk to researchers about their experiences.

Conclusions: The counselling services that are provided in all Gambian state secondary schools seem to be a valuable source of support for girls, which is often the only support available when children are distressed and unable to cope. The effectiveness of counselling is yet to be confirmed by data. However, emerging results are very positive.

Funded by BACP Seed-Corn Funding Research Grant, supported by the University of Newcastle upon Tyne UK and the Department for State for Education, Gambia.

back to top

Dr Nicholas Peckham

Professional Role: Clinical Psychologist
Institution: Northgate & Prudhoe NHS Trust
Contact details: Psychology services, Northgate & Prudhoe NHS Trust
Email: nick.peckham@nap.nhs.uk

ABSTRACT: Paper

The delivery and evaluation of a psychotherapy group for women with significant learning disabilities who have been sexually abused

Research Question: Will a psychotherapy group help seven female survivors of sexual abuse with a significant learning disability to improve sexual knowledge, trauma, self-esteem, anger, depression and challenging behaviour?

Research Rationale: It is estimated that sexual abuse is more prevalent in the learning disabled population and has been associated with trauma, low self-esteem, anger, depression and problem behaviours. This pilot study builds on previous research by evaluating a 20 session psychotherapy (survivors) group, run weekly in the community over five months for women with a learning disability, and a concurrent support group for their carers. The model of group therapy is educational with session content informed by CBT and person centred counselling. Education is a prerequisite to psychotherapy, as people with learning disability tend to have poor sexual education (McCabe, 1993). The group hoped to improve sexual knowledge, trauma, self-esteem, anger, depression and challenging behaviour.

Research Design: The group (seven women with learning disabilities and seven carers of these women) was evaluated using a repeated measures design (double baseline, mid treatment, post treatment and follow-up). Data were collected by independent researchers. We constructed our own sexual knowledge assessment and used standardised measures (Beck Depression Inventory, Impact of Events Scale, Novaco Anger Scale, Culture Free Self-esteem Inventory and the Challenging Behaviour Inventory) which were simplified for this population. In addition, participants were interviewed about their experience and its effectiveness.

Results/Findings: Sexual knowledge improved for the survivors group and carers group. The survivors group appeared to help the women reduce their trauma and depression. Neither self-esteem nor anger improved for most of the survivors group and challenging behaviour worsened at first before improving. Qualitative interviews with participants of both the SG and ESG supported the effectiveness of both groups and highlighted future needs.

Conclusions: The psychotherapy group seemed to be successful in improving sexual knowledge and in reducing depression and trauma. Challenging behaviour may get worse before its get better as these clients needed considerable time to understand, reprocess and move on from their sexual abuse. Positively, the client and carer participants said they wanted more groups in the community. This is supported by the research literature, which indicates there is a need for more sexual abuse/sexual education groups for men and women with learning disabilities.

back to top

Sara Perren

Other Authors: Cath Snape, Lesley Jones, Krys Shelmerdine and Nancy Rowland

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

ABSTRACT: Work in progress symposium

An assessment of the impact of counselling over the longer term: a qualitative study to explore users' views

Background: Provision of counselling in primary care has increased considerably in recent years. Counselling is one of the treatment options available for mental health problems. Little is known about the long-term impacts of time-limited counselling. If we are to assess its cost effectiveness and its value to patients and GPs we need more information - particularly about why and in what contexts users achieve and maintain improvements in life situation and mental health after counselling.

Aims: To investigate whether there is any lasting treatment impact meaningful to service-users. To identify impacts that users consider important 1-3 years after counselling. To explore users' understanding of the processes by which psychological therapies achieve change.

Method: Qualitative study using in-depth interviews, focus groups and written responses. User consultation has been important in the design of this study and this continues. NHS Primary Care counselling services in Northern England will invite feedback from people who attended counselling 1-3 years ago.

Participants will be interviewed by a researcher using in-depth interviews: a number of areas will be explored, while maintaining a flexible approach. The emphasis will rest with the interviewees' understanding and interpretation of events. Lines of thought arising from earlier interviews will be added as the interviews proceed. Interviews will be tape recorded and the data generated transcribed and analysed.

We will also utilise questionnaire responses from people who do not wish to be interviewed. These will be six open questions aiming to elicit answers in narrative form, as follows: 1) Please tell us what you know about the type of counselling you received and the counselling contract you were offered (number of session etc.); 2) Can you tell us a bit about how helpful or unhelpful the counselling was?; 3) Looking back on it, what was the most important thing you received from counselling?; 4) Have you found that the effects of counselling have lasted? If so, please tell us a bit about these; 5) Any other comments about your counselling experience?; 6) Any general comments about this study. Focus groups after completion of interviews will extend and develop conceptions from the interviews. Our user group will be consulted at all stages including interpretation of data. The project has been approved by the local NHS ethics committee.

Results: At time of submission interviewing has not begun. We hope to begin interviewing in March and have some early data by the time of the conference.

Funded originally by a Yorkshire Primary Care Research Network (YReN) research bursary. Currently funded by BACP's seed-corn funding research award.

back to top

Seamus Prior

Professional Role: Co-Director
Institution: University of Edinburgh
Contact details: Counselling Studies, School of Health in Social Science, University of Edinburgh Medical School, Teviot Place, Edinburgh EH8 9AG
Email: seamus.prior@ed.ac.uk

ABSTRACT: Paper

'This is me-time': young people as a new generation of counselling consumers

Research Question: The research upon which this paper is based is a set of interviews with young people who had used a young people's counselling service. The research question was: how do young people perceive the therapeutic effectiveness of their engagement in this counselling service?

Research Design and Sample: All young people who had used the counselling service in the previous twelve months, who had attended for two sessions or more and who had completed their counselling (22 in total) were invited to take part in the interviews. Nine young people participated in a single one-to-one interview. The interview was semi-structured and focussed primarily on the young person's evaluation of therapeutic change, change in their relationships with others and in their situations, and their perception of the contribution of the counselling to these changes. The interviews were transcribed and a thematic analysis undertaken.

Results: All service users interviewed reported significant therapeutic benefits and expressed high levels of satisfaction with all aspects of the counselling service. Some young people described attending counselling as a life-changing experience. The theme of consumer awareness and consumer confidence emerges from the young people's narratives of their experience of counselling. It can be argued that the young people are expressing a sense of entitlement to the therapeutic space and relationship they have experienced, summed up in the phrase used by one interviewee: 'this is me-time'.

Conclusion: With the gradual expansion of counselling services now proliferating into young people's education and social settings, a new generation of counselling consumers is emerging. The present analysis of young people's accounts of their experience of counselling supports the contention that, as young people have become an active and confident consumer group within the wider marketplace of goods and services, they have also become a group with a sense of entitlement to therapeutic services.

back to top

Dr Maggie Robson

Professional Role: Senior Lecturer
Institution: Keele University
Contact details: School of Psychology, Keele University ST5 5BG
Email: m.a.robson@psy.keele.ac.uk

ABSTRACT: Work in progress symposium

Experiences of personal development: useful to the student consumer?

Research Question: What are the participant's experiences of Personal Development (PD) Groups?

Research Rationale: Within the humanistic perspective, PD groups are viewed as an integral part of counsellor training where the purported purpose is to develop personal awareness. Whilst several authors acknowledge the centrality of these groups to counsellor development, Izzard and Wheeler (1995) concluded that it was unclear if PD groups did indeed facilitate change in counselling trainees. Little is documented regarding participants' experience in PD groups, so this research aims to explore participants' experience of PD.

Sample: Tutors and students participating in two counselling training programmes (Humanistic core model with person centred practice) were invited to keep an anonymous journal of their experiences in PD for 3-4 months. No attempt was made to differentiate the source of the data. Facilitated PD groups were held weekly for an hour and were differentiated from other areas of training by not having a defined task other than that of increasing awareness. Purposive sampling was used.

Method: Because of my dual role as researcher and tutor, it was important to reassure students that anything they handed into me would not form part of any assessment. It was also important that I could not identify the participants. The 11 participants who participated handed in an anonymous disc via my pigeon hole. Journals were the only source of data analysed. Journals were read through many times and emergent themes were identified and connections between them sought. To triangulate the process and guard against bias from my dual role, some of the data were analysed by both my self and my research partner, Jenna Robson, and a comparison made as to themes identified. This is an ongoing process. Ethical approval was granted by the Research Ethics Committee in the School of Psychology, Keele University.

Preliminary Findings/Conclusions: Common themes that are emerging from the thematic analysis of the journals are: safety, feeling part of group, organisation of group, facilitator's role, physical surroundings, relationships with other group members, personal growth, anger, indicators of group working well and effects of past experience in groups. Safety, either feeling safe or not feeling safe, seems to have the greatest impact upon involvement in the group and links to emergent themes.

References:

Denzin, N., and Lincoln, Y. (Eds.). (1994). Handbook of qualitative research, Thousand Oaks: Sage

Izzard, S., and Wheeler, S., (1995). Development of self-awareness: An essential aspect of counsellor training? 1st BACP Research Conference, February 1995. Counselling, Vol. 6, No.3: 227

back to top

Brian Rodgers

Professional Role: PhD Student
Institution: University of Abertay Dundee
Contact Details: Tayside Institute for Health Studies, University of Abertay Dundee, Dudhope Castle, Dundee DD3 6HF
Email: research@brianrodgers.co.uk

ABSTRACT: Paper

Life space mapping: preliminary results from the development of a new method for investigating counselling outcomes

Introduction: Counselling outcomes are often measured in terms of standardised questionnaires. Though efficient for large numbers of participants, this method cannot capture the unique and subtle 'shifts' that clients may be able to report when qualitative methods are utilised. Further, such questionnaires usually focus on the individual, missing the wider social implications of therapy. This paper presents the preliminary findings from a study that utilises the client's own perceptions of changes in their "Life Space" to establish the significance of their change process. These results are compared and contrasted with a standard outcome questionnaire and the participant's experience of using the two methods are explored.

Method: Twenty participants (12 female, eight male) aged between 19 and 67 were recruited from people attending a volunteer counselling service in Glasgow. A Life Space Map (LSM) interview was conducted with each participant prior to their commencing counselling, along with a standard CORE outcome questionnaire. On completion of counselling, participants were again asked to complete a LSM and CORE questionnaire. Participants were asked to compare their post-counselling maps and questionnaires with their pre-counselling ones. Interviews were recorded and analysed for both the changes perceived over the course of therapy, and the experience of using the different methods. A further interview was conducted after three to four months to gain follow-up data and participant feedback on the analysis of previous interviews.

Results: Preliminary results from the study will be presented illustrating changes in a number of participants' Life Space Maps and their comparable CORE scores. Some significant differences between the change detected using CORE and LSM are discussed. The study also reveals a number of inconsistencies in the interpretation of CORE questions by participants. Participants' perception of the advantages and limitations of using the LSM are reported.

Conclusions: The Life Space Map gathers rich, in depth narratives about peoples' experience of change over the course of therapy. By inviting participants to reflect on this, new insights into the meaning of outcome are possible which are more sensitive to the client's lived reality, including their diverse social worlds.

back to top

Julie Anne Ryan

Professional Role: School Counsellor
Institution: John Bunyan School
Contact details: John Bunyan School, Mile Road, Bedford MK42 9TR
Email: julie.ryanfowle@btinternet.com

ABSTRACT: Poster

Raising achievement with adolescents in secondary education: the school counsellors' perspective

Research Rationale: Present government policy requires results led education and the raising of achievement in schools. The Children's Act 2004 also requires schools to take a broader view of supporting children with a greater emphasis on personal development. There is a growing acceptance of having counsellors working within schools to address the emotional needs of children and adolescents that might otherwise hinder the learning process. However, very little has been found in the literature on how counsellors might perceive their therapeutic interventions within a secondary education setting as contributing toward adolescent learning and achievement. This study sought to address that gap by exploring the school counsellors' perspective.

Research Design: This qualitative study used data from semi-structured interviews with eight school counsellors from four different counties in England. This study grew from the researcher's experience as a practitioner in schools and was undertaken in part-fulfilment of an MA in Counselling Inquiry. The research was approved by the University of Hertfordshire Research Ethics Committee and was funded by the Bedford Charity (the Harpur Trust).

Results/Findings: Counsellors perceived their therapeutic interventions as student centred in contrast to their perception of schools being predominantly school centred. This more holistic approach to their clients' development affected the counsellors' perceptions of what was meant by raising achievement. They perceived therapeutic interventions as raising personal, social and life skills achievement and less directly academic achievement. However a limitation of these findings was the inherent bias present when asking professionals about the effects of their interventions. The implication would be to triangulate these findings through exploring the comparative perspectives of adolescents themselves on the question of achievement.

Conclusions: The counsellors' perceptions suggested that a more holistic approach toward young people could be beneficial toward raising their personal achievement. The findings were consistent with the current and emerging theories of adolescent development and learning. Further study is indicated to triangulate these findings and to explore how the personal and the academic in schools could be informed by a complementary integration and understanding of counselling theory and educational philosophy and how this might influence raising achievement with adolescents in secondary education.

back to top

Elizabeth Schmitt Friere

Other Authors: Mick Cooper and Robert Elliott

Professional Role: Research Assistant
Institution: University of Strathclyde
Contact details: University of Strathclyde, Counselling Unit
Email: elizabeth.freire@strath.ac.uk

ABSTRACT: Paper

Development of a psychotherapy outcome measure based on Rogers' theory of therapy change

Background: Current results from comparative outcome studies suggest the general equivalence of psychotherapeutic treatments based on different theories and techniques. One of the alternative explanations for this general finding of no difference in the outcome of therapy is that different outcomes do occur but are not detected by current research strategies. It is important, therefore, to develop research assessing humanistic therapy's specific effects using rating scales designed to assess dimensions beyond symptom intensity or global evaluations.

Aims: To develop and test the validity of a psychotherapeutic outcome measure based on Rogers's theory of therapy change. This measure is entitled the 'Strathclyde Inventory'.

Method: The instrument consists of 51 items developed according to Rogers' description of the 'fully functioning person', encompassing the dimensions of locus of evaluation, open-ness to experience, self-liking, existential living, acceptance of others and psychological adjustment. In the pilot phase of the development of the inventory, 121 subjects responded, they also completed a range of other instruments as a means of testing the validity of the measure. The discriminant validity was assessed by comparing it with CORE (Clinical Outcome and Routine Evaluation) and the Marlowe-Crowne Social Desirability Scale, and its convergent validity was assessed through comparisons with Behr's Stuttgart Emotional Experiencing Scale and Rosenberg's Self-Esteem Scale.

Results: The instrument had a Cronbach's Alpha of 0.94 showing excellent item-reliability. Pearson Correlations with Rosenberg's Self-Esteem Scale and the subscales 'Accepting own Emotions' and 'Experiencing lack of emotions' of the SEE measure were 0.76, 0.69 and -0.60 respectively showing that the instrument has good convergent validity. However, the discriminant validity in relation to the CORE measure was poor (-0.63). The correlation with Marlowe-Crowne was 0.27 showing only a modest degree of social desirability bias. An exploratory factor analysis suggested two components identified as Congruence/Experientially Fluidity and Incongruence/Experiential Constriction factors.

Conclusions: The instrument was found to have excellent item-reliability and showed good convergence with related measures. It was not substantially associated with social desirability, but showed greater than desired overlap with clinical distress. A revised version of the measure has been developed and is currently being tested.

back to top

Bridget Sheehan

Professional Role: Centre Manager
Institution: Excellence in Cities
Contact details: The Alf Morris Centre, Ashgate School, Crossacres Road, Wythenshawe M22 5DR
Email: b.sheehan@lea.manchester.sch.uk

ABSTRACT: Paper

Is it possible to use a combination of therapeutic and educational techniques to improve a child's ability to access education?

Research Rationale: There is a growing awareness within the education system of the importance of addressing children's emotional needs resulting in initiatives such as Circle Time, Emotional Literacy and Nurture Rooms. There are also an increasing number of therapeutic interventions within schools: Quiet Places, The Place to Be, school counsellors. This research explores whether it is possible to effectively combine approaches from both. The Children Act (2004) also requires Children's Services to co-operate to improve well-being. This approach contributes to all five outcomes from the Every Child Matters agenda.

Research Design: Children participated in a term long programme including therapeutic approaches (therapeutic play, art, visualisation) and educational approaches (emotional literacy, circle time) delivered in a specially designed environment by trained staff, during the school day. Quantitative checklists on emotional, learning and conduct behaviour and qualitative questionnaires were completed by school staff before and after the programme and after follow up. Qualitative data was also collected from parents, the participating children and the programme staff. Quantitative data provided graphs and percentages; qualitative data was subjected to a content analysis.

Research Sample: Thirty-six children aged between 8 and 10, from 11 inner-city primary schools, who were failing to access school fully for emotional reasons.

Results/Findings: Quantitative data from schools showed overall improvement in emotional behaviour for 75% of the children, in learning behaviour for 67%, in conduct behaviour for 58%. 43% of parents completed questionnaires, 75 % indicating the programme had made a lot of difference, 25% indicating some difference. Qualitative information from schools, parents and therapeutic staff indicated a range of positive developments. Qualitative information from the children indicated a range of positive experiences, increased self-esteem and awareness of lessons learnt about themselves and others.

Conclusion: This approach is effective but progress would be easier to maintain if delivered by schools themselves. A new programme is now underway setting up Th.Inc.Rooms (Therapeutic Inclusion Rooms) in primary schools as part of their core provision.

back to top

Sheila Spong

Professional Role: Lecturer
Institution: University of Wales Newport
Contact details: School of Health and Social Sciences, University of Wales Newport, Allt-yr-yn Campus, PO Box 180, Newport NP20 5XR
Email: sheila.spong@newport.ac.uk

ABSTRACT: Paper

The client as informed consumer: how much should we tell our clients about ourselves?

Research question: Do clients need to know about their counsellor's personal and political values?

Rationale: Clients tend to move towards the values and world-views of their counsellor whether or not the counsellor intends this to happen, but generally the client knows little about the counsellor before entering the counselling relationship. This paper explores counsellors' ideas around potential clients having information about counsellors' beliefs and values in order to make informed choices.

Research Design: This is a qualitative study using discourse analysis. Data was gathered through a focus group study concerned with counsellor influence, and this paper explores one topic that emerged in the discussions. The analysis was in keeping with the discursive psychology approach (Potter and Wetherell, 1987). The study was subject to ethical approval from the University of Manchester.

Sample: Twenty eight counsellors met in six focus groups in 2004/5. Each group discussed four scenarios/questions relating to counsellor influence, with a particular focus on the counsellor's social belief systems. The participants were a convenience/snowball sample from varied theoretical orientations and work contexts.

Findings: There was considerable tension within the participants' talk around transparency. In particular there was a tension between the idea that the counsellor's values and beliefs ought not to be important, and that it might be significant for some clients to know more about their counsellor.

Conclusions: Counsellors are often aware of multiple ways in which their identities, characteristics and values impact on clients, but may not be convinced of the benefits to clients from sharing information about themselves. We need to consider carefully the extent to which clients would benefit from having information about counsellors in order that they can make informed choices when approaching or working with a counsellor.

Reference:

Potter, J., and Wetherell, M. (1987). Discourse and social psychology: Beyond attitudes and behaviour London: Sage.

back to top

Dr Natty Triskel and Mrs Heather Weston

Other Authors: Wendy Patterson, Rowen Jade, Sue Atkins

Professional Role: Consultant Clinical Psychologist (NT), Counsellor (HW)
Institution: Disabled Adults' Resource Team (DART)
Contact details: DART, South Gloucestershire PCT, Westerleigh House, Blackberry Hill Hospital, Bristol BS16 2EW
Email: natty.triskel@nbt.nhs.uk

ABSTRACT: Workshop

How to use counselling research and other evidence bases to meet the needs of disabled consumers

Participants will be supported to plan to meet their obligations under the Disability Discrimination Acts 1995 and 2005 to provide accessible counselling services. The workshop will include:

  • presentation of relevant evidence, including research study as discussed below
  • small group work to address participants' concerns and look at how they can implement research evidence and best practice guidance in their own settings

Target audience: Those who want to think about access issues, especially if you think 'oh, but I don't work with disabled people'. Please note: this is not a disability awareness / disability equality training session.

Research Study question: Can we provide good quality, effective counselling to disabled people which meets their access needs?

Rationale: Disabled people are more likely than most people to experience distress for which counselling might be helpful. We were increasingly aware, from research and from experience, of the difficulties disabled people experience in accessing counselling.

Research design: We set up a pilot counselling service to work with, and learn from, disabled people with complex access needs. Clients completed Likert scales before and after counselling, rating their own competency with self-generated problem statements. Reflexive external supervision helped us to offer creative and useful interventions.

Sample: 129 people were referred. 102 had one or more counselling meetings.

Results: Clients had on average eight counselling meetings. Themes included relationships (70%), the impact of being disabled (70%), low mood (65%), transition (63%) and unresolved trauma (57%). Clients felt more than twice as able to cope with problems after counselling, and 83% rated their ability to cope as significantly improved. We spent an average of 2½ hours problem-solving access issues per client. We developed practical and intrapersonal strategies for working well with disabled people.

Conclusions: With thought and support we can address the physical, psychological and structural (attitudinal) barriers which traditional approaches to service provision can unwittingly perpetuate, so that disabled people can access counselling.

back to top

Andreas Vossler

Professional Role: Research Fellow
Institution: German Youth Institute
Contact details: German Youth Institute, Nockherstraûe 2, D-81541 Mônchen, Germany
Email: vossler@dji.de

ABSTRACT: Paper

Counselling and the family sense of coherence (FSOC): empirical findings and practical implications

Background/aim: The family sense of coherence (FSOC, Antonovsky & Sourani, 1988) is a collective concept based on Aaron Antonovsky's model of individual sense of coherence (SOC). As core concept of the salutogenic model, the SOC refers to the extent to which one sees one's world as comprehensible, manageable and meaningful. Antonovsky and Sourani expanded the SOC construct to the family level and hypothesized that families who perceive their family life as coherent (high FSOC) are more likely to cope with stressful family life events without displaying physical and/or emotional symptoms. They also argued that the FSOC influences the development of the individual sense of coherence of the family members. Given this background, the aim of the study was to explore the possibilities to foster the FSOC in a family counselling context and to provide evidence for counselling consumers that this kind of service may encourage basic family competences.

Method: I assessed the FSOC and the counselling experiences of 108 families who went through a child guidance and family counselling process two to three years before (follow up-history). Questionnaires were used to ask the parents about counselling and their view concerning family life. Seventeen young clients of these families were interviewed using qualitative, semi-structured interviews. Interviews were tape recorded and analysed through a "structured content analysis" approach.

Results: The extent of family sense of coherence is positively correlated with the counselling effects as perceived by the parents. The interview results show that under certain conditions family counselling strengthens the family's ability to manage the demands of family life and to see the efforts as meaningful and comprehensible.

Conclusions: The empirical findings have to be considered in terms of their methodical limitations. Their practical implications include the use of FSOC measures as diagnostic tools and systematic interventions to improve the coping strategies of families and their sense of coherence.

Reference:

Antonovsky, A., & Sourani, T. (1988). Family sense of coherence and family adaption. Journal of Marriage and the Family, 50, 79-92.

back to top

Patti Wallace and Audrey Gachen

Professional Role (PW): Assistant Dean
Institution: Roehampton University
Contact details: School of Human and Life Sciences, Roehampton University, Whitelands College; Holybourne Avenue, London SW15 4JD
Email: P.Wallace@roehampton.ac.uk

ABSTRACT: Workshop

Researching the client experience: what counselling and psychotherapy can learn from psychiatric service-user research

Background: Arguably, the person who can tell practitioners most about the experience of counselling/therapy is the client. Research with users of psychiatric services has shown that the involvement of service-users in research leads to studies which are reliable and more likely to result in positive implementation (Davies and Braithwaite, 2001; Rose, 2001). At the same time, there is a dearth of published research into clients' experiences of counselling (Elliot and Williams, 2003) and often counsellors and counselling students are dissuaded from engaging in research that involves potentially vulnerable service-users due to concerns about the impact of the research on these participants.

Workshop Aims: The aim of the workshop is to inform and encourage counsellors to engage in research which elucidates the client/service-user experience. It will explore the specific challenges which arise in research involving what are often perceived to be vulnerable client groups. It will take as an example a successful user-led qualitative study undertaken by the presenters in 2005 in which participants were interviewed about their experiences of psychiatric hospitalisation. It will address issues of: research design and procedures, ethics, researcher and participant safety, confidentiality, and advantages and disadvantages of qualitative methodologies in consumer research.

Workshop format: The workshop will be interactive in style and will involve the co-presenters (one experienced service-user research supervisor and one experienced service-user researcher) offering ideas from their own experiences and engaging participants in discussion of important issues to consider in this type of research. Participants will be involved in a group exercise to generate potential research ideas and encouraged to bring dilemmas/issues arising from their own research with counselling/psychotherapy clients.

Conclusion: This workshop will engage participants in generating research ideas and designs which balance valid concerns about the impact of research on potentially vulnerable counselling/psychotherapy clients with the benefits of findings which can truly have an impact on the practice of counselling and psychotherapy, and on counselling and psychotherapy service planning and provision.

References:

Davies, A., & Braithwaite, T. (2001). In our own hands. Mental Health Care, 41, 413-444

Elliot, M., & Williams, D. (2003). The Client Experience of Counselling and Psychotherapy. Counselling Psychology Review. Vol 18 (1) pp. 34-38.

Rose, D. (2001). Users' Voices. London: Sainsbury Centre for Mental Health.

back to top

Dot Weaks

Other Authors: Professor John McLeod and Dr Heather Wilkinson

Professional Role: Research Training Fellow (DW)
Institution: University of Abertay Dundee in collaboration with NHS Tayside
Contact details: TIHS, Dudhope Castle, University of Abertay Dundee, Dundee DD6 3HE
Email: Dotweaks@aol.com

ABSTRACT: Paper

Dealing with the aftermath: an ethnographic study into the impact of an early diagnosis of Alzheimer's disease

Research question: What is the impact of an early diagnosis of Alzheimer's disease on the person and their family?

Rationale: Research to date shows that counselling and psychotherapy in the immediate post-diagnostic period for people with an early diagnosis of Alzheimer's disease is rarely available. Anecdotal evidence and professional reflection highlight the need for counselling services to be made available for people with Alzheimer's disease, based on the findings of research.

Research design: A qualitative, ethnographic methodology was used to study the experiences of five people who had been diagnosed with early Alzheimer's disease. Participants were contacted within the first two weeks of their diagnosis and the research design was a collaborative venture between the first person recruited and the researcher, which set the pattern for the data collection. Data were collected through participant observation and audio-tape recorded interviews over a six month period. Members of participants' social networks were also interviewed.

Sample: The sample comprised of two men and three women who had been diagnosed with early Alzheimer's disease by a consultant psychiatrist, and their family members.

Results/findings: The study identified nine different therapeutic tasks, relevant to counselling in early diagnosis of dementia. These tasks are embedded in four key themes which were identified during constant comparative analysis of data: struggling with the emotional process, daring to talk about Alzheimer's disease, re-authoring their story and the challenge facing relationships.

Conclusions: Discussing a diagnosis of Alzheimer's disease with family and friends is highly challenging, and would be enhanced by the skills and knowledge of a counsellor/psychotherapist available to work alongside the person and their family. It is argued that this type of assistance has the potential to facilitate co-construction of identity that allows the person with dementia to come to terms with this diagnosis and integrate it into their daily lives. The implications of these findings for the role of counselling in relation to other chronic disease conditions are discussed.

back to top

Sue Webb

Professional Role: Senior Lecturer in Counselling
Institution: Massey University, New Zealand
Contact details: School of Arts, Development and Health Education, College of Education, Massey University, PB 11-222, Palmerston North, NZ
Email: s.b.webb@massey.ac.nz

ABSTRACT: Work in Progress Symposium

Using video to analyse discourse: how counsellor and client negotiate a session

Background: Discourse analysis in counselling research has traditionally focussed on written transcripts of counselling, based largely upon audio sources. There is however a long-standing premise that non-verbal communication is a key element of both the relationship and process in counselling. Moreover in counselling training, the complexity and richness of interpersonal communication are acknowledged through the use of live demonstrations, demonstration videos and through trainees recording and viewing their own skills practice. New video technology offers researchers the opportunity to explore the rich but subtle relationships amongst language, auditory and visual cues and to investigate how these negotiate the content, direction and interpersonal dynamics in a counselling session.

Aims: To examine how counsellor and client negotiate the narrative of a session and the enactment of their relationship through a discourse analysis that includes visual, auditory and textual information.

Method: Digital video editing technology is used to plot the development of the session by coding, grouping and categorising segments, to explore patterns in language, tone and non-verbal behaviour and the inter-relationships amongst these.

Results: Initial results suggest this new technology provides a powerful tool to consider important mediators in the counselling process that can be neglected, using traditional means. It also provides an extra dimension to a consideration of the development and maintenance of relationship.

Conclusions: In addition to its use in research to explore how counsellors and clients co-construct their work together, video analysis can be an important tool for counsellors, their supervisors and trainers to examine the process within a counselling session and to address interpersonal factors that influence focus and direction.

back to top

Dr William West

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

ABSTRACT: Workshop

Some ethical issues in counselling research

The whole approach of counselling researchers to ethics has developed in recent years, especially with the recent publication of the BACP research guidelines (Bond, 2004), with its focus on trustworthiness and on the researcher actively engaging with ethical issues. However, in the realm of counselling and therapy ethics in the UK, there remain some key areas of concern for researchers to grapple with. These include: why do counselling research at all?; counselling research that hurts participants; the impact of research on the therapeutic process; restrictive notions around what is research data; the politics of research funding; and issues of informed consent. The clients' needs can get lost in the drive to produce research findings to support therapeutic interventions. The question of whether we view the recipients of counselling as 'clients', 'patients' or 'consumers' is more than a semantic one. Indeed, it is a crucial matter with ethical implications, which will be explored. These issues will be aired in a lively workshop format that will invite contributions and debate from participants.

back to top

Heather Weston and Mary Adams

Other Author: Dr Kim Etherington

Professional Role (HW): Counsellor and Researcher
Contact details: 11 Harptree Close, Nailsea, North Somerset BS48 4YT
Email: heatherwestonuk@aol.com

ABSTRACT: Paper

Narratives of mothers' experiences of coping with their sons drug use

Background: The consumers of this research are the commissioning drugs project, their workers and workers in similar drugs agencies, and the clients served by them. The learning from this study can be applied in a variety of settings where workers deal with issues of parenting, loss and drug abuse.

Aim: The aim of the study is to highlight the needs of mothers of drug misusers, who are often overlooked in the planning and delivering of services (Barnard, 2005) and to raise awareness for counsellors, psychotherapists and workers in the drugs field of some of the issues faced whilst working with this client group.

Methods: This paper is based on narrative interviews (Etherington, 2004) with three mothers, recruited from the parents' group of a community drugs project as part of an ongoing qualitative evaluation of their services. The stories are analysed using narrative analysis and discourse analysis, by examining the transcripts for what mothers tell us about the questions below:

  • what do mothers experience as they try to cope with the crisis of discovering their son's drug problem;
  • what is the process they go through in coming to terms with that knowledge;
  • how do they set boundaries and look after themselves;
  • and what is the value of support group membership.

Findings highlight the impact on the mothers' own lives and their emotional struggles involved in finding out and trying to understand how and why their children have become drug users.

Conclusion: There is a need to develop facilities to support families affected by drug misuse and to improve the awareness and knowledge of other support agencies. It also suggests that by focusing on the mothers themselves, rather than on their drug using offspring, mothers can be helped to identify and deconstruct societal discourse and negative messages that might cause them unnecessary distress.

References:

Etherington, K. (2004). Becoming a reflexive researcher: using our selves in research. London: Jessica Kingsley Publishers.

Barnard, M. (2005). Drugs in the family: the impact on parents and siblings. UK: Joseph Rowntree Publication.

Commissioned by the Southmead Drug Project and funded by the European Social Fund

back to top

Sue Wheeler     

Other Author: Tom Schroder

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

ABSTRACT: Paper

Who in the world has supervision and how does it help?

Background: BACP makes supervision a requirement for all counsellors and therapists throughout their career. This requirement is not shared by many other organisations in Britain or elsewhere in the world. An international collaborative network led by David Orlinsky has been studying therapists using the Development of Psychotherapists Questionnaire (Orlinsky et al, 1999) for more than a decade. Detailed information on more than 6000 therapists worldwide has been collected. Recently, data has been collected from a British sample of 700 BACP members.

Aims: To report on supervision as it is practised world wide. To compare groups of counsellors and psychotherapists that do and do not have supervision throughout their career on variables such as job satisfaction, healing involvement and stressful involvement.

Method: The British data set and the worldwide data set of the Development of Psychotherapists Questionnaire are combined. Statistical tests are used to compare the experience of therapists with or without supervision.

Results: Over 50% of therapists in the combined British and worldwide sample have career long supervision although in most countries the amount of supervision is negatively correlated with practice duration. More women than men have career long supervision. Counsellors and psychotherapists are much more likely to have career long supervision than psychologists or medically trained psychotherapists. Analytic, humanistic and systemic therapists are more likely to have supervision than cognitive behavioural or broad spectrum therapists. Supervision has a greater impact on therapist development, job satisfaction, constructive coping and healing involvement at the beginning of their careers.

Conclusions: There is a diversity of practice with respect to supervision in terms of country, gender and profession. Supervision has a bigger impact at the beginning of therapists' careers. Supervision contributes to positive coping strategies and healing involvement, but less so over time.

Reference:

Orlinsky, D. E., Ronnestad, M.H., Gerin, P., Willutzki, U., Dazord, A., Ambuhl, H., Davis, J., Davis, M., Botermans, J.F., & Cierpka, M. (1999). Development of psychotherapists: concepts questions and methods of a collaborative international study. Psychotherapy Research, 9(2): 127-153.

back to top

Sue Wheeler and Kaye Richards

Professional Role: Professor of Counselling and Psychotherapy (SW) / BACP (KR)
Institution: University of Leicester, Institute of Lifelong Learning
Contact details: 128, Regent Road, Leicester LE1 7PA
Email: sw103@le.ac.uk

ABSTRACT: Work in progress symposium

What impact does supervision have on the supervisee? A systematic review of literature

Background: In 2002 a scoping search of literature related to supervision was completed that identified almost four hundred research reports on various aspects of supervision (Wheeler, 2003). The scoping search had a broad focus, seeking to identify all the empirical research that had been conducted on clinical supervision for two decades. That review has been well received but is rapidly becoming out of date. Rather than update the broad review a more focused review has been commissioned that will contribute to the evidence base for supervision, particularly as the profession moves towards regulation that will put current practice under scrutiny.

Aims: To identify research conducted since 1988 on the impact of supervision on counsellors and psychotherapists, using strict inclusion and exclusion criteria. The focus will be on evidence derived from empirical research both quantitative and qualitative that provides information about ways in which practitioners develop skills and clinical competence and are supported or guided in their clinical work through supervision.

Method: The review is conducted using a structured review methodology and Evidence for Policy and Practice Information software tools (EPPI-Reviewer)*. Strict inclusion and exclusion criteria are determined. All studies to be included in the review are systematically evaluated using a purposely constructed pro forma. A report is written summarising the information extracted from the included studies.

Results: To date detailed inclusion and exclusion criteria have been identified. A pilot study is being conducted to assess the degree to which the criteria are rigorous enough to ensure that only relevant studies are included, but not so rigorous that no studies meet the criteria.

Conclusion: A vast quantity of research has been conducted on supervision particularly in the USA. This review may provide evidence to support future decisions on the nature, requirements and organisation of supervision for both trainees and experienced practitioners.

References:

Wheeler, S. (2003). Research on supervision of counsellors and psychotherapists: A systematic scoping search. Rugby, BACP.

EPPI Centre, (2005) http://eppi.ioe.ac.uk/EPPIWeb/home.aspx, accessed 17.11.05

*The review is conducted using EPPI-Centre software tools (EPPI-Reviewer) but is not subject to EPPI-Centre methods, quality assurance, or publication.

back to top

Shelley Wild

Professional Role: Counsellor
Institution: Pastoral Care Dept, Fieldhead Hospital, Wakefield
Contact details: Rodley House, School Lane, Emley, Nr Huddersfield, West Yorkshire
Email: shelly.wild@swyt.nhs.uk

ABSTRACT: Poster

Counsellors' experiences working with clients with physical disabilities in multidisciplinary team settings

Aims: The aims of this qualitative study were firstly to explore the shared experiences, both positive and negative, of counsellors in this field. Secondly to examine the impact of multidisciplinary team working on the counsellor/client relationship and the counsellor's job satisfaction. Finally to raise the awareness of disability counselling, and the fact it is an interesting and fulfilling area of counselling work.

Background: There is considerable literature discussing the politics of disability as a cultural issue and some literature on presenting client issues, but there has been little exploration of the specific area of disability counselling comparing several counsellors' experiences.

Method: The sample of six counsellors was chosen from the CRT network, which is a national organisation developed to provide a focus of shared knowledge and practice throughout similar multidisciplinary teams supporting disabled clients. Only counsellors in teams dealing with adult (under 65) patients were selected. The subjects were interviewed in their workplace. The semi-structured interviews were audio taped and these later transcribed. The transcripts were analysed using grounded theory methodology, which provided a systematic approach to the analysis and is well -established.

Findings: The main findings were as follows. The counsellors described the major presenting issues of the newly disabled as being loss, disruption in relationships and cultural factors stemming from society's attitudes and the client's own previous attitudes to disability. In the congenitally disabled, individuation of the young adult and lack of intimacy in relationships were the main problems for these clients.

All the counsellors found that their practice had benefited in working in this area of counselling. They had become more knowledgeable, more flexible, more self-reflexive in examining their own cultural attitudes and found that they had developed increased unconditional positive regard.

Conclusions: Attitudes to working within a multidisciplinary team varied and were dependant on the maturity of the team and the level of understanding of counselling amongst team members. The subjects mentioned confidentiality, communication and inappropriate referrals as being the major areas of difficulty. Relationships within the team were of great importance and affected counselling practice.

 
       
corner