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Research Conference 2010  


BACP's 16th Annual Research conference was entitled 'Research impacts' and took place on 14-15 May 2010. It was held at Renaissance London Heathrow Hotel, London.

Click here for an evaluation of this year's conference

Abstracts

 

Pre-Conference Workshop

Professor John McLeod

Professional Role: Professor of Counselling
Institution: University of Abertay Dundee
Contact details: Kydd Building, Bell Street, Dundee DD1 1HG
Email: j.mcleod@abertay.ac.uk

Pre-conference workshop (Thurs, 18.00 - 19.30)

Case study research by practitioners and students: making the connection between systematic inquiry and personal/professional development

Case study research has the potential to make a major contribution to the knowledge base for counselling and psychotherapy. The aim of this workshop is to examine some of the ways that both experienced practitioners, and students/trainees, can work together in groups to carry out systematic and rigorous case-based research. The workshop will offer an overview of concepts and methods in case study research, along with opportunities for experiential exploration of issues and dilemmas associated with this form of inquiry.

Workshop facilitator: John McLeod is Professor of Counselling at the University of Abertay Dundee. He is author of books and articles on many aspects of counselling and psychotherapy, and is committed to the value of research as a means of informing practice.

 

Friday Keynote

Professor Bernhard Strauss

Professional Role: Past President Society for Psychotherapy Research
Institution: Institute of Psychosocial Medicine and Psychotherapy
Contact details: University Hospital Friedrich-Schiller-University, Jena, Germany
Email: Bernhard.Strauss@med.uni-jena.de

Friday Keynote (Fri, 09.15 - 10.00)

Research impacts on training in counselling and psychotherapy - reality and fiction

Training in counselling and psychotherapy has increasingly received attention from a research perspective, especially since evidence based treatment consequently needs evidence based training.

On the one hand, training itself has become a focus of research with the goal to improve its process and outcome; on other hand, there is an increasing discussion about how research informed practice can be transformed into training concepts and therefore have an impact on the trainees' development.

The presentation will first summarise empirically supported models of training and selected research evidence related to different stages and components of counselling and psychotherapy training, including the selection of trainees, their development and the determination of therapeutic/counselling competence.

In a second part, the question will be raised which results from psychotherapy research should be intensively integrated into training programs, independent of the theoretical orientation of the training. These include some basic findings of psychotherapy research that focus on contextual and conceptual aspects of psychotherapy, some overarching empirically supported theoretical models and findings showing similarities between different treatment modalities.

In summary, it will be discussed, why and how psychotherapy trainees and researchers should intensively communicate with each other.

 

Saturday Keynote

Dr Chris Mace

Professional Role: Chair
Institution: Psychotherapy Faculty, Royal College of Psychiatrists
Contact details: St Michael's Hospital, Warwick & Department of Psychology,University of Warwick
Email: C.Mace@warwick.ac.uk

Saturday Keynote (Sat, 09.30 - 10.15)

Coming soon to a screen near you? Impacts of research on practice

Many psychotherapists' attitude to research remains ambivalent. To overcome this, conflicts between the perspectives of science and therapy need to be understood. Although the ideal of the scientist-practitioner may not be shared by everyone, nearly all therapists are influenced already by research findings in what they do. In future, the extent to which research informs routine practice will reflect its impacts in three areas: prediction, terminology and therapeutic process. Each of these will be explored and then illustrated through informed guesses about how therapists could be working in 30 years' time.



Steph Adam and Fevronia (Fenia) Christodoulidi

Professional Role: Counsellor, Independent Supervisor and Trainer (SA). Counsellor and Lecturer in Counselling (FC)
Institution: York College
Contact details: Sim Balk Lane, York YO23 2BB
Email: cshrinkit@aol.com

ABSTRACT: Workshop (Sat, 10.40 - 11.40)

Keywords: research, reflexive, insight, impact, identity

The challenges of researcher reflexivity: towards academic rigour that entails identity change

Relevance of the workshop to counselling and psychotherapy research: This workshop identifies and discusses the impact on therapists who research topics using qualitative, reflexive methodologies. The primary researcher's perceptions influence the evolving research process and may also generate unexpected personal consequences.

The aim of the workshop: Recent literature (Etherington, 2004; Scott, 2007; West, 2007) highlights the significance of researcher reflexivity and therapist awareness as potential resources in the research process. In order to achieve reflexivity researchers must apply a level of transparency and decide what information enters the public forum. The presenters, both counsellors (one having completed a Doctoral study and the other in her final PhD year) give attention to their changing identities when attempting to engage honestly with their qualitative studies. This workshop will explore ‘hidden' elements of the research process, which can have profound physical and psychological impacts on primary researchers.

How the workshop will be structured: The presenters will explain the format and purpose of the workshop. Explanations will be given to the audience via a visual power point presentation of the concepts of reflexivity and insight and the manner in which these two experiences direct researchers. Participants will be invited to discuss in small groups a structured activity identifying aspects of the researcher's process which may infiltrate and change the identity of qualitative researchers.

Key points for discussion: How helpful are the concepts of reflexivity and insight in qualitative methodologies?

How unhelpful are the concepts of reflexivity and insight in qualitative methodologies?

What impact do they have on the research process?

What impact do they have on researcher identity?

How will any impacts affect clinical practice?

Who will benefit from attending the workshop: This workshop is useful for researchers who are involved in qualitative reflexive methodologies. We hope the discussion will raise awareness about the impact of reflexivity and insight on the research process, and arm participants with ideas that will assist them with their own studies. References will be distributed at the workshop

References available on request, please email research@bacp.co.uk

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Marie Adams

Professional Role: Psychotherapist and Doctoral candidate
Institution: Metanoia
Contact details: 31B, Rush Hill Road, London SW11 5NW
Email: mariead@aol.com

ABSTRACT: Paper (Fri, 12.05 - 12.35)

Keywords: therapist, depression, attachment, personal lives, narrative

Private lives and professional practice

Aim/Purpose: To determine how therapists' personal lives affect their work with patients/clients.

Design/Methodology: Qualitative study. Individual interviews with 40 therapists from four main therapeutic traditions, (psychoanalytic, integrative, humanistic and cognitive) and across three countries, the UK, Canada and Australia.

Results/Findings: Therapists revealed their personal struggles, including depression, marital breakups and managing difficult elements in their attachment histories. They revealed how deeply earlier experiences have impacted the kinds of therapists they have become and how this has both enabled, and hindered, their work with clients/patients. Preliminary findings indicate that a high percentage of therapists struggle with depression since qualifying and a number have had to take time out to manage and recover. Several therapists spoke of their difficulty in finding a therapist who would ‘take them on' when they were well known within the therapeutic community, or lived in 'small' communities. How do therapists cope when they are dealing with family members suffering mental health issues and when they fear that exposure of such vulnerability might mean professional 'death'?

Research Limitations: One hour interviews cannot delve more deeply into particular elements of each therapist's history. Often therapists were deeply self-conscious until they determined they could trust the interview. Fear of shame, judgement and professional exposure were often evident, which may have hindered some therapists from revealing 'too much'. For ethical reasons I was also unable to speak to clients or patients to determine how they experienced the therapists during difficult periods.

Conclusions/Implications: After years of therapy, how difficult is it for therapists to expose their vulnerability and seek support from others within the therapeutic community? How do training programmes address the possibility of earlier trauma having to be 're-negotiated' at transitional times in therapists' lives? While we pay lip service to therapists' humanity, how much do we really accept that therapists may continue to struggle within their personal lives once their training is complete? If the general view is that therapists suffering depression, or other personal struggles ‘should not be working', how is it possible for those therapists to find help and be supported through difficult psychological times?

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Ese Agambi and Maria Nakabugo

Other Authors: Carey Buchanan / Elizabeth Roberts

Professional Role: HPD in Counselling Students
Institution: LC&CTA - Lewisham Counselling and Counsellor Training Associates
Contact details: (c/o) LC&CTA, Broadway House, 15-16 Deptford Broadway, Deptford, London SE19 2DU
Email: (c/o) christine.brown@lcandcta.co.uk

ABSTRACT: Poster (Fri, 10.00 - 10.20)

Keywords: diversity, race, culture, experiential, phenomenology

What personal and professional impact has experiential diversity issues training had on the development of our peers during counsellor training, specifically in relation to the development of clinical practice?

Aim/Purpose: Recent research illuminated that culturally sensitive training programmes deepen trainees' understanding of difference; which has proven to have a positive impact on how black/people of colour experience ethnically different counsellors (Cooper, 2008). Therefore, the aim/purpose of our research was to explore and define how the experiential diversity training our counsellor training group received impacted on the personal and professional development of our peers, specifically in relation to the development of their clinical practice.

Design/Methodology: We audio recorded and transcribed the responses of 15 peers in a series of semi-structured interviews. Descriptive generalisations/conclusions were then drawn as to the impact experiential diversity training had on their personal/professional development and clinical practice using the Duquesne Method of Empirical Phenomenology (Moustakas, 1994). We were also able to compare/contrast our research findings to the findings from a similar project undertaken by the HPD student cohort studying at Lewisham College in 2006/07. The project was conducted following the BACP Guidelines for Researching Counselling & Psychotherapy (Bond, 2004).

Results/Findings: Our findings allowed us to descriptively identify how the experiential diversity training on our counsellor training course assisted our respondents in becoming openly aware of personal discriminatory attitudes and prejudices which had previously been ‘veiled' or denied. Additionally it seems for most respondents the training broke down some differential barriers between peer participants and enabled voice to be given to thoughts and fears about difference. As a result respondents felt the increased awareness of their own attitudes had led to an increased positive defencelessness/vulnerability with clients, and an enhanced ability to empathise with difference due to a broader knowledge/acknowledgement /valuing of other creeds. We also discovered that our results were similar to the findings of the previous research project mentioned above.

Research Limitations: Limited to investigating the experiences of our peers.

Conclusions/Implications: Findings suggest that culturally sensitive training programmes do indeed deepen trainees' understanding of difference, and provide some independent triangulation to this postulation. However, findings specifically suggest that in-depth experiential diversity training is particularly useful and may be a vital aspect of practitioner training; which has implications on the future design of counsellor training programmes.

References available on request, please email research@bacp.co.uk

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Jane Balmforth

Professional Role: PhD student/counsellor
Institution: University of Strathclyde
Contact details: University of Strathclyde, 76 Southbrae Drive, Glasgow G13 1PP
Email: jane.m.balmforth@strath.ac.uk

ABSTRACT: Paper (Sat, 14.45 - 15.15)

Keywords: disclosure, significant event, qualitative research

'There wasn't any me in there': analysing a client-identified significant disclosure event in therapy

Aim/Purpose: This qualitative study aimed to analyse what was helpful about a client-identified important disclosure event and track whether the significance of the event changed for the client over the course of the therapy.

Design/Methodology: The process, effects and context of the event were analysed using Comprehensive Process Analysis (CPA; Elliott, 1989), a systematic qualitative method for analysing significant therapy events developed by Professor Robert Elliott. A number of post-session instruments were used to identify the event and analyse the data: the Helpful Aspects of Therapy (HAT) form (Llewellyn, 1988), the Interpersonal Process Recall (IPR) interview (Elliott, 1984) and the Change Interview (carried out after 10 sessions of therapy with clients at the University of Strathclyde Research Clinic.)

Results/Findings: The data revealed that the client's process of identifying, processing and disclosing the significant material began well before the client entered therapy. The analysis also showed the important extra-session work that the client engaged in, in addition to the work with the counsellor. The client's process of assimilating a difficult experience matched the stages in the assimilation model (Stiles et al., 1990). The client experienced the disclosure as helpful in several ways: as an acknowledgement, an identification of an issue to work on and a personal aim for the future. The event was described as significant by the client in the end of therapy interview.

Research Limitations: This is a study of one event and is not generalisable. CPA is to an extent an interpretive method, depending on the researcher's understanding of the client's description of the event.

Conclusions/Implications: The HAT form and the interviews provided a rich source of data to explore this significant event. This study highlights how disclosure may contribute to the client's assimilation of problematic experiences and process of change; disclosing to the therapist may have lasting significance for the client. The client's extra-therapy work is also shown to be important in enabling him/her to modify old schemes and move forward in the therapeutic process.

References available on request, please email research@bacp.co.uk

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Wally Barr

Professional Role: Senior Research Fellow
Institution: University of Liverpool
Contact details: Health and Community Care Research Unit, Quadrangle, Thompson Yates Building, Brownlow Hill, Liverpool L69 3GB
Email: walb@liv.ac.uk

ABSTRACT: Paper (Fri, 15.00 - 15.30)

Keywords: personality disorder, therapeutic community, non-residential

How effective are non-residential therapeutic communities for people with personality disorder? Quantitative findings from a mixed methods research study

Aim/Purpose: We present quantitative findings from a mixed methods study of four one-day-a-week democratic therapeutic community services for people with personality disorder. In the UK this model of day service has recently enjoyed a period of rapid growth but research has failed to keep up with this expansion; this study is the first to quantitatively evaluate the effectiveness of the approach for people with personality disorder. The aim of the paper is to clarify the impact of one-day weekly therapeutic community services for people with personality disorder.

Design/Methodology: Data were gathered from four one-day therapeutic communities in the north of England. A number of service users, service user consultants and staff members contributed to the development and design of the evaluation. The quantitative element that will be reported in this paper included baseline (T1) data collection from 20 service users and follow-up at four further assessment points (T2-T5) at three-monthly intervals over the following 12 months. Several instruments were used to identify change over time in mental health, social functioning, self-harm and service utilisation. All participants provided written consent and ethical approval was given in October 2005. The study commenced in November 2005 and finally reported in July 2008.

Results/Findings: We found statistically significant improvements in both the mental health and social functioning of service users. Changes in patterns of self-harm and service use were suggestive of possible underlying improvements but failed to reach significance levels. We also found evidence of the possible offset of costs within 16 months of an individual leaving one of the services.

Research Limitations: Comparisons were made between the T1 and T5 assessments, which both included data from all 20 service users. However, missing data at the interim assessments limited statistical analysis across these assessment points. This meant that trends through time could not be suitably examined, nor was it feasible to analyse disaggregated data for each of the four one-day services.

Conclusions/Implications: This study suggests one-day therapeutic communities may be both clinically and cost-effective for people with personality disorder.

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Christine Bonsmann

Professional Role: Counsellor
Institution: Private practice
Email: cbonsmann@aol.com

ABSTRACT: Poster (Fri, 10.00 - 10.20)

Keywords: client experience, counselling, narrative research, qualitative research, ethics

Reflections on being a client - a narrative inquiry

Aim/Purpose: Most existing research into the client's experience of therapy privileges the researcher's conceptual framework and the voice of the client tends to be underrepresented and submerged into theories or themes (Conran and Love, 1993; Swartz, 2005). This research explored the experience of therapy from the perspective of the client. It was felt that hearing clients' stories may inform the work of counsellors by increasing awareness of what matters to clients in therapy.

Design/Methodology: Narrative methodologies were used which enable the rich meaning of an individual's experience to be co-created (Bird, 2000). Four co-researchers were invited to participate in research conversations to share their experience of being a client in therapy. The researcher recognised that 'analysis' had already taken place when the co-researchers selected their preferred story to tell. After creating a temporal order of the stories, the individual stories were written using the words of the co-researchers as far as possible to honour individual agency (Riessman, 2008). The research did not attempt to reduce the co-researchers' experiences to a set of themes to try and determine a truth, but sought to embrace difference.

Results/Findings: Client's concerns such as congruence, pacing, power, boundaries and ethics emerge from the individual stories. The themes of client ambivalence and power are also identified and are consistent with the literature (see Feltham, 2002; McLeod, 1990; France, 1988; Masson, 1997). The relevance of narrative methodologies to counselling research is identified as is the importance of giving an opportunity for the voice of the client to be heard (Etherington, 2008).

Research Limitations: This small scale research project is based on four stories. However, it is argued that the stories illustrate the subtleties of therapy and may help to inform counselling practice.

Conclusions/Implications: This research connects to the larger stories about power, boundaries, counsellor training, political drives towards time-limited therapy and evidence-based practice and impending regulation of psychological therapies in the UK. Most importantly, the enduring damage caused by unethical practice is made visible within the very personal stories.

References available on request, please email research@bacp.co.uk

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Maria Bowens

Professional Role: BACP accredited therapist and student
Institution: University of Strathclyde and Glasgow Caledonian University
Contact details: C/O Prof. Mick Cooper, Counselling Unit, University of Strathclyde, 76, Southbrae Drive, Jordanhill Campus, Glasgow, G13 1PP
Email: mariabowens@yahoo.co.uk

ABSTRACT: Paper (Fri, 15.00 - 15.30)

Keywords: client feedback, collaboration, measure development, pluralistic framework, therapists' dilemmas

Development of a client feedback tool - stage one: a qualitative study of therapists' dilemmas

Aim/Purpose: This study was the first part of a measure development project, which intends to construct a new client feedback tool that can be used by therapists to help tailor their practice to each individual client. The proposed tool will ask clients, at the end of sessions, to indicate on a series of dimensions how they think their therapy could be improved: for instance, ‘more directive - less directive,' ‘more focus on feelings - more focus on thoughts.' To identify appropriate items, this study conducted semi-structured interviews with therapists, to find out the dimensions along which their practice varied. This study is primarily influenced by the recent development of a pluralistic approach to counselling and psychotherapy (Cooper and McLeod, 2007).

Design/Methodology: Ethical approval was sought and granted by the University of Strathclyde's research ethics committee. It was a qualitative design using semi-structured interviews. Twenty participants were recruited in two university counselling settings as well as a number of therapists working in other settings, and came from a variety of orientations. A thematic analysis based on grounded theory methodology was conducted independently by two doctorate trainees in counselling psychology, and results were then combined.

Results/Findings: Twenty dimensions were identified that can form the basis for an initial raft of a client feedback form. Some of the most frequently identified dimensions were: ‘more challenging or more supportive and gentle'; ‘more directive or less directive'; ‘giving space and allowing the narrative to flow or interrupting to focus'; ‘the use of more techniques and exercises or less techniques and exercises'; and the therapist ‘to be more transparent or less transparent'.

Research Limitations: Limitations include that generalisation is difficult from such a relatively small sample. A comparison between the participants of different theoretical orientations may yield interesting findings. Also, the study will have been inevitably biased by our own interest in the pluralistic approach.

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Sharon Cox

Professional Role: Part-time PhD Student
Institution: York St John University
Contact details: 33 Chirton West View, North Shields, Tyne and Wear. NE29 0EP
Email: sharon.cox@live.com

ABSTRACT: Poster (Fri, 10.00 - 10.20)

Keywords: eating disorders, grounded theory, subjectivity, existential, counsellor

The impact of working with eating disordered clients on the counsellor's sense of self: a pilot study

Aim/Purpose: An individual's relationship with food, eating and their body is central to their sense of self; this study will investigate counsellors' awareness of their personal relationship between food and their existential experience and explore how being in a therapeutic relationship with clients presenting with food and body image concerns may cause the counsellor to re-examine their own subjectivity.

Design/Methodology: The study is rooted in grounded theory with constructivist leanings, as advocated by Charmaz (2006). Therapists with current or recent experience of working with clients presenting with eating related issues (clinically diagnosed or self presentation) were interviewed, using a semi-structured interview format. All interviews were transcribed verbatim and studied for emerging patterns of affect. This study was designed in line with BACP guidelines and ethical approval was granted from York St John University Faculty Research Ethics Committee.

Results/Findings: It appears that a number of therapists are lacking awareness of the significance of their individual existential relationship with food, eating and body experience, and hence the personal impact of working with eating disordered clients' existential subjectivity.

Research Limitations: As this research is based on the findings of a pilot study, the sample size is unavoidably small. In terms of following a grounded theory methodology, the data has not yet reached saturation point, hence not providing a complete picture. The findings from this study will go on to inform the next stage of the grounded theory investigation.

Conclusions/Implications: It is anticipated that the findings of this study will influence the type of self awareness work that counsellors engage in before, or whilst working with, clients presenting with eating disorders. An awareness of how this client group may impact on therapists will ensure that therapists, supervisors and employing agencies are better prepared to facilitate a more effective therapeutic relationship with clients.

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Nurul Ain Mohd Daud

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

ABSTRACT: Poster (Fri, 10.00 - 10.20)

Keywords: school counselling, cultural values, seeking counselling, secondary school students, ethnographic narrative inquiry

The influence of cultural values in seeking counselling among secondary school students in Malaysia; a counsellors' voice

Aim/Purpose: My research focuses specifically at investigating the influence of cultural values in seeking counselling. This paper explores how school counsellors perceive students' cultural values and how these influence students' decisions on seeking counselling.

Design/Methodology: The study embraces ethnographic narrative inquiry method to understand the culturally specific patterns of behaviour and attitudes of students of different cultural backgrounds at one national secondary school in Malaysia. One to one semi-structured interviews with seven counsellors at one national secondary school in Malaysia were conducted. Interviews were transcribed and the data thematically analysed. Prior to the fieldwork, ethical approval was granted by the University of Bristol and Ministry of Education, Malaysia.

Results/Findings: Two distinct cultures emerged; school counselling and students' cultural values which appeared to be at odds with each other. School counsellors were undervalued and relatively powerless in the school community. The themes that came out of the data were that counsellors felt alienated in their own environments and struggled to be trusted by students.

Research Limitations: 1) This research is an intensive study of one selected school so care must be taken in generalising. 2) Methodology is descriptive rather than seeking to establish cause and effect.

Conclusions/Implications: The perceived negative perceptions and distrust towards school counsellors and school counselling have had a powerful impact, specifically on counselling relationships and the implementation of guidance and counselling services in secondary schools in general. The findings indicate the difficulty of school counselling in finding its place in contributing to a healthy school environment that is free from negative connotations, prejudices and stigmas. Cultural differences seem to influence students' receptiveness and willingness to seek counselling.

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Elaine Davies

Professional Role: Counsellor and Supervisor of Counsellors in Primary Care
Institution: Gwent Healthcare NHS Trust, Primary Care Counselling Service
Contact details: Grange House, Llanfrechfa Grange, Cwmbran, Torfaen NP44 8YN
Email: rustydavies@griff911.fsnett.co.uk

ABSTRACT: Poster (Fri, 10.00 - 10.20)

Keywords: counsellor, heuristic, impact, primary care, waiting list

"It's just a little jump before they say you've lost your job": what is the impact of the waiting list on counsellors in primary care?

Aim/Purpose: The purpose of this research was to understand the distress of the waiting list on peers in a primary care counselling service. Ethical approval was gained from the University of Wales, Newport and the Department of Research and Development for what was then Gwent Healthcare NHS Trust.

Design/Methodology: A qualitative purposive sample was chosen of one counsellor from each borough representing the five boroughs of this service. The approach of informal conversation was used with peers to gather data about the impact of waiting lists in primary care. Heuristic method of inquiry (Moustakas, 1990) was adopted and by using this method of lifting out the experience of others I was able to transform myself. After collecting the data the analysis followed the design of heuristic inquiry of internal retrospect of immersing and returning to the data until final themes emerged. Outcome measures were achieved by returning back to the counsellors with themes and then final synthesis of data in the form of individual and group depictions. Counsellors were able to challenge, change or delete any of the final words used. One counsellor changed one sentence.

Results/Findings: The research identified strained relationships between client and counsellor, counsellor and supervisor and counsellor and the referring G.P. There was unethical practice both on behalf of the counsellor and the organisation. There were boundary issues and a lack of self-care in the case of the counsellor. Through immersing myself in this data I concluded that my own non-experience of 'waiting list distress' might be due to self -awareness, assertiveness and recognising my inferior and superior beliefs in coping with this phenomenon.

Research Limitations: This was a small-scale study on people I knew well. However, it reveals the scope for a wider study into these phenomena.

Conclusions/Implications: This research does suggest that waiting lists can have an impact on counsellors. Therefore this provides a possible focal point for the training of counsellors.

References:

Hiles, D. (2008) Heuristic Inquiry: Researching personal significance. University of Keele.

Moustakas, C. (1990) Heuristic Research, Design, Methodology and Applications. London: Sage.

Patton, M.Q. (1990) (2nd Ed) Qualitative evaluation and research methods. Newbury Park CA: Sage.

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Janie Dickson

Professional Role: Teaching Associate on MSc Counselling; independent counsellor and supervisor
Institute: Bristol University
Contact details: Senate House, Tyndall Avenue, Bristol BS8 1TH
Email: janie.dickson@bristol.ac.uk

ABSTRACT: Paper (Fri, 14.25 - 14.55)

Keywords: narrative inquiry, ethnography, sexual minority counselling, gay affirmative practice, sexuality training

'Just the same as the rest of us' a collective auto-ethnography of three women's experiences of 'coming out' in counselling

Aim/Purpose: This paper focuses on the narratives of three women's transitions from heterosexual to lesbian identity, whilst in counselling. It aims to show the substantive contribution and impact (Richardson and Pierre, 2005) of small scale qualitative research and how research could potentially progress beyond MSc level by creating larger research questions with wider implications for counselling training.

Design/Methodology: This paper is based on research undertaken as part of an MSc dissertation (University of Bristol). Ethical approval was granted through systems in place within the Graduate School of Education. The researcher threaded her own autoethnography through the ethnographies of two other participants, who were also practicing counsellors, allowing the data to give voice to a human experience through an experience-centred narrative. Describing not just 'what someone does in the world but what that world does to that someone' (Mattingly 1998:08)

Results/Findings: There is little research on this late 'coming out' experience, although studies in the US show that 25% to 30% of lesbians have been in heterosexual marriages prior to coming out (Kitzinger and Wilkinson, 1995). The study describes the participants counselling experiences during this transition and the narratives give voice to the issues arising for this client group. The research found that these counselling experiences varied in affirmative practice concurring with other recent papers, dissertations and government reports on homophobia and suggesting implications for the training on sexuality in counselling courses.

Research Limitations: This is a small scale research with a small number of participants and the methodology may be in contrast with the current preference for evidence based research practice

Conclusions/Implications: The study suggests that affirmative practice is not a given and implies a review of training in sexuality and affirmative practice in current counselling training institutions and within PPD.

References:

Kitzinger, C. & Wilkinson, S. (1995) Transitions from heterosexuality to lesbianism: the discursive production of lesbian identities. Developmental psychology, 31 (1): 95-104.

Mattingly, C. (1998) Healing dramas and clinical plots: the narrative structure of experience. Cambridge: Cambridge University Press.

Richardson, L. and St Pierre, E.A. (2005) Writing: A method of Inquiry. The Sage Handbook of Qualitative Research. London: Sage: 959-978.

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Linda Dubrow-Marshall

Professional Role: Counsellor
Institution: Cardiff University
Contact details: Cardiff, Wales CF10 3XQ
Email: Dubrow-MarshallL@cardiff.ac.uk

ABSTRACT: Paper (Fri, 16.30 - 17.00)

Keywords: single session psychotherapy, brief therapy, university counselling, outcome, CORE

The use of single session therapy in a university counselling service

Aim/Purpose: The purpose of the research was to consider and evaluate the model for single session therapy used at a university counselling service.

Design/Methodology: This paper reviewed the innovative use of single session therapy at the Student Counselling Service at Cardiff University, where selected students are seen for an extended 90 minute therapeutic consultation with a 15 minute follow-up session approximately four weeks later. A literature review was conducted, where the use of single session therapy in this setting was compared with other applications of single session therapy. The author's experience in offering single session therapy over the course of one year was analysed, using both quantitative and qualitative data.

Results/Findings: The model for single session therapy used at Cardiff University incorporated research recommendations found in the literature, including using criteria to determine for whom single session therapy would be likely to be appropriate, and using experienced counsellors to provide this service. In a sample of 18 clients seen for single session therapy by the author, 12 completed both pre and post-outcome measures (CORE). Of the six clients who scored initially in the clinical range, five scored in the non-clinical range on the post measure, and the other one showed reliable (if not clinical) improvement. An analysis of counselling interventions which were reported as having been effective by clients who moved from the clinical to the non-clinical range included referrals to self-help books and websites, relaxation techniques, and learning how to stay in the moment instead of catastrophising.

Research Limitations: The study was based on one counsellor's experience over the course of a year, so the sample size was very small. All results and findings should be viewed as preliminary.

Conclusions/Implications: The efficacy of single session therapy in a university counselling service was demonstrated through preliminary quantitative and qualitative analysis. Single session therapy appeared to be a good match for a number of students and university or FE students may be especially amenable to a solution focussed single or brief therapy model because they are at a developmental stage in which they are particularly open to learning, change, self-exploration, and working toward specific goals.

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Julie Folkes-Skinner

Professional Role: Lecturer in Psychodynamic Counselling
Institution: University of Leicester
Contact details: Leicester Institute for Lifelong Learning, University of Leicester, Vaughan College, St Nicholas Circle, Leicester LE1 4LB
Email: jafs1@le.ac.uk

ABSTRACT: Paper (Fri, 12.05 - 12.35)

Keywords: change, training, trainees, mixed methods

The early effects of professional counsellor training: a qualitative study

Aim/Purpose: Only a few studies have investigated the impact of professional training (Bischoff et al., 2002; Orlinksy and Ronnestad, 2006) on trainee therapist's development. Even fewer have attempted to examine the experience of trainees whilst in training, with the exception of Turner et al., (2008), and Howard et al., (2006). To date, studies have provided an overview of trainee experience rather than investigated different stages of training. In addition, no studies have been found that have identified which aspects of training programmes influence trainee change. The aim of this investigation therefore, was to identify the changes experienced by trainees at the start of training and to examine the ways in which training courses may contribute to the changes they experience.

Design/Methodology: Interviews (50 minutes), with seven individual trainees, from the same cohort, were conducted over the last three weeks of term one. They were semi-structured and used an adapted version of the 'Change Interview Schedule' (Elliott et al., 2001). Interviews were transcribed and then analysed using Interpretative Phenomenological Analysis (Smith, 2003).

Results/Findings: Quantitative:

1. Training is preceded by recent stressful life events. 2. Trainees commence training in a state of change. 3. Training accelerates change from the outset. 4. Helpful aspects of training courses are those that support change, unhelpful aspects are those that obstruct it. 5. 'Altruistic reflexivity' i.e. developing greater self-awareness for the sake of future clients, is central to trainee experience and a key driver for change.

Research Limitations: Extra-training factors that were not investigated may be responsible for some of the changes identified. This study may not be representative of other trainees.

Conclusions/Implications: This study brings us closer to understanding not only how training helps students to become therapists but what trainees contribute to this process from the outset.

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Julie Folkes-Skinner and Sue Wheeler

Professional Role: Lecturer in Counselling (JFS)
Institution: University of Leicester
Contact details: Institute of Lifelong Learning, 128 Regent Road, Leicester LE1 7PA
Email: jafs1@le.ac.ak

ABSTRACT: Workshop (Fri, 13.50 - 14.50)

Keywords: research clinic, counselling

Setting up a counselling research clinic

Aim/Purpose: In January 2010 the University o Leicester Counselling and Psychotherapy research clinic opened. This workshop offers a unique insight into the development of the counselling research clinic. Inspired by the success of the research clinics in Scotland at Strathclyde and Abertay Universities in 2008, we started looking for a partner organisation that had premises and was already offering a counselling service, and for funding to establish a clinic in Leicester. After 18 months of negotiation with one potential partner organisation it became clear that the required change of culture was not going to work. A timely and fortuitous meeting with the head of the university Counselling Service, met with a welcoming and positive response to the suggestion of using the University counselling service premises in the evenings to establish the research clinic. £40,000 was raised through various income generating activities at the university, including conferences, training days and seminars and £10,000 was donated by BACP to support the first research clinic to be set up in England.

The workshop will present the plan for the Leicester research clinic (and indeed some early data collected from the clinic). Experiential exercises will encourage participants to think about strategies for developing their own local research clinics.

Design/Methodology: The workshop will include a presentation, experiential exercises and discussion. Ideas will be generated and research methods discussed. A network of people interested in developing a counselling research clinic will be established.

Originality/Value: This project is unique in England.

Conclusions/Implications: There has been considerable interest in the development of our clinic and this is an opportunity for others to hear about the stages of clinic development and to explore potential for future clinics.

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Elizabeth Freire

Professional Role: Lecturer in Counselling Psychology
Institution: University of Strathclyde
Contact details: University of Strathclyde, Counselling Unit, 76 Southbrae Drive, Glasgow G13 1PP
Email: elizabeth.freire@strath.ac.uk

ABSTRACT: Paper (Fri, 12.05 - 12.35)

Keywords: effectiveness, counselling, primary care, routine evaluation

The effectiveness of counselling in primary care: a naturalistic evaluation

Aim/Purpose: This study aims to evaluate the outcomes of counselling in a primary care setting

Design/Methodology: This evaluation was undertaken as part of the routine clinical practice of a service that provides counselling to 65 GP surgeries in West Scotland. All clients who were referred to counselling by their GPs attended an initial screening appointment, at which they completed the CORE-OM (CORE Outcome Measure) and the HADS (Hospital Anxiety and Depression Scales). Clients completed these measures again at the beginning and at the end of therapy.

Results/Findings: Five hundred and fifty-seven clients attended the counselling service across 56 GP practices. Clients attended in average six sessions of counselling. Ninety-three percent of clients were offered person-centred counselling or some integrative modality based on person-centred principles of counselling. Clients waited an average of 45 days between the initial screening assessment and the first session. During this waiting period, there were no significant reductions in the HADS scores. The mean CORE score showed a statistically significant reduction during this waiting period, although this reduction was not clinically significant. Paired samples t-test showed significant reductions in the CORE and HADS scores following counselling. These reductions were reliable and clinically significant and translated into effect sizes of 1.8 for CORE-OM and HAD-A and 1.4 for HAD-D, which are considered ‘large'.

Research Limitations: Due to the naturalistic characteristic of the design, the completion rate was low.

Conclusions/Implications: These results add strong evidence for the effectiveness of counselling in primary care for common mental health problems.

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Jan Grove

Professional Role: University Lecturer
Institution: Newman University College
Contact details: Newman University College, Bartley Green, Birmingham B32 3NT
Email: j.grove@newman.ac.uk

ABSTRACT: Paper (Fri, 13.50 - 14.20)

Keywords: same sex, online survey, thematic analysis, couple counselling, clients

An exploration of the counselling process for same sex couples: the client's perspective

Aim/Purpose: This research aims to improve the effectiveness of same sex couple counselling by listening to the experiences of the couples themselves. Research into the experiences of individual lesbian and gay clients (Mair, 2003; Pixton, 2003) has provided rich insights for counsellors, however this is missing for same sex couple counselling. In particular, the research aims to determine how couples access counselling, and the helpful and hindering aspects of the counselling process.

Design/Methodology: Data will be collected through an on-line survey with demographic, Likert-style choice and open-ended questions. Online research has the capacity to access respondents who are hard to reach through other means (Fricker et al., 2002) providing anonymity and the opportunity to gain responses from a wide geographical area. Descriptive statistics will be used to summarise quantitative data. Qualitative data will be subjected to thematic analysis seeking to report the experiences and realities of the respondents (Braun and Clarke, 2006).

Results/Findings: This work in progress will provide insight into the counselling encounter, testing and broadening the results of a previous pilot project to include a wider diversity of respondents. Results will show for example: the criteria couples use in selecting a service, how the clients perceive their counsellors' comfort or discomfort in working with a same sex couple, whether clients withhold parts of their relationship in order to protect the counsellor and how assumptions made about the counsellors' sexual orientation impact on the counselling.

Research Limitations: Online surveys rely on literacy and private access to the internet that potentially excludes some participants. Respondents can exit the survey at any stage resulting in incomplete data collection. Whilst this method reduces the impact of power in the interview, it also removes the ability of the interviewer to rephrase or reword questions.

Conclusions/Implications: The results in this under-researched area will be of value to service providers seeking to attract same sex couples. It will also identify elements of the interpersonal encounter that help and hinder the process, enabling counsellors and others who work with same sex couples to reflect on their practice.

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Terry Hanley

Other Author: Clare Lennie

Professional Role: Lecturer in Counselling (TH), Lecturer in Education and Counselling Psychology (CL)
Institution: University of Manchester
Contact details: Oxford Road, Manchester M13 9PL
Email: terry.hanley@manchester.ac.uk

ABSTRACT: Paper (Sat, 14.10 - 14.40)

Keywords: counselling in schools, multiple baseline, strengths and difficulties questionnaire, CORE-YP, effectiveness

The impact of in-school counselling upon adolescents' psychological well-being

Aim/Purpose: Increasingly secondary schools are becoming mindful of the emotional well-being of their students. In doing so, counsellors are becoming commonplace within the support structures of schools. To date, research findings from practice-based outcome studies suggest this is a positive move; however, there are numerous limitations to this work. In particular, a majority of the quantitative literature concentrates solely upon pre to post outcome data and does not provide findings to draw comparisons. This project develops upon this body of literature and reflects more systematically upon the effectiveness of such work.

Design/Methodology: This is an ongoing quantitative pilot which examines the practice-based evidence for in-school counselling. Specifically, it focuses upon the experiences of young people aged 13-15 who are referred to five in-school counselling services provided by Relate (n=estimated 20). The study adopts a multiple baseline approach in which standardised self report questionnaires (the Strengths and Difficulties Questionnaire [SDQ] and CORE-YP) will be collected at four intervals: (1) the point of referral, (2) the onset of counselling, (3) the completion of counselling and, (4) a two month follow-up.

This study works within BACP's ethical framework and is further informed by the same organisation statement upon research ethics. Ethical approval was granted by the University of Manchester.

Results/Findings: This is an ongoing project which will be completed by March 2010. The change noted by both the SDQ and the CORE-YP during the period of time in counselling will be compared to that reported whilst waiting for counselling and after the completion of counselling.

Research Limitations: This is a small scale investigation. It attempts to trial a methodology that may strengthen the research storyline of in-school practice-based evidence, however working in naturalistic settings means that there is an inevitable messiness to the data generated. Thus, further research will need to respond to challenges encountered in this work and increase the number of participants involved.

Conclusions/Implications: This work adds to the developing literature on in-school counselling. It develops upon existing practice-based data collection methods and increases our understanding of the effectiveness of in-school counselling.

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Andy Hill

Professional Role: Head of Research
Institution: British Association for Counselling and Psychotherapy
Contact details: BACP House, 15 St John's Business Park, Lutterworth, Leicestershire LE17 4HB
Email: andy.hill@bacp.co.uk

ABSTRACT: Paper (Fri, 16.30 - 17.00)

Keywords: evidence-based practice, manualised therapy, person-centred/experiential therapy, Improving Access to Psychological Therapies, depression.

Engaging with evidence-based practice: developing a manualised, brief person-centred/experiential therapy for depression

Aim/Purpose: To describe the development of a manualised form of brief person-centred/experiential (PCE) counselling for the treatment of depression.

Design/Methodology: This paper reports on work undertaken so far in the UK to produce a brief, manualised, PCE therapy concordant with the NICE guideline for depression. The process of developing the competences required to deliver effective humanistic psychological therapies (Roth, Hill and Pilling, 2009) is described, together with the development of a manual for the delivery of counselling for depression in the Improving Access to Psychological Therapies (IAPT) programme. The utility of the counselling for depression manual as a basis for further research and training in PCE therapy is discussed.

Results/Findings: The project has produced a manual describing the competences necessary for the delivery of effective brief PCE therapy for depression. The competences are organised into domains and a narrative is provided describing how the competences should be implemented. A therapy adherence scale has also been produced to evaluate how far therapists' practice is concordant with the manual. These materials will be used in the training of counsellors in the IAPT programme, but can also be used in the design of clinical trials of counselling for depression.

Research Limitations: The utility of the manual and therapy adherence scale in the training of counsellors needs to be tested. The effectiveness of the manualised therapy in the treatment of depression needs further evaluation.

Conclusions/Implications: A manualised version of brief PCE therapy is needed to facilitate the introduction of counsellors into IAPT. Research into the effectiveness of this therapy is necessary if counselling is to be recognised as an evidence-based therapy in future revisions of the NICE guideline for depression.

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Suzanne Hodge

Professional Role: Researcher
Institution: University of Liverpool
Contact details: Health and Community Care Research Unit, Thompson Yates Building, Brownlow Hill, Liverpool L69 3GB
Email: smh@liv.ac.uk

ABSTRACT: Paper (Fri, 10.55 - 11.25)

Keywords: sight loss, integrated low vision service, emotional support

Addressing the psychological impact of sight loss within an integrated low vision service: findings from an evaluation of an emotional support and counselling service

Aim/Purpose: The study was set up as part of a pilot project providing an Emotional Support and Counselling (ESaC) Service as part of an Integrated Low Vision Service. The project was based in two sites - Gateshead and London. The study aimed to evaluate the effectiveness of the service.

Design/Methodology: A mixed quantitative/qualitative methodology was adopted. The Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM) and a 'needs and expectations' questionnaire were administered at the client's first counselling session and again at their final session. Complete baseline and follow-up data were collected from a sample of 34 individuals. Qualitative interviews were conducted with service providers (n=15) and clients of the service (n=16) to explore their views and experiences in more depth.

Results/Findings: Results from the CORE data show statistically significant improvements in the mental health of the sample between baseline and follow-up. These improvements were mirrored in findings from the 'needs and expectations' questionnaires, which indicated that after counselling clients had a more positive outlook and more clarity of understanding about how they might address their difficulties. The qualitative interviews with clients explored in more depth the difficulties facing them, including bereavement, divorce, physical and mental health problems, which compound the difficulties relating to their sight loss. Clients reported that the ESaC service was of great value to them, enabling them to address feelings such as anger and frustration. Findings from the qualitative interviews with service providers suggest that although the ESaC services have taken some time to become embedded within the Low Vision Services, they have become an important and valued element of those services.

Research Limitations: Low rates of referral into the services meant that the study sample was smaller than anticipated. A methodological limitation of the study was the use of the ESaC counsellors to administer questionnaires. Ideally these would be self-completed by clients, but their visual impairment made this impossible. Although every effort was made to ensure that this had minimal impact on the data, it must be acknowledged as a limitation.

Conclusions/Implications: Working with people with sight loss involves a considerable amount of emotional support work. Offering an ESaC service as part of an Integrated Low Vision Service provides a valuable additional resource for clients accessing the service, as well as for Low Vision Service staff. However, although the service is of value and has been shown to produce positive outcomes, difficulties remain in generating a sustainable rate of referrals and in promoting the service to a predominantly older client group who tend to be averse to the idea of counselling.

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Jane Hunt

Professional Role: Deputy Director of Counselling Psychology/Lecturer in Counselling
Institution: Keele University
Contact details: School of Psychology, Keele University, Keele, Staffordshire ST5 5BG
Email: j.a.hunt@psy.keele.ac.uk

ABSTRACT: Paper (Fri, 15.00 - 15.30)

Keywords: sex, gender, transgender, discourse, counselling

Sex and gender in transwomen's discourses: implications for counselling practice and training

Aim/Purpose: A recent BACP systematic review noted an absence of research concerning counselling and transgendered clients that was not solely concerned with preparing transgendered people for gender reassignment surgery (King et al., 2007). The same report argued that a knowledge of transgendered issues should be seen as a core element in counselling and psychotherapy training. As a contribution to developing understanding in this area, this paper will present findings from my doctoral research regarding the constructs of sex and gender in transwomen's discourses, and consider the implications for counselling training and practice.

Design/Methodology: This research was conducted using semi-structured in-depth interviews with six male-to-female transwomen who had undergone gender reassignment surgery, and the data analysed using a discourse analytic approach (Parker, 1992; Willig, 2001). Ethical approval was granted by the University of Manchester Ethics Committee.

Results/Findings:

(i) Participants used the word sex to talk about sexual intercourse or orientation, and gender when referring to their identities, with little reference to sex as a biological category. In doing so, they challenged the feminist discourse that sex is biological and gender is cultural (Fausto-Sterling, 2000; Hird, 2000) and rejected the term transsexual.

(ii) Participants drew upon two competing discourses, which I term ‘interiority' and ‘performance', when talking about gender identity. The ‘interiority' discourse is an essentialist discourse, which locates gender in the brain, mind, or soul. The ‘performance' discourse is a non-essentialist discourse, which understands gender as form of doing or practice.

Research Limitations: All participants were post-operative transwomen and findings cannot be generalised to transwomen who have not undergone surgery or to transmen.

Conclusions/Implications: This study challenges the inclusion of transgender issues under the LGBT categorisation. It highlights the merits of a constructivist paradigm for work with transgendered clients, and argues that competing discourses within transwomen's talk poses a challenge to the emphasis on the unified self within counselling theory.

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Werner Kierski

Professional Role: Lecturer, psychotherapist and researcher
Institution: Independent
Contact details: 52 Purley Avenue, London NW2 1SB
Email: wernerk@gotadsl.co.uk

ABSTRACT: Paper (Sat, 14.10 - 14.40)

Keywords: supervision, doctoral candidates, counselling

Academic supervision experiences amongst doctoral candidates in counselling and psychotherapy

Aim/Purpose: A doctorate for counsellors and psychotherapists is fast growing in importance and reflects the growing academic recognition that the profession is gaining and in turn is asked to provide. Doctorate research directly contributes to the generation of therapeutic knowledge. However, the completion of a doctorate lasts several years and may be fraught by academic and emotional problems. There is a suggestion that the experience of academic supervision contributes to severe problems thus negatively influencing successful completion. Taylor's (2008) examination alerts to the considerable number of doctoral students failing to complete their course. Problems in academic supervision of doctoral candidates in psychotherapy specifically have been pointed out by Etherington (2004) who identified the quality of the relationship between student and supervisor as fundamental to the outcome. Taylor and Beasley (2005) warn that even though doctoral supervisors have completed research for their own doctorate they may not be effective supervisors and instead need an understanding of academic supervision that goes beyond mere research experience. With doctorates in counselling and psychotherapy being a relatively new development it is not yet known, apart from anecdotal evidence and unstructured accounts, how candidates view their academic supervision.

Design/Methodology: A qualitative design is employed to explore academic doctoral supervision experiences. Eight BACP/UKCP accredited therapists were interviewed using a semi-structured questionnaire. Hermeneutical phenomenology is employed in the analysis. Recruitment was carried out through doctorate courses including Metanoia Institute, Regents College and Roehampton University. This is the first phenomenological research into academic doctoral supervision experiences amongst BACP/UKCP registered counsellors and psychotherapists.

Results/Findings: Findings will be presented at the conference.

Research Limitations: This research will not quantify to what extend emotional experiences of academic supervision directly affect student retention and successful completion of a doctorate. However, it offers textured descriptions of how students experience academic supervision.

Conclusions/Implications: A better understanding of how therapists experience academic doctoral supervision will help to raise awareness of the actual needs of students, thus making a successful completion of a doctorate more likely.

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John McLeod and Andrew Sweeting

Professional Role: Professor of Counselling (JM)
Institute: University of Abertay Dundee
Contact details: Kydd Building, Bell Street, Dundee DD1 1HG
Email: j.mcleod@abertay.ac.uk

ABSTRACT: Poster (Fri, 10.00 - 10.20)

Keywords: policy, preferences, public attitudes

Public perceptions of the credibility and usefulness of CBT, person-centred therapy and counselling

Aim/Purpose: There is considerable evidence that people seeking therapy express preferences for different approaches and intervention styles, and that these preferences have an impact on both the development of the therapeutic alliance and eventual outcome. The aims of this study were to examine perceptions within the Scottish general population of the credibility and usefulness of forms of therapy that are widely available within that cultural setting.

Design/Methodology: Participants (29) were asked to read expert-generated descriptions of CBT, person-centred therapy, and counselling, and to indicate their preferences for each approach, using ratings scales that had been validated in previous studies. Participants were also invited to comment on the reasons for their choices - these open-ended responses were subjected to thematic analysis.

Results/Findings: The results of this survey indicated that participants gave higher ratings to CBT and counselling, rather than person-centred therapy. Overall, counselling was the most favoured option. A variety of reasons were provided to account for these choices.

Research Limitations: This was an exploratory study, carried out on a relatively small sample - further large-scale replication is required in order to determine the general applicability of these findings.

Conclusions/Implications: The findings of this study suggest that there is support for all three of the therapy approaches examined in this investigation. To ensure an appropriate level of client choice, it may be important for policy-makers to ensure that a range of therapy options are available to service users. It may be significant that counselling, which was described in this study as a flexible approach that incorporated both problem-solving and relational elements, was most highly valued by participants.

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Julia McLeod and John McLeod

Professional Role: Lecturer in Counselling (Julia M)
Institution: University of Abertay Dundee
Contact details: Kydd Building, Bell Street Dundee DD1 1HG
Email: julia.mcleod@abertay.ac.uk

ABSTRACT: Paper (Fri, 10.55 - 11.25)

Keywords: action research, counselling skills, dementia, embedded counselling, nursing, qualitative methods

Changing practice: the impact of counselling skills training on community mental health nurses working with people with dementia

Aim/Purpose: A diagnosis of dementia presents substantial challenges to well-being and support networks. At present, there is little psychological support offered within the NHS to people diagnosed with dementia. The aims of this study were to examine the effect of participation in a counselling skills course, along with follow-up supervisory support, on a group of community mental health nurses who work with people with dementia.

Design/Methodology: Seven experienced community mental health nurses were followed up over a 15 month period. Participants undertook a 120 hour counselling skills programme (based on a pluralistic embedded counselling framework) over nine months, and then engaged in monthly Learning Sets for a further six months. Data were collected through individual and focus group interviews, learning journals and recordings of Learning Set meetings, and subjected for a form of case-based grounded theory qualitative analysis within an action research design.

Results/Findings: The results of the study indicated that involvement in the course had a significant personal impact on nurses in this group - all of them reported areas of meaningful personal learning. Key characteristics of the experience of being on the course were identified as contributing to change: permission to make mistakes, being part of a supportive group, on-going practice with feedback, and time to consolidate and apply what had been learned. Nurses described a range of shifts in their approach to their work encompassing relationships with colleagues as well as engagement with people with dementia and their families. These work-related changes mainly occurred in three areas: a more reflective stance; being facilitative rather than directive; greater confidence in exploring emotionally-charged issues.

Research Limitations: The study was based on a small sample, in one setting - the general applicability of these findings needs to be tested through replication on other contexts. Further research should also elicit the views of people with dementia, regarding the use of counselling interventions.

Conclusions/Implications: The findings of this study suggest that counselling skills training represents a practically-relevant form of training for health professionals working with people with long-term health conditions, particularly if supplemented by on-going supervisory support and mentoring. Counselling skills training has the potential to enhance the quality of service delivery and patient care, by facilitating patients and family members to activate personal resources and support networks. This kind of training appears to be most effective when a community of practice approach is employed, in which participants become members of a practitioner network characterised by different levels of expertise.

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Graham North

Professional Role: Primary Care Counsellor and Primary Care Mental Health Worker
Institution: The University of Manchester
Contact details: School of Education, The University of Manchester, Oxford Road, Manchester M13 9 PL
Email: Graham.North@postgrad.manchester.ac.uk

ABSTRACT: Paper (Sat, 11.45 - 12.15)

Keywords: counselling, supervision, audio-recording, reflective-practice, stress.

Recording supervision: educational and therapeutic?

Aim/Purpose: To explore the impact on counsellors of listening to an audio-recording of their latest supervision session. Supervision is mandatory for counsellors and most psychotherapists in Britain (Feltham, 2002), and is important in personal and professional development (Wheeler and Richards, 2007). While audio-recording supervision has been advocated as a training and quality measure for supervisors (Page and Wosket, 2001: Walker and Jacobs, 2004:79-80; West and Clark, 2004:25), I found only two references commending it to supervisees (Houston, 1995:75; West and Clarke, 2004:25)

Design/Methodology: This study used phenomenological interviews, informed by researcher's existing knowledge. These were transcribed and analysed using grounded theory methodology (Glaser and Strauss, 1967; Strauss and Corbin, 1998), which is appropriate for understanding phenomena associated with un-researched areas and is acceptable to many positivist psychologists (Rennie, 2000). Participants were a theoretical sample of 13-female and two-male therapists with 0-20-years experience, representing person-centred, CBT, psychodynamic and integrative approaches. Their qualifications ranged through doctorate, masters, diploma to student. They were in established supervisory relationships; and were not in a close professional or social relationship with the researcher.

Results/Findings: It was as if listening to the audio-recording allowed participants to ‘reflect-in-action' (Schon, 1983) in the supervision room as they re-experienced their thoughts and emotions, just as in Interpersonal Process Recall (Elliott, 1986). Participants recalled experiences in supervision. Many of these memories were in their conscious; but some had been forgotten, not noticed or (arguably) repressed. This re-experiencing was usually less emotive than in real-time; but suppressed emotions could be felt more intensely. Integrating noticed and unnoticed events enabled some participants to accept what had been unacceptable, gaining self-awareness, which could be therapeutic. Similarly, noticing what had been unnoticed permitted insights into the client, therapy process, supervisory relationship and how participants used supervision, which were all educational and more than ‘reflection-on-action' (Schon, 1983).

Research Limitations: Qualitative research findings are not generalisable.

Conclusions/Implications: This study suggests that listening to a recording of supervision can be educational and it may be therapeutic if therapists use the recording to challenge their own maladaptive beliefs and behaviours.

References available on request, please email research@bacp.co.uk

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Denis O'Hara

Professional Role: Lecturer in Counselling and Psychology
Institution: Australian Catholic University/ Tayside Institute of Health Studies, University of Abertay
Contact details: School of Psychology, Australian Catholic University, PO Box 456, Virginia, Brisbane, 4014, Australia
Email: denis.o'hara@acu.edu.au; d.ohara@abertay.ac.uk

ABSTRACT: Paper (Sat, 13.35 - 14.05)

Keywords: psychotherapy integration, evidence-based practice, multiple qualitative methodologies, theory/practice gap

Factors influencing how psychotherapists approach psychotherapy integration

Aim/Purpose: Over the past 20 years, two major shifts have occurred in the field of psychotherapy, the first is a movement towards the integration of theories, and the second is a drive towards identifying the most effective and efficacious theories founded on research evidence. In some respects these two movements have produced contradictory outcomes, one, an integration of the field, and two, a separation of the field of psychotherapy. Researchers have identified a number of factors that influence therapists' theoretical orientations but little exploration has been undertaken to identify factors which influence therapists' approaches to psychotherapy integration (Poznanski & McLennan, 2004). This paper reports the second part of a study with a two-part aim one, to identify different approaches to psychotherapy integration and, two, to identify and examine factors which influence how therapists integrate their psychotherapy theory and practice.

Design/Methodology: This study used a multidimensional qualitative design wherein five experienced therapists representing broadly different theoretical orientations were interviewed three times. The first semi-structured interview aimed at identifying the respective therapists' theoretical commitments. The second interview was focused around a process recall observation/interview of a video recorded therapy session conducted by each therapist. Of particular interest was the comparison of the therapists' first interview espousals with the nature of their actual practice. Discrepancies or gaps between espousal and practice were noted. A grounded theory approach to the interview data provided detailed participant conceptualisations of the topic. A comparison of these conceptualisations was made by examining any theory/practice gaps evident between interview one espousals and interview two practice. Interview three provided another window to check the therapists' understanding of psychotherapy integration especially after the juxtaposition of interviews one and two.

Results/Findings: A number of influencing factors were identified of which two will be explored in this paper, (i) therapists' personal factors, and (ii) meta-theory.

Research Limitations: The study cannot easily be generalised to the field owing to the small sample size and the idiosyncratic nature of psychotherapy practice.

Conclusions/Implications: The paper concludes with a discussion of how these two factors influence psychotherapy integration and how they also influence the dictum of evidence- based practice. How the strengths of both psychotherapy integration and evidence-based practice can be mutually supporting will also be reflected upon.

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Valerie Owen-Pugh

Professional Role: Lecturer in Counselling and Psychotherapy
Institution: Institute of Lifelong Learning, University of Leicester
Contact details: LILL, University of Leicester, 128 Regent Rd, Leicester LE1 7PA
Email: vap4@le.ac.uk

ABSTRACT: Paper (Sat, 14.45 - 15.15)

Keywords: counselling profession, career development, professional identity, career choice

How do counsellors interpret their professional development? A qualitative study

Aim/Purpose: To explore counsellors' reflections on their professional development trajectories, with the aim of clarifying: how counsellors view their entry into the profession; how they view their subsequent development trajectories; what motivates them to stay within the profession; their ambitions for future professional development.

Design/Methodology: Nineteen participants in a large-scale quantitative survey of BACP members, carried out in 2003, also completed an optional series of qualitative questions, including questions exploring their development as therapists. The qualitative data they supplied is now being subject to thematic analysis.

Results/Findings: The narrative offered by participants was one of gradual development of an interest in counselling, commonly triggered initially by the demands of other paid professional work. Surprisingly few made reference to the existence of earlier personal problems, or suggested that their professional interest in counselling was linked with a need to resolve personal issues, a finding which conflicts with the conventional portrayal of counsellors as 'wounded healers'. Training courses were very prominent in participants' accounts of their development; they viewed the completion of certified training as markers, or staging posts in their professional trajectories. Such courses served not only to validate and strengthen students' prior professional interests but also to alter the course of their trajectories by allowing them to move into new areas of work. Participants were motivated, not only by successes achieved in their work with clients, but by a desire to help others and by the personal development that they gained through working as counsellors. They all expressed strong identification with the counselling profession, but some referred to the need to overcome barriers to development, such as the need to attend further training courses, build counselling hours, and find strategies for ameliorating the low income open to professional counsellors.

Research Limitations: The qualitative data explored in this study represents students' subjective interpretations of their professional trajectories. As such, it must be understood as shedding light on their construction of wider life narratives, rather than as offering objective descriptions of actual change events. The data is also limited in that it primarily offers a series of success stories; counsellors who have left the profession were not represented in the survey; those with negative views of the profession are less likely to have completed the questionnaire.

Conclusions/Implications: The study's participants presented their researchers with a series of success stories, tempered by concerns for their future professional development. Its findings are discussed in the light of theories of professional development, in particular, Lave and Wenger's theorising of 'communities of practice'.

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Sue Pattison

Professional Role: Degree Programme Director, Integrated PhD Education and Communication
Institution: University of Newcastle upon Tyne
Contact details: King George VI Building, Victoria Road, Newcastle upon Tyne NE1 7RU
Email: susan.pattison@ncl.ac.uk

ABSTRACT: Paper (Sat, 13.35 - 14.05)

Keywords: school counselling, primary, special and secondary schools, children and young people, mental health and well-being, North East England

School counselling: promoting the mental health and well-being of children in primary, secondary and special schools in the North-East of England

Aims/Purpose: This is primarily a needs assessment rather than a satisfaction study. The aim is to answer the question ‘How can school counselling help to improve the mental health and well-being of children in primary, secondary and special schools in the North-East of England? Objectives: to obtain children, school counsellors, teachers, learning mentors and parents' views; to map these views against contemporary theory, practice and policy. Children's emotional well-being is topical nationally (Primary Review (2007) Community Soundings: Primary Review regional witness sessions, Cambridge: University Cambridge Faculty of Education; Aiming High for Young People: A 10 Year Strategy for Positive Activities, 2007, DfCSF; and internationally: An overview of child well-being in rich countries, Innocenti Report Card 7, 2007, UNICEF Innocenti Research Centre, Florence).

Design/Methodology: Explorative qualitative research was carried out with an opportunistic sample of children, school counsellors, teachers, learning mentors and parents. Schools: four primary, one special school and eight secondary; rural and urban in four areas of the North-East. Data collection: audio-recorded semi-structured interviews; focus groups; ethnographic school-based conversations and observations with teaching staff. Thematic analysis and iterative research/analysis process, addressing ‘gaps' in participants perspectives; synthesis of findings in relation to conceptual and theoretical material.

Results/Findings: Participants viewed counselling as a useful intervention in preventing children's problems from escalating in ways that promote mental health and well-being. A ‘gap' was identified around confidentiality, with all secondary school children wanting total privacy from parents and other school staff, including teachers, whilst some teachers and parents would prefer to be given information about children who access counselling.

Research Limitations: As a small scale study involving qualitative methodology, the results cannot be generalised to larger populations. The sample was confined to the North East of England. The nature of the information collected from children with moderate and severe learning disabilities, severe autism and multi-sensory disabilities, where understanding of some concepts inherent in the interview questions, could not be verified.

Conclusion/Implications: This research suggests that school counselling is perceived to be helpful to children in terms of promoting mental health and well-being, reflecting findings from other studies. The level of confidentiality required by children in secondary schools is already well-documented and by identifying the ‘gap' between children and adults' perceptions of privacy, conceptual understandings can be advanced in relation to child and adolescent development, special educational needs, parenting, education and policy.

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David Rennie et al.

Professional Role: Professor Emeritus & Senior Scholar
Institution: York University, Toronto, Canada
Contact details: Dept of Psychology, York University, Toronto, Canada, M3J 1P3
Email: drennie@yorku.ca

ABSTRACT: Workshop (Fri, 13.50 - 14.50)

Keywords: qualitative methods, procedures, pluralism, issues, problem solving

Issues in qualitative research

Relevance of the workshop to counselling and psychotherapy research: It should be of interest for anyone interested in and attempting to create a path through the often conflicting assumptions seen in the range of approaches to qualitative research.

The aims of the workshop: To provide an informative, engaging conversation between the panellists and the participants to the end of helping the latter to position themselves on the issues they either are facing or anticipate facing in their qualitative research work.

How the workshop will be structured: I plan to recruit two or three other panellists who hold different views on the topic than I do, in the interest of representing the pluralism in this field. We'll introduce the issues aided by powerpoint then initiate active dialogue with the participants in terms of their personal wrestlings with the issues.

Key points for discussion: In virtue of the pluralism characterising them on many fronts there are issues involved in the use of qualitative research methods - issues such as the epistemologies supporting them (objectivist, constructionist, in-between); the grounds for truth claims made for returns from the methods; the role if any for the researcher's reflexivity; whether the methods are descriptive or explanatory, or both; whether or not they are interpretive at root and if, in what ways; and the place for the individual case and the general case in them. Related to these methodical concerns are procedural ones such as the extent to which analyses should be micro-analytic; and whether analyses can be done solo or should entail a research team. As leader of the workshop, the author will represent an epistemological middle ground expressed mainly in terms of the grounded theory and related approaches to method. In order to broaden this representation, he will seek to add to the panel two or three fellow qualitative researchers well-known as offering alternative perspectives. The plan for the workshop is to make it a dialogical engagement with participants where they will be invited to direct to the panel questions bearing on their own concerns and interests.

Who will benefit from taking the workshop: Those either thinking about doing or actually doing qualitative counselling and psychotherapy research.

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Brian Rodgers 1

Other Author: Robert Elliott

Professional Role: Project Co-ordinator
Institution: University of Strathclyde
Contact details: Counselling Unit, University of Strathclyde, 76 Southbrae Drive, Glasgow G13 1PP
Email: brian.rodgers@strath.ac.uk

ABSTRACT: Paper (Fri, 15.55 - 16.25)

Keywords: social anxiety/phobia, person-centred/experiential therapy, outcome

Person-centred/experiential approaches to social anxiety: initial outcome results

Aim/Purpose: Good evidence exists for the effectiveness of person-centred/experiential (PCE) therapies with clients experiencing depression and post-trauma difficulties; however, evidence for its effectiveness with anxiety problems is much more sparse. Social anxiety (or social phobia) is a chronic condition with wide-ranging effects on interpersonal, occupational and psychological functioning. Almost all previous research on social anxiety has been carried out on CBT and psychopharmacological interventions. The purpose of this presentation is to present pilot quantitative results on the outcome of person-centred/experiential (PCE) therapy for clients with social anxiety.

Design/Methodology: Using a naturalistic pre-post design (open clinical trial), we assessed client functioning quantitatively on the Social Phobia Inventory (SPIN), CORE-OM, among others.

Results/Findings: Pre-post data from our first 15 clients will be presented, including pre-post significance tests, effect size, and reliable change and clinical significance calculations. Overall, clients showed substantial pre-post gains, comparable to bench-marked previous research on CBT and medication.

Research Limitations: Limitations of small sample size prevent comprehensive conclusions from the study.

Conclusions/Implications: To date our results are promising and begin to provide justification for using PCE therapies for social anxiety. To our knowledge this is the first study of a bona fide PCE therapy with social anxiety and provides a basis for larger and more controlled studies to follow.

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Brian Rodgers 2

Professional Role: PhD Student
Institution: University of Abertay Dundee
Contact details: Bell Street Dundee DD1 1HG
Email: research@brianrodgers.co.uk

ABSTRACT: Paper (Fri, 11.30 - 12.00)

Keywords: life space mapping, CORE-OM, outcome measurement

The clients' perspective on outcome measurement: life space mapping versus the CORE-OM questionnaire

Aim/Purpose: Counselling and psychotherapy outcomes have traditionally been measured using standardised quantitative questionnaires. Though efficient for large numbers of participants, this method is not well suited to capturing the unique and subtle ‘shifts' that clients often report when qualitative methods are utilised. Additionally, the use of words and numbers alone potentially misses the more creative, holistic, and insightful outcomes of therapy. This paper reports how clients made use of a visual 'Life Space Map' (LSM) approach to assessing outcome compared to a standardised outcome questionnaire (CORE-OM).

Design/Methodology: Qualitative interviews were conducted with 17 participants before and after therapy to elicit their views on the usefulness of the LSM versus CORE-OM for reflecting on the outcomes of therapy. A thematic analysis of these interviews was undertaken to establish the dominant themes from the participants' perspective.

Results/Findings: Results from the study reveal that clients utilised the different methods to gain different perspectives on the outcomes of their therapy. Participants reported a number of benefits and limitations with each method, but indicated that the methods complimented each other to give a more complete view of what had changed for them over the duration of therapy.

Research Limitations: The study was part of a larger project designed to explore the potential of the LSM as an alternative to standardised quantitative outcome measures. This initial bias decreased as the researcher heard how participants valued the different approaches in different ways.

Conclusions/Implications: The results of the study suggest that a mixed method approach to outcome assessment captures a more complete picture of client change. Further, a visual / creative approach such as the LSM would seem to offer a valuable complement to traditional linguistic / numeric based measures such as the CORE-OM.

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Salma Siddique

Professional Role: Lecturer
Institution: Edinburgh Napier University
Contact details: School of Health and Social Sciences, Edinburgh Napier University, Edinburgh EH10 2LD
Email: s.siddique@napier.ac.uk

ABSTRACT: Methodological Innovation Paper (Sat, 11.45 - 12.15)

Keywords: anthropology, thick description, witnessing, journey, other

In the thick of it: how the anthropological methodology of 'thick description' can offer a new way of making meaning with counselling research

Background and Introduction: As a medical anthropologist and a therapist I experience research in terms of bearing witness to the lives of ‘other(s)'. Geertz (1995) argues, "Anthropology is the most fascinating, bizarre, disturbing, and necessary form of witnessing ..." ‘Thick description' Geertz (1973) is one approach that encourages the researcher to journey with the subject/client to explore the lived experience as webs of meaning and ethnography as interpretations of these webs. The researcher is bearing witness to the subject/client's journey through the cultural perceptions of reality through the engendered inequality of difference and the voice of the oppressed within the therapeutic relationship.

Nature of the methodological innovation/critique being proposed: The anthropological methodological approach to fieldwork provides the researcher the opportunity to see the tension between and within the subjects' beliefs and practices and that of the context within which it is experienced Geertz (1984) ie, the process of the content. This differs from the interview-based qualitative method; essentially an analysis of data grouped into categories and evaluation ie, the content of the process. During fieldwork in a respite mental health service, staff were confident about their holistic assessment approach, based on a systemic therapy approach. A number of clients however, had a different perspective. They engaged with the assessment by sharing information creatively to help them negotiate their entry to a contained familiar environment during a psychological crisis. Both subject groups' contradictory explanations appeared to create a successful outcome for all. The ‘thick description' approach allows for contradictions to be witnessed as being held within the webs of meaning.

Conclusion and relevance to counselling and psychotherapy research practice: The experience of collecting qualitative data can never be a disengaged, purely objective process: rather, the transparency of the gaze must be understood as a crucial aspect of research observations, interpretations and political critique of the mental health system. The power dynamic between the observer and the observed is one of the definer and the defined. I would suggest that this anthropological approach encourages a dialogue for the participation of the observed to share their narratives of unstable, shifting and alienating social identities alongside the researcher's observations. Areas, within which ethnographic methods might be applied to counselling and psychotherapy, and implications for training of therapy researchers, are discussed.

References available on request, please email research@bacp.co.uk

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Anita Silvester

Professional Role: Staff Counsellor (part time) Student (part time - Professional Doctorate)
Institution: Central Manchester University NHS Foundation Trust / University of Manchester
Contact details: 136 Buckingham Road, Heaton Moor, Stockport SK4 4RG
Email: anita.silvester@talk21.com

ABSTRACT: Paper (Fri, 11.30 - 12.00)

Keywords: NHS Staff Counselling, co-operative inquiry, IPA

Client, practitioner and employer issues as part of the same public sector organisation

Aim/Purpose: To explore how working with clients who are all employed by the same employer as the counsellor may impact upon counselling practice. This research specifically explores the impact for staff counsellors in the NHS. NHS Ethical Approval: 08/H1012/103

Design/Methodology: A co-operative inquiry group was formed with co-researchers from five different NHS Trusts. Five meetings were held enabling induction to the group and three full cycles to take place over ten months. A further meeting to discuss the findings also took place. Data gathered at the four research cycle meetings was transcribed and analysed using Interpretative Phenomenological Analysis (IPA) with particular attention paid to how this approach was used with data gathered from a group.

Results/Findings: These indicate a number of tensions surrounding the differences in understanding of the term counselling, the role(s) and responsibilities of a staff counsellor and the value that is thus placed (or not) upon the service offered.

Research Limitations: The number of Trusts represented is limited mainly due to the length of commitment required to take part in a co-operative inquiry group for 10 months. Further research may be needed to establish how applicable these findings are in a wider range of Trusts.

Conclusions/Implications: At present the implications of this research are that there are specific pressures upon counsellors in this environment. Understanding what these are could enable staff counsellors to take better care of themselves. It is also possible that these findings could be embedded in the structure and development of staff counselling services and thus support staff further at an organisational level. There is also the potential for these results to be applied to other large public service organisations.

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Lesley Spencer

Professional Role: Senior Lecturer in Counselling
Institution: University of Wales, Newport
Contact details: Lodge Road, Caerleon, Newport, South Wales NP18 3QT
Email: lesley.spencer@newport.ac.uk

ABSTRACT: Paper (Sat, 14.10 - 14.40)

Keywords: narrative inquiry, ethnography, ethical dilemmas, genetic counselling

Dilemmas, difficulties and delights in using narrative inquiry in a health setting

Aim/Purpose: This paper focuses on the initial ethical dilemmas and ethnographic challenges involved in negotiating an 18-month study of families going through a genetic counselling process for the risk of sudden arrhythmic death syndrome (SADs) and other similar conditions. The overall aim of this doctoral project is to produce five composite case studies, which will explore the lived experience of such families as they engage in genetic counselling. The narratives of families will be compared with those of the genetic counselling staff involved, building a picture of the genetic counselling process in order to understand better how to help families cope with their genetic circumstances. This paper will review the problems faced by the researcher and how she is seeking to ethically resolve them.

Design/Methodology: This ethnographic study combines participant observations of the families' clinic appointments, narrative interviews with family members and clinical staff and a reflexive account of the researcher's own processes (Speedy, 2008).

Results/Findings: Gaining NHS ethical approval to research this highly sensitive area resulted in significant dilemmas for the researcher in obtaining informed consent from families who need to be seen quickly by the genetics service. This paper will examine how these dilemmas were tackled creatively, as well as how the researcher managed the complexities of the multiple roles involved in ethnographic research (Coffey, 1999; Clandinin et al., 2006). The delights are the rich narratives which are emerging when co-constructing narrative conversations with families and clinical staff (Etherington, 2004).

Research Limitations: Although still in its preliminary stages, the small numbers in this exploratory study means the results cannot be generalised.

Conclusions/Implications: This paper explores the ethical dilemmas researchers might face when they are trying to negotiate research relationships within a short time scale with people facing issues such as grief and fear of dying. The paper invites us to evaluate how we can make this type of research possible while still ethically and sensitively looking after the needs of potential research participants.

References available on request, please email research@bacp.co.uk

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Sheila Spong

Professional Role: Lecturer/ Counsellor
Institution: University of Wales, Newport
Contact details: Lodge Road, Caerleon, Newport, South Wales NP18 3QT
Email: sheila.spong@newport.ac.uk

ABSTRACT: Paper (Fri, 15.55 - 16.25)

Keywords: discourse analysis, social power, social responsibility, individualism

Validity, vision and vocalisation: social responsibility arguments in counselling talk

Aim/Purpose: This paper explores the tension between two key social/ideological themes in counselling talk: social responsibility and individualism (Billig et al., 1988), and considers the implications of this for power-sensitised counselling practice.

Design/Methodology: Two small interview/focus group projects collected counsellors' talk about a number of issues relevant to social power relations. Topics discussed by the participants included feminist counselling, challenging clients' prejudices, and the interface between therapy and social power relations. The analysis identified ways in which participants dealt with cross-content themes of social responsibility and individualism relating to their counselling. Ethical permission was gained from the University of Manchester.

Results/Findings: Counselling discourse holds resources for arguments based on both 'social responsibility' and on 'individualism'. When 'individualism' and 'social responsibility' are in immediate conflict, 'individualism' tends to be the dominant argument in counselling talk, but nonetheless 'social responsibility' arguments are available.

Research Limitations: These findings are based on small scale projects with limited generalisability.

Conclusions/Implications: Power sensitised practice (Milton and Legg, 2000; Spong and Hollanders, 2005) is compatible with existing dominant counselling discourses. It rests on acknowledging the validity of social responsibility arguments, a willingness to vocalise such arguments, and the counsellor's vision of her/his personal engagement with arguments around social responsibility and individualism.

References available on request, please email research@bacp.co.uk

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Léonie Sugarman

Professional Role: Reader in Applied Psychology
Institution: University of Cumbria
Contact details: Counselling Section, School of Social Work and Applied Behavioural Studies, University of Cumbria, Bowerham Road, Lancaster LS1 3JD
Email: leonie.sugarman@cumbria.ac.uk

ABSTRACT: Paper (Fri, 11.30 - 12.00)

Keywords: training, curriculum development, learning and development, learning styles, embedded research

Integrating a research project into the counselling curriculum: challenges and rewards

Aim/Purpose: This paper discusses a research project on learning and development during counselling training that is integrated into the curriculum of a part-time BA (Hons) Person Centred Therapy programme. The project has four aims: (1) A learning agenda - to generate data through self-reflective activities that also contribute to participants' self-awareness and academic development; (2) A teaching agenda - to utilise the data generated for the research in students' ‘Research and dissertation' module later in the programme; (3) A research agenda - to contribute to our understanding of learning and development during counselling training, thereby providing an input to curriculum planning and evaluation; and (4) A staff development agenda - to involve the majority of teaching staff in the project in order to generate concepts that link different teaching areas and to facilitate the development of counselling section's research ethos.

Design/Methodology: The project has ethical clearance from the University's Ethics Sub-Committee. Data for the project includes: (1) Students' ‘Life-Space Maps' (LSMs) and commentary/dialogue on their meaning. (2) Scores on Kolb's Learning Styles Inventory (LSI). (3) Questionnaires and/or interviews concerning students' evaluation of the course and their personal learning, development and needs. The LSM and LSI are completed at the onset of the course and annually or biannually thereafter. The questionnaire/interview evaluations are completed at the end of each semester and/or year.

Results/Findings: Data thus far (at times a partial set) comes from 40 students and 6 staff members. It comprises: (1) Student LSM and LSI data for years one and two of the 2008 intake, and for year one of the 2009 intake; (2) Students' reflective comments on the data generated from these instruments; (3) Interviews with a sample of 2008 intake students at the end of year one, based on Elliott's change interview; (4) LSI data from programme staff.

Staff and student evaluation of the year one use of LSMs and LSIs indicate that both made a valuable contribution to student induction and to linking different course elements.

In addition to discussing the data, the present paper addresses the challenges and rewards of attempting to integrate the research project into the curriculum.

Research Limitations: The sample size is small and the study constitutes work in progress rather than a completed study.

Conclusions/Implications: Embedding a research programme into the curriculum can provide valuable data for course evaluation and can contribute to teaching, learning and staff development agendas. In order to achieve the learning agenda goals, compromises have to be made, primarily in relation to deviating from 'ideal' or ‘pure' research designs.

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Andreas Vossler and Dr Naomi Moller

Professional Role: Academics, Counselling Psychologise
Institution: The Open University, Faculty of Social Sciences, Department of Psychology
Contact Details: Walton Hall, Milton Keynes MK7 6AA
Email: a.vossler@open.ac.uk

ABSTRACT: Paper (Sat, 13.35 - 14.05)

Keywords: couple counselling, marital therapy, infidelity, thematic analysis, relate

Relate couple counsellors' experiences of working with infidelity

Aim/Purpose: Research suggests that about a quarter of persons in committed relationships will commit infidelity in their lifetime (Blow and Hartnett, 2005a). Infidelity is described in the literature as a difficult and relationship-threatening event (Whisman, Dixon and Johnson, 1997), and also a major reason why couples seek marital therapy. However despite the prevalence of infidelity and its potentially critical impact on relationships, research on therapeutic work with infidelity is surprisingly limited (Blow and Hartnett, 2005b). Besides two smallish outcome studies for marital therapy interventions aimed at infidelity, only one prior study has explored the views of couple counsellors and this study did not focus clearly on the client or professional expertise of these practitioners (Charny and Parnass, 1995). This study therefore aims to extend the sparse literature by exploring couple counsellors' experiences of working with infidelity.

Design/Methodology: Semi-structured interviews were conducted with seven experienced couple counsellors working for Relate. The interview transcripts were analysed using thematic analysis (Braun and Clarke, 2006) and systematic efforts were made to ensure that the analysis was trustworthy and credible (Morrow, 2005).

Results/Findings: The analysis resulted in the identification of a number of themes:

1) Changed and varied perceptions and definitions of infidelity by clients 2) complex netting of underlying couple/client factors associated with infidelity, 3) the trauma of disclosure and clients' emotional responses, which is linked to 4) the challenges in working therapeutically with infidelity. The findings also indicate that the process of readjustment in the aftermath of infidelity can offer opportunities for clients to develop a closer and more satisfying relationship than before.

Research Limitations: This exploratory study is an important step in an under-researched area; the results however need to be validated and extended. Further quantitative and qualitative research is needed to explore client experiences of couple therapy for infidelity.

Conclusions/Implications: By exploring the experiences of couple counsellors working with infidelity, the study findings have clear practice implications for couple counsellors working with this presenting issue.

References available on request, please email research@bacp.co.uk

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William West and Dori Yusef

Professional Role: Reader in counselling (WW)
Institution: Manchester University
Contact details: Oxford Road, Manchester M13 9PL
Email: William.west@manchester.ac.uk

ABSTRACT: Workshop (Fri, 15.55 - 16.55)

Keywords: researcher's voice, a/r/t/ography, qualitative, rhetoric, auto-ethnography

Writing up qualitative research

Relevance of the workshop to counselling and psychotherapy research: This workshop addresses the challenging question of how to write a research report in an engaging readable rigorous manner. Many novice and even experienced researchers struggle to find their voice and to put themselves into print. The traditional way was to write research reports in a third person and ‘objective' voice. The increasing usage of qualitative research methods which give a voice to research participants has resulted in more frequent use of the first person as a way of acknowledging, of voicing the researcher. However, this still remains very problematic for many researchers. In this workshop, we will explore some innovative ways of giving voice to us as researchers.

One way we will explore the researcher's voice is using A/r/t/orgraphy (Irwin and De Cosson, 2004) which is an overarching methodology that becomes the province of creative engagement for the artist, the researcher, the teacher- who can use varied media to gather, present and explore the data. It presents the data in such a way that it creates mometic resonance with the reader who re-experiences the material ‘as if' they had truly been there.

The process of finding one's voice as a researcher can involve exploring the experience of doing the research, the field of inquiry and the impact that inquiry has on researcher. This is the reflexive component of researching, writing and presenting. It can be viewed as working in the field as a lone ethnographer and writing as an auto-ethnographer. The researcher as auto-ethnographer is then both the ‘eye' and the ‘I' and Ellis suggests (2004, PG xix) ‘might the ‘I' refer to the researcher who looks inward as well as well as outward?'

The aims of the workshop: To expose participants to some fresh ways of writing. It is crucial that key research findings are disseminated - too much important research remains in grey literature and unpublished. Many therapy practitioners do not read research reports which are often viewed as distanced from practice. This question of how we write-up our research, the rhetoric of research writing is vital. This workshop aims to raise this issue and explore some possible creative answers.

How the workshop will be structured: Presentation, writing, exercises and discussion.

Key points for discussion: Authenticity, rhetoric, rigour.

Who will benefit from attending the workshop: Anyone struggling to find their voice as a researcher or interested in helping others do the same.

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Sue Wheeler, Michael Barkham and Mark Aveline

Professional Role: Director of Counselling and Psychotherapy (SW)
Institution: University of Leicester
Contact details: Institute of Lifelong Learning, 128 Regent Road, Leicester LE17PA
Email: sw103@le.ac.uk

ABSTRACT: Workshop (Sat, 10.40 - 11.40)

Keywords: supervision, research, network proposal

SuPReNet: Supervision Practice Research Network: evaluation of project and future plans

Aim/Purpose: In October 2008, the presenters were successful in their bid to BACP for funds to set up a Supervision Research Network. The mission statement for the Network is to promote good quality practitioner supervision research, both nationally and internationally, with the aim of improving practice. The BACP funded project concluded in December 2009 and the first part of the workshop will provide an evaluation of the Network activities and the outcomes of the funded project.

The second part of the workshop will introduce several ongoing supervision research projects set up by the network and invite participants to look at ways in which they can adapt and contribute to existing projects or set up new practice based projects themselves. Network members have developed a toolkit that they are using in on going projects that can be used in future projects.

Participants are invited to come to the workshop with their own supervision research ideas that can be discussed. Network members have the potential of working together on projects or aspects of projects in order to maximise the potential for credible research that is coordinated and not fragmented into small projects that have little impact. This event is an important part of this strategy and anyone interested in supervision research should attend.

Design/Methodology: The workshop will include a presentation, experiential exercises and discussion. Ideas will be generated and research methods discussed. Relationships will be formed that can result in collaborative research enquiries.

Originality/Value: This project is unique.

Conclusions/Implications: This workshop is an essential aspect of the supervision research network agenda that is building a research agenda for supervision.

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David Winter and Siobhan Bradshaw

Other Authors: Frances Bunn and David Wellsted

Professional Role: Professor of Clinical Psychology and Programme Director (DW)
Institution: University of Hertfordshire
Contact details: School of Psychology, University of Hertfordshire, College Lane, Hatfield, Herts AL10 9AB
Email: d.winter@herts.ac.uk

ABSTRACT: Paper (Fri, 10.55 - 11.25)

Keywords: systematic review, counselling, psychotherapy, suicide, prevention

Counselling and psychotherapy for the prevention of suicide: a systematic review of the evidence

Aim/Purpose: The aim is to review the research literature relevant to the prevention of suicide by counselling or psychotherapy. As well as considering studies which explicitly focus upon this topic, the review also encompasses research on counselling and psychotherapy for people who deliberately self-harm. It is not limited to randomised controlled trials but also considers quasi-experimental and non-experimental studies, including qualitative research. Furthermore, it includes studies of treatment process as well as outcome.

Design/Methodology: Extensive literature searches identified nearly 8,000 publications relevant to counselling and psychotherapy in relation to suicide or self-harm. Critical appraisal led to the exclusion of most of these, and there was then a narrative review of previous systematic reviews, a meta-analysis of quantitative outcome studies; a narrative review of quantitative process studies; and a meta-synthesis of qualitative studies.

Results/Findings: Limitations were identified in some of the previous systematic reviews and meta-analyses, but these provided evidence for the effectiveness of some, primarily cognitive-behavioural therapies. Meta-analysis of quantitative outcome studies indicated an effect size approaching a medium level. While most studies concerned broadly cognitive-behavioural therapies, there were promising findings concerning other forms of therapy. The effectiveness of therapy was confirmed by qualitative studies, most of which concerned dialectical behaviour therapy. Studies of the therapeutic process indicated the importance of the therapeutic relationship and qualitative studies also highlighted a lack of adequate training and support in working with suicidal clients.

Research Limitations: The studies included in the review were heterogeneous in terms of the extent of suicide risk in their participants. The measures of suicidal behaviour were proximal, and evidence concerning reduction of suicide rates is lacking. The research considered was dominated by approaches within the cognitive-behavioural spectrum.

Conclusions/Implications:

1. There is evidence of the effectiveness of psychological interventions for clients at risk of suicide, who should have access to such interventions, including cognitive-behavioural therapies.

2. Studies of the treatment process provide evidence of the importance of the therapeutic relationship.

3. There is evidence of lack of adequate training and support for counsellors and therapists working with suicidal clients.

4. Therapies which are under-researched, but for which there are promising findings, should be a research priority.

SYMPOSIUMS

Symposium A

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Glenys Parry 1

Discussant: Glenys Parry will discuss with Nancy Rowland

Professional Role: Professor of Applied Psychological Therapies
Institution: University of Sheffield
Contact details: Health Services Research, ScHARR, The University of Sheffield, Regent Court, 30 Regent St, Sheffield S1 4DA
Email: g.d.parry@sheffield.ac.uk

ABSTRACT: Symposium overview (Fri, 10.55 - 12.25)

Keywords: client safety, harm, deterioration, complaints

Poor therapy, bad practice and adverse outcomes: research that can make a difference in improving professional practice

The aims of the symposium: This symposium addresses a neglected area of research in counselling and psychotherapy: poor therapy and bad practice. The growing awareness that psychological therapy is not always benign, that it can cause harm, generates research which challenges complacency and explores some uncomfortable areas of practice. In different ways, each of the papers in this symposium challenges us to re-examine our assumptions about these issues.

Contribution of each symposium paper to the overall theme: Papers (*Presenter):

Sexual boundary violations: process for managing risk, problematic strategies and creating safe boundaries from the therapist perspective

Mary Godfrey*, Carol Martin*, Bonnie Meekums and Anna Madill, University of Leeds.

"Acknowledging the dirty little secret." Client accounts of why they don't complain about poor or harmful therapy.

Clare Symons*, Dr Andrew Reeves, Professor Sue Wheeler University of Leicester.

Understanding and preventing adverse effects of psychological therapies: current status and future directions.

Glenys Parry*, Joe Curran, Dave Saxon, Eleni Chambers, Michael Barkham, Rachel O'Hara, University of Sheffield.

Implications of the symposium theme for counselling and psychotherapy theory, research and practice: The results of this research can help reduce the risks of clients being harmed and improve our professional systems to protect them.

Role of the symposium discussant: To pull out common themes, critique the research and suggest key issues for wider discussion.

Symposium A

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Mary Godfrey and Carol Martin

Other Authors: Bonnie Meekums, Anna Madill

Professional Role: Academic researcher; practitioner (clinical psychologist) and researcher
Institution: Leeds Institute of Health Sciences, University of Leeds
Email: m.godfrey@leeds.ac.uk; c.martin@leeds.ac.uk

ABSTRACT: Symposium Paper 1 (Fri, 10.55 - 12.25)

Keywords: sexual boundary violations, managing risk, therapeutic boundaries

Sexual boundary violations: process for managing risk, problematic strategies and creating safe boundaries from the therapist perspective

Aim/Purpose: The study aimed to:

1) Identify strategies adopted by practitioners when facing threats to boundaries, especially risks relating to sexual boundary violations;

2) Inform recommendations to minimise risk of such violations by practitioners.

This paper focuses on one facet of the study: the processes involved in preserving therapeutic boundaries, and potentially successful and problematic strategies for avoiding sexual boundary violations.

Design Methodology: Qualitative interviews were conducted with 13 purposively selected experienced practitioners: varying in age and gender; they had experience of managing risk of sexual boundary violations without having engaged in boundary breaches. An innovative feature of the analysis was pairing clinician and academic researchers, combining clinical perspectives with academic research expertise. Themes and concepts developed in pairs were refined through comparative analysis and modified via the search for negative cases.

Results/Findings: From participants' accounts, a model of the processes involved in containing therapeutic boundaries was developed. Whilst our focus was on managing risk of sexual boundary violations, the findings have wider applicability. They relate to the broader terrain that therapists negotiate routinely: being both observers and participants in order to understand, manage and work with emotional content for therapeutic benefit. The model - comprising the elements of: noting indicators of risk, facing up to it personally, reflecting, processing, formulating and using the understanding therapeutically for client benefit - is explored. Four problematic response types with potential for negative impacts on clients are identified: self-protective/defensive, moralising/omnipotent, neediness/over-identification and over-protective anxiety. The implications of the findings for support and supervision are drawn out.

Research Limitation: While the study benefits from the richness and nuance of data derived from qualitative methods, the small sample size means that care must be taken in generalising beyond this context.

Conclusions/Implications: Sexual boundary violations cannot be attributed to a 'few bad apples'. Sexuality is ubiquitous in therapeutic encounters and needs to be both normalised and problematised so that practitioners are made aware of it through training and feel safe in taking it to supervision.

Symposium A

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Clare Symons

Other authors: Andrew Reeves and Sue Wheeler

Professional Role: Lecturer in Psychodynamic Counselling, PhD student
Institution: The University of Leicester
Contact details: Vaughan College, St Nicholas Circle, Leicester LE1 4LB
Email: cms49@le.ac.uk

ABSTRACT: Symposium Paper 2 (Fri, 10.55 - 12.25)

Keywords: professional conduct, complaints, ethical practice, malpractice, client accounts

"Acknowledging the dirty little secret." Client accounts of why they don't complain about poor or harmful therapy

Aims/Purpose: This project aims to investigate the reasons why people who have experienced poor or harmful therapy might not bring a formal complaint to a professional body. The research comprises two parts: an online questionnaire to analyse the variety of reasons that people do not complain and face-to-face interviews in order to explore in depth people's experiences of not complaining. This paper will present only findings from the interviews. The project has been part-funded by BACP.

Design/Methodology: One hundred and ten people volunteered via the online questionnaire to participate in an individual, face-to-face, semi-structured interview. Inclusion and exclusion criteria were developed to select a manageable number of volunteers and a total of 18 individual interviews were conducted. Consideration of ethical issues informed every stage of the research design, with particular concern for the safety of interviewees in terms of the scope of the interviews and the nature of the interview setting. Recordings of the interviews were transcribed and analysed using Interpretative Phenomenological Analysis (IPA).

Results/Findings: Analysis of the interviews yielded categories that have been organised into four domains relating to

a) Being silenced within the therapy

b) Being silenced by complaints procedures

c) Being silenced by the therapist

d) Reclaiming power.

Running through these domains is a central theme or essence of being silenced and needing the experience in the therapy to be acknowledged - by the therapist and by the relevant professional body.

Research Limitations: The small number of participants interviewed limits the generalisability of the findings.

Originality/Value: This research gives a voice to a group of people whose experiences have not previously been researched.

Conclusions/Implications: The research findings have implications for therapists and supervisors, and can also contribute to the development of complaints procedures in counselling and psychotherapy.

Symposium A

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Glenys Parry 2

Other Authors: Joe Curran, Dave Saxton, Eleni Chambers, Caroline Dryden, Michael Barkham and Rachel O'Hara

Professional Role: Practitioner-Researcher-Academic
Institution: Centre for Psychological Services Research, University of Sheffield,
Contact details: : Health Services Research, ScHARR, The University of Sheffield, Regent Court, 30 Regent St, Sheffield S1 4DA
Email: g.d.parry@sheffield.ac.uk

ABSTRACT: Symposium paper 3 (Fri, 10.55 - 12.25)

Keywords: psychological therapies, adverse effects, scoping review

Understanding and preventing adverse effects of psychological therapies: current status and future directions

Aim/Purpose: This presentation provides a map of the current status of research in this area and reports on the following: (1) definitions and concepts of adverse effects, (2) initial findings from a scoping review of the literature and user testimonies on adverse effects of psychological therapies, and (3) a programme of work aimed at advancing our understanding in this area arising from a successful NIHR Research for Patient Benefit award on this topic.

Design/Methodology: Scoping review based on a highly sensitive search of two of the main electronic databases (PsychInfo and Medline), using terms for psychotherapy combined with a range of terms for adverse effects, produced a total of 7,464 results. Of these 963 relate to the potential harmful effects of psychotherapy.

Results/Findings: First, we clarify definitions and meanings of the term adverse effects with a particular focus on both user and professional perspectives. Second, we report on the initial results of the scoping review as well as initial findings from a parallel search carried out of user testimonies relating to adverse effects. [eg 1,2].

Research Limitations: The scoping review is restricted to published/reported material which may introduce publication bias. We address limitations by providing an overview of our planned RfPB-funded work in which our methods include: a meta-analysis of data from trials informing this topic area; mining of large naturalistic data sets of psychological therapies; and surveying a wide range of views of patients and therapists with experience of failed therapies using a mixed methods approach.

Conclusions/Implications: The investigation of adverse effects of psychological therapies has not been incorporated into mainstream research and there is an urgent need for the development and implementation of appropriate practitioner and service user-tools to help safeguard against adverse effects.

References:

1. Sands, A. (2000) Falling for Therapy: Psychotherapy from a Client's Point of View. London: Palgrave Macmillan.

2. Bates, Y. (2006) Shouldn't I be Feeling Better by Now?: Client Views of Therapy. London: Palgrave Macmillan

Symposium B

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Bonnie Meekums, Jeannie Wright and Jane Macaskie

Discussant: William West

Professional Role: Lecturer in Counselling (BM)
Institution: University of Leeds School of Healthcare
Contact details: Baines Wing, Leeds, LS2 9JT
Email: b.meekums@leeds.ac.uk

ABSTRACT: Symposium overview (Fri, 13.50 - 15.20)

Keywords: narrative, auto-ethnography, creative research methods, writing, identities

Using ourselves in counselling research

The aims of the symposium: This symposium calls for research that speaks to the heart of the counselling / psychotherapy practitioner, recognising the value of subjectivities in research. It will focus on methodological choices that recognise the value of self narratives (Chang, 2008) connected to cultural understanding. These include auto-ethnography, arts-based research, collective biography, writing as inquiry and narrative inquiry. In health and social science research, a shift towards the legitimacy of the ‘subjective' and the ‘emotional' in epistemological debates has been noted (Freshwater and Lees, 2008). However, while the narrative turn has had impact in counselling and psychotherapy research (Angus and McLeod, 2004; Etherington, 2004; Speedy, 2008) research in the talking therapies has traditionally been dominated by the medical model, positivism and quantitative evaluations. In the UK, positivist approaches are increasingly in vogue, given the need for ‘evidence based' outcomes research. However, some researchers have argued for greater reflexivity and an acknowledgement that research is a creative act (Meekums, 1993). Some researchers have begun to use themselves as a legitimate part of the inquiry (Meekums, 2008; Wright, 2009) and others acknowledge that the act of communicating research involves both the creativity of the researcher and of the audience / witness (Freshwater, 2008). This symposium aims to capture some of the current thinking and research in counselling in which subjective and narrative knowledge is a legitimate focal point at all stages in the research process.

Contribution of each symposium paper to the overall theme: Jane Macaskie considers the process of personal transformation that is at the heart of counselling / psychotherapy practice, highlighting multiple perspectives in her method. Jeannie Wright uses collective biography to consider multiple voices and the constraints of discourse in cultural transitions. Bonnie Meekums' paper offers another perspective on transmigration, separation and belonging. Together, the papers embody the concept of multiple voices and multiple truths.

Implications of the symposium theme for counselling and psychotherapy theory, research and practice: This theme offers a focus on methods that can be used by counsellors wishing to engage in research that is consistent with their practice and training. Discussion will focus on key theoretical and philosophical issues of interest to researchers.

Role of the symposium discussant: The discussant, an expert on reflexivity who deconstructs taken-for-granted assumptions in research (Freshwater & Rolfe, 2004), will listen to each paper, adopting a critical stance. After all three papers have been presented, he will offer comment on the whole from the perspective of seeing each paper as a 'story' that can be viewed along with other 'stories' and 'readings' as alternative versions of 'truth'.

References available on request, please email research@bacp.co.uk

Symposium B

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Jane Macaskie

Professional Role: Teaching Fellow in Counselling
Institution: University of Leeds
Contact details: School of Healthcare, Baines Wing, Leeds LS2 9JT
Email: j.f.macaskie@leeds.ac.uk

ABSTRACT: Symposium paper 1 (Fri, 13.50 - 15.20)

Keywords: dreams, Jungian analysis, practitioner methods, auto-ethnography, healing splits

Dreaming the research process

Aim/Purpose: This paper describes a personally transformational journey from therapy practitioner to researcher during the first year of doctoral study. To address the research question, ‘what kind of experiences do therapists find personally and professionally transformational?' I began by interrogating my own experience. My aim is to explore whether methods emerging directly from psychotherapy practice, in this case reflexive self-awareness, dream analysis and active imagination, can generate research data.

Design/Methodology: The paper describes an auto-ethnographic approach to research (Bochner and Ellis, 2002; Meekums, 2008) using dreams to structure reflexive awareness. The research design and methodology evolve out of the scrutiny of a dream sequence, using Jungian analytic techniques as a means of data analysis. These techniques include journaling, meditative practice and art work to elaborate the data, which is analysed in terms of collective unconscious symbolism. This approach draws on Boyd's (2008) ‘Jungian research methods' and contributes to the development of practitioner-based research (Lees and Freshwater, 2008).

Results/Findings: The findings are methodological. Methods familiar in psychotherapy practice are found to generate research data and offer a meta-commentary on the research process. These methods enable me to continue a journey of identity transformation through healing a split between traditional binary opposites of internal and external, psychological and spiritual, research and practice. The relevance to counselling and psychotherapy lies in the potential for healing split perceptions of research as alien ‘Other' (Meekums, 2009), thus potentially facilitating greater practitioner engagement in research.

Research Limitations: This paper focuses on one person's experience and cannot be generalised. However, it is hoped that stories emerging from one individual's experience may resonate with others and suggest different ways of engaging in reflexive research practices.

Conclusions/Implications: 1. Particular techniques in counselling/psychotherapy practice, in this case a focus on Jungian dream analysis, can be useful in developing reflexive research methods. 2. Such methods can contribute to healing a perceived split between practice and research, potentially engaging more practitioners in research and more researchers in studies relevant to practice. 3. Implications for training include encouragement to students to apply their practice skills and knowledge in conducting masters' and doctoral research, and the likelihood that students will increasingly appreciate the relevance of research to the profession.

References available on request, please email research@bacp.co.uk

Symposium B

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Sue Cornforth, Steve Lang, Jeannie Wright

Professional Role: Associate Professor, Counselling
Institution: Victoria University and Massey University
Contact details: Palmerston North, 4442, New Zealand
Email: j.wright@massey.ac.nz

ABSTRACT: Symposium paper 2 (Fri, 13.50 - 15.20)

Keywords: collective biography; migration; landscape; identity

Re-membering 'scapes': landscapes and identities in transitional times

Aim/Purpose: To investigate the perceived usefulness of a new methodology, collective biography, to explore how landscape has influenced our identities as migrant academics and how, as Tau Iwi*, we have been able to position ourselves in relation to whenua.

Design/Methodology: We used a form of collective biography (Davies and Gannon, 2006), which draws on social-constructionism, feminist and post-structural theory, to investigate the influence of shared memories on our current subjectivities. We shared a sequence of memories of geographical transitions, following the structured sequence described in Davies and Gannon (2006). Using their recommended ‘attentive embodied listening' (p. 10), our analysis exposed the discursive processes and story lines that form who we are able to be in the environments that surround us.

Results/Findings: We analysed our writing by selecting those passages which spoke from the heart (Denzin, Lincoln, and Smith, 2008; Pelias, 2004) and avoided cliché, yet also viewed the environment as integral to the experience of being alive. We found that normative discourses, even after deconstruction, strongly reassert themselves. Subsequently, we found rational prose inadequate to the task of describing our relationship with the natural world and resorted to poetry to describe the surprising, enduring and pervasive influence of ‘scapes' in our collective identities.

Research Limitations: Embodied and subjective knowledges rely on different discourses of validity. We would not claim generalisability or objectivity. In this case, a focus on text avoids the problem of whether a statement is true or not. The test becomes whether it is able to be said (Denzin, 2009). The emphasis on relationality and memories has the potential to disturb and distress if not carefully managed and particular attention given to trust-building, clear group guidelines and respectful, ethical practice. This is a very time-consuming research methodology, although it does produce a quantity of rich data.

Conclusions/Implications: This enjoyable and inclusive research process enabled us to think beyond the individual subject to the discourses that constrain us. This facility is increasingly important in current globalised and environmentally challenged contexts. We were able to see how landscape had enabled our transition to Tau Iwi.

* Tau Iwi is a term commonly used to refer to recent settlers in Aotearoa/New Zealand, as distinct from Maori, who are Tangata Whenua, people of the land. Whenua is ‘land' in Te Reo Maori.

References available on request, please email research@bacp.co.uk

Symposium B

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Bonnie Meekums

Professional Role: Lecturer in Counselling
Institution: University of Leeds, School of Healthcare
Contact details: Baines Wing, Leeds LS2 9JT
Email: b.meekums@leeds.ac.uk

ABSTRACT: Symposium paper 3 (Fri, 13.50 - 15.20)

Keywords: belonging, attachment, separation and loss, embodiment, dreams, poetic and fictionalised representations

Lost bodies

Aim/Purpose: This paper considers the experience of adult separation between mother and daughter in the context of voluntary migration. The concept of 'lost bodies' is considered in relation to socially constructed identities of belonging, linked to inhabited and shared spaces. Implications for adult experiences are discussed in relation to families in which one or more members relocate geographically.

Design/Methodology: This paper uses an auto-ethnographic approach. Making use of journal entries including records of dreams and poems, interspersed with email and instant message records, it tracks my experiences of lost bodies over a period of 18 months, during which I was also engaged in group analysis. A discourse analysis (Potter and Wetherell, 1994) is applied to the data in order to highlight what is said and not said in comparison to journal entries, and to highlight references to embodied experiences of closeness, separation and shared spaces / experiences.

Results/Findings: The findings reveal the following key points: (1) that email can be used both the reveal and conceal affect; (2) that the sense of belonging is linked both to place and to an embodied sense of the other; (3) that dreams and poems can reveal essential truths about the experience of being and having lost bodies.

Research Limitations: This being based on one woman's experience, the study cannot claim generalisability. However, it is hoped that through this in depth exploration some 'truths' will emerge that have resonance for other practitioners.

Conclusions/Implications: Practitioners who are working with clients experiencing issues of loss should consider loss as an embodied experience linked to identity construction and occurring within social frameworks, and not merely a function of intra- or inter-personal dynamics. The method also has relevance for counsellors and psychotherapists in their search for understanding of human experience. Ethical implications are discussed.

References available on request, please email research@bacp.co.uk

Symposium C

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Karen Cromarty

Discussant: John McLeod

Professional Role: Senior Lead Advisor, Children and Young People
Institution: British Association for Counselling and Psychotherapy
Contact Details: BACP House, 15 St John's Business Park, Lutterworth, Leicestershire LE17 4HB
Email: karen.cromarty@bacp.co.uk

ABSTRACT: Symposium overview (Sat, 10.40 - 12.10)

Keywords: school-based counselling, children and young people, person-centred therapy, humanistic therapy, randomised controlled trial

A pilot randomised controlled trial of school-based counselling for emotional distress: process, outcomes and experiences

The aims of the Symposium: To discuss the feasibility and ethics of conducting a randomised controlled trial of school-based counselling, to explore design issues, and to present qualitative and quantitative findings from a pilot trial

Contribution of each Symposium Paper to the overall theme: Cooper gives a rationale for the development of an RCT of school-based counselling, the design of an initial pilot study, and results regarding both feasibility and quantitative outcomes. Lynass presents qualitative outcomes for young people in the pilot trial participating in counselling. McArthur considers design issues, and alternative strategies for conducting a randomised design.

Implications of the symposium theme for counselling and psychotherapy theory research and practice: This symposium identifies, for the first time in the UK, the potential for researching school based counselling in a controlled manner. The papers demonstrate that although extremely challenging, school based counselling can be rigorously studied with complementing qualitative and quantitative methods. The symposium highlights the necessity for further studies to build upon successful methodology, thus developing an evidence base for the counselling in schools field. Implications for the development of a full trial of school-based counselling -- the SCOOLS trial (Study of Counselling Outcomes On Life in Schools) -- will be discussed.

Role of the symposium discussant: The discussant will encourage delegates to question and critically challenge the presenters on their methodology and findings, and will encourage debate about how to extend this research.

Symposium C

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Mick Cooper, Nancy Rowland, Katherine McArthur, Susan Pattison and Karen Cromarty

Professional Role: Professor of Counselling (MC)
Institution: University of Strathclyde
Contact details: 76 Southbrae Drive, Glasgow G13 1PP
Email: mick.cooper@strath.ac.uk

ABSTRACT: Symposium Paper 1 (Sat, 10.40 - 12.10)

Keywords: school-based counselling, children and young people, person-centred therapy, humanistic therapy, randomised controlled trial

Efficacy of person-centred counselling in schools for emotional distress: pilot randomised controlled trial

Aims/Purpose: The objective of this study was to test the feasibility of a trial comparing humanistic school-based counselling versus waiting list in the reduction of emotional distress in young people.

Design/Methodology: Children aged 13-18 years with a score of four or more on the emotional symptoms subscale of the Strengths and Difficulties Questionnaire (SDQ) were randomised to either humanistic counselling or waiting list in this multi-site study. The primary trial outcome was self-reported emotional symptom scores at six-weeks.

The study received ethical approval in December 2008 from the University Ethics Committee of the University of Strathclyde.

Results/Findings: Thirty two participants were recruited and 88% were followed up. Completion rates for randomised participants were acceptable; no major ethical obstacles emerged; participants and professionals involved in the trial described their experience as rewarding; and recruitment rates indicate that a larger number of young people can be inducted into the trial in a viable manner.

No significant differences were found between the counselling and waiting list groups in reductions in levels of emotional symptoms. However, young people who participated in counselling were significantly more prosocial at endpoint. There were also some indications that counselling was more efficacious for young people meeting threshold criteria for depression.

Research Limitations: The small numbers of participants involved in this pilot trial mean that no clinical implications can be derived from these initial findings.

Conclusion/Implications: This study suggested that a randomised controlled trial of counselling in schools was acceptable and feasible. Key lessons for implementation of a definitive trial are discussed.

References:

http://www.strath.ac.uk/counsunit/research/counsellinginschools/

Symposium C

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Rosemarie Lynass and Karen Cromarty

Other Authors: Mick Cooper and Olga Pykhtina

Professional Role: D Psych Student (RL)
Institution: Glasgow Caledonian University & Strathclyde University
Contact details: Dept. of Psychology, Glasgow Caledonian University, Cowcaddens Road G4 0BA
Email: r.lynass@gcal.ac.uk

ABSTRACT: Symposium Paper 2 (Sat, 10.40 - 12.10)

Keywords: counselling in schools, young people, clients' experiences, thematic analysis, qualitative

A thematic analysis of young people's experience of counselling in five secondary schools across the UK

Aim/Purpose: To investigate the views of young people on what they found helpful and unhelpful about school counselling as well as what they felt changed for them since having counselling. Previous research has pointed to talking and being listened to as well as "getting things off your chest" as particularly helpful, as well as confidentiality and being given some guidance. Identified changes have tended to be on an emotional and interpersonal level.

Design Methodology: A semi-structured interview based on Elliott's Change Interview was utilised. Interviews were analysed using thematic analysis. The study was approved by the University of Strathclyde's Ethics Committee. Participants were aged 13-15. Three were male and eight were female. Number of counselling sessions received ranged from two-six.

Results/Findings: Participants expressed predominantly positive views of the counselling and a large number of changes were identified as having taken place since counselling. These changes were in three domains: emotional, interpersonal and behavioural. Participants viewed these changes as having had an important impact on their lives. The most commonly cited helpful aspects of counselling were related to talking or "getting things out", counsellor qualities and confidentiality.

Research Limitations: Post-counselling interviews were not compared with the interviews of those who were on the waiting list. Furthermore, due to this being a dissertation study, themes were identified by a single researcher, not by a process of collaboration with a number of researchers. This would have allowed for greater validity.

Conclusions/Implications: It is concluded that in-school counselling is an appropriate and valuable intervention for young people that is viewed positively by those young people who have experienced it.

Symposium C

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Katherine McArthur

Other Authors: Mick Cooper and Lucia Berdondini

Professional Role: PhD Student
Institution: University of Strathclyde
Contact details: Counselling Unit, 76 Southbrae Drive, Glasgow G13 1PP
Email: katherine.mcarthur@strath.ac.uk

ABSTRACT: Symposium Paper 3 (Sat, 10.40 - 12.10)

Keywords: school-based counselling, children and young people, randomised controlled trial, person-centred therapy, humanistic therapy

A pilot randomised controlled trial to assess the impact of school-based counselling on young people's wellbeing, using pastoral care referral

Aim/Purpose: The SCOOLS pilot tested the feasibility of a procedure for conducting a randomised controlled trial of school counselling for emotional distress. The current pilot aims to both build on the findings and address the limitations of the previous pilot by testing an alternative procedure. The screening process used to recruit participants will be replaced by a pastoral care referral system, which is more closely aligned to usual practice. The six-week intervention period will be extended to allow a more flexible counselling contract for participants. In addition, the study will assess the suitability of a recently developed wellbeing measure for use in this context.

Design/Methodology: This small pilot study in a secondary school with no existing counselling service will use pastoral care referrals to identify young people aged 13-18 with emotional distress. The cut-off point for emotional distress scores will be set higher than the previous pilot to reflect the finding that counselling may be more helpful to more severely distressed young people. Participants will be randomised to either school counselling or waiting list for one school term (approximately 12 weeks), with outcome assessments at midpoint and endpoint. The primary outcome will be subjective wellbeing scores.

Results/Findings: Data collection began in January 2010 and it is expected that initial findings from approximately 10 participants will be presented and discussed.

Research Limitations: The small sample size means that clinical implications cannot be drawn from the findings.

Conclusions/Implications: Implications of the initial findings regarding this alternative means of recruitment will be discussed and the different methods compared.

Symposium D

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Jane Speedy 1

Discussant: Symposium audience (an appropriately collective discussant)

Professional Role: Reader in Qualitative Inquiry
Institution: University of Bristol
Contact details: Graduate School of Education, 8-10 Berkeley Square Bristol BS8 1JA
Email: jane.speedy@bristol.ac.uk

ABSTRACT: Symposium overview (Sat, 10.40 - 12.10)

Keywords: troubling binaries, overlapping stories, identities and subjectivities, collaborative methodologies, ethical know how, aesthetic inquiry

Collaborative writing practices: research methodologies congruent with counselling and psychotherapy?

Aims of the Symposium: To consider collective biography and collaborative writing/textual inquiry as

a) Methods that trouble everyday ideas in counselling research and

b) Contest expectations about co-research, authorship and ownership

The papers will serve as exemplars of the genre: two collective biographies (Dalzell et al.; Speedy et al.) and extracts from a larger body of work that combines a broad range of practices from narrative therapy, narrative inquiry, collaborative/performative writing and collective biography (Bristol Collaborative Writing Group-BCWG).

Contribution of each symposium paper to the overall theme: On first reading the papers are evenly divided into two groups: those written by clients and those written by practitioners/researchers, although a closer reading suggests considerable overlap. The themes of the presentations will illustrate the breadth and depth but also the limitations of these approaches, which rely on extensive commitments of time and energy from all concerned

Implications of the symposium theme for counselling and psychotherapy theory, research and practice: The most obvious implications of these ideas are for counselling research - a body of work traditionally carried out by researchers /practitioners on or (at best) with participants. These methods enable service users and providers not only to participate together in research projects, but also to engage jointly in the representation and dissemination of findings. This offers a welcome challenge to more hierarchical genres of counselling research that have relied on a sharp divide between client stories ('evidence' obtained from the 'sample') and researcher representations.

Role of the symposium discussant: To consider, as a critical friend to the symposium, how they, the audience might take these ideas forward (or not) into their own work and what they perceive as the strengths and weaknesses of these approaches.

Symposium D

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Jane Speedy 2

Other Authors: Audrey, Jenny, Rita, Barbara and Stella

Professional Role: Reader in Qualitative Inquiry
Institution: University of Bristol
Contact details: 8-10 Berkeley Square, Bristol BS8 1JA
Email: Jane.speedy@bristol.ac.uk

ABSTRACT: Symposium Paper 1 (Sat, 10.40 - 12.10)

Keywords: women's voices, suicide, family members, arts-based research, visual narratives collective biography

Video haiku: collective biography with women whose lives have been touched by suicide

Aim/Purpose: Representing voices rarely heard, using creative presentation methods, privileging collectivity as a form of anonymity in order to say the unsayable.

Design/Methodology: Collective biography methods were used online over a period of months by women from UK, Australia and the North and South Americas to produce texts that were distilled into haiku, wordles and digital images and film.

Results/Findings: The multimodal installation that has emerged from this work seems to capture the experience of living lives that have been touched by suicide. It has been added to wherever it has been exhibited (Bristol, 2007; Urbana-champaign 2008, 2009) and seems highly evocative. Many of the participants in this study had never expressed themselves as clearly or as publicly as they were able to do within the anonymity of 'collective voice' and within the scope of a wide range of digital and other arts-based media.

Research Limitations: There are complicated ethical issues to consider when collective work is presented by an individual author. This work requires considerable digital expertise and equipment to both generate and present and can only ever present these voices. This work is not generalisable.

Conclusions/Implications: People who find it difficult to express their individual pain in orthodox ways may find these methods (both arts based and collective approaches)

a) therapeutically effective and affirming of identity,

b) research methods congruent with 'unsayable' life stories.

This particular group was women whose lives have been touched by suicide, and other studies, have shown the effectiveness of working in this way as therapists with young men who have considered suicide (Speedy, 2005) and as art therapists working with a variety of client groups. Collective biography is however, still relatively unknown to European counselling researchers and has, we would suggest, vast untapped potential.

References available on request, please email research@bacp.co.uk

Symposium D

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Ann Dalzell

Other Presenters: Christine Bonsmann, Deborah Erskine, Maria Kefalogianni, Jennifer Heathercote-Osborne and Kalliopi Maniorou

Other Author: Donna Basavaraja

Professional Role: Full Time PhD Student (AD)
Institution: University of Bristol
Contact details: Graduate School of Education, 35 Berkeley Square, Bristol BS8 1JA
Email: ann.dalzell@bristol.ac.uk

ABSTRACT: Symposium Paper 2 (Sat, 10.40 - 12.10)

Keywords: collective biography practices, counselling researcher, story-telling, multiple identities

Stepping across the divide: seven stories of moving from 'counsellor' to 'counselling researcher'

Aim/Purpose: Taking part in counselling research has been identified as a potentially transformative experience for those involved (Etherington, 2004). Less frequently recognised is the impact on the counsellor of shifting from 'learning to do counselling research' to 'becoming a counselling researcher'. This perfomative paper, therefore, stories the learning arising from a study using collective biography practices to research memories of traversing the liminal space that frequently exists between 'counsellor' and 'counselling researcher'.

Design/Methodology: Beginning with the telling of their remembered individual stories - through the use of creative and fictionalised writing, poetry, performance, visual imagery and multiple spoken languages - the co-authors experimented with collective biography practices (Davies and Gannon, 2006; Speedy, 2005; Davies, 2000) to interrogate the individual's 'well-worn' tales in order to open up new spaces for exploration in relation to the focus of the research. Through the collective witness of the 're-viewed' stories, new texts were created by the group, which broke down the focus traditionally given to 'the author', and a collective voice emerged detailing the lived experiences of moving from 'counsellor' to 'counselling researcher'.

Results/Findings: The resulting collective biography illuminated stories of trust, intuitive knowing, taking risks, creativity and embodied listening, which stretched across both professional roles. The overlapping stories challenged the size of the gap frequently constructed between 'counsellor' and 'counselling researcher'.

Research Limitations: The experiences identified within this research are specific to the seven co-researchers taking part in the study.

Conclusions/Implications: This research demonstrates the potential use of collective biography methods in the training of counselling and psychotherapy researchers. By amplifying the details of individual stories in forming the resulting collective biography, this research also shows how these methods can be used to research into the professional spaces between research and practice; in this case, the researchers identified how cultural heritages, multiple identities, societal expectations and associated power relations, impacted on their specific experiences of crossing the boundaries that frequently create the binaries of 'counsellor' and 'counselling researcher'.

Symposium D

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Nell Bridges and Jane Speedy

Other Authors: Susan Williams, Sue Wilson, Artemi Sakellariadis, Viv Martin, Tony Brown, Laurinda Brown and Dave Bainton

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

ABSTRACT: Symposium paper 3 (Sat, 10.40 - 12.10)

Keywords: collaborative writing, collective biography, community, ethical knowhow, writing as inquiry, subjectivities

Encountering Gerald: how a sense of connexion and community emerges in a collaborative writing group

Aim/Purpose: To explore the ways in which a sense of intimacy, community and trust developed over time in a collaborative writing group and, to consider how such methods might be used in therapeutic ways and, in particular, how writing with others might enable people to construct ways of seeing themselves and being in the world that they might otherwise not have found. Clearly these early, tentative findings suggest that carefully constructed collaborative writing experiences have strong transformative potential and might be used in both therapy research and therapeutic group work settings.

Design/Methodology: Collective biography - interfaced with witnessing practices, borrowed from narrative therapy.

Results/Findings: Various writing/talking/not writing/reading and writing again practices over time in a collaborative writing group of nine developed a cumulative sense of being together that became a force for change in the lives of all participants, which was recorded in the writing collected by the group over time. Writing as a form of collaborative inquiry into our selves and our world is a well established qualitative research method (Richardson and St Pierre, 2005, Speedy, 2005). Unexpected, however was the insight at a richer, deeper community-based level than could have been anticipated, that led the group to consider the therapeutic as well as discovery-based learning potential of collective biography methods.

Research Limitations: This kind of research group takes a very long time to develop and requires a huge commitment from all concerned. Findings of this kind of group-based action research are always going to be nuanced, situated and specific rather than generalisable.

Conclusions/Implications: Collaborative writing practices such as collective biography have hitherto mostly been used for research purposes, but might also be used for transformative co-research purposes in more therapeutic ways.

 
       
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