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Research Conference 2014  


BACP's 20th Annual Research Conference entitled "Researching the Special Relationship" took place on 16-17 May 2014 at the Marriott Hotel Regent's Park, London.  

Click here for an evaluation of this year's conference  

Abstracts

 

Pre-Conference Workshop

Presenters: Andy Hill and Pete Sanders

Professional Role: Head of Research; Retired counsellor, trainer and supervisor, and author
Institution/Affiliation: BACP; PCCS Books
Contact details: BACP House, 15 St. John's Business Park, Lutterworth, LEICS, LE17 4HB
Email: andy.hill@bacp.co.uk; pete@pccs-books.co.uk   

ABSTRACT: pre-conference workshop                                                   

Introducing Counselling for Depression, an evidence-based integration of person-centred and emotion-focused therapies

The workshop will introduce 'Counselling for Depression', a new evidence-based IAPT therapy conceived in a project funded by BACP. Andy Hill will describe the origins of Counselling for Depression and track its trajectory from writing competencies through establishing an evidence base to approval by IAPT. Pete Sanders will explain the origins of the theoretical substrate and practice framework in person-centred and emotion focused therapies. There will be some brief activities to engage with practice vignettes and opportunities for discussion in a closing plenary.

 

Friday Keynote

Presenter: Louis G. Castonguay, Ph.D.

Professional Role: Professor of Psychology
Institution/Affiliation
: Penn State University
Email: lgc3@psu.edu

ABSTRACT: Keynote presentation  

Keywords: principles of change, psychopathology, practice-oriented research

Researching relationship and beyond to help us help (and train) others.

The goal of this presentation is to suggest ways by which research (including studies on therapeutic relationship) can potentially improve the effectiveness and training of psychotherapy. Specifically, it will be proposed that findings related to principles of change, psychopathology, and psychotherapy integration may provide helpful clinical guidelines without necessarily imposing drastic change in the practice of many clinicians.  It will also be proposed that "evidence based research" (typically designed by full-time researchers) can be complemented by findings related to "practice-oriented research", which focus on the active collaboration between researchers and practitioners in conducting clinically relevant and scientifically rigorous research.   In conclusion, it will be argue that both research and researching can help clinicians help clients and train other therapists. 

Aim/Purpose: The purpose of this talk is provide suggestions to improve psychotherapy practice and training by expanding evidence based treatments.

Design/Methodology: The presentation will offer a brief overview of research regarding client characteristics, relationship variables, technical factors, psychopathology, as well as process and outcome studies related to psychotherapy integration. Research conducted by or with clinicians will also be briefly discussed.

Results/Findings: Results of research to be presented suggest that evidence base knowledge can be improved upon by building on convergences and complementarity across theoretical orientations, scientific domains, and professional expertise.

Research Limitations: Suggestions offered to improve psychotherapy should be viewed with caution, as they required further investigations from a diversity of research methodologies.

 

Saturday Keynote 

Presenter: Dr Miranda Wolpert

Professional Role: Director, The Evidence Based Practice Unit at the Anna Freud Centre and University College London
Institution/Affiliation
: University College London and Anna Freud Centre
Email
: Miranda.Wolpert@annafreud.org

ABSTRACT: keynote presentation                                                           

Keywords: outcome measurement, therapeutic relationship, PROMS, PREMS, clinical practice

Outcome measurement and the therapeutic relationship: help or hindrance?

Context/Research Problem: Counsellors and Psychotherapists are increasingly being called upon to use Patient Reported Outcome Measures (PROMs) and Patient Reported Experience Measures (PREMs) in their routine practice. However, many practitioners report feeling unsure about implementing measures to support their practice, highlighting concerns about how data may be used and the impact on their relationship with their clients.

Aim/Purpose: This presentation will explore research findings to date relevant to the implementation of PROMs and consider the potential advantages and disadvantages of widespread use of PROMs as part of routine care in counselling and mental health support services.

Design/Methodology: This presentation will draw on research and learning from over a decade of PROMs implementation and training.

Conclusions/Implications: Miranda will highlight key challenges and suggest ways forward for both practice and research if PROMs are to support best clinical practice rather than undermine it.

 


Susan Armstrong

Other Authors: Moorhead, S. A., Simms, J., Hazlett, D.
Professional Role
: PhD Student
Institution/Affiliation
: University of Ulster
Email
: Armstrong-S3@email.ulster.ac.uk

ABSTRACT: poster                                                                                      

Keywords: teacher, pupil, psychological, emotional, support

An exploration into the multi-dimensional relationship between the teacher and pupil

Aim/Purpose: To explore the teacher/pupil relationship with regards to psychological and emotional support.

Design/Methodology: This study was an exploratory qualitative design using recorded semi-structure interviews with stratified sampling. Interviews were conducted with Principals and Senior Teachers in 15 Secondary/Grammar schools (n=19 participants) throughout the different educational boards within Northern Ireland. Data was analysed using Interpretative Phenomenological Analysis. Ethical approval was obtained from the School of Communication Filter Committee, University of Ulster.

Results/Findings: From the IPA analysis, five key themes emerged from the data, including the "type", "purpose", "needs", "benefits" and "barriers" to the teacher/pupil relationship. It was identified that the relationship between teacher and pupil, whilst professional, addressed the emotional needs of the pupil. The main purpose of the teacher/pupil relationship was commonly identified as an academic sharing of information and learning relationship, however this relationship is multi-dimensional with the teacher taking on numerous roles including that of providing psychological and emotional support. Further discussions revealed the need and lack of support and training in skills and knowledge among teachers to further enable them to support their pupils. The barriers to the relationship were identified including time constraints, lack of training/funding and the professional boundaries with which a teacher works in. Comparisons were drawn between the counsellor and teacher roles, whilst acknowledging the similarities that exist, specific recognition of the differences in training, support and guidance were identified.

Research Limitations: The study focused solely on teachers' experiences and views, and is not from the pupils' perspective.

Conclusions/Implications: The findings identify the multi-dimensional relationship between teachers and pupils, and recognise the need for training and support for teachers to enable them to support their pupils.

 
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Iti Arora

Other Authors: Dr. Nick Midgley, Dr. Paul Lysaker, Dr. Giancarlo Dimaggio and Jacob Clark
Professional Role
: Student
Institution/Affiliation
: University College London/ Anna Freud Centre
Email
: iti.arora.3@gmail.com

ABSTRACT: poster  

Keywords: metacognition, depression, self-harm, adolescence, qualitative analysis

The capacity for metacognition in depressed and self-harming adolescents

Aim/Purpose: Research suggests the presence of metacognitive impairments in young people presenting with depression and self-harm, but the specific nature of these deficits remains unexplored. Understanding such deficits is of clinical importance, as evidence suggests that standard treatments are less effective when depression and self-harm present together in adolescence, making it important to understand the challenges that these young people may bring to treatment. The present study investigated the nature of metacognitive functioning in such adolescents and how it might relate to their psychological difficulties.

Design/Methodology: This study used a two-stage, mixed-method design, using data from an on-going study of young people's experiences of depression (Midgley, Ansaldo and Target, 2014). For study one, the Metacognition Assessment Scale - Abbreviated Version (Lysaker et al, 2005) was used to rate 26 semi-structured interviews with a clinical population of depressed, self-harming adolescents, to obtain a measure of the adolescents' metacognitive functioning. For study two, thematic analysis (Braun and Clarke, 2006) was carried out on the same interview transcripts to explore how those metacognitive impairments manifested themselves in the way the adolescents spoke about their difficulties.

Results/Findings: Results confirm that these adolescents display significant impairments in metacognition. This emerged as central to the adolescents' difficulties, in terms of experiencing their own thinking processes as incoherent, chaotic and fragile. Impairments in self-reflection and coping skills was linked with adolescents managing their difficulties through maladaptive strategies to gain control as well as to communicate their distress.

Research Limitations: The MAS-A was applied on this clinical population for the first time. Thus, generalizability of the findings would require replication of the study with diverse clinical and non-clinical samples. Also, the analysis of the interviews was conducted only by one person. While steps were taken to ensure that the analysis was reliable and credible, this was a limitation of the project.

Conclusions/Implications: Recognizing the specific nature of metacognitive difficulties experienced by depressed and self-harming adolescents is important in therapeutic work. The findings have implications for the therapeutic space being a structured space to think which promotes self-efficacy. Finally, the MAS-A shows potential for being a useful clinical tool.

 
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Zachary D. Bloom

Other Authors: Paulina Flasch and Kelley Holladay
Professional Role:
PhD student
Institution/Affiliation:
University of Central Florida
Email:
Zbloom@knights.ucf.edu

ABSTRACT: poster                                                                                  

Keywords: internet, adolescents, pornography, human sexuality, assessment

Male adolescents and internet pornography: counseling implications

Aim/Purpose: To disseminate counseling implications associated with male adolescents' use of Internet pornography. 

Design/Methodology: The information in this presentation is a synthsized review of nearly 40 landmark studies reported in a variety of peer-reviwed journals. This research juxtaposes recent findings (since 2006) with historical findings (between 1984 and 1998) and endeavors to draw conclusions regarding the trends and counseling implications associated with pornography use since the advent and widespread use of the Internet. The information in this presentation is currently under review with the Family Journal for publication.   

Results/Findings: Male adolescents use pornography more than female adolescents (Bleakley, Hennessy, & Fishbein, 2011). One of the premier reasons male adolescents report viewing pornography is to gain sexual knowledge (Chen, Leung, Chen, & Yang, 2013). However, pornography has been described as an inappropriate tool to educate adolescents about healthy sexual experiences due to distorted modeling of sexual practices (Owens, Behun, Manning, & Reid, 2012). The literature has indicated that educational efforts may deflect some of the adverse effects correlated with adolescent males' pornography consumption (Peter & Valkenburg, 2010). However, the majority of therapists are minimally prepared to do so (Ayres & Haddock, 2009).

Research Limitations: Research conducted regarding the implications of pornography use amongst adolescents in the counseling literature is sparse. The majority of the research available has taken place with Dutch, Swedish, and Taiwanese adolescents, thus making making it difficult to generalize conclusions indiciated in what literature is available. 

Conclusions/Implications: In relation to counselling adolescent males and in regard to the promotion of human development and wellness, the Council for Accreditation of Counselling and Related Educational Programs (CACREP) stated that the role of the counsellor is threefold: To prevent, to educate, and to act as a social justice advocate (2009). Consequently, it is suggested that competent therapists assess for pornography use amongst adolescent males in the intake interview and, when appropriate, incorporate sex education into the counselling process.

 
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Zachary D. Bloom

Other Authors: Paulina Flasch, Kelley Holladay
Professional Role:
PhD student and counselor
Institution/Affiliation:
The University of Central Florida
Email:
Zbloom@knights.ucf.edu

ABSTRACT: poster                                                                                    

Keywords: counselors-in-training, CACREP, competency

Self-perceived competency of CACREP core standards by master's level counselors-in-training (CIT): a focus group study

Aim/Purpose: To explore master's level CITs' self-perceived competency over core standards as defined by the Council for Accreditation of Counseling and Related Educational programs (CACREP).

Design/Methodology: A qualitative focus group was held with five master's level CITs from a top 10 ranked CACREP accredited master's level program in the United States. CITs were beginning their second year of training, prior to working with clients, and were asked to evaluate their preparedness in meeting competency in eight domains established by the eight core CACREP standards.

Results/Findings: This study was accepted through the University of Central Florida's Institutional Review Board. CITs identified areas of self-perceived competence and confidence in regard to working with clients as well as areas of incompetence and anxiety in anticipation of working with clients. CITs also identified areas of strength and weakness in their CACREP accredited counselor education training program. We found seven primary themes: (1) counseling fears, (2) recommendations, (3) coping, (4) ethical considerations, (5) multicultural competencies, (6) motivation, and (7) group work. Within the primary categories, we established several secondary categories. We will share results and implications.​ 

Research Limitations: The focus group was the sole data collection point to gather data regarding CITs self-perceived competency of CACREP core standards. Unfortunately, due to time constraints, only three CACREP core standards were addressed in the focus group session. Also, fewer participants (five) participated in comparison to the anticipated number of participants (10).

Conclusions/Implications: We were able to identify several themes that emerged from this focus group experience. CITs made several recommendations themselves, including the implication and regular use of a "skills club," – with implications for an expanded role for doctoral students. CITs' areas of perceived-incompetence suggested that counsellor training programs need to offer more opportunities for CITs to practice running various kinds of therapy groups. Additionally, CITs recommended that professors play a greater role in supervising doctoral students when doctoral students are the primary teachers of course material.

 
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Angelo Brieussel, Pauline Ross

Other Authors: Stella Ameny, Sophie Hillwood-Harris, Shaanak Raeoef
Professional Role:
Trainee and Volunteer Counsellor
Institution/Affiliation:
LC&CTA (Lewisham Counselling and Counselling Training Associates)
Email:
c/o christine.brown@lcandcta.co.uk

ABSTRACT: poster                                                                                    

Keywords: trauma, rape, person-centred approach, PTSD, treatment

Person-Centred therapists' experiences of working with rape victims presenting with the symptoms of Post-Traumatic Stress Disorder: what can we learn from this?

Aim/Purpose: This qualitative research aims to explore and describe the experiences of Person-Centred psychotherapists working with rape victims who presented with the symptoms of Post-Traumatic Stress Disorder (PTSD) (APA, 2010). Our research also aims to explore whether such practitioners perceive the Person-Centred Approach (PCA) as an effective treatment for clients suffering from the effects of PTSD, as it appears that PCA is rarely identified as a healing option in major texts outlining/discussing PTSD treatment (Joseph, 2004).

Design/Methodology: Four experienced Person-Centred therapists who had worked with rape victims presenting with the symptoms associated with PTSD were interviewed about their experiences and the apparent outcomes of their work with these clients. The interviews were semi-structured and audio-taped. These tapes were then transcribed and the resulting data analysed by employing the Thematic Analysis Method informed by The Principles of Phenomenology (Moustakas, 1994). Our research study adhered to the BACP ethical guidelines for researching counselling and psychotherapy (Bond, 2004).

Results/Findings: From our findings it seems that when a PCA counsellor and his/her client from this client group, commits to and trusts the developing therapeutic alliance, that is often long term rather than short term, the gradual process of jointly building a deep, empathic connection between the two participants results in the client uncovering/discovering a self-resourced and self-directed recovery from PTSD. Such a recovery for rape victims appears to be highly restorative for clients who seem to reap personally defined additional dividends in their relationship/s with self and others. Working with a flexible attitude and possessing an understanding of PTSD symptoms appears highly useful and reassuring for the therapist; and such knowledge also appears to assist clients from this group when they seek formally defined understanding of the condition as an aid to recovery.

Research Limitations: The respondent sample was small and therefore further research would be useful in determining if and how our conclusions can be extrapolated.

Conclusions/Implications: PCA appears to be highly effective in providing the healing dynamics necessary to facilitate raped traumatised clients who are suffering from the symptoms of PTSD; empowering clients to navigate through their trauma and personally symbolise their traumatic experience/s, inspiring self-renewal and self-rejuvenation.

 
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Jeanne Broadbent

Professional Role: Counsellor; PhD student
Institution/Affiliation:
Department of Social Studies & Counselling, University of Chester
Email:
jrbroadbent@btinternet.com

ABSTRACT: paper                                                                                   

Keywords: phenomenology, traumatic bereavement, personal and professional integration, IPA

'Hear my voice': a phenomenological study of humanistic therapists' lived experience of traumatic bereavement and its impact on their professional identity development and practice

Aim/Purpose: Although research identifies the significance of the continued integration of therapists' personal and professional lives, comparatively little is known of how personal life events influence professional identity and practice (Orlinsky & Ronnestad 2005). The aim of this phenomenological study was to explore the experience of traumatic bereavement on qualified humanistic therapists and its impact on their personal and professional identities.

Design/Methodology: Grounded in a phenomenological-hermeneutic philosophy (Heidegger 1962),  Interpretative Phenomenological Analysis (IPA) (Smith, Flowers & Larkin 2009) was selected as the methodology most appropriate to reveal the participants' lived experience. Purposive sampling was used to recruit a homogenous sample of seven female humanistic therapists who had experienced traumatic bereavement while practising. Data comprises field notes, interview transcripts and participants' reflective writing. IPA's idiographic approach facilitates the creation of a detailed and nuanced thematic analysis that allowes for both convergence and divergence. 

Results/Findings: Preliminary findings highlight the unique contextual nature of traumatic bereavement and suggest that this experience can result in a profound disconnection from 'Being-in-the-world' (Heidegger 1962). It can also result in a personal and professional dissonance that impacts, and is impacted by, therapeutic work. Whilst entailing a painful process of readjustment to a changed reality, the experience can also be personally transformative and can inform therapists' professional understanding. Supportive supervision and personal therapy are evidenced as significant mediating factors.

Research Limitations: This was a small sample and unrepresentative in terms of gender and ethnicity and results are not presented as being generalisable to a wider population. The analysis is inevitably influenced by the researcher's own 'fore understandings' and interpretation.

Conclusions/Implications: The research demonstrates that the process of integrating the experience of traumatic bereavement into the therapist's personal and professional life is a continuing process. It is crucial that therapists carrying this burden have opportunities to reflect on this process in supportive supervisory relationships in order to ameliorate difficulties they may face in client work. A greater understanding of therapist bereavement is needed across the profession.

 
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Liddy Carver

Other Authors: Andrew Reeves, Valda Swinton
Professional Role:
Ph.D Research Student
Institution/Affiliation:
University of Chester
Email:
e.carver@chester.ac.uk

ABSTRACT: paper                                                                                    

Keywords: counselling training, psychotherapy training, counsellor education, gatekeeping, professional competence

A qualitative exploration of counselling and psychotherapy trainers' experiencing of course members with significant personal growth issues

Aim/Purpose: Despite the demand for training, little is known about the challenges counselling and psychotherapy trainers face as a distinct professional group. This paper has two aims. First, to explore how trainers experience course members giving cause for concern. Second, to consider what information would be needed by trainers to support them in that role.

Design/Methodology: Interviews were conducted with six experienced humanistic therapy trainers practicing within a higher education context. Interviewing was semi-structured during which participants were asked to explore their impressions and experiences of working with students giving cause for concern and the critical incidents that impacted on them. Interview transcripts were analysed using Interpretative Phenomenological Analysis (IPA) applied because of its transparency when exploring individual subjective experiences.

Results/Findings: Analysis yielded six main themes, comprising twenty seven sub-themes. Findings captured a complex picture of painful and conflicting emotions. The overarching themes inherent in the data indicate a) a gradual uneasy awareness about a student's process of self-development, b) an emerging sense of vulnerability and riskiness associated with authentic challenge c) limited faith in a formal process d) ambivalence about role and shelf-life, e) experiencing work at the edge as a sustained onslaught on self, and f) reflection on the experience as transformational.

Research Limitations: The small sample size, and restriction to humanistic counselling and psychotherapy trainers limit generalisability. The study focused only on trainers' experiences and did not include the student's perspective.

Conclusions/Implications: When the course member's experiencing and that of the trainer collide, the working alliance, founded on the core conditions can be interrupted or threatened. The trainer's usual way of being can alter as they respond to what is perceived as an 'attack' on them. Such experiencing can be complicated by the organisational context, the multifarious nature of group dynamics, and the course member's particularly complex way of being. Further research within counselling and psychotherapy training focused on a more consistent in depth understanding of the complexity of trainers' experiencing, may require collaboration, particularly across different backgrounds.

 
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Liddy Carver

Other Authors: Stuart McNab, Valda Swinton, Andrew Reeves
Professional Role:
Ph.D. Research Student
Institution/Affiliation:
University of Chester
Email:
e.carver@chester.ac.uk

ABSTRACT: poster                                                                                  

Keywords: counsellor education, counselling trainers, psychotherapy trainers, co-training, experiential groups

Counselling and psychotherapy trainers' fears and fantasies: an initial exploratory study

Aim/Purpose: This poster reports the preliminary findings of a research study that set out to collaboratively explore with counselling and psychotherapy trainers how they experience their role.  The research was engendered by the primary researcher's interest in how much trainers know about the theory and practice of learning, teaching and personal development, An eerie silence exists in the literature about trainers' inter and intra-personal experiences. The aim was to explore trainers' beliefs, practices and concerns about students who give cause for concern and discover whether sharing their experiences as part of the research process changed anything for them. 

Design/Methodology: Qualitative study involving six co-operative inquiry sessions with four co-researchers, all of whom were experienced humanistic counselling and psychotherapy trainers in a higher education context. Each session was videoed, questions were semi-structured and transcriptions analysed using thematic analysis combined with the researcher's autoethnographic analysis of recent experiences during training, and as part of the collaborative group.

Results/Findings: Preliminary results suggest that trainers experience 'in the moment' authenticity with their students as inherently risky. A sense of being caught up in the student's experiencing, seemingly without consent, can engender feelings of shock, resentment, and a realisation that boundaries have somehow been transgressed. Coupled with a perceived lack of support from within their organisation, co-researchers may experience feelings of 'alone-ness', and vulnerability. However, these feelings co-exist with an enduring belief in the individual's capacity for growth, active and a valuing of colleagues and supportive management.

Research Limitations: Key limitations include accommodating co-operative inquiry within an academic milieu, the researcher's experience of group facilitation, the small number of co-researchers unlikely to fully represent the diversity of trainer experiences, integrating practical involvement with reflexivity and issues of confidentiality within a group setting

Conclusions/Implications: Initial conclusions suggest that although the rewards of the role (including developing relationships with colleagues and students) outweigh feelings of self-doubt and inadequacy, trainers find their work gruelling, particularly during critical incidents. Recommendations based on these findings are made for counselling and psychotherapy programme leaders to learn from these examples to develop cohesive management support systems and group supervision to support trainers

 
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Liddy Carver, Andrew Reeves

Other Author: Valda Swinton
Professional Role:
Ph.D. Research Student
Institution/Affiliation:
University of Chester
Email:
e.carver@chester.ac.uk

ABSTRACT: workshop                                                                              

Keywords: co-operative inquiry, higher education, counselling trainers, psychotherapy trainers, personal development

Co-operative inquiry: embracing a collaborative approach to counselling and psychotherapy training

Relevance of the workshop to counselling and psychotherapy research: This workshop will explore the challenges of conducting a co-operative inquiry with counsellor trainers, and how such challenges mirror the difficulties facing trainers in their workplace.  This work, undertaken as part of a doctoral research project in counselling, is guided by the research question 'How do trainers feel about the work they do and by sharing that does anything change for them? I am interested in learning about the 'process' of training, and the clash between academic achievement and personal development within a higher education context. Particular areas of interest include problems within counselling 'teams', trainers' working relationship with students, assessment of fitness to practice, the lack of training available for trainers themselves in terms of group development, group norms and group dynamics and the lack of research evaluating trainers' performance. Methods include: participation in co-operative inquiry discussions, a Delphi Study and reflexive journaling.

The aims of the workshop: This workshop aims to: a) contribute to co-researchers' understanding of the complexity of trainers' working relationships within a higher education context; and b) explore the value of co-operative inquiry as a means of research within an academic context.

How the workshop will be structured: A short presentation of findings will be followed by facilitated group discussion. Participants will work in groups discussing three key areas identified from research evidence, before reporting back with their ideas and suggestions. This is a learning occasion based on the collaborative experience of the participants. Ideas and suggestions will be collated at close of workshop to inform the facilitator's research process and future direction for the research. Outcomes will be forwarded to participants as a reminder of their collected ideas. 

Key points for discussion: The relational challenges of counsellor training for the trainer and how collaborative inquiry, drawing on trainer experience and practice, can contribute to the development of an evidence-base to affirm and challenge current training approaches.

Who will benefit from attending the workshop? It will potentially be of interest to trainers, facilitators and practitioners interested in conducting collaborative research within an organisational context.

 
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Jacob Clark

Other Author: Nick Midgley and Iti Arora
Professional Role:
Research Assistant
Institution/Affiliation:
University College London/ Anna Freud Centre
Email:
  Jacobharryclark@gmail.com

ABSTRACT: paper                                                                                   

Keywords: adolescence, depression, narrative inquiry, men's mental health, expectations of therapy

How do adolescent males with depression talk about 'talking'? A qualitative analysis of pre-therapy narratives

Aim/Purpose: Male adolescents with depression are hard to identify and at high risk of suicide, yet their voice in the literature is relatively silent. This study aims to contribute to our understanding of adolescent males' experience of depression and expectations of therapy. It intends to develop narrative analysis techniques for examining young male identities.

Design/Methodology: This study examines pre-therapy interviews of eleven 15-17 year old boys, purposively sampled at the first time-point of the 'IMPACT'  RCT, comparing efficacy of short term therapy for depression in adolescents (Goodyer et al, 2011). It addresses the question, how do depressed adolescent males talk about 'talking'?' Subsequent to a thematic investigation of the interviews, Bamberg's (2004) positioning analysis was implemented to examine the 'small stories' on three levels: how the boy depicts the characters within the story; how the speaker positions himself in the here-and-now of the telling; their sense of self in relation to cultural discourses. 

Results/Findings: The analysis found three core ways in which the boys talked about 'talking': 'not talking, 'explaining emotions, and 'talking therapy'. They explained their 'not talking' as a way of protecting others, but also as a way of maintaining their own sense of identity.  They questioned the assumption that 'talking' helps, and found emotional talk could impact on their relationships. The boys anticipated that 'talking' would be a barrier to therapy but also a goal of therapy. 

Research Limitations: Several boys were not strongly represented in the findings; future work should investigate co-construction of narratives, intonations, unspoken, and non-verbal aspects of talk in this population.  The 'small story' framework in an interview context may be unable to unmask the emotional experience of boys who struggle most in 'talking'.

Conclusions/Implications:  Findings were discussed in light of the current knowledge base in three overlapping domains, recognising adolescent depression, professionals' capacity to hear and 'hold' the emotional needs of young depressed males, and expectations of therapy. A case is made for clients' "relationship to 'talking'" to be considered in engaging this population.  Talk about 'self' in the context of others could be an important point of inquiry in examining young masculine identities.

 
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Abigail H. Conley

Other Authors: Catherine L. Griffith, Donna M. Gibson
Professional Role:
Assistant Professor, Counselor Education
Institution/Affiliation:
Virginia Commonwealth University
Email:
ahconley@vcu.edu

ABSTRACT: poster                                                                                    

Keywords: counselling, power-based personal violence survivors

Responding to power-based violence survivors: a review of the literature and considerations for counsellors

Aim/Purpose: As trauma recovery is a highly individual process, differing greatly from client to client, this poster serves to explore a diverse assortment of successful techniques for counsellors working with survivors of PBPV.

Design/Methodology: The researchers will review the facts and statistics about PBPV and share the literature review results of best practices for counselling survivors of PBPV. Implications and application to various counselling settings will be presented.

Results/Findings: According to the World Health Organization (WHO, 2013), 35% of women worldwide have experienced sexual violence, intimate partner violence, or stalking in their lifetime. In addition, women are disproportionally affected by this power-based personal violence (PBPV). Specific counselling techniques that encourage survivor healing include crisis counselling, restorying, anchoring, art therapy, complementary and alternative medicine (yoga, breathing, etc.), and psychoeducation aimed at challenging rape myths.  

Research Limitations: While the ubiquitous nature of intimate partner violence, sexual violence, and stalking are well documented and there is much research regarding the devastating effects this type of violence has on survivor's physical and mental health, there is little theoretical or empirical research on the most effective interventions counsellors should use with power-based violence survivors (Kress, Trippany & Nolan, 2003).

Conclusions/Implications: As previously stated, there is little theoretical or empirical research on the most effective interventions and as a result, often interventions that might be best practices with general populations are used to the detriment of survivor healing. In fact, some basic counselling techniques such as confrontation and giving directives may disempower survivors. And when used inappropriately, techniques such as reliving the assault and in vivo exposure may even have a deleterious effect on survivor healing. Counsellors-in-training, supervisors, practicing counsellors, doctoral students of counsellor education, and counsellor educators will find the suggested counselling techniques useful for their own counselling practice, training, and research.

 
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Dr Beverley Costa

Other Author: Professor Jean-Marc Dewaele
Professional Role:
CEO and Clinical Director
Institution/Affiliation:
Mothertongue multi-ethnic counselling (http://www.mothertongue.org.uk/)
Email:
beverley@mothertongue.org.uk

ABSTRACT: paper                                                                                    

Keywords: multilingualism, code-switching, emotions, identity, attunement

Multilingual clients' experience of psychotherapy

Aim/Purpose: The research question is: How important is it for multilingual clients to feel that code-switching (CS) - 'changes from one language to another in the course of conversation' - is possible in therapy and that their multilingualism is appreciated? The purpose of this research is to incorporate the voice and the perspective of multilingual clients into the growing bank of research into psychotherapy across languages from the therapists' perspective.

Design/Methodology: This is a joint, mixed-method research project across the disciplines of Applied Linguistics and Psychotherapy. Ethical approval was sought and granted from Birkbeck College, University of London. Participants in professional networks who might be former or current multilingual clients of psychotherapists were invited to participate in an online survey. The data was collected through non-probability, snowball sampling. 186 multilingual clients who had been exposed to various therapeutic approaches in various countries completed an online questionnaire which was used to collect quantitative and qualitative data. 

Results/Findings: The analysis showed that clients initiate and use significantly more code-switching than their therapists, and that it typically occurs when the emotional tone is raised. CS is used strategically when discussing episodes of trauma and shame, and to regulate proximity or distance. Contrary to therapist recommendations (Pitta, 1978; Verdinelli and Biever, 2009) clients prefer to manage the CS in order to express themselves more fully to the therapist, adding depth and nuance to the therapy.

Research Limitations: There is a limit to the generalisation possible from the relatively small yet diverse sample. Clients self-assessed their language proficiency.

Conclusions/Implications: Therapists' multilingualism promotes empathy and clients' own multilingualism constitutes an important aspect of their sense of self. Multilingual clients benefit from a therapeutic environment where they can use CS whether or not therapists and clients are language- matched. This has implications for the way in which monolingual and multilingual therapists create an environment where clients' multilingualism is appreciated as a resource in their therapy.

 
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Norma L. Day-Vines

Professional Role: Professor, Counseling
Institution/Affiliation:
Johns Hopkins University
Email:
norma.dayvines@jhu.edu

ABSTRACT: paper  

Keywords: counselling, broaching, multiculturalism, assessment, race

The construct validation of the Broaching Attitudes and Behavior Survey (BABS): a tool for measuring the extent to which counsellors discuss race, ethnicity, and culture with clients

Aim/Purpose: This study measured the extent to which counsellors broach race, ethnicity, and culture with culturally diverse clients by operationalizing the Continuum of Broaching Behavior. The Continuum of Broaching Behavior is a conceptual framework for explicating how counselors broach or have explicit discussions about racial, ethnic, and cultural factors with their clients (Day-Vines et al., 2007). An emerging body of research seems to suggest that counsellors' explicit discussions of racial, ethnic, and cultural concerns with clients of color can enhance client disclosure, willingness to return for follow-up sessions, and favorable counseling outcomes. The Continuum of Broaching Behavior posits that counselors can assume five broaching orientations: avoidant, isolating, continuing/incongruent, integrated/congruent, and infusing. The progression of broaching behaviors proceeds from the counsellor's refusal to initiate discussions about culture and advances to the counsellor's ability to translate the client's sociocultural and sociopolitical realities into meaningful counseling interventions. The presenter orperationalized the Continuum of Broaching Behavior using the Broaching Attitudes and Behavior Scale (BABS).

Design/Methodology: One thousand members of ACA were administered the BABS. Factor analysis was used to determine the latent variable structure of the instrument. Preliminary evidence of the construct validity of the BABS was determined by assessing group differences by gender, race, previous multicultural training, and years of experience, on each broaching subscale.

Results/Findings: Factor scores for the BABS correspond with four categories along the Continuum of Broaching Behavior: avoidant, continuing/incongruent, integrated/congruent, and infusing. Findings demonstrated significant differences based on years of experience and race, but not differences by gender and previous multicultural training.

Research Limitations: Although higher than the typical response rate for web surveys, the response rate was 36.5%.

Conclusions/Implications: The study provides empirical support for the broaching construct and implications for promoting the counsellor's broaching effectiveness.

 
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Dr Linda Dubrow-Marshall

Other Authors: Janelle Yorke, Pauline Adair, Anne-Marie Doyle, Robert Niven, Sharon Fleming, Caroline Shuldham, Andrew Menzi-Gow, Ann Caress, Claire Piltcher
Professional Role:
Programme Leader, MSc Applied Psychology (Therapies) Programme
Institution/Affiliation:
University of Salford
Email:
l.dubrow-marshall@salford.ac.uk; LJDMarshall@aol.com

ABSTRACT: paper                                                                                    

Keywords: cognitive-behaviour therapy, group psychotherapy, asthma, practitioner researcher, feasibility

A randomised controlled feasibility study of group-CBT (G-CBT) in severe asthma: a practitioner researcher's perspective

Aim/Purpose: To assess the feasibility and acceptability of G-CBT in severe asthma, pilot a manual for treatment delivery, evaluate treatment fidelity, explore the views of clients and service providers, and consider the relationship of the practitioner to psychotherapy research.

Design/Methodology: Eligible participants were diagnosed with severe asthma and scored greater than 8 on either subscale of the Hospital Anxiety and Depression Scale (HADS). They were randomly assigned to the treatment and control groups (who received no treatment) in two hospital settings. Outcome assessments, which were administered at baseline, week 8 and week 16 were: Asthma Quality of Life Questionnaire, Asthma Symptom Control Questionnaire, HADS, Dyspnoea-12, Euro Qual-5D, and Brief Illness Perceptions. Interviews/focus groups were held with participants, research staff and clinicians.

Results/Findings: From a sample frame of 148, 51 participants were randomised (G-CBT=25; control=26). Challenges to recruitment included reliance on referrals during busy clinics, client refusal, and screening for HAD scores which presented some ethical and practical issues. The dropout rate at week 8 was 8 for the G-CBT group and 4 for the control group.  Reasons for attrition included the need to travel long distances, challenges with weekly commitment, and poor health. Although there were no differences in the questionnaire outcome measures, participant feedback was generally positive regarding the group format as it provided the opportunity to learn from other asthma patients, and the relaxation techniques were reported as being particularly helpful in preventing panic-related hospital admissions. Clinicians reported some conflicts between the need to adhere to fidelity to the treatment manual for and attending to the presenting issues of the group participants.

Research Limitations: This was a preliminary study with a relatively small sample size.

Conclusions/Implications: There were difficulties in recruiting and retaining the sample. There was positive feedback from participants, although there was lack of significance in outcome measures. Group-CBT warrants further investigation as a potentially promising treatment option for clients with severe asthma. Psychotherapist researcher feedback suggested some changes to the treatment protocol and revealed some ethical conflicts.

 
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Racheal Dzumbira, Anne Jones, Julia Savage

Other Authors: Knaisha Curtis, Claudia Turbet-Delof
Professional Role
: Trainee Counsellor
Institution/Affiliation
: LC&CTA
Email:
c/o christine.brown@lcandcta.co.uk

ABSTRACT: poster                                                                                     

Keywords: depression, children, person-centred relationship, diagnosis, symptoms

Person-Centred counsellors' perspectives on the effectiveness of the approach when working with children suffering from the symptoms of depression

Aim/Purpose: As there is little mention of the extension of the Person-Centred Approach (PCA) in current research on successful treatments for children presenting with the symptoms of depression, the aim of this research is to explore Person Centred counsellors' experiences of the effectiveness of the PCA when working with this client group.

Design/Methodology: Five Person-Centred counsellors experienced in working with children presenting with the symptoms of depression participated in a semi structured interview. These interviews were audio recorded and transcribed. The resulting data was analysed using Thematic Analysis, informed by Phenomenological Principles (Moustakas, 1994). The BACP ethical guidelines for researching counselling and psychotherapy (Bond, 2004) were vigorously adhered to during the research process.

Results/Findings: Our findings appear to indicate that our sample group of Person Centred Counsellors perceive that the extension of the PCA benefits children who present with the symptoms of depression. Their experiences indicate that through the therapeutic alliance, characterised by the three Rogerian Core Conditions (Rogers, 1951), it appears a 'depressed' child can begin to feel empowered through the client/counsellor relationship and thus begin to develop a greater sense of self-awareness and self-positivity. This in turn appears to lead a child organically to improved cognitive abilities, enhanced social skills and better relationships. It also appears a child's experience of school and home life improves.

Research Limitations: Due to ethical considerations children in this client group were not interviewed, thus our findings are based on the perceptions and experiences of therapists only. Our research was qualified by time and resources.

Conclusions/Implications: Our research findings indicate that Person Centred Counsellors perceive that the extension of the PCA is an effective and valid treatment for children presenting with the symptoms of depression. Therefore we believe that this has implications that impact on current views on the treatment of children in this client group and affect current generalised psychotherapeutic thinking on 'what works and for whom'.

 
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Julian Edbrooke-Childs

Other Authors: Miranda Wolpert, Duncan Law, Kate Martin, Melanie Jones, Katy Hopkins
Professional Role:
Research Fellow
Institution/Affiliation:
The Anna Freud Centre and University College London
Email:
Julian.Edbrooke-Childs@annafreud.org

ABSTRACT: paper                                                                                   

Keywords: CAMHS, PROMs, therapists, training, shared decision making

Training therapists to use Patient Reported Outcome Measures (PROMs) within a shared decision making context

Aim/Purpose: Patient Reported Outcome Measures (PROMs) are recommended by healthcare policy (Department of Health, 2011, 2012). Patients and therapists report that PROMs can be used to promote patient-therapist communication (Moran et al., 2011; Norma et al., 2013). To achieve this, therapists recommend training be provided to support the introduction, analysis, and feedback of PROMs within a shared decision making context. The aim of this study was to explore whether training therapists to use PROMs improved attitudes, knowledge, and self-efficacy.

Design/Methodology: UPROMISE (Using Patient Reported Outcome Measures to Increase Service Effectiveness) training has been developed over three years with therapists from Child and Adolescent Mental Health Services (CAMHS). It involves the use of videos, role plays, Plan Do Study Act cycles and embedding in context, and it was developed and delivered with input from young people with direct experience of using child mental health services. A mixed methods, pre-post design was used to evaluate the impact of training, in which N = 75 therapists and nominated colleagues completed measures of attitudes, knowledge, and self-efficacy before and after UPROMISE.

Results/Findings: Therapists' self-reported attitudes, knowledge, and self-efficacy significantly improved after UPROMISE; likewise, colleagues' reports of therapists' attitudes, knowledge, and self-efficacy also significantly improved. Qualitative data from open-ended feedback surveys mirrored these findings, and therapists particularly noted that training around the rationale for using PROMs and how to use PROMs as a source of information to complement clinical judgement was useful. Still, therapists noted that UPROMISE was somewhat intensive and demanding.

Research Limitations: The longitudinal follow-up was relatively short, limiting conclusions about sustainment of effects, and the low completion rates of follow-up questionnaires resulted in small sample sizes.

Conclusions/Implications: Training therapists may improve attitudes, knowledge, and self-efficacy around introducing, analysing, and feeding back PROMs with patients. In doing so, PROMs may promote patient-therapist communication and shared decision making.

 
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Bradley T. Erford, Ph.D.

Professional Role: Professor (Past President of ACA)
Institution/Affiliation:
Loyola University Maryland
Email:
berford@loyola.edu

ABSTRACT: workshop                                                                              

Keywords: outcome research, meta-analysis, effect size, publication bias, homogeneity

12 steps and practical procedures for conducting a metaanalysis of counselling research

Relevance of the workshop to counselling and psychotherapy research: Meta‐analysis is a methodology for quantitatively combining and synthesizing results from numerous individual clinical trials with similar characteristics (e.g., similar client characteristics, outcome measures, research designs, effect size computations) to reach general conclusions about clinical outcome research questions. It allows counsellors to summarize what we know works in counselling.

The aims of the workshop: This presentation will review simplified, best practice procedures for conducting meta‐analyses on counselling outcome studies by demonstrating a 12‐step model with practical procedures. While the emphasis of this presentation is on clinical trials of counselling treatments, meta-analysis can be applied to wide‐ranging research questions with robust extant literature bases, for example correlative studies of a given phenomenon, psychometric studies (score reliability, validity) of commonly used psychological or educational tests, or treatment/intervention programs of important societal phenomena (e.g., teen pregnancy, domestic violence).

How the workshop will be structured: The presenter will didactically review the 12 steps and then lead an interactive discussion of how the steps were applied to previous studies, and could be applied to questions posed by audience members, who are encouraged to develop their own working research questions and apply the procedures.

Key points for discussion: Each of the 12 steps will be reviewed quickly and applied to two real‐life meta‐analyses: (a) a small demonstration sample of a 9‐study meta‐analysis on the treatment of PTSD, and (b) a mid‐sized 42‐study meta‐analysis on the treatment of depression in school-aged youth.

Who will benefit from attending the workshop? Researchers and students will benefit from the methodological overview, while consumers of counselling research will better understand how meta-analyses are conducted to allow for critical analyses and integration of findings. Special attention is given to expectations for publishing meta‐analyses in counselling journals.

 
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Magda Evans

Professional Role: Accredited Psychotherapist, completing a Doctorate in Psychology & Psychotherapy
Institution/Affiliation:
Metanoia Institute/Middlesex University
Email:
magdaevans@blueyonder.co.uk

ABSTRACT: paper

Keywords: client experiences, brief-term psychotherapy, qualitative, IPA, metaphor

What happens to psychological depth in brief-term therapy? Clients' experiences of therapy and the therapeutic relationship using Interpretative Phenomenological Analysis

Aim/Purpose: The purpose of this qualitative doctoral research project was to explore the conscious and subconscious thoughts and feelings clients that had on meeting their therapists; and how clients perceived the therapeutic relationship and their experience of therapy.

Design/Methodology: The methodology of choice was Interpretative Phenomenological Analysis (IPA). Face-to-face semi-structured interviews were conducted with 10 male and female clients who had recently ended their therapy with trainee integrative practitioners at one low-cost counselling agency in West London. The focus of the interview was on how clients made sense of their therapy and the therapeutic relationship. An 'object-tray' of miniature objects used as stimuli was utilised during each interview to trigger metaphorical thinking and facilitate access to participants' out-of-awareness cognitive and emotional processes.

Results/Findings: Results showed how a range of client fears impacted the therapeutic process by preventing full collaborative engagement. Findings also demonstrated how clients are active in overcoming their fears (or not!), how they connected with their therapists, and also how the development of a warm and trusting therapeutic relationship reduced their fears and facilitated deeper disclosures. Additionally, this study offered clients' perceptions of various helpful interventions found to be therapeutically successful for psychological recovery and personal growth.

Research Limitations: This was a small scale research carried out by one researcher in one particular area of London. Another group of ex-client participants may have different sense-making narratives; and another researcher would have responded differently in the interview process and perhaps have drawn out different data with correspondingly different results.

Conclusions/Implications: There is much going on underneath the surface when clients entered therapy, on first meeting and when working with their therapists. For full therapeutic engagement and optimal benefits, clients need to overcome multi-faceted fears, develop a positive transference towards, and feel trusted by their therapist. This engenders hope and empowers clients. Clients also need to connect deeply and share control with their therapists. Therapists also need to be flexible in ways of working collaboratively with clients.

 
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Federica Ferrari

Professional Role: Assistant Professor, Researcher & Counselor
Institution/Affiliation:
University of Bologna
Email:
federica.ferrari10@unibo.it

ABSTRACT: poster

Keywords: conceptual metaphor, embodiment, personal development, awareness, integration

The 'transformative' power of metaphor: assessing its (unexplored) potential for the sake of the patient/client self-exploration and well-being

Aim/Purpose: The study aims to cast light on a promising experimental perspective on metaphor and the implications on practice. Metaphor has long been investigated as a linguistic and conceptual device, and used for fostering exploration in counselling/therapy. And yet, some of its potential is still available for further exploitation and the implications on practice might be promising.

Design/Methodology: Given the centrality of bodily experience to the notion of conceptual metaphor in cognitive theory (Johnson & Lakoff 1980, Lakoff 1993, Gibbs 2006) the relationship between metaphor and emotion (Kövecses 2000), the centrality of metaphor in the (re-)structuring of experience (Burns 2005, Loue 2008, Roffman 2008…), the 'transformative power' of metaphor is investigated in strategic communication settings (Psychotherapy, Counseling) to implement its application potential. Following a public presentation of the project at the Modena's ASPIC centre, 6 initial clients were recruited and tested before and after the sessions (5 each, apart from 2 clients who had a preliminary session only) using the psycho-test which was designed with the School supervision.

Results/Findings: An experimental integrated model is presented, adapting textual identification procedures (Steen 1999; Ferrari, 2007, 2013) to an integrated psychological approach (Rogers, 2003[1951]; Perls, 1951), to further develop metaphor transformation guidelines. A psycho-test is created to evaluate the power of metaphor in counselling sessions in a diachronic perspective. Some preliminary cases (e.g. 'the frog', 'the hare', 'the desolate land') are presented as examples of application and potential. For instance, conjuring up 'the desolate land', allowed one client to get in touch with emotions she would not have dared to face otherwise, and suggested new lines of intervention. All the metaphors explored proved to be auto-transformative in the long run of each case.

Research Limitations:

  • subjectivity vs. objectivity & reliability of the test
  • how to measure the psycho-test results: transformation into numbers?
  • the method should be tested on a larger scale
  • scope of the equipe: the research project might improve if other expertises and experts join (clients/patients, counsellors, psychotherapists, conversational analysts, neuroscientists...)

Conclusions/Implications: The evidence gathered shows how an implemented use of metaphor may help deal with resistant cases, foster personal development/change and improve personal wellbeing, awareness, integration as well as open new, experimental perspectives of intervention.

 
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Paulina Flasch, Sandra Robinson, Edward H. Robinson III, Glenn Lambie, Kelley Holladay, Zachary Bloom

Professional Role: Doctoral Student
Institution/Affiliation:
University of Central Florida
Email:
paulinaf@knights.ucf.edu

ABSTRACT: poster

Keywords: altruistic caring, caring communities, caring classrooms, counseling implications, counselor development

Creating caring communities: implications of altruistic caring on counselors and communities                                                                                                                     

Aim/Purpose: Research supports that altruism is related to positive mental health and can be fostered and nurtured to help create caring communities. This poster will provide an overview of research projects and findings on altruistic caring and the implications for counselors and counselor development.

Design/Methodology: This presentation will employ "best evidence synthesis research" (Slavin, 1995) methodology to summarize the current state of the research on altruistic caring. Studies are selected based on Slavin's (1995) Principles of Inclusion: (1) studies are germane to the issue at hand, (2) methodological adequacy of the studies to minimize bias, (3) well-controlled studies that provide internal and external validity, (4) and germane studies using several methods. The studies selected will also include presenters' own research on altruism and altruistic caring, including a phenomenological research study; the development of the Heintzelman Altruism Inventory; a longitudinal study measuring children's altruism; a qualitative study assessing counseling students' perceptions of altruism and the role of spirituality/religiosity in the U.S. and U.K.; and other studies examining impacts of altruism.

Results/Findings: Altruistic caring has positive effects on both communities and mental health and is found to be a contributing factor to being a successful counselor. There is a possible developmental component to the perception of the manifestation of altruistic caring. Altruism is either inhibited or promoted through one's environment, which makes caregivers, teachers, and counselors especially influential. This poster will share research findings and examine ways to foster caring communities. The poster will present implications for counselors and how research findings apply to counselor development and success.

Research Limitations: Limitations in the above studies varied, but included sample size and generalizability.

Conclusions/Implications: Research findings provide greater insight into how altruism is related to positive mental health and increased social skills and can be fostered and nurtured in communities, clients, and counselors. Altruistic caring is also found to be a contributing factor to being a successful counselor. Understanding and measuring altruism can help target areas of improvement in counselors and individuals and promote healthier and happier communities.

 
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Donna M. Gibson, Abigail Conley and Colette T. Dollarhide

Professional Role: Associate Professor, Counselor Education
Institution/Affiliation:
Virginia Commonwealth University
Email:
dgibson7@vcu.edu

ABSTRACT: workshop

Keywords: professional identity development, professional relationships, grounded theory

Transformational tasks and the role of professional relationships: a grounded theory approach to understanding professional identity development

Relevance of the workshop to counselling and psychotherapy research: Professional identity development of counsellors, students, and educators includes intrapersonal and interpersonal dimensions (Dollarhide, Gibson, & Moss, 2013; Gibson, Dollarhide, & Moss, 2010). Specific professional relationships are integral to this developmental process for each of these groups.

The aims of the workshop: In order to examine the intrapersonal and interpersonal dimensions of professional identity development, a series of qualitative studies of grounded theory methodology were conducted with students, counsellors, and educators.  Transformational tasks were identified as part of the transitions in development.  Notably, the role of "expert" or "experienced" professionals was integral in the need for external validation in the early phases of professional identity development in all four studies.  

How the workshop will be structured: The researchers will share the research results and invite workshop participants to share their own experiences and ideas as they relate these findings to their own professional identity development as counselling professionals. Using one of the four research models (i.e. student, practitioner, educator/supervisor), each participant will be asked to reflect (in small groups) on their own professional identity development as it relates to the most relevant model.

Key points for discussion: The process of professional identity development is a cycle of learning, practice, and feedback in which the new professional experiences dependence and autonomy in the search for individuation, professional viability, and internal locus of evaluation (Auxier, Hughes, & Kline, 2003).  In this process, there are several transformational tasks that students, counsellors, and educators may experience that is also influenced by professional relationships.  The transformational tasks and relationships will be reviewed and explored for each of the grounded theory studies conducted by the authors. 

Who will benefit from attending the workshop? Counsellors-in-training, supervisors, practicing counsellors, doctoral students of counsellor education, and counsellor educators will find this information useful as they are developing their own professional identities but also as they interact in professional roles with other counselling professionals.  Training, supervision, and educational implications will be evident.

 
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Clare Green

Other Author: Dr Miriam Isaac
Professional Role:
MA student
Institution/Affiliation:
University of Leicester
Contact details:
Institute of Lifelong Learning, 128 Regent Road, Leicester
Email:
cg196@student.le.ac.uk

ABSTRACT: poster

Keywords: metaphor, psychodynamic, unconscious mind, symbols, primary process

The symbolic in practice: a qualitative study of psychodynamic therapists' use of metaphor

Aim/Purpose: Metaphor is a relevant area for study because psychodynamic practitioners are "...particularly attuned to the use of metaphor and symbolism..." (Howard, 2010 p.2) as they decode latent content. The purpose of this research is to explore therapists' experiences of working with metaphor in therapy day to day, whether client- or therapist-generated. The aim is to increase awareness of what metaphor may bring to the process in helping therapists recognise significant information from the unconscious mind.

Design/Methodology: The research uses semi-structured, face-to-face interviews with up to 12 psychodynamically trained therapists who self-selected in response to publicity about the project. Snowball sampling was also employed to gain sufficient numbers. It is analysed utilising structured thematic analysis. It is carried out with University ethical approval. 

Results/Findings: Preliminary coding from April 2014 (8 interviews so far) reveals four categories emerging: 1 Therapists' responses to clients' metaphor - hearing meaning FULL words, hearing words seeing images, 'just like a dream', links to the past, the clients' private world, and playing with images, 2 Therapists' use of metaphor, - therapist generated or the alliance?, 3 Effect of metaphor, 'going through the wardrobe into Narnia', understanding symbols, 4 Clients' use of metaphor – the benefits of distancing, using the familiar to communicate the inner mystery.

Research Limitations: A limitation will be the small sample size. In addition, therapists will reflect on what information they can give about metaphor use and may be restricted by not divulging confidential client details.

Conclusions/Implications: It is hoped that this research will explore the rich ways that metaphor is used in therapy and raise its  profile as a mechanism for providing the therapist with clues about the unconscious mind of clients. It may raise implications for training.

Conclusions/Implications: Knowledge of current service provision provides an indication of the role of counselling and psychotherapy within women's centres, and how they may best be used in such settings in the future.

 
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Victoria Hatchett

Other Authors: Ursula De Pledge Tebbet-Duffin, Joanne Pybis, Nancy Rowland
Professional Role:
Research Intern
Institution/Affiliation:
British Association for Counselling and Psychotherapy (BACP)
Email:
vjhatchett@live.co.uk

ABSTRACT: paper                                                                                   

Keywords: counselling, women, criminal justice, mental health, vulnerability

Mental health provision in women's centres

Aim/Purpose: Women's centres offer gender-specific services to vulnerable women currently, or at risk of being, in contact with the criminal justice system. By exploring the current mental health provision across these centres, information can be gathered about the services offered and the women who use them in order to identify and promote best practice and increase awareness of the needs of women who access such services.

Design/Methodology: A survey was designed in collaboration with two partner organisations  to ascertain: the level, type(s), delivery and funding of mental health interventions available; the use of external providers to deliver interventions; the use of service evaluations; and client demographic information. It was produced in an online format to facilitate completion, with one centre selected to act as a pilot site. The survey link and invitation to complete the survey were sent via email to the pilot site. Following the pilot, the survey was rolled out to a further 47 centres in a similar fashion. Data gathered were analysed descriptively.

Results/Findings: Thirty four services (including the pilot site) participated in the survey. Over two-thirds provided psychological interventions, of which counselling was the type most frequently offered. In-house mental health interventions were typically delivered by a qualified counsellor.

2,296 women had used services in the previous month; the majority were white and aged between 25 and 64. Clients displayed a range of presenting issues, including mental health problems, personality disorder, self-harm, and substance/alcohol misuse.

Thirteen services undertook evaluations of the mental health interventions they provide in-house. Data from evaluations were used for various purposes, including securing funding, improving interventions, and justifying service provision.

Research Limitations: This project was a small-scale survey, with only one pilot area and a limited pool of potential respondents. The information gathered is dependent on the willingness of identified sites to participate, and their ability to provide detailed responses. Inherent to all survey designs are the potential for response bias and misinterpretation of questions.

Conclusions/Implications: Knowledge of current service provision provides an indication of the role of counselling and psychotherapy within women's centres, and how they may best be used in such settings in the future.

 
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Helen Hayes

Professional Role: Psychotherapist, counsellor, supervisor, lecturer
Institution/Affiliation:
New School of Psychotherapy & Counselling (NSPC); this study was undertaken as part of the DProf in Existential Psychotherapy & Counselling
Email:
helen@counselling-psychotherapy-london.co.uk 

ABSTRACT: paper 

Keywords: empowerment, women, domestic violence, feminism

Playing with power? Meanings of power and empowerment in counselling women affected by domestic violence

Aim/Purpose: To investigate: (1) the experiences and meanings of empowerment offered by counsellors and former clients in a counselling service for women affected by domestic violence; (2) counsellors' views on the dynamics of power within the therapeutic relationship; (3) to  consider these views alongside various philosophical perspectives on power. 

Design/Methodology: This was a small-scale qualitative study, comprising semi-structured interviews with a purposive sample of seven counsellors and four former clients. The interviews were analysed using Interpretative Phenomenological Analysis (IPA) and further discussed using Foucauldian Discourse Analysis (FDA), considering several philosophical perspectives on meanings of power and empowerment with particular attention to the contributions of feminist theory and practice. 

Results/Findings: Both counsellors and clients viewed empowerment as synonymous with  a process of recovery or discovery of selfhood, and emphasised the core conditions of the person-centred approach in facilitating this process. Counsellors paid little attention to the impact of structural power inequalities on clients' possibilities, reflecting the dominance of an individualistic discourse of personal power, whereas clients were more aware of the ways in which their choices were constrained. In considering the power dynamics of the therapeutic relationship, most counsellors demonstrated discomfort about the power invested in their role. Their concern not to misuse their power demonstrated a view of interpersonal power as inevitably dangerous. There was little evidence that the counsellors integrated the contributions of feminist therapy into their practice. 

Research Limitations: The research is limited by the small sample size and being situated in one specific counselling service. The particular difficulties encountered in recruiting former clients to participate in the study should also be noted. 

Conclusions/Implications: Counsellors' practice would be enhanced by greater consideration of social/structural factors impacting on clients' lives. The contributions of feminist therapy to practice with women affected by domestic violence could be revitalised and reintegrated into contemporary practice. The value of a person-centred approach to therapeutic work with this client group should be affirmed and a greater dialogue between person-centred and feminist thinking and practice should be encouraged.

 
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Gary Herrington

Other Author: Jon March
Professional Role:
MA Student Researcher
Institution/Affiliation:
Vaughan Centre for Lifelong Learning, University of Leicester
Email:
ghh3@le.ac.uk

ABSTRACT: poster

Keywords: unexpected disclosure, childhood sexual abuse 

Unexpected disclosure of childhood sexual abuse during therapy: an issue for trainee therapists?

Aim/Purpose: Unexpected disclosure of childhood sexual abuse (CSA) has the potential to significantly impact the therapeutic relationship and, therefore, therapy outcomes. 

This study seeks to understand the impact that an unexpected disclosure of CSA may have on the therapy and therapist, where the therapist is a trainee whose personal history does not include CSA, with a view to understanding immediate, short and long-term effects of the disclosure.

Design/Methodology: Grounded Theory will be employed, with the intention of deriving hypotheses that may be tested in future research. 8 – 12 participants are being recruited through universities, delivering appropriate courses, and counselling organisations that do not provide CSA specific services. Semi-structured interviews are being used to gather data.

Results/Findings: This research is ongoing but early analysis has found a number of key over-arching categories that will be further tested as more data is gathered. These categories include: initial shock at disclosure; feeling unprepared and de-skilled; return to basic technique; fear of causing further harm; supervision ameliorates impact of disclosure. There appears to be a difficulty in recruiting participants, possibly due to the difficult experiences of trainees in this situation.

Research Limitations: The most significant limitation of this research is the number of subjects that can be interviewed within the timescales of an MA research project. Researcher reflexivity will be monitored closely due to the nature of the subject area.

Conclusions/Implications: Whilst there are no conclusions at present, it is anticipated that this research will aid in understanding how unexpected disclosure of CSA may affect the process and outcomes of therapy from a trainee's perspective and how it may impact on the trainees themselves. It is hoped that the findings will provide a comparison with a similar study on therapists who were survivors of CSA. The findings appear to have implications for practice, training and supporting/supervising trainees who experience this phenomenon.

 
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Kelley Holladay

Other Author: Joseph Graham
Professional Role:
Practicum Coordinator
Institution/Affiliation:
University of Central Florida
Email:
Holladay@knights.ucf.edu 

ABSTRACT: paper 

Keywords: flow, substance use, addictions counselor, Event Experience Scale 

Do addiction counselors experience flow while in a self-reported "excellent" session with a substance use client? 

Aim/Purpose: The quantitative portion of this research is designed to answer the question, "Do counselors experience flow in "excellent" sessions?"  The qualitative component is designed to answer the question, "What are the characteristics of counselor flow?" Noted flow researcher Csikszentmihalyi (1975) first described flow as an internal motivating factor where an individual is in a state of complete concentration or absorption.  A state of flow is typically measured by feelings of loss of time, loss of self-consciousness, loss of conscious effort, and the merging of actions and awareness (Ainley et al., 2007).  

Design/Methodology: This research design consists of two parts.  In the first part, experienced clinicians (defined as mental health clinicians with at least seven years of post-graduate experience) working Florida will be invited through an email to participate in a survey. The clinicians are asked to recall their most recent "excellent" (as defined by the participants) session with a client in an individual modality. Participants are asked to fill out the Event Experience Scale (FSS-2) Flow Scale in response to their remembrance of a counseling session with a substance use client. Through this survey, participants are invited to submit their email address if interested in participating in a one-hour interview facilitated by two doctoral students in accordance with the IRB protocol. This qualitative piece is coded for themes by four independent coders, who then meet to reach thematic consensus, and then one expert reviewer for finalization. 

Results/Findings: Researchers found the Challenge – skill balance (M = 5.50) dimension to be the most predictive of whether a counselor reportedly experienced flow in an "excellent" counseling session. The least impactful dimension was found to be Transformation of time (M = 4.63).  

Research Limitations: The Event Experience Scale (FSS-2) Flow Scale was validated with athletes and musicians, but not with work-related flow experiences.  An additional limitation is the fact that participants are relying on their memories from events that could have occurred a significant time ago.

Conclusions/Implications: Researchers will present findings at research presentation.

 
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Jon Howarth

Other Author: Dr Clare Symons
Professional Role
: Post Graduate Student
Institution/Affiliation
: University of Leicester
Email
: jon_howarth@hotmail.com

ABSTRACT: poster

Keywords: humour, therapist attributes, humour styles, humour in therapy

You cannot be serious! A quantitative study of the humour styles of therapists

Aim/Purpose: The purpose of the research is to understand the humour styles of therapists and to explore whether there is a relationship between humour style and attitude toward and the use of humour in therapy. The research primarily aims to discover whether therapists have a predominant humour style, the relationship between the therapists' demographic variables and their humour style and the relationship between therapists' humour style and their propensity to use humour with a client.

Design/Methodology: The research uses an online questionnaire that begins with a small number of closed demographic questions followed by up to 40 questions in a Likert scale format. The 32 questions that measure humour styles are a replication of The Humour Styles Questionnaire (HSQ) developed and validated by Martin et al (2003). The primary method of recruiting participants has been to invite a random sample of approximately 1,500 BACP members, other methods include publicity and snowball sampling. Ethical approval for the research has been granted by the University of Leicester.

Results/Findings: Preliminary results indicate that there is a statistically significant difference between therapist and non-therapist humour styles. There were also found to be some significant differences in counsellor's attitudes toward the use of humour in therapy based on age, gender, modality and experience.

Research Limitations: The potential limitations of the study include the fact that the additional questions developed to measure attitude to humour will not have been tested in the same rigorous manner as the original HSQ.

Conclusions/Implications: It is hoped that the study will add to the body of knowledge regarding the attributes of therapists. It is also hoped that the research will make a contribution to the debate concerning the use of humour in therapy including whether therapists with adaptive or maladaptive humour styles are more likely to use humour and the implications for their client work.

 
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Celia Hulme, Hazel Flynn

Professional Role: KTP Associate
Institution/Affiliation: SignHealth & UCLan School of Health
Contact details: SignHealth, 5 Baring Road, Beaconsfield, Buckinghamshire, HP9 2NB 
Emailchulme@signhealth.org.uk

ABSTRACT: paper

Keywords: hard to reach communities, Clinical Commissioning Groups (CCG's), sustainability, equity of access

Commissioning a hard to reach group service: a provider's perspective 

Aim/Purpose: The study is based on a service evaluation that highlights issues with commissioning IAPT services in particular with a hard to reach group that are small in numbers. It looks to why and to address the issues. The study focuses specifically on Deaf BSL users.
BSL IAPT service (a hard to reach group) is looking to have its services commissioned all over England but are facing questions from commissioners about low numbers/high costs as opposed to the impact the service has on the user. Commissioners are making decisions based on policy/criteria and financial restraints and this does not match the needs of hard to reach groups.

Design/Methodology: A mixed method study design has been adopted drawing on quantitative outcomes from the PHQ9, GAD7 and WSAS assessment/measurement scales and qualitative data are extracted from service user and patient experience questionnaires. This information will offer CCG's an insight on the issues that clients face.

Results/Findings: The results showed that BSL IAPT produced a high recovery rate of 75% (national IAPT 44%), Drop outs 8% (national IAPT 29%), Declined treatment 10% (national IAPT 29%) 87% were satisfied with the service. Proof of excellent outcomes as well as emphasis of cultural provision was produced to CCG's however in some areas the service was still decommissioned due to perceived low numbers and high costs.

Research Limitations: Experience based on one service.

Conclusions/Implications: The outcome of this research will be to highlight the need of working with CCG's and educating them that making decisions is not just based on numbers. The importance of finding ways of sustaining IAPT services for hard to reach communities is discussed in the context of equity of access to primary mental health services. The learning from this study could have implications for commissioning local and national service.

 
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Martin Jordan

Professional Role: Senior Lecturer, Counselling and Psychotherapy
Institution/Affiliation: University of Brighton
Email: m.j.jordan@bton.ac.uk

ABSTRACT: workshop                                                                             

Keywords: outdoor therapy, nature, research questions, methodology, methods

Revitalising the relationship: researching counselling and psychotherapy in nature

Relevance of the workshop to counselling and psychotherapy research:
This is a growing area of practice and research, with a number of counsellors both experienced and in training interested in exploring the potential of taking their work outdoors into  natural settings. The research process and findings will be of relevance to this audience.

The aims of the workshop: This workshop will focus on the emerging area of outdoor and nature based therapy. It will focus on doctoral research undertaken by the presenter. The workshop will explore aspects of the research process looking at challenges of devising a research question, choosing an appropriate methodology, and methods of data analysis. Specifically challenges of researching human-nature  relationships will be explored, alongside the status and role of research data in supporting our understanding of therapeutic practice outdoors.

How the workshop will be structured: There will be a discussion of the background to the research, then some small group work exploring the challenge of devising research questions and appropriate methodology and methods. Following this there will be whole group discussion of these issues, we will also look at the findings of the research and reflect upon the research process.

Key points for discussion: We will explore the challenge of devising appropriate and focused research questions, how these link to a methodology and methods. There will also be a focus on the philosophical and methodological challenges of researching human-nature relationships and in particular how findings can be linked to practice issues and concerns.

Who will benefit from attending the workshop? Experienced therapists, trainees, and those with an interest in this emerging field. Those undertaking research into counselling and psychotherapy. Those interested in the findings of research into outdoor therapy.

 
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Mohammed Abbas Khan

Professional Role: Psychotherapist/PHD student
Institution/Affiliation
: University of Manchester/ Trent PTS
Email
: arbaskhan87@yahoo.co.uk

ABSTRACT: paper                                                                                     

Keywords: British South Asian students, University Counselling Services (UCS), Izzat, help- seeking behaviour, integrative approach

Seeking therapeutic help: a comparison of British South Asian and international students' attitudes towards accessing University Counselling Services

Aim/Purpose: There is increasing evidence that  a lack of knowledge about  University Counselling Services regarding their waiting times (together with shame and stigma) can all be strong discouraging factors for students when considering accessing these services (Russell et al, 2008 and Gilbert et al, 2007). However, we know little about how these factors relate to British South Asian and international students. Therefore, the aim of this study was to explore British South Asian and international students' attitudes and the specific barriers they may face, with the aim of gaining a further understanding of their discouraging and encouraging factors when considering accessing UCS.

Design/Methodology: A qualitative method was adopted in this study. A sample of 12 participants containing six from each focus group (a mix of males and females) were selected utilising a purposive sampling method (Marchel and Owen, 2007). Ethical approval was granted by the University of Derby and Liverpool John Moores University.

Results/Findings: The findings of this study suggested that international students will not access UCS due to their lack of knowledge about such services and because they are not familiar with the Western concept of counselling approaches, which has been identified in the previous literature (Masuda and Boone, 2011 and Russell et al, 2008). In contrast, the British South Asian home students expressed that not having a counsellor from a similar race would prevent them from entering into UCS because the counsellors (who are often white and middle-class) do not have an understanding of ‘Izzat'. This concept is  vital because it will determine how an individual will be seen within the family. Furthermore, going against ‘Izzat' will bring the client's name and that of their family into disrepute which has not been identified within most of the previous literature (Inman et al, 2007 and Sue and Sue, 2008).

Research Limitations: Larger, more representative samples from various universities would enhance the external validity in order to gain a further understanding of the problem of minority students accessing UCS.

Conclusions/Implications: The findings of this study added knowledge to the existing literature, namely that providing culturally-sensitive services will enable more students from minority backgrounds to access them.

 
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Glenn Lambie, Sandra Robinson, E.H. Mike Robinson III, Paulina Flasch 

Professional Role: Professor (Counselor Education, UCF)
Institution/Affiliation:
University of Central Florida
Email: paulinaf@knights.ucf.edu

ABSTRACT: paper                                                                                     

Keywords: counseling competency scale, counselor competency, student development, assessment, student evaluation

The Counselor Competencies Scale (CCS): development and practical implications

Aim/Purpose: The Counselor Competencies Scale (CCS) is an instrument that was developed to evaluate counselor competencies in a comprehensive fashion (counseling skills, professional dispositions, and professional behaviors). Research questions examined in this investigation were: (a) What is the factor loading of the CCS? (b) What is the interrater reliability between supervising instructors and supervising doctoral students using the CCS to evaluate counseling students' competencies? And (c) What is the relationship between counseling students' scores on the CCS and their academic performance, measured by the students' final grade in a counseling practicum course? Presenters will share the process of developing the CCS and will explain how the CCS can be utilized as a developmental instrument to assess counselor competency.

Design/Methodology: The CCS was developed using scale development procedures (e.g., DeVellis, 2012; Dimitrov, 2012), including (a) deciding on what to measure, (b) producing an item pool, (c) creating the format for measurement, (d) having the initial item pool reviewed by experts, (e) thinking about inclusion of validation items, (f) administering items to a developmental sample, (g) evaluating the items, (h) optimizing scale length. In addition, authors examined the construct validity (exploratory factor analysis, EFA), internal consistency reliability (Cronbach's alpha), interrater reliability, and criterion-related validity of the CCS with a sample of counseling graduate students (N = 535).

Results/Findings: The results of the EFA identified a five factor model for the CCS: (a) Professional Behaviors, (b) Counseling Relationship, (c) Counseling Skills, (d) Assessment and Application, and (e) Professional Dispositions. The internal consistency reliability for the CCS was strong (final .933) and the interrater reliability moderate to questionable.

Research Limitations: Limitations included the sampling and no literature was found that comprehensively explored counseling competencies, which may have resulted in potential items being missed during instrument development.

Conclusions/Implications: The CCS is a tested instrument that can aid supervisors in evaluating counsellors'-in-training competencies. Used as a developmental tool that tracks students' development over time, the CCS helps communicate feedback regarding students' counselling performance. Currently used by 27 programs, the CCS can also assist with standardization of the evaluation process.

 
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Dodie Limberg, Glenn Lambie, E. H. Mike Robinson III

Professional Role: Assistant Professor
Institution/Affiliation: Texas A&M University-Commerce, College of Education 
Email: dodielimberg@hotmail.com

ABSTRACT: paper                                                                                       

Keywords: counselor burnout, counselor altrusim, school-based counseling, quantitative, structural equation modeling 

The contribution of practicing school counselors' level of altruism to their degree of burnout 

Aim/Purpose: This investigation tested the theoretical model that practicing school counselors' level of altruism will contribute to their levels of burnout. In addition, the investigation examined the relationship between the practicing school counselors' levels altruism and burnout and their reported demographic information (e.g., age, school counseling level, self-reported levels of wellness).

Design/Methodology: The overall sample for this study is 437 practicing school counselors. A random sampling procedure was utilized. Dillman's (2009) Tailored Design Method, which consists of strategies to increase response rate, was used A descriptive, correlational research design was employed to investigate the research hypothesis and exploratory questions. The research hypothesis was analyzed using structural equation modeling. More specifically, multiple regression, path analysis, and confirmatory factor analysis were conducted. The exploratory research questions were examined using: descriptive statistics, Spearman's rho correlations, multiple regressions, Kruskal-Wallis test and Mann Whitney U test. The results are reviewed and compared to existing research in the field. 

Results/Findings: The results of the study support that school counselors with higher levels of altruism have lower levels of burnout. The findings of this study show two dimensions of altruistic motivation: (1) positive future expectations and (2) self-efficacy contribute significantly to all dimensions of burnout (emotional exhaustion, depersonalization, and personal accomplishment). Additionally, a significant relationship was found between altruism and burnout and self-reported wellness. 

Research Limitations: The limitations to this study include: sampling (response rate and distribution of data), and threats to internal and external
validity. 

Conclusions/Implications: The implications of our study provide: (a) an increased awareness of altruism within the field of counseling, and (b) further understanding of the relationship between altruism and burnout.

 
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Dodie Limberg, Jonathan Ohrt

Other Author: Renee Sherrell
Professional Role: Assistant Professor
Institution/Affiliation: Texas A&M University-Commerce, College of Education
Email: dodielimberg@hotmail.com 

ABSTRACT: paper                                                                                      

Keywords: school counseling, qualitative, adolescents, thematic analysis 

A phenomenological investigation of adolescents' perceptions of school counseling 

Aim/Purpose: This phenomenological investigation sought to describe the influential experiences of adolescents with their school counselors. The purpose of this study is to focus on adolescents common experiences as they relate to school counseling, and to describe what adolescents find valuable in this unique relationship. 

Design/Methodology: This study utilizes a phenomenological research design. Students (N = 150) wrote essays describing their experiences with their school counselors. A purposive sample selection procedure was utilized.  The essays were coded and examined using thematic analysis in order to identify patterns within the data. More specifically, the themes were compared to components of suggested school counseling models to examine if there was a commonality between what school counselors are supposed to do compared to what adolescents perceive to be effective for their development. 

Results/Findings: The findings of this study describe what aspects of school based counseling adolescents perceive to beneficial. Preliminary themes include the counsellor caring about the adolescent as a person, the counsellor being influential in the adolescent's career path, and the counselor being a support and resource for academic learning. Additionally, the findings provide support for a developmental, comprehensive school counseling program. 

Research Limitations: The limitations for this study include researcher bias when reading the essays, and the participants may not be able to equally articulate their responses in written form. 

Conclusions/Implications: The findings have implications for the school counseling profession. Unfortunately, the voice of adolscents is not well represented in the school counseling literature, rather the perspective of the school counsellor is more commonly used. Although both perspectives are important, it may be more valuable to hear from those receiving the services within the schools.

 
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Jacqui Lindsay

Other Authors: John McLeod, Anne Goldie
Professional Role: Counselling service manager
Institution/Affiliation: Crossreach Counselling Lothians, Edinburgh
Email: jacqui.lindsay@crossreach.org.uk 

ABSTRACT: paper                                                                                      

Keywords: client perspective, counselling, outcome, qualitative, voluntary sector 

The meaning of counselling from the client's perspective: a qualitative study of client experiences of therapy in two voluntary sector agencies 

Aim/Purpose: To explore how clients understand and evaluate the outcomes of counselling. 

Design/Methodology: Clients in two inner-city voluntary sector counselling agencies were asked to indicate whether they would be willing to take part in follow-up interviews. After their counselling had been completed, clients were contacted again and invited to participate in intensive, semi-structured interviews. Clients were recruited in order of completion of counselling. Interviews were  structured around the use of a visual  time-line technique, incorporating elements of Change Interview methodology, and were conducted and transcribed by a team of counsellors using an approach based on Consensual Qualitative Research. Analysis of interview data focused on (a) case-based identification of individual client trajectories, and (b) cross-case analysis of themes. Data were collected from 12 clients, from a range of backgrounds and presenting problems. 

Results/Findings: Analysis of interview data identified a distinct  set of life trajectories associated with different types of client experience of therapy. The majority of  clients reported positive outcomes from the counselling they had received, and gratitude for the existence of the service(s). Central themes that occurred in the majority of cases included: interconnectedness between NHS provision and counselling, the positive qualities of the counselor, and the role of the agency as a stable and known presence within the community. Some clients reported that it would have been useful
to have received more information about what to expect, before commencing counselling. 

Research Limitations: This research was carried out on a relatively small sample of clients within a specific counselling agency. It is possible
that a wider sample, based in different settings, would yield other themes. 

Conclusions/Implications: The findings of this study have suggested that the meaning and value of counselling may not be captured in existing questionnaire outcome measures, and that further client-focused research is required. The study also uncovered several ways in which service delivery might be enhanced.

 
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Jonathan Lloyd

Professional Role: Professional Doctorate in Counselling student (Y5)
Institution/Affiliation: The University of Manchester
Contact details: Counselling Studies, The School of Education, Environment & Design, University of Manchester, Oxford Road, Manchester.
Email: jonathan@calmminds.com

ABSTRACT: poster                                                                                     

Keywords: metaphor, counselling, psychotherapy, hope

The experiences of therapists using metaphor in therapy

Aim/Purpose: To explore practitioners' perspectives on their experience of the use of metaphor in therapy.

Design/Methodology: In-depth face to face interviews were conducted with 7 therapists (counsellors and psychotherapists) in the UK for this Heuristic study. Ethical approval was obtained from The University of Manchester.

Results/Findings: The therapists experience of using metaphor in therapy involves a multi faceted web of involvement, depth, energy, humour, ego-states, ownership, efficacy, communication, measurement, embodiment, hope and power. Various levels of therapeutic metaphors were revealed in this study along with interesting examples of the use of metaphor in therapy. Therapist-generated metaphors were engaged with more by psychodynamic oriented therapists. Common themes of pervasiveness, hope and change were identified.

Research Limitations: The study focused only on practitioners' experiences and views, and is not from the client's perspective, and the sample size is relatively small.

Conclusions/Implications: The  findings  raise awareness  and  understanding of  helpful processes in the use of metaphors in therapy.

 

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Maggie Long

Other Authors: Dr Roger Manktelow and Dr Anne Tracey
Professional Role: Lecturer
Institution/Affiliation: University of Ulster
Contact details: School of Communication, University of Ulster, Jordanstown Campus, Shore Road, Newtownabbey, BT37 0QB.
Email: m.long@ulster.ac.uk 

ABSTRACT: paper                                                                                       

Keywords: qualitative, client perspectives, relationship, self-harm, healing 

"Knowing that I'm not alone": client perspectives on the role of the counselling relationship in overcoming self-harm 

Aim/Purpose: To explore client experiences of the counselling relationship in facilitating healing from self-harm. 

Design/Methodology: This qualitative study used semi-structured interviews to collect data from a purposive sample of counselling clients (n=10) who reported a history of self-harm. Participants were recruited through advertisements in community counselling agencies and a university in Northern Ireland. Ethical approval was granted from the University of Ulster Research Ethics Committee (UUREC). Data analysis was conducted using the major tenets of Grounded Theory and the analysis was facilitated with NVivo 9.0. Validation strategies including: negative case analysis;
clarifying researcher bias; member checking; and rich, thick description, were employed to ensure the trustworthiness and authenticity of the analysis process. 

Results/Findings: Four subcategories were created, pertaining to client perspectives of: (1) building trust in the seminal stages of the counselling relationship; (2) establishing human contact through the counselling relationship; (3) sharing a space wherein the problems that led them to self-harm could be confronted; and (4) experiences of counselling that were emotionally damaging. 

Research Limitations: Recruiting clients who were engaged in counselling at the time of research participation could have skewed the sample, because these participants may have been more likely to report positive experiences of counselling. Also it would have been useful to gain more insight into men's experiences, as males accounted for only two in the sample of ten.

Conclusions/Implications: Findings demonstrated that clients perceive the counselling relationship to be helpful when counsellors are willing to work with clients' underlying issues rather than focus primarily on stopping the self-harm behaviour. In addition, the option to provide longer term counselling for clients who self-harm, if required and choice regarding the type of counselling offered were core implications to emerge from the study.

 
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Jane Macaskie

Professional Role: Teaching fellow in counselling and psychotherapy
Institution/Affiliation: University of Leeds
Contact details: School of Healthcare, University of Leeds, Leeds LS2 9JT
Email: j.f.macaskie@leeds.ac.uk 

ABSTRACT: poster                                                                                       

Keywords: transformation, relational conversation, reflection, moments of meeting, impasse 

T and -T: transformation and impasse in professional contexts 

Aim/Purpose: The paper explores how transformation and its antithesis was experienced by research participants, different ways of understanding these experiences and the meanings attributed to them. 

Design/Methodology: Seven participants were interviewed twice, using adapted interpersonal process recall in the second conversation. Dialogical analysis was used to identify processes of connection, disconnection, integration and potential transformation. 

Results/Findings:

  • Transformational experiences arose in a variety of professional contexts including the research conversations. 
  • Contributing elements were connecting thinking and feeling, reflection within a relational matrix, leading to integration and potentially transformative action. 
  • The antithesis of transformation (-T) occurs in some professional contexts. 
  • -T closes down connections between thinking/feeling and self/other, leading to impasse. 
  • Transformational experiences are recognised by a feeling of wholeness/integration. 
  • They may promote freedom from rules or constraints. 
  • They may have a transpersonal dimension. 
  • Participants noted a reciprocal influence of personal and professional transformation.

Research Limitations: This was a small-scale study and the results cannot be generalised. Research conversations were analysed, so further
research is needed to analyse therapy dialogues. 

Conclusions/Implications: Reflection on emotional experience in dialogue promotes greater integration and capacity for transformative action including changes in self- acceptance and relational dynamics. A model of a therapeutic approach is proposed drawing on relational conversational processes. ‘Minus T' experiences are understood to arise intersubjectively. Their contributory elements of disconnection, polarisation, difficulty in thinking/feeling and non-recognition of self/other are similar to elements often associated with traumatic experience and/or personality disorders. A relational understanding of -T locates it in the dyad rather than the individual and so enables creative negotiation to transform impasse.

 
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Jonathan Ohrt, Lindsay Webster

Professional Role: Assistant Professor of Counseling
Institution/Affiliation: University of North Texas
Contact details: Department of Counseling and Higher Education, University of North Texas
Email: jonathan.ohrt@unt.edu

ABSTRACT: poster                                                                                       

Keywords: group leadership, counselor trainees, counselor education, supervision 

Group counselor reflections on training and experience: implications for group counsellor trainers and supervisors 

Aim/Purpose: Group counseling is a common modality that is used across various populations (i.e., children, adolescents, adults), within many settings (e.g., schools, community agencies, college counseling centers), and for multiple client concerns (Corey, Corey, & Corey, 2013). Although
effective methods for training individual counselors are often studied, less is known about group counsellor development. Multiple training models are proposed in the literature (Gladding, 2012); however, the empirical support for training methods is limited. Therefore, the purpose of this study was to explore group leaders' unique perceptions of their training and experience. 

Design/Methodology: We approached this study from a phenomenological perspective (Creswell, 2012). We contacted local area counselors in private  practice, schools, and community agencies via phone, email, and in-person, to invite them to participate. Twenty two practicing group counselors participated in individual, face-to-face, semi-structured interview that were audio-recorded and lasted between 45 minutes and one hour. Consistent with the phenomenological tradition, our purpose was to uncover the central underlying meaning of the leaders' experience by reducing
data, analyzing specific statements, searching for all possible meanings, and creating meaningunits (Moustakas, 1994). 

Results/Findings: We discovered themes that we grouped into two broad categories: (a) training influences, and (b) critical aspects. Training influences include the participants' beliefs about helpful aspects of their graduate training in group leadership. Within training influences, five main themes emerged: (a) practice, (b) observation, (c) supervision, (d) experiential participation, and (e) academic/instruction. Critical aspects encompass participants' perspectives about the most important aspects of group counseling. Within critical aspects, two themes emerged: (a) leader role, and (b) group process and dynamics. Multiple subthemes emerged within each primary theme for critical aspects. 

Research Limitations: Interviews were conducted with a small sample of  participants. Findings can't be generalized beyond our sample and may not be applicable to all counselor training programs. Specifically, the study included primarily white, female group counselors from the Southwestern United States. 

Conclusions/Implications: Group counsellor trainers may consider the following educational practices: (a) balancing content with experiential learning, (b) providing observation opportunities, (c) providing practice opportunities, (d) emphasizing supervision and feedback, and (e) focusing on leadership responsibilities as well as group dynamics.

 
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Jonathan Ohrt, Lindsay Webster

Professional Role: Assistant Professor of Counseling
Institution/Affiliation: University of North Texas
Contact details: Department of Counseling and Higher Education, University of North Texas
Email: jonathan.ohrt@unt.edu; Lindsay.webster@unt.edu 

ABSTRACT: paper                                                                                      

Keywords: group counseling, adolescents, self-regulation, self-esteem, learning competence 

The effects of a success skills group on adolescents' self-regulation, self-esteem, and learning competence 

Aim/Purpose: The purpose of this study is to evaluate the effects of a Student Success Skills ([SSS]; Brigman, Campbell, & Webb, 2010) group counseling curriculum on adolescent students' self-regulation, self-esteem, and competence for learning. The SSS curriculum consists of 8, 45-minute sessions and includes topics such as goal setting, social skills, problem-solving, team-work, managing attention, and motivation. Our specific research question was: Does an 8-week Student Success Skills curriculum improve adolescent students' self-esteem, self-regulatory skills, and competence for learning? 

Design/Methodology: In order to answer the research question we utilized a quasi- experimental (one-group, pretest-posttest) design. The dependent variables were measured prior to the intervention, during the intervention, and after the intervention. Twenty two students participated in the groups (three groups with 6-8 members). The adolescents completed three brief assessments: Rosenberg Self-Esteem Scale (Rosenberg, 1965), Adolescent Self-Regulatory Inventory ([ASRI; Moilanen, 2007), and the Perceived Competency Scale ([PCS]; Williams & Deci, 1996). 

Results/Findings: We analyzed the data using repeated-measures ANOVAs and visual data analysis. We found significant increases in self regulation and perceived competence for learning from pretest to posttest with a large effect size. However, the increases were not maintained at two-month follow-up. There were no changes in self-esteem. 

Research Limitations: The study included a small sample size and did not include a control group. The sample for this study is primarily male adolescent clients from two schools in the Southwest United States. Therefore, results may not be generalizable to other populations. 

Conclusions/Implications: Counselors may consider using the group curriculum for adolescents who struggle with self-regulation or perceived learning competence.

 
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Valerie Owen-Pugh

Other Author: Nick Jewson
Professional Role: Associate Tutor
Institution/Affiliation: University of Leicester
Email: vop1@le.ac.uk 

ABSTRACT: paper                                                                                      

Keywords: workplace learning, situated learning, communities of practice, counselling and psychotherapy, professional development 

Workplace learning among counsellors and psychotherapists: a qualitative study 

Aim/Purpose: This research was funded by BACP and designed as a precursor to a quantitative survey. It explored the opportunities for workplace
learning open to qualified counsellors and psychotherapists. 

Design/Methodology: Semi-structured interviews were carried out with a quota sample of 26 qualified practitioners varying in terms of level of experience and practice setting. Participants were invited to reflect on past and ongoing opportunities for professional learning. Transcripts were first interrogated for themes representing the participants' own understanding of their learning. Relevant academic literature was then interrogated for relevant theoretical constructs. These constructs were  subsequently integrated with the themes already identified and the resulting conceptual framework tested against the transcripts. This was a ‘researcher-led', ‘deductive', ‘theoretical' or ‘top-down' analysis, designed to provide a ‘detailed and nuanced account of a group of themes within the data' (Braun & Clarke, 2006, pp. 83-84). 

Results/Findings: Counselling is a ‘portfolio profession' characterised by a mosaic of work settings, modalities and career options. In different practice settings, practitioners faced contrasting learning barriers and opportunities. Our participants described the sometimes fragmented and opaque learning pathways that characterised their experiences of  paid employment, voluntary work and private practice. We identify ways in which professional networks and organisational ties in each of these three broad areas of work tend to lead therapists' learning trajectories in contrasting
directions. 

Research Limitations: The interview sample was relatively modest, although comparable with other research into workplace learning. 

Conclusions/Implications: We found there was much good practice to celebrate. However, we also identified significant areas of concern, such as blurred boundaries between supervision and line management, the transition from formal training into  practice, and professional isolation among some groups of  practitioners. We suggest ways in which counsellors could be supported to improve the effectiveness and reach of the learning environments they encounter at different stages in their careers. Suggestions include the continued development of local support networks and the improved sign-posting of learning pathways

 
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Glenys Parry

Other authors: Gillian Hardy, Michael Barkham, Gemma Kothari, Dave Saxon, Lindsey Bishop-Edwards, Rachel O'Hara, Joe Curran, Alexis Kilgarriff-Foster, Kim Dent-Brown, Mike Bradburn, Eleni Chambers
Professional role: Professor of Applied Psychological Therapies
Institution/Affiliation: Centre for Psychological Services Research, University of Sheffield
Email: g.d.parry@sheffield.ac.uk 

ABSTRACT: paper                                                                                       

Keywords: harm, adverse effects, failed therapy, mixed methods, service research 

When the special relationship goes wrong: headline results from a research project on understanding and preventing adverse effects of psychological therapy (AdEPT) 

Aim/Purpose: a) to use a range of research methods across four linked studies to understand the risk of psychological therapy causing harm and to determine the prevalence and causes of negative outcomes, b) to develop tools for clients and therapists to help in preventing harm. 

Design/Methodology: From an initial scoping review we developed recommendations for research, distinguishing between adverse events, adverse effects, deterioration and harm. A narrative synthesis of the qualitative research evidence developed a summary model of process factors potentially leading to adverse effects. A survey was then followed by a qualitative study of the experience of therapists and therapy recipients of failed therapy. Analysis of a large routine practice dataset used hierarchical linear modelling to explore prevalence and predictors of deterioration and drop out. Finally, data from RCTs, comparing a psychological treatment with a no-treatment control, were re-analysed to investigate risk of harm. 

Results/Findings: Eighteen themes were identified and elaborated from the therapist survey, including client factors, therapist competence, service pressures and constraints, and problems in the therapeutic relationship. In the CORE-OM dataset, the proportion of clients per therapist showing reliable deterioration ranged from 0.24% -15.8%; drop-out ranged from 0% to 71.2%. In the meta-analysis, we found no evidence that deterioration rates systematically differ between treatment and control groups. 

Research Limitations: The survey recruited an opportunity sample. Missing data at end of therapy in the CORE-OM dataset may produce an underestimate of deterioration. The meta- analysis was limited to 16 studies with access to full datasets. 

Conclusions/Implications: These strands of work are integrated in the final phase of the project; to develop clinically useful methods of fostering safer therapy, including a website for clients and therapists to access useful tools and information. Although meta-analysis suggests that therapy does not in general cause harm, the wide variation between sites and therapists is striking. It demands greater awareness of risk factors for deterioration or dropout, including service factors, e.g. caseloads, client complexity, which signal need for therapist support.

 
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Peter Pearce, Ros Sewell, Sarah Osman

Other Authors: Professor Mick Cooper, Andy Hill, Jo Pybis, Karen Cromarty
Professional Role: Head of Person-Centred Dept
Institution/Affiliation: Metanoia Institute
Email: peter.pearce@metanoia.ac.uk 

ABSTRACT: paper                                                 

Keywords: randomised controlled, school-based, person-centred, efficacy 

Outcomes of the Align project: a randomised controlled trial of school-based person- centred counselling 

Aim/Purpose: Summary findings for this pragmatic RCT will be presented along with a review of the researchers' experience of conducting an RCT in this area. 

Design/Methodology: A Randomised Controlled Trial. The principle experimental hypothesis is that, for young people experiencing emotional distress, weekly counselling will be more effective than waiting list conditions after one school term (12 weeks) and at 6 and 9 months follow up. After randomisation both intervention and waiting list control arms of the project receive YP-CORE, SDQ, RSEI and an Individualised Goal-based Outcome Record developed by CAMHS Outcome Research Consortium at 6 and 12 weeks and 6 and 9 months follow up. The study employed ‘blinding' in both assessment and ascertainment. Sessions were recorded and a random selection audited using the Person Centred and Experiential Psychotherapy Scale (PCEPS) scale to ensure adherence to the Skills for Health Humanistic Competency Framework. If the counselling intervention is associated with statistically significantly greater amounts of change than the control group, (who have access to all other initiatives within the school) it can then be claimed with some confidence, that it is the counselling intervention that is responsible for bringing about this effect. 

The study sample size is 60 students and reporting will follow,  ‘intention to treat' and CONSORT guidelines. 

Results/Findings: A statistically significant interaction between time point and intervention group was found for both YP-CORE and SEQ. Between participant t-tests showed a statistically significant difference at the end of intervention, time 3 (3 months). 

Research Limitations: The study takes place within naturalistic settings and maps onto the usual system for referral within school counselling services. The three participating schools were all inner city London schools in areas of very significant deprivation and cultural and religious diversity. Whilst the schools represented many of the challenges in this setting, individual schools can differ in the make-up of their institutional systems which could impact the generalizability of the results. 

Conclusions/Implications: This project will make a valuable contribution to evaluating the effectiveness of school-based, person-centred counselling and contribute to the development of a viable RCT methodology for person-centred and humanistic school-based research.

 
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Michael Pearson

Professional Role: Training Manager & Psychotherapist
Institution/Affiliation: Warwick University
Email: Michael.Pearson@warwick.ac.uk 

ABSTRACT: paper                                                                                       

Keywords: person-centred, dissociative identity disorder, psychological contact 

Person-centred therapists' psychological contact with clients diagnosed with Dissociative Identity Disorder (DID). What is it really like? 

Aim/Purpose: Research into person-centred work with clients diagnosed with dissociative identity disorder is scarce. Research into the relationship and the presence of psychological contact from the therapists' perspective is even scarcer. This study aims to give a qualitative representation of the experiential essence of psychological contact and how we can use this experience to enhance our practice with DID. 

Design/Methodology: An IPA research study was conducted, using structured and semi-structured interviewing techniques across a homogenous interviewee cohort of six person- centred therapists; all female, at the same agency and with similar exposure to working with DID, selected for their experiential expertise in the field. Thematic findings were extracted and a qualitative analysis conducted with the interview transcripts. 

Results/Findings: All interviewees expressed similar experiences of psychological contact when in therapy with clients diagnosed with DID. Findings indicate points in therapy when psychological contact can become weak and is prone to breaking and damaging the therapeutic relationship. It was identified that there is a dual experiencing of psychological contact; a need for it and a fear of it. All interviewees reported the necessity of trust in holding this contact. Findings have also shown a need for  soothing the experience of psychological contact in order to lower  levels of threat  and meet the clients' apparent yearning for it. A contact-threat cycle has been produced to depict the process. 

Research Limitations: Further research is needed to compare the experience of psychological contact amongst different cohorts. All clients discussed by therapists in this research have experienced sexual abuse, so a comparative study of clients with DID but with varied backgrounds would need to be conducted to understand the links with psychological contact. 

Conclusions/Implications: This project serves as an introductory understanding of the therapist experience of DID. Limited research leaves person-centred therapists often ill- equipped to face the complexities of such a relationship and the complexity of working towards the six conditions when sometimes those very conditions can threaten therapy. This identifies the need for adjusting the therapists' approach in practice in specific circumstances.

 
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Humera Quddoos

Professional Role: Psychotherapist in Private Practice
Institution/Affiliation: Psychosynthesis and Education Trust, London for MA thesis
Email: humeraq@yahoo.com 

ABSTRACT: paper                                                                                     

Keywords: endings, therapeutic relationship, boundaries, loss 

Therapist experiences of client endings 

Aim/Purpose: This qualitative research project addresses the question; "How do Psychosynthesis therapists understand their experience of endings with their clients?" 

Design/Methodology: An Interpretative Phenomenological Analysis (IPA),  methodology was applied to gathering data through semi structured, face to face interviews with five Psychosynthesis therapists who practiced long term, open ended psychotherapy. Therapists were recruited through a referral network of peers, supervisors and independent internet searches. All had a minimum of 500 hours of clinical experience with an average
length in practice of 14 years. The interviews were then subjected to IPA as outlined by Smith et al (2009). 

Results/Findings: Research found evidence that endings were experienced, thought about, and related to in a distinct way by therapists. Four overarching themes emerged within which the experience of therapist participants could be grouped: 

The Pre-ending Zone: a range of indicators related to personality integration were used by participants for assessing when an ending was approaching. In addition there was awareness that endings could be communicated through transference, counter transference and disturbances in boundary conditions. 

Multiplicity of Endings: the range of endings that can occur in practice could all be identified and named by participants. Unilateral, abrupt and traumatic endings were understood within an object relations and attachment theory frame and focused on clients' resistance, avoidance and traumatic re-enactment 

The Ending Itself: the end stage of therapy was found to be discrete with its' own operational parameters. In relation to ending these affect; session content, the relational dynamic and therapeutic container boundaries. 

Therapists Response to Endings: therapists do remember, forget and miss clients. Who is remembered, forgotten and missed is dependent on the quality of the relationship that existed between client and therapist, those that frustrated as well as those that gratified stay with therapists.

Research Limitations: This is a small, scale study that does not address time limited, therapeutic contracts such as those practiced within the NHS, or by EAP's.

Conclusions/Implications: The loss metaphor for endings is critically evaluated and a case made for this to be updated and for therapists to understand the multiple tasks involved in making an effective ending to the therapeutic relationship.

 
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Stephanie Revell

Other Author: Elaine Duncan, Christina Knussen and Joe Hinds
Professional Role: Lecturer
Institution/Affiliation: University of Cumbria
Contact details: University of Cumbria, Room 12 Melling, Bowerham Road, Lancaster LA1 3JD
Email: Stephanie.revell@cumbria.ac.uk

ABSTRACT: paper                                                                                    

Keywords: walk and talk therapy, helpful, hindering, walking, therapeutic relationship

Therapists' experiences of integrating walk and talk therapy into professional practice 

Aim/Purpose: Initial desk research indicates there are a growing number of therapists within the UK who currently offer walk and talk therapy as part of their therapy practice. The aim of this study was to systematically investigate the provision, helpful and hindering aspects, and theoretical foundations of walk and talk therapy practice in the UK.

Design/Methodology: An on-line survey was conducted, consisting of closed and open- ended questions and was followed-up with self selected semi-structured interviews. Purposeful sampling of walk and talk therapists resulted in 18 survey responses and seven follow up interviews via Skype or  telephone. Thematic analysis was conducted on the qualitative data whilst the quantitative data was analysed using descriptive statistics.

Results/Findings: Initial findings indicate there is an impact upon the dynamics of the therapeutic relationship within walk and talk therapy sessions. Main themes include being in an outdoor setting, movement associated with walking and use of metaphor. Limitations of the utility of walk and talk include weather, setting and client perceptions. 

Research Limitations: Only therapists perceptions were gained and the small sample population limits generalizability. 

Conclusions/Implications: Initial conclusions indicate the use of walk and talk therapy within a therapeutic relationship can be potentially beneficial for both therapist and client. However, there are important considerations to be attended to prior to incorporating this way of working within a therapeutic relationship and the development of this practice would benefit from further exploration into best practice models.

 
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Martin Rigby

Professional Role: MSC student, Counsellor (Private Practice)
Institution/Affiliation: University of Central Lancashire
Contact details: Martin Rigby, c/o Galloways Society for the Blind, Howick House, Howick Park Avenue, Penwortham, Preston, PR1 0LS
Email: martinrigby103@btinternet.com 

ABSTRACT: paper                                                                                     

Keywords: counselling training, visually impaired, inclusion and exclusion, interpretative phenomenological analysis

The experiences of visually impaired counsellors and psychotherapists in training

Aim/Purpose: Despite recent legislation (Disability Discrimination Act 1995/Equality Act 2010), claims in the literature suggest therapists aren't immune to holding disabilist attitudes and that oppression exists within the counselling room/training environments.

This qualitative study looked to identify the needs visually impaired therapists have from training, exploring how they feel included and excluded and inviting interviewees to recommend improvements to therapy training. The overall purpose of the research was to make recommendations to raise awareness amongst practitioners, placement providers, educators, supervisors and tutors about the needs and experiences of visually impaired trainees. 

Design/Methodology: Interpretative Phenomenological Analysis was used to capture lived experience. Purposive sampling included nine participants (8 females and 1 male). All participants were visually impaired (blind/partially sighted), varied in their age, gender, ethnicity, location
and training. Digitally recorded, semi-structured interviews were conducted face-to-face and by telephone, transcribed and analysed by the researcher. Informed consent was obtained from participants and confidentiality ensured. Ethical approval was granted from University of Central Lancashire. 

Results/Findings: Trainees' experiences of exclusion will be presented including institutional barriers, the need for better communication and adapting teaching and learning methods, feelings of low self-esteem and rejection, tutors' negative attitudes and trainees' need to be treated and seen as a whole person. 

Conversely, participants' experiences of  inclusion will then be discussed including peer helpfulness, feeling understood and belonging, positive feedback, recognition of abilities and experiencing a non-judgemental attitude. 

Research Limitations: Generalisability of findings may not be possible due to small sample and potential for bias exists due to researcher's strong identification with interviewees. 

Conclusions/Implications: The sample of visually impaired therapists reported mixed experiences of inclusion and exclusion during training, describing feelings ranging from resignation to resolve. The research findings support the view that change may still be required concerning how difference and diversity issues are covered on training courses. During interviews participants were asked for their recommendations about how therapy training could be made more inclusive for visually impaired people. These recommendations, along with some very thought provoking literature findings, will be discussed at this year's conference.

 
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Jack Rochon

Professional Role: Lecturer in Counselling
Institution/Affiliation: University of South Wales
Email: Jack.Rochon@southwales.ac.uk

ABSTRACT: poster                                                                                   

Keywords: benefits, collaborative, ethical risk, participative, protocols

Who's afraid of the big bad wolf? An exploration of the benefits and risks of collaborative research within single case study practice

Aims/Purpose: This paper explores the tensions and benefits of existing collaborative or participative single case study research, in which editorial control is shared. This paper considers these and other  ethical dimensions while attempting to ask why client  voice remains so little represented in qualitative counselling research. The following specific questions under consideration are... 

-      What are the potential benefits of participative research?
-      What are the risks to clients and others?
-      How desirable is it for counselling to revisit this approach to research? 

Design/Methodology: My on-going doctoral research draws heavily on the experience of a single client case study. The client in question is part of a phenomenological and intersubjective methodology in which editorial control and other creative research processes are shared.  To date the project has not been without risks to the original therapeutic counselling work. The client has been clear about her need for therapeutically grounded boundaries to be maintained throughout the process. 

Results/Findings: Findings include the perception that risk to the original therapeutic gains need to be rigorously contained, principally through negotiated protocols. Unfiltered client experience is also revealed in complex and surprising ways that appear to provide opportunities for autonomy and agency to both participants. A groundswell of current interpretation of ethical tensions and risks in this area,  particularly by supervisors and academics, may in part have driven collaborative research and any perceived benefits to unregulated margins within the field. 

Research Limitations: Many limitations of collaborative research are evident. There is too much data or ‘lived experience' for easy analysis and this may be exacerbated by the collaborative approach. These phenomenological methods produce a complex picture that is difficult to represent simply and thus the ‘results' do not lend themselves to numerical representation. 

Conclusions/Implications: A thematic conclusion is that little current collaborative counselling research is being undertaken. This raises the question of why, and whether, perceived risks to professional stakeholders may currently be outweighing notions of benefit to client, self or associated groups.

 
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Jeannette Roddy

Professional Role: PhD Student
Institution/Affiliation: York St. John University; University of Hull
Email: j.roddy@yorksj.ac.uk; j.roddy@hull.ac.uk 

ABSTRACT: paper                                                                                    

Keywords: domestic violence, hope, trust, client-based research, grounded theory 

Foundations for domestic violence counselling: trust and hope 

Aim/Purpose: This research investigated the client perception of domestic violence counselling, identifying factors which supported or undermined the process. 

Design/Methodology: In this qualitative PhD study, four separate domestic violence agencies each recruited at least four participants who had received counselling after suffering domestic violence. Participants (male and female) worked with therapists from a range of theoretical backgrounds and were interviewed 3-18 months after counselling had finished. They varied in age and in economic and social backgrounds. Ethical approval was given by York St. John University and by each of the agencies prior to commencing the research. This approval included the provision by the agency of additional counselling to participants should it be required. Semi-structured interviews were conducted and then transcribed and analysed using an adapted grounded theory  methodology. Participants could choose to participate in reviewing and providing feedback on the research outcomes. One in six of the interviews were independently reviewed to check for bias in analysis. 

Results/Findings: Experiencing domestic violence can result in feelings of significant distress and hopelessness and a lack of trust in others, which can make it difficult to engage with counselling. This research showed that building sufficient trust for counselling  to develop successfully came from  factors both inside and outside the counselling room. Different types of trust were developed during counselling and factors which supported this process were identified. The restoration of hope in participants' lives was a significant outcome. Hope could also be seen to appear prior to beginning counselling, before being developed and expanded during therapy. These two factors, hope and trust, provided a therapeutic foundation which could withstand relational difficulties during counselling. 

Research Limitations: This was a small, qualitative study and all of the participants were of white, European descent. This will limit the generalisation of the findings. 

Conclusions/Implications: This research identified several constructs of trust and hope which can be consciously and beneficially integrated into counselling practice for this client group. External factors are also significant and can be constructively addressed.

 
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Maria Rogerson

Other Author: Dr Clare Green
Professional Role: MA student
Institution/Affiliation: University of Leicester
Email: mjr52@student.le.ac.uk 

ABSTRACT: poster                                                                                       

Keywords: somatisation, psychodynamic counsellors, interpretative phenomenological analysis (IPA), challenges, opportunities 

Working with clients who somatise - the challenges and opportunities identified by psychodynamic therapists 

Aim/Purpose: The aim of this study is to explore the challenges and opportunities experienced by psychodynamic counsellors/psychotherapists working with clients who somatise, including the way in which these factors impact  on the therapy relationship, understanding of clients' difficulties and therapeutic process. 

Patients who somatise are frequently considered demanding and meet with negative response from practitioners. Psychological therapists also find it challenging to work with patients who somatise due to the frequent expression of  concrete, symptom-orientated language and the apparent absence of psychological reflections (Luca 2009). 

Design/Methodology: This qualitative study is approached from a phenomenological perspective, capturing participants' first-hand ‘lived' experience of the phenomenon under study. Participants are self-selected, in response to advertisements publicised through psychotherapy organisations. The research uses in-depth, face-to-face, semi-structured interviews with up to 12 experienced psychodynamic counsellors. Themes are identified using interpretative phenomenological analysis (IPA) of transcripts. Ethical approval has been obtained from the University of Leicester. 

Results/Findings: Initial findings suggest that participants note a significant impact on the therapist and the therapeutic process, especially regarding transference issues. Concern is raised about labelling patients who somatise and its potential to hinder conceptualisation and intervention. A body-mind engagement with clients appears to enhance therapeutic outcomes. 

Research Limitations: The study focuses on psychodynamic counsellors, so contributions of counsellors from other orientations are not explored. 

Conclusions/Implications: In exploring psychodynamic counsellors' experiences when working with clients who somatise, it is anticipated that that the emerging detail and depth in the findings will enhance practitioners' understanding of difficulties as well as opportunities when working with these clients, thereby contributing to more effective practice and positive outcomes with this client group.

 
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Alistair Ross

Professional Role: Director of Psychodynamic Studies
Institution/Affiliation: Oxford University
Email: Alistair.ross@kellogg.ox.ac.uk 

ABSTRACT: workshop                                                                                

Keywords: research ethics, trainees, reflective practice 

‘Research ethics' a relational approach 

Relevance of the workshop to counselling and psychotherapy research: This workshop will explore how research ethics are central to and enhance good research. Rather than being seen as a hurdle to be overcome or an administrative process one needs to go through, the workshop will focus on a relational understanding of research ethics. 

The aims of the workshop:
1.  Provide a structured context to examine existing practice around research ethics
2.  Offer a fresh philosophical perspective drawn from Levinas for orientating research and relational ethics
3.  Develop the practice of a reflective space for ethics in research 

How the workshop will be structured:
1.  A short presentation based on a small research study drawn from trainee therapists about their understanding and needs around research ethics. This will be followed by small group discussion in order to learn about participants existing practice and needs, leading to large group feedback.
2.  A second short plenary input outlining the ethical perspective of Levinas and the development of relational ethics, followed by small group discussion exploring the relational approaches used by participants.
3.  A third reflective space will be offered that allows participants to explore and bring their own questions to the workshop. This models a Levinasian relational approach of valuing the Other.

Key points for discussion:
How is research ethics understood?
How do research ethics links to ethical practice and the Ethical Framework?
How do we view the ‘Other' we are researching?
Why a relational dimension to research ethics is important Developing reflective practice 

Who will benefit from attending the workshop? Any researcher, but especially students or new researchers, could benefit from attending the workshop through the opportunity for a fresh examination of their ethical practice. The workshop will offer learning from others through the research project, learning through a new way of seeing the Other in research and the experience of a reflective space.

 
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Alison Rouse

Professional Role: Counsellor, part-time lecturer
Institution: University of Abertay
Email: a.rouse@abertay.ac.uk

ABSTRACT: paper                                                                                     

Keywords: attunement, creativity, integrated experience, intuition, relational depth, transformation

Enabling connections: counsellor creativity and the therapeutic relationship

Aim/Purpose: To gain a deeper understanding of ‘creativity' within the context of counselling, and in particular how the personal creativity of counsellors informs their professional work with clients.

Design/Methodology: This was a qualitative study which used grounded theory methodology alongside arts-based research methods. 10 experienced counsellors of various theoretical orientations, who met the selection criteria of at least 5 years post qualification practice and an active involvement in some form of expressive art (visual, drama, writing, music) were recruited for the study by a combination of convenience sampling and snowballing methods. They took part in two semi-structured interviews on the role of creativity in their counselling practice, prior to and following an experiential creative task. For the task they were asked to represent what creativity meant to them and to keep a reflective log for the duration of the process.

Results/Findings: Creativity was seen by participants as important in therapeutic work. In both art and counselling, creativity was understood as a relational process, necessary for moment-by-moment responsiveness. It was found to be concerned with establishing meaning and coherence; integrating different forms of ‘experience' and to be transformational, linked closely to self and identity. Counsellors' personal creativity was understood to foster professional creativity, and to deepen capacities to work with clients, in part through the interconnection between creative expression and self-awareness. Therapeutic connections were also seen to be enhanced by qualities and abilities they had developed as artists.

Research Limitations: The study was based on a particular group of participants, for whom ‘creativity' was a key part of their identity and practice. The findings may have been different if participants had not placed such a high value upon creativity. More research is needed to embed research within the actual ‘experience' of creative moments in the counselling process and to understand this from both the perspective of the counsellor and the client.

Conclusions/Implications: The study highlights the value of enhancing counsellors' understanding of, and confidence in, working creatively alongside a solid knowledge and experience base. Implications for training are also considered.

 
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Gail Simon

Professional Role: Principal Lecturer in Systemic Practice
Institution/Affiliation: University of Bedfordshire
Email: gail.simon@beds.ac.uk

ABSTRACT: methodological innovation paper                                         

Keywords: relational ethnography, counselling, writing, relational, reflexivity

Relational ethnography: writing and reading in and about research relationships

Background and introduction: Writing as a practitioner-researcher within the field of relationally focused therapy, I am concerned to use a method of inquiry which echoes the ethics and practices of teaching, supervising and counselling. It is important for me to allow readers to hear/feel the sound of talk from within counselling and research relationships and from within the reflexive inner dialogue of the therapist. My doctoral research committed to finding ways of writing from within relationships rather than about others to avoid objectifying people with whom I work. Understanding writing and reading as dialogical activities inspired me to find ways of responding to other writers as dialogical partners.

Nature of the methodological innovation/critique being proposed: Relational ethnography studies inner and outer workings of relationships, offering detailed, transparent and subjective rendering of thoughts and embodied responses to make connections between our inner and outer dialogue. Using reflexive dialogical writing as a method of inquiry (Richardson, 2000; Simon, 2012)  generates new understanding of the complex workings within therapeutic relationships. This methodological development in the field of ethnography re-describes autoethnography (Ellis, 2004, 2009) as a relational activity and borrows creative techniques from performance ethnography (Denzin, 2003). Relational ethnography arises out of the post-positivist movement of Qualitative Inquiry (Denzin & Lincoln 1994, 2000, 2005, 2010) and draws on the work of Systemic Therapy (Cecchin 1987), Narrative Therapy (White & Epston 2000) and Collaborative Therapy (Anderson 1997) and the philosophy of dialogue (Bakhtin, 1986; Shotter, 2011; Wittgenstein, 1953).

Conclusion and relevance to counselling and psychotherapy research practice: Relational ethnography foregrounds ethical aspects of research relationships with practical suggestions. Reflexive writing of inner and outer dialogue produces learning about therapeutic activity, dilemmas and choices as well as creating opportunities for collaborative meaning-making in the therapeutic relationship. Reflexivity is portrayed as a relational process which strengthens awareness of relational ethics. As guiding principles for practitioner research, relational ethnography promotes not only an ethics of care but an aesthetics of care. Writing in the first person, as a reflexive relationally oriented inquirer, allows for new knowledge to emerge and enhances the relational and aesthetic quality of research writing. Practitioner-researchers are urged to develop methods of inquiry which are coherent with the values and practices of their profession.

 
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Joan Shearer

Professional Role: MSc student / counsellor
Institution/Affiliation: University of Strathclyde
Email: jshearer26@ntlworld.com

ABSTRACT: poster                                                                                   

Keywords: client factors, social anxiety, person-centred/experiential therapy, client experience, qualitative research

Socially anxious clients' views of their contributions to therapy

Aim/Purpose: The aim of this study is to investigate the nature of the client factors, both personal and environmental, that socially anxious clients report as either helpful or hindering to their making use of person-centred/experiential therapy.

Design/Methodology: Using data from the Social Anxiety Project at the University of Strathclyde, clients' experiences as reported in the semi-structured client Change Interview were analysed qualitatively using grounded theory analysis. Forty-five clients (who responded to adverts for a research study of specialised counselling for social anxiety) participated in time-limited therapy for social anxiety and received either person-centred or emotion-focused therapy; all available data were analysed.

Results/Findings: Results from the first 15 clients have identified key facilitative self attributes of motivation, persistence and the ability to be open; both about self and openness to new ideas and ways of working in therapy. Key environmental facilitative factors emerging are supportive relationships and an absence of hindering circumstances. The negative results are thinner but mirror these results, pointing to the counter-therapeutic role of relationships and life situations.

Research Limitations: Questions about client factors are only small part of a much larger interview, which diluted the attention given to this specific question. In addition, some of the researchers were inexperienced interviewers and thus failed to question clients sufficiently. This method also suffers from limitations typical of client self-report, such as client attribution errors and inability of the client to identify and express their own contributions.

Conclusions/Implications: Client factors have been studied for 60 years, with no wide- ranging or conclusive results emerging from this work to date. To remedy this situation, this study has taken a different stance: asking clients themselves what they bring to the therapy process. Client factors research moves beyond DSM diagnosis, identifying other relevant client characteristics that may support matching of a client to a specific therapy. In addition, identifying resources that support clients in their use of therapy may allow resource-oriented therapists to be more responsive to individual clients and to foster those resources.

 
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Vicki Smith

Professional Role: Senior Lecturer in Counselling Studies
Institution/Affiliation: University of Huddersfield
Contact details: Department of Behavioural and Social Sciences, Queensgate, Huddersfield, HD1 3DH.
Email: v.smith@hud.ac.uk

ABSTRACT: paper

Keywords: therapeutic relationship, existential, relatedness, authenticity, practice

The power of relational work in existential therapy

Aim/Purpose: This paper aims to present some preliminary findings from a PhD research study focusing on how existential therapists define and convey their role as therapists, with a particular emphasis on the therapeutic relationship. According to Spinelli (2007) one of the key underlying principles of existential therapy is relatedness, such that we can only make sense of ourselves through our relationships with others and the meanings that emerge between people. This paper aims to focus on how existential therapists conceptualise and use relatedness in their work with clients.

Design/Methodology: Thirty UK existential therapists with entries on professional body websites were contacted by email. One man and four women agreed to participate and were interviewed using semi-structured interviews. Following transcription, the data was analysed using thematic analysis (Braun and Clarke, 2006) leading to identification of some initial themes focusing on aspects of the therapeutic relationship.

Results/Findings: All therapists emphasised working relationally and made insightful connections between philosophical concepts such as ‘authenticity' and ‘not knowing' and rich examples of how such concepts can influence practice. This included sharing with the client what was going on between them ‘in the room', which was regarded as one of the most powerful tools of therapy. Overall, the research concluded that the participants share a common and distinct vision in terms of working relationally, which, whilst recognised as one of the most challenging aspects of the therapeutic endeavour, may dramatically enhance the psychological growth of both client and therapist.

Research Limitations: The data discussed is based on preliminary findings during the initial phase of a PhD research project. The sample is small at this stage; further data will be collected as the project continues.

Conclusions/Implications: The findings suggest that existential therapists regard working relationally, in an existential sense, as a powerful tool central to their therapeutic practice. Although it is too early to identify specific implications for practice, this paper will also argue that existential relatedness could potentially enhance therapists' professional practice and development.

 
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Simon Spence

Professional Role: Counsellor
Institution/Affiliation: Highland Hospice
Contact details: Highland Hospice, Ness House, Bishops Road, Inverness, IV3 5SB, Scotland
Email: s.spence@highlandhospice.org.uk

ABSTRACT: paper                                                                                    

Keywords: bereavement, counselling, counsellors' experience, grief, person-centred

Person-centred counsellors' experiences of working with bereaved clients

Aim/Purpose: Empirically-based literature relating to person-centred work with bereaved people is conspicuous by its absence. This qualitative study aims to discover more about the experiences of person-centred practitioners in this area. It explores how they conceptualise their work, practice issues of importance to them, what use they make of person-centred and/or other theory, and other factors experienced as particularly significant.

Design/Methodology: Approval was given by Strathclyde University Ethics Committee. Ten participants were selected purposively, having substantial training in person-centred psychotherapeutic practice and in the bereavement field. Semi-structured interviews generated the transcribed texts from which, using a broadly phenomenological and person- centred research approach, commonalities were identified before being structured into themes and categories. These were reviewed for validity by participants and research colleagues.

Results/Findings: Person-centred practitioners are aware of and respond to a wide variety of perspectives on, and therapeutic responses to grieving. They aim to work in holistic, responsive, and highly individualised ways. The resulting variety is viewed not as eclecticism or integrative practice, but as an ever-deepening understanding of person-centred work based on relational factors and client experience and preference. In  addition to non- directivity and the active facilitation of client self-agency, participants describe the importance of encounter, of openness to the unknown, and of working in ways which cannot be prescribed in advance. Attention is also paid to practitioner self-care when engaged with the human and existential suffering inherent in grief.

Research Limitations: This is a small-scale study. It may raise and clarify valid and important issues but it cannot, and is not intended to demonstrate generalisable truths. The study does not directly explore the experience of clients.

Conclusions/Implications: The study adds to the body of knowledge and may prompt research and debate in a neglected area. There may be implications for the understanding of pluralism within the person-centred approach, and also for the approach's articulation with wider theoretical and practice developments in the bereavement field.

 
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Lesley Spencer, Els van Ooijen

Professional Role: Senior Lecturer in Counselling
Institution/Affiliation: University of South Wales
Contact details: University of South Wales, Caerleon Campus, Caerleon, Newport NP18 3QT
Email: Lesley.Spencer@southwales.ac.uk

ABSTRACT: paper                                                                                     

Keywords: supervision, training, counselling, psychotherapy, practice

Supervision training and its effect on practice

Aim/Purpose: Since supervision is regarded as mandatory for counsellors and psychotherapists, adequate preparation for the role of supervisor is essential. Despite a significant increase in the number  of supervision courses in recent  decades,  however, research into the effectiveness of such training is scant.

The aim for this qualitative study was to explore students' perceptions of an established postgraduate diploma course in consultative supervision. In this paper we discuss interim results of a study carried out by the two tutors with the most recent cohort.

The research question was: ‘What are the effects of supervision training on new and established supervisors in terms of how they conduct their supervision practice?'

Design/Methodology: Fourteen students consented to have data collected from six non- assessed written ‘end of teaching unit' structured reflections that invited them to examine how the training had impacted on their supervision practice. The anonimised data was analysed independently by both researchers using thematic content analysis (Burnard et al, 2008). The results were sent to students for comment. In a second phase of the study, six months after completing the course, the same students will be invited to participate in a focus group, to triangulate the data and establish whether changes initiated by the training are being integrated into their ongoing practice.

Results/Findings: The findings indicate that students reflected both on the impact of the course on their supervision experience, and on how it affects their counselling/psychotherapy practice. Other interim findings include: the use of models provides more focus for their supervision sessions; students become more aware of the influence of the organisational context within which they practise; awareness of how differences of culture, gender, class, etc. can surface in the supervision triad (Lago, 2006).

Research Limitations: Small sample size. In course work students may write what they think tutors want to hear.

Conclusions/Implications: Overall the results suggest that supervision training provides an excellent opportunity for experienced practitioners to reflect on their development to date, with positive effects on all their practice. Further research is required to ascertain whether these results pertain across different types of supervision training.

 
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Donatella Spinelli-Coleman

Other Author: Dr. Valerie Owen-Pugh
Professional Role: Student, MA in Psychodynamic Counselling and Psychotherapy
Institution/Affiliation: Institute of Lifelong Learning. University of Leicester

ABSTRACT: poster                                                                                     

Keywords: dreams, novice therapists, interpretation, therapeutic relationship, insight

‘I have a dream...': Novice and trainee therapists' experience of the client's communication of dreams in therapy: a phenomenological study

Aim/Purpose: The purpose of this research is to understand how trainee and novice psychodynamic therapists experience their clients' communication of dreams in therapy, presupposing that variations in experience and training might affect the therapists' response, their perception of the effect the dream has on the session quality, their self-esteem and their ability to interpret or explore the communication embedded in the dream.

Design/Methodology: Grounded on a phenomenological epistemology this research is a qualitative study, complemented by Interpretative Phenomenological Analysis (IPA) as a method of data analysis. It is based on the analysis of a maximum of 12 semi-structured interviews of 45-50 minutes.

Results/Findings: Preliminary results suggest that the dream attracts metaphors of movement (entering, going there, being transported), passage (door, way in) and vision (illuminating, window, helping to see).  An attitude of  reverence and fear  is frequent  in trainees' and in novices' memory of early situations where ‘feeling unprepared', ‘panicking about having to interpret', and ‘fearing being trapped' are recurring categories. There is a ‘valuing of the dream', not necessarily related to its interpretation, with subcategories describing its ‘intimate' nature and its role in ‘strengthening the therapeutic relationship' as intrinsic characteristics.

Research Limitations: The research is based on a very detailed analysis of data collected from the interviewing of 10-12 participants. The choice of a small sample is consistent with IPA's commitment to a ‘detailed interpretative account of the cases included' (Smith 2008) but it will also limit the possibility of generalising the findings.  This must  therefore be considered a pilot study into this specific area of research.

Conclusions/Implications: Variation in the therapists' response to clients' dream, if related to training, would be supportive of the inclusion of specific pedagogical interventions, aimed at equipping newly trained practitioners with the basic skills which will enable them to support their client in gaining the insight  and deeper  self-knowledge that  (as evidence sustains) is obtainable from dream analysis.

 
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Sheila Spong

Other Author: Rachel Waters
Professional Role: Senior Lecturer/ Research Manager
Institution/Affiliation: Newport Community Counselling Service, University of South Wales
Email: sheila.spong@southwales.ac.uk

ABSTRACT: methodological innovation paper                                          

Keywords: community participatory research, carers, counselling research clinic

Developing a community participatory research project with carers in a counselling research clinic

Background and introduction: This paper describes an adaptation of Cargo and Mercer's (2008) framework for community participatory research (CPR) to create a model to use at the Newport Community Counselling Service (NCCS). It describes the particular difficulties and advantages of this approach in counselling research, with examples from a project about carers' expectations of counselling.

Nature of the methodological innovation/critique being proposed: This approach to research explicitly focuses on collaboration with local community partners, including relevant agencies in the voluntary and statutory sectors, and members of the local communities potentially impacted by the research projects' outcomes.  The research team is embedded in a service based at the University of South Wales,  which is funded to provide no-cost counselling in association with community agencies, offer placements to counselling students and to undertake counselling research. The research approach is therefore designed to be consistent with the community engagement focus of the service provision and includes the development of small scale studies in collaboration with community partners on an equitable basis. The research focus and method for each project are chosen collaboratively, and findings will be disseminated to and through community partners as well as through more traditional academic routes.

This model for community participatory research in counselling identifies key factors to be addressed at each stage of the research process when identifying the respective roles of the University and community partners. Explicit attention is paid to the contextual and ethical issues of research into counselling, the value-base of participatory research, and respecting the priorities and constraints of all research partners. The initial project undertaken using this model involves developing a research collaboration with local carers, ex-carers and carers support networks to define a research question and implement a small scale qualitative study of carers expectations of counselling.

The model of community participatory research in counselling is at an exploratory stage, and the first studies reported here are small in scale.

Conclusions/Implications: Adopting a community participatory model in counselling research can add an additional dimension to developing knowledge about practice, though there are significant costs  and limitations involved.

 
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Faith Stafford

Professional Role: Counsellor/psychotherapist, Supervisor, Trainer, Coach. Director of Services for Ubuntu Counselling Services
Institution/Affiliation: Private Practice
Contact details: Ubuntu Counselling Services, c/o CVS, Wat Tyler House, Exeter EX4 6PD
Email: faith@faithstafford.co.uk

ABSTRACT: paper                                                                                     

Keywords: archetypes, heroes, scapegoats, self, self-actualisation

The role of the hero archetype in the journey towards self-actualisation/individuation

Aim/Purpose: To discover, as part of a PhD, the role of the hero archetype in successful therapy. The research aimed to identify if successful therapy put clients in touch with their own heroic tendencies.

Design/Methodology: A qualitative study was designed, using semi-structured interviews. An invitation to 53 contacts and colleagues in search of participants who had had a successful experience of therapy, produced 16 responses. 13 interviews were held, nine of which were analysed. A form of Narrative Analysis was used to discover what changes had taken place as a result of therapy. The study sought to identify how the change had taken place and to investigate the role of the hero archetype. The University Ethics Committee approved the research.

Results/Findings: Findings were that successful therapy made a significant difference to the interviewees' stories of the Self and had an ongoing impact on the way they lived their lives. The results in this study confirmed that successful therapy puts clients in touch with their own heroic tendencies. Clients had experienced different types of therapy but the outcomes had been the same.

Research Limitations: This was a small sample and generalisabilty cannot be claimed. To help manage bias, interviewees were not told of the significance of the archetypes within the study. The limits of the thesis prevented exploration of the scapegoat archetype to the same depth.

Conclusions/Implications: The study confirmed the significance of the archetypes in the stories we tell in order to give meaning to our lives. Practitioners would benefit from an understanding of the role of therapists in reframing clients' stories in ways that enable clients to be in touch with their own heroic tendencies. There was resonance with the thinking of a number of authors on the societal role of therapy. An awareness of how people can be empowered in this way could be beneficial in areas such as Education and government.

 
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John T. Super

Professional Role: Post-Doctoral Associate
Institution/Affiliation: University of Central Florida
Contact details: College of Education and Human Performance, University of Central Florida, Orlando FL 32816 USA
Email: johntsuper@gmail.com

ABSTRACT: paper                                                                                     

Keywords: counselor self-efficacy, counselor-in-training, technology, heirarchical linear modeling, anxiety

A study in using technology to increase counselor self-efficacy during the first semester of practicum for counselors-in-training (CIT)

Aim/Purpose: Exploring the effect of discussion boards and counseling skills modeling videos with CITs on the levels of counselor self-efficacy, anxiety and treatment outcomes.

Design/Methodology: A quasi-experimental research design examined the difference between an experimental and comparison group with repeated measures. The treatment group accessed the technology interventions and the comparison group did not. The particpants received three assessments and the data analysed using heirarchical linear modeling. The results were  cross-analyzed with a  mixed, between and within subjects ANOVA.

The sample was purposive in that  the sample included CITs in their first semester of practicum at a university in the southeastern United States. The sample (N = 32) consisted of students from eight practicums that were divided into an experimental group (n = 16) and a comparison group (n = 16). Although larger sample sizes are suggested for experimental research, studies with as few as 15 members per group can be effective if the conditions are controlled as in this study.

This study used three instruments to assess the constructs. The instruments used were: (a) the Counselor Self-Efficacy Scale, (b) the State-Trait Anxiety Inventory, and the (c) Outcome Questionnaire-45.2.

Results/Findings: Results of the analysis showed the intervention produced significant results in the development of counselor self-efficacy, mixed results on the reduction of anxiety in counselors-in-training and did not have an effect on treatment outcomes.

Research Limitations: The study was conducted during one semester at a one university and using the students in eight practicums that limited the number of participants. Additionally, during this period, historically events (e.g. holidays, power outages) impacted the study. Finally, using a quasi-experimental design limited the randomization of participants.

Conclusions/Implications: The indicate the use of media and discussion forums during the transition from foundation knowledge to clinical skills is beneficial to the development of counselor self-efficacy, is inconclusive on controlling anxiety during this period and does not affect treatment outcome.

 
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Rachel Taylor

Other Author: Professor Sue Wheeler
Professional Role: Counsellor
Institution/Affiliation: University of Leicester
Email: rachel.feaver@gmail.com; RST12@le.ac.uk

ABSTRACT: paper                                                                                    

Keywords: shame, therapy, qualitative, non-disclosure, countertransference

From avoidance to light-bulb moments - therapists' conceptualisations of shame

Aim/Purpose: This qualitative study sought to explore therapists' conceptualisation of shame in the therapy room with clients, and in supervision. When shamed we suffer hidden turmoil (Mollon, 2002), loneliness, abandonment and isolation (Morrison, 1989); we are "seen in a way we would prefer not to be" (Klinger et al, 2012) and we attempt to avoid and conceal this perceived "defect in our core being" (Morrison, 1988).

Design/Methodology: An on-line questionnaire collected details of therapist's shameful events in the room with clients, and therapists' subsequent experiences of the same event in supervision. Twenty-seven (27) completed on-line questionnaires and responses underwent thematic analysis.

Results/Findings: Three superordinate themes emerged from the body of qualitative data:

"A cracked container" - Therapists felt shame and discomfort when they were unable practically, emotionally or psychotherapeutically to ‘be' there for their clients, or when their credentials as a therapist felt questioned.

"Exposure: A quest for avoidance" - at times, to avoid the discomfort associated with shame, therapist client and supervisor colluded in unison or as a dyad, to avoid its discussion.

"A safe, enlightening space" - Both therapy and supervision were felt to be enlightening spaces on the occasions when shame was given space for thought and exploration.

Research Limitations: The small sample size means the findings cannot be extrapolated. Respondents were a self  selected cohort, representing those comfortable writing about shame. Researcher reflexivity was acknowledged, but as a lone -researcher, bias cannot be eliminated.

Conclusions/Implications: Shame is an under researched area. This study offers new insights into therapists' experiences of shame in the therapeutic and supervisory space. The study confirms the need for teaching and training regarding shame amongst therapists and supervisors, as well as the tendency of therapist and supervisor to avoid shame. Possible positive effects on client outcome, and the supervisory relationship, were reported when shame was acknowledged and explored. Possibilities for future research include comparing novice versus experienced therapists' conceptualisation of shame, cultural differences in the conceptualisation of shame, and the effects on client outcome brought about by discussion of shame.

 
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Ladislav Timulak

Other Authors: Ladislav Timulak, Julia Buckroyd, Jan Klimas, Mary Creaner, David Wellsted, Frances Bunn, Siobhan Bradshaw and George Green (order of authorship in the original study).
Professional Role: Counselling Psychologist
Institution/Affiliation: Trinity College Dublin
Contact details: School of Psychology, Trinity College Dublin
Email: timulakl@tcd.ie

ABSTRACT: paper                                                                                    

Keywords: qualitative meta-analysis, eating disorder treatment

Helpful and unhelpful aspects of eating disorders treatment involving psychological therapy: a meta-synthesis of qualitative research studies

Aim/Purpose: Commissioned by BACP, this study meta-analysed qualitative studies to answer the research question: ‘What aspects of eating disorders treatment that includes psychological therapy do clients find helpful or unhelpful?'

Design/Methodology: Qualitative meta-analysis was employed as a form of secondary data analysis to provide a comprehensive picture of the studied phenomenon. The search strategy included electronic searches of relevant databases (e.g. PsycINFO; PubMed; CINAHL) texts and reference list hand searches. Inclusion criteria contained the following: studies that examined clients' perceptions of helpful/unhelpful factors involved in ED treatment; involved psychological treatment delivered by a trained professional; involved clients (over 11 years) voluntarily attending ED treatment or recovered from an ED; used qualitative research methods and were written in English. From 4737 citations identified, 476 full papers were considered and 43 papers critically appraised. On further critical appraisal, 25 papers (24 studies) involving 1,058 participants were included.

Results/Findings: The helpful aspects of treatment identified by clients comprised 6 domains (30 meta-categories) for example; 1) Broader social support (e.g. co-patients); 2) Relational support from mental health professional (e.g. trust); 3) Important characteristics of mental health professional (e.g. expertise). The unhelpful aspects comprised 6 domains (18 meta-categories) for example; 1) Perceived lack of broader social support (e.g. co-patients); 2)  Perceived lack of relational support from mental health professional (e.g. lacking warmth); 3) Perceived deficiencies in important characteristics of mental health professional (e.g. expertise).

Research Limitations: Local conditions of the primary studies may not be fully considered.

Conclusions/Implications: The crucial role of mental health professionals' relational qualities and specific ED expertise was identified. Psychological therapy needs to be accessible and facilitate clients to take an active role in their treatment which may reinforce motivation to change. Current ED empirically based treatment, particularly CBT, was supported. Clients appreciated emotion-focused aspects and a broader focus of the treatment while highlighting the importance of follow-up. Clients valued both an ED symptom and underlying personality/identity related dynamics focus suggesting the usefulness of combining both aspects of treatment in clinical practice and future research.

 
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Dwight Turner

Other Authors: Dr Jane Callaghan, Dr Alasdair Gordon-Finlayson
Professional Role: PhD Research Student
Institution/Affiliation: University of Northampton and Centre for Counselling and Psychotherapy Education (CCPE)
Contact details: CCPE, Beauchamp Lodge, 2 Warwick Crescent, London W2 6NE
Email: dwight.turner@northampton.ac.uk

ABSTRACT: poster                                                                                     

Keywords: other, transpersonal, phenomenological, creativity, internalised

Relating to the other: a transpersonal exploration of our internalised experience of difference

Aim/Purpose: Grounding itself in the I/Thou relational idea of Buber (Buber, 2010) this research sought to uncover the lived experience and the meaning of being the Other, thereby realising a pathway for psychotherapy in its use of creative techniques to assist clients in understanding their own sense of difference.

Design/Methodology: Qualitative interviews were conducted with 25 participants to explore their experience of being different, utilising creative techniques common to Transpersonal psychotherapy such as Sand Tray work and visualisations (Rowan, 1993). Creative techniques were selected for this particular research to entice from the unconscious the internalised symbolic experience of this phenomena (Jung, 1968; Stevens, 1990). Moustakas' (Moustakas, 1994) Phenomenological Research method was also utilised to analyse the data derived from the interviews in uncovering the participants' experience of difference and its actual nature. This research received ethical approval from the School of SocialSciences Research Ethics Board at the University of Northampton.

Results/Findings: The use of symbols and drawing visually presented varying, and often difficult, experiences of being different, including:

  • One is an alien/monster when different; 
  • The pain and loneliness of being different; 
  • Finding inspiration in being the other; and 
  • Being part of a group brings a level of safety. 

The findings also suggest  that  understanding the internalised experience of otherness, reveals the other as possible pathway to accessing the true self  and a route towards individuation.

Research Limitations: The small size of the participant base is a limitation of the research.

Conclusions/Implications: The implications for the research suggest that working creatively to understand difference offers practitioners from varying disciplines another means of working with this difficult and challenging phenomena beyond the limiting use of just words.

 
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Joël Vos

Other Authors: Prof Mick Cooper & Dr Meghan Craig
Professional Role: Reader in Counselling Psychology
Institution/Affiliation: University of Roehampton
Contact details: Dept of Psychology, Whitelands College, University of Roehampton, Holybourne Avenue, SW15 4JD, London, UK.
Email: Joel.Vos@roehampton.ac.uk

ABSTRACT: paper                                                                                    

Keywords: existential therapy, meta-analyses, literature review

Existential therapies: a systematic literature review and meta-analyses

Aim/Purpose: 1.To perform a systematic literature review of all published quantitative articles on existential psychotherapies (a group of psychological interventions explicitly addressing existential themes in life, such as meaning and mortality). 2.To calculate the mean effect size of existential therapies, and to examine possibly influencing moderators.

Design/Methodology: Relevant electronic databases, journals, reference lists and handbooks were searched for eligible studies. Effects on meaning, psychopathology (anxiety and depression), self-efficacy and physical well-being were extracted from each publication or obtained directly from its authors. All types of existential therapy for adult samples were included. Weighted pooled mean effects were calculated, assuming random-effects-models.

Results/Findings: Forty-two eligible studies on existential therapy were found, from which 14 studies with unique data from Randomized Controlled Trials (RCT), comprising a total over 2500 participants. Both RCT-studies and non-RCT-studies (n=14 studies) showed that meaning-therapies have large effects on positive meaning in life immediately post- intervention (resp. d=0.67, .65) and at follow-up (resp. d=0.54, .64), and at self-efficacy post- intervention (resp. d=0.48, .68); RCTs showed strong effects on psychopathology (d= 0.47), and biological functioning (d=.49). Both RCT-studies and non-RCT-studies on supportive- expressive therapy (n=8) had small effects at post-treatment on psychopathology (d= 0.19), but RCTs on experiential-existential (n= 2) and cognitive-existential therapies (n=1) had no significant effects. No significant long-term effects were found for experiential-existential (n=2) and cognitive-existential interventions (n=1). Several moderators were significant, such as shorter and more structured therapies being more effective, but these moderators overlapped with the characteristics of meaning-therapy. Additional results of 27 non-RCT studies and moderation-analyses will be presented at the conference.

Research Limitations: The number of studies was small, especially of cognitive-existential and experiential-existential interventions, but results were corroborated by 27 non-RCT- studies. Four studies had a high risk-of-bias, but differences in quality between studies did not significantly influence the results in moderation-analyses.

Conclusions/Implications: Some existential therapies  appear beneficial for certain populations. We found particular support for structured interventions incorporating psycho- education, exercises, and discussing meaning in life directly and positively with physically ill patients. Variations between individuals within the studies suggest to select and tailor existential interventions to individual needs.

 
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Joël Vos

Professional Role: Reader in Counselling Psychology
Institution/Affiliation: University of Roehampton
Contact details: Dept of Psychology, Whitelands College, University of Roehampton, Holybourne Avenue, SW15 4JD, London, UK.
Email: Joel.Vos@roehampton.ac.uk

ABSTRACT: methodological innovation paper                                          

Keywords: development of research, philosophy of science, conceptual modelling

How to develop and validate conceptual models in psychotherapy research

Background and introduction: Many scientific articles in psychotherapy research do not seem to present clear, systematic conceptual foundations. Consequently, the validity of these studies may be questioned. Therefore, a literature review will be presented on the conceptual-models used in the 50 most frequently cited ‘original study'-articles in psychotherapy. With the help of these findings, a systematic approach will be suggested about ‘how to develop and validate conceptual models in psychotherapy research'. A concrete example of how to use this approach will be presented, including possible software for conceptual-modelling.

Nature of the methodological innovation/critique being proposed: Each scientific study consists of several ‘conceptual models', which either symbolise a part of reality (e.g. describing existing clinical theories), or create new interpretations by the use of our imagination (e.g. generating hypotheses) (cf. Lacan). Thus, research starts with symbolisations/imaginations of reality, and subsequently checks whether these models connect with the reality of the clients' lived experience: the validity of these models needs to be tested explicitly, to ensure that the symbolised/imagined conceptual models ‘work in reality'. This reality-check generates new models, e.g. methodological/statistical-models. Thus, each article consists of a chain of explicit or implicit models. On the basis of the literature review, I will present a systematic approach to explicate, align and validate conceptual-models in psychotherapy research. The presented method consists of 20 models. The most important models seem to be: explicating the author's own intuitive/clinical-experience model; developing a clinical model (‘why does who experience which psychological problems under which conditions'); developing a therapeutic model (‘how may which problem of which individual be improved under which conditions'); research model; methodological model; data-analyses model; results model; interpretation model; feedback model. Each model consists of concrete steps, in which scientific literature may be used to validate and extend the conceptual model.

Conclusion and relevance to counselling and psychotherapy research practice: The validity and readability of articles on psychotherapy may be improved by using this structural approach to develop and validate the underlying conceptual-models.

 
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Cristen Wathen

Other Author: David Kleist, PhD
Professional Role: Assistant Professor, Counseling Program
Institution/Affiliation: Montana State University Department of Health and Human Development
Email: cristen.wathen@montana.edu

ABSTRACT: poster                                                                                     

Keywords: phenomenology, counsellor training, international experiences, cross cultural, qualitative

Visions in our heads: lived experiences of counsellors-in-training participating in study abroad programs

Aim/Purpose: The purpose of this study was to explore the lived experiences of counsellors-in-training participating in study abroad programs.

Design/Methodology: This study used van Manen's hermeneutic phenomenology to explore the lived experiences of four counsellors-in-training participating in study abroad programs. Photosharing and photo-elicitation methods were used in two semi-structured online interviews and a member check for each participant. Interviews were recorded, transcribed, and analyzed for themes according to van Manen's holistic and selective approaches. The researcher kept a reflective memoir through a private blog. This study was approved by Idaho State University's Human Subjects Committee. Participants gave permission for their quotes and photographs to be shared.

Results/Findings: The overall essential and co-constructed themes for participants were shared and represented with photographs: Experiencing New Learning, Experiencing New Contexts, and Experiencing Emotions, with EXPERIENCING being key to each participant's narrative.

Research Limitations: Participants' length of time and types of  activities abroad were varied as different training programs had different international study abroad program designs. Technology difficulties took place during some of the interviews.

Conclusions/Implications: Current counsellors-in-training can gain perspective on what to expect when traveling internationally; that they may experience new contexts, experience strong emotions, and gain new learning. They can think about what types of trips they want to participate in and look for congruency in what they want and what a program offers. In planning a study abroad training experience, counsellor educators and trainers can benefit from hearing and reflecting on the experiences of these students. Practice implications include practitioners gaining an understanding of the importance of multicultural competence in counselling practice and how international study may foster this development.

 
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Cristen Wathen, Rebecca Koltz

Other Author: Dr Bonnie Meekums
Professional Role: Assistant Professor, Counseling Program
Institution/Affiliation: Montana State University Department of Health and Human Development
Email: cristen.wathen@montana.edu

ABSTRACT: poster                                                                                   

Keywords: pedagogy, technology, cross cultural, theory, online

Cross cultural perspectives: an online learning environment

Aim/Purpose: The purpose of this research is to explore the experience and implementation of a cross cultural (UK/USA) student videoconference.

Design/Methodology: Participating students were video-recorded while participating in a video conference between Montana State University's class Counseling Theories II and the University of Leeds' class, Becoming a Reflective Practitioner 2A. The video-conference took place December 5, 2013. Students at both universities participated in a cross cultural dialogue regarding counselling theories and counsellor self-awareness. Both sets of students also engaged in a debrief with their tutors immediately after the conference. The three tutor/researchers analyzed the video and transcription, paying attention both to what was said, and to the embodied engagement between students. Utilizing a modified narrative analysis methodology, researchers identified narrative and metaphoric themes emerging from the intersubjective process of cross-cultural dialogue.

Results/Findings: Both sets of students identified their own cultural assumptions about the ‘other' during the videoconference. Analysis revealed both cultural differences and some surprising similarities. For example, the American context included a greater emphasis on wellness and prevention which interested the British students and encouraged them to consider how counsellors can contribute to society in terms of prevention. Identified emergent themes included: "Exploring differences and similarities through dialogue," "developing cross cultural metaphors for connection," "connecting through expected and unexpected ways," and "providing context to assumptions" and "learning through interaction." In their post conference debrief, the British students acknowledged that while there are differences in the way the two trainings are delivered, there were also some striking similarities that challenged their cultural assumptions. In particular, an overarching theme of Stiff upper lips and cowboy mentalities united the two cultures in their struggles to develop more emotionally intelligent societies and practices.

Research Limitations: The students spoke via technology, which could impact the experience. Technical difficulties delayed the beginning of the conversation. This was a one time conversation and more information could be gained by more consistent contact.

Conclusions/Implications: The research showed the impact  of  learning through cross cultural dialogue in order to gain new understanding and challenge assumptions regarding the counselling profession in both the US and UK. Implications for counsellors in practice include ideas for potential cross-cultural learning, supervision, consultation, and the development of cultural competence for counsellors-in-training.

 
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William West

Other Author: Rev Dr Terry Biddington
Professional Role: Reader in Counselling Studies/Visiting Professor in Counselling and Spirituality
Institution/Affiliation: The University of Manchester/University of Central Lancs
Contact details: Counselling Studies, The School of Education, Environment & Design, University of Manchester, Oxford Road, Manchester
Email: william.west@manchester.ac.uk

ABSTRACT: paper                                                                                      

Keywords: spirituality, religion, pastoral care, training, supervision

Counsellors and religious pastoral carers in dialogue: an initial inquiry

Aim/Purpose: There has been much debate over the years around the extent to which counsellors work well with client issues involving religion and spirituality and a somewhat similar debate around the role of counselling skills within religious pastoral care. There are some people who feel that religion loses something when its pastoral care becomes overly psychologised and there remain fears among some counsellors that religiously minded people will misuse counselling for evangelical purposes. These concerns have continued despite the fact that increasing numbers of people are working within both settings. This initial project aimed to open up a dialogue between a group of counsellors and religious pastoral care workers.

Design/Methodology: This was clearly a qualitative study and with the research aim of having a dialogue between two groups a focus group using a ‘goldfish bowl' approach seemed the best choice for gathering data. The group met for an afternoon and consisted of 3 stages:

Stage One: the counsellors discussed their understanding of spirituality and religion within their work whilst the pastoral care workers listened;
Stage Two: the pastoral care workers discussed their understanding of counselling within their work whilst the group of counsellors present listened carefully;
Stage Three: open discussion within the whole group.

The 7 participants were recruited from contacts known to the researchers. The results were analysed using Braun and Clarke's thematic analysis. Ethical approval for this research was obtained from The University of Manchester.

Results/Findings: Both groups emerged as seasoned professionals who were willing to admit to short comings within some of their colleagues' professional practice. The main themes were: clients' issues - including what  spirituality means to clients;  language - including how to talk about spirituality; the relationship between pastoral care and counselling - including boundaries; counsellors' view of spirituality and religion; doing pastoral care; training issues - including supervision; and participants' own journeys.

Research Limitations: The study included only Christian ministers and a limited range of counsellors, and the sample size was small.

Conclusions/Implications: The findings raise some important issues especially related to training of counsellors and clergy.

 
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Peter Williamson

Other Author: Dr Jeannie Wright
Professional Role: Undergraduate Student and Counsellor
Institution/Affiliation: Centre for Lifelong Learning, Warwick University
Contact details: Centre for Lifelong Learning, Warwick University, Coventry, CV4 7AL
Email: P.J.Williamson@warwick.ac.uk

ABSTRACT: paper                                                                                     

Keywords: person-centred approach, mindfulness, compatibility, core conditions, person- centred therapist training

Mindfulness-based practice and the person-centred approach - compatible bedfellows or opposing forces?

Aim/Purpose: The aim of this study was to explore the compatibility of Mindfulness practice and the Person-Centred approach in a sample of person-centred therapists. Specific research aims included how Person-Centred therapists use mindfulness and which features of their practice, if any, were most enhanced by this? Whether therapists use mindfulness with clients following formal training to deliver, or after self-training and how they felt with regard to the compatibility of their therapeutic approach and mindfulness were also explored.

Design/Methodology: This was a qualitative IPA study designed to explore the experiences of person-centred therapists who use mindfulness. The inclusion criteria for participants consisted of counsellors and/or psychotherapists who self-identified as Person-Centred in their core therapeutic modality and who practiced some form of mindfulness. A total of 99 counsellor/psychotherapists were invited to participate and 11 individuals replied positively. The first 8 inclusion-eligible respondents were selected on a ‘first response' basis resulting in a final total of 6 study participants. The therapists were asked about their views and experiences of the subject using a semi-structured interview framework. Interviews were recorded and informal transcripts were analysed using a reductive stance for emerging themes from which a list of master themes was developed.

Results/Findings: Six master themes emerged, namely 1) Nourishment of, and connection with ‘self', 2) Resonance with personal philosophy or belief-system, 3) Mind, body and power, 4) Compatibility with and enhanced ‘Core Conditions', 5) Sharpening of presence and 6) Challenges of mindful awareness.

Research Limitations: This initial study was limited to the collection of experiential accounts from a small sample of six therapists. Some variability in the level of Mindfulness practice existed within the sample, so further studies are necessary with a larger sample with lower heterogeneity in order to validate the findings.

Conclusions/Implications: In the experiences of this small sample group of therapists, a clear compatibility existed between mindfulness practice and the person-centred approach. Key principles of both approaches appeared to be supported by the other, suggestive of a potentially synergistic relationship. This compatibility and possible synergism requires further exploration but alludes to the potential benefits of incorporating Mindfulness practice into Person-Centred therapist training and continuing professional development.

 
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John Wilson

Other Authors: Lynne Gabriel, Hazel James
Professional Role: Bereavement Counsellor and Trainer
Institution/Affiliation: Saint Catherine's Hospice Scarborough
Email: john.wilson@st-catherineshospice.org.uk

ABSTRACT: poster                                                                                   

Keywords: theory-building, case-study, assimilation, accommodation, grief

Tony's story: a theory-building case-study of delayed grief

Aim/Purpose: This approach aims to chart moments of therapeutic change in the bereavement counselling process, by close observation of the moments of assimilation and accommodation in clients relearning their post-bereavement world.

Design/Methodology: Grief as an emotional state is differentiated from grieving as an active, biologically determined process, mediated by personal narrative and cultural context. In this project the researcher, who is also the therapist, posits a theory that grieving involves the assimilation and accommodation of a post-loss personal world. The theory is tested with a theory-building case-study. The subject was bereaved by a road traffic death at age 11. He had not effectively grieved until he began counselling 34 years later. Data was collected by digitally recording each counselling session. Through immersion in the data, the practitioner/researcher was able identify and transcribe key moments of assimilation and accommodation as indicators of therapeutic change. A sample of transcriptions was also read by peer counsellors as part of an iterative protocol. Agreed moments of  change were  triangulated against the client's perceptions of progress recorded during the counselling sessions.

Results/Findings: During weekly counselling sessions, key moments of assimilation and accommodation were observed. The client was able to take these changes into his real world between sessions, and report back on their significance and effectiveness; self-judged by improvements in his  perceived psychological wellbeing. There was practitioner/client consensus on key moments and the client stated that the outcomes were life-changing.

Research Limitations: It is imprudent to draw conclusions from a single case-study. However, a theory-building methodology allows each new case-study to add a small degree of confidence to the theory being constructed. There is an omnipresent risk of researcher subjectivity in judging the significance of moments of psychological change.

Conclusions/Implications: Multiple case-studies would allow the theory to be refuted or modified. We call for more counsellors to become practitioner researchers by adopting this observational, theory-building methodology. Working in this way may lead to more focused therapeutic intervention and concomitant diminution of grief.

 
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Stephan Wilson

Other Author: Dr Valerie Owen-Pugh
Professional Role: University Counsellor and Tutor
Institution/Affiliation: University of Leicester
Contact details: Vaughan Centre for Lifelong Learning, 128 Regent Road. LE1 7PA
Email: sw304@le.ac.uk

ABSTRACT: paper                                                                                     

Keywords: professionalism, professionalisation, development, novice, counsellor

Emerging professionals in an emerging profession: novice psychodynamic counsellors' experiences of themselves as 'professionals'

Aim/Purpose: To find out how novice psychodynamic counsellors experience themselves as 'professionals'. What qualities do these practitioners  regard as being constitutive of professionalism? What challenges do they encounter to their sense of professionalism? How do they resolve these challenges? How does this affect their work with clients?

Design/Methodology: In this qualitative study, eleven psychodynamic counsellors with a maximum of seven years' post-qualification counselling experience were selected for interview using convenience sampling. The interviews were semi-structured with 15 open- ended questions. The interviews were transcribed and a thematic analysis of the resulting data was conducted.

Results/Findings: Participants reported experiencing deep conflicts between their own personal conceptions of professionalism and the rhetoric of professionalism derived from employers, training providers and professional bodies. Challenges to the participants' sense of professionalism generally involved dilemmas to do with balancing conflicts between their own developmental needs as novice counsellors with the needs of their clients. Furthermore, the idea of professionalism was strongly connected with the notion of boundaries and many of the participants' professional dilemmas were framed as attempts to delineate a professional relationship with their clients by setting and maintaining appropriate boundaries between their professional and personal roles. However, this often meant that the practitioners had to make difficult decisions about whether to break the 'rules' of training or their workplace setting in order to retain a sense of professionalism that remained true to their own personal beliefs and values.

Research Limitations: The small sample size and the participant's similar theoretical orientations and experience levels mean that the findings cannot be generalised to a larger population.

Conclusions/Implications: The findings suggest that managing conflicts between personal and institutional interpretations of professionalism is a central task for novice psychodynamic counsellors. It is recommended that CPD opportunities are created in which novice counsellors can reflect on the challenges involved  in finding  an interpretation of professionalism which fits with their personal value systems.

 
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Mark Young

Other Author: Christopher Christmas, Ph.D
Professional Role: Instructor
Institution/Affiliation: Stetson University
Contact details: Counseling Department, Stetson University, DeLand, FL 32720
Email: cchristm@stetson.edu; mark.young@ucf.edu; meyoung3000@gmail.com

ABSTRACT: methodological innovation paper                                          

Keywords: spiritual competencies, script concordance test, counselling competencies, clinical judgment

Development of a test for spiritual/religious competency using a script concordance method

Background and introduction: The Script Concordance method compares respondents' answers with experts' answers about authentic clinical situations containing a measure of uncertainty. Script Concordance Tests have been used in North American medical education to assess clinical competence. The purpose of the study was to construct an instrument to evaluate counselor competency in addressing religious and spiritual issues. The instrument contains vignettes that assess clinical judgment according to the Spiritual Competencies developed by the Association for Spiritual, Ethical and Religious Values in Counseling.

The methodology employed a Delphi study with 15 experts specializing in integrating spirituality into counseling. An initial set of case vignettes informed by an extensive literature review was presented to panelists. In three successive rounds, the Delphi panel modified or eliminated case vignettes and follow-up questions, and then they responded to the fully constructed instrument. These vignettes presented panelists with cases that included problems and conflicts of a spiritual or religious nature and asked panellists how they would proceed. An initial investigation of reliability was conducted. The instrument demonstrated Cronbach's alpha of .64 (n=50).

Nature of the methodological innovation/critique being proposed: The Script Concordance Test is an innovative tool that puts examinees in clinical situations and tests their judgment and insight. It taps tacit knowledge, which is not normally revealed by multiple-choice formats. Examinees  are given a clinical situation and then asked follow-up questions that complicate the story by adding new information, requiring respondents to use both knowledge and judgment. Respondents are asked if they want to change their initial answers based on additional information, and their answers are correlated with those of the experts. The scoring method allows test participants to achieve "partial  credit"  for any answers that a member of the expert panel has chosen. Full credit is given for the modal response of the expert panel.

Conclusion and relevance to counselling and psychotherapy research practice: Script Concordance Testing assesses the clinical decision making process in counsellor training. This approach improves practice by exposing counsellors to authentic clinical situations and offering immediate expert feedback on responses. It is not only relevant to the area of spiritual competency but is promising for clinical situations involving diagnosis, suicide potential, and additional counseling competency areas (multicultural, advocacy, etc).

 
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Zainah Ahmad Zamani

Other Authors: Rohany Nasir, Fatimah Yusooff, Mohd Norahim Mohd Sani, Salina Nen, Salleh Amat
Professional Role: Senior Lecturer in Counselling
Institution/Affiliation: School of Psychology and Human Development, Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi, Selangor, MALAYSIA
Email: zainah@ukm.my

ABSTRACT: paper                                                                                     

Keywords: online counselling, counsellors-in-training, attitudes, modality

Attitudes towards online counselling:  a new modality for counsellors-in-training

Aim/Purpose: Trends over the past decade have shown that online or internet counselling has grown in terms of its utilization and popularity. In fact, its emergence has made this medium of counselling a much debated phenomenon. Malaysia, is of no exception in incorporating this electronic medium into its services. This preliminary study aims to investigate the perception of counsellor-in-training students towards online counselling.

Design/Methodology: This is a qualitative study exploring participants attitudes toward online counselling using semi-structured questions. A total of 10 participants recruited from a Masters' counselling program in a research university were individually interviewed. Interviews were transcribed and interpretive phenomenological analysis were applied to draw out the themes from the participants' perception of online counseling

Results/Findings: Participants viewed online counselling as an expansion of their face-face counselling practices  and would incorporate this medium in their services. Despite the concerns over ethical issues, all participants had positive views about online counselling.

Research Limitations: This study was limited to 10 counsellors-in-training and findings cannot be generalised to all Malaysian counsellors.

Conclusions/Implications: Implications of this study were discussed in terms of the factors that need to be considered by counsellors who use this medium of service delivery. This includes counsellors utilizing this modality who need to consider the ethical issues besides taking into account the type of clients that would benefit from this type of service. Also, the establishment of a model of e-counselling to be used by counsellors in Malaysia will be introduced.

 


SYMPOSIA

 

Symposium A - Mick Cooper

Professional Role: Professor of Counselling Psychology
Institution/Affiliation: University of Roehampton
Contact details: Department of Psychology, University of Roehampton
Email: mick.cooper@roehampton.ac.uk

ABSTRACT: symposium A overview                                                         

Keywords: counselling, young people, children, school counselling, systematic review

Counselling with children and young people: scoping the field

The aims of the symposium: To present the findings from a series of recent reviews, commissioned and published as part of the Counselling MindEd project (counsellingminded.com), that have scoped out the delivery, outcomes and context of counselling with children and young people in a range of national and international settings.

Contribution of each symposium paper to the overall theme: Street's paper is the first systematic review of counselling for children, young people and young adults in the voluntary and community sector (VCS), as well as in the growing area of online counselling. It reports on the extent of service provision in these areas, as well as client characteristics and emerging evidence of effectiveness. Cooper then goes on to present a recent review of counselling in secondary schools, looking at service and client characteristics, outcomes, and areas for development. This is followed by Spong's paper, which presents primary research exploring the relationship between school- and VCS-based counselling services and specialist Child and Adolescent Mental Health (CAMH) provision. Finally, Harris's paper looks more globally, presenting the first systematic report on who, and how, school-based counselling is delivered around the globe.

Implications of the symposium theme for counselling and psychotherapy theory, research and practice: Together, these papers make an originaland significant contribution to our understanding of how counselling is delivered to children and young people, in the UK and beyond. As such, it forms a firm foundation for further research and service delivery in this area.

Name of the symposium discussant: None

 

Symposium A - Cathy Street

Professional Role: Independent mental health consultant and researcher
Institution/Affiliation: N/A
Email: cathy.street1@btinternet.com

ABSTRACT: symposium A paper 1                                                           

Keywords: children and young people, counselling, voluntary and community sector (VCS), online counselling, Counselling MindEd

Counselling provision for children, young people and young adults: scoping current provision in the voluntary and community, and online, sectors

Aim/Purpose: This study was undertaken to provide an overview of voluntary and community sector (VCS) services for children, young people and young adults aged 5-25 years in England. A supplementary scoping report reviewed developments in the provision of online counselling for this age group. The study was undertaken to inform the Counselling MindEd e-learning resources being developed by BACP for the Department of Health.

Design/Methodology: Data was collected via online searches and consultation with a range of agencies providing counselling services, including Action for Children, B-Eat, Barnardo's, Brook, Kooth, The Children's Society, Relate and Mind. Youth Access, the national charity for Youth Information, Advice, Counselling and Support Services (YIACS) provided access to their membership database. Thematic analysis was used to synthesise the data gathered, with material from the scoping of online provision being written up in a case study format.

Results/Findings: The data gathered suggest that there are around 400 VCS counselling services for children, young people and young adults in England. There is considerable variation in how they operate, with services ranging from small standalone services located in a small town with two to three counsellors, up to much larger inner city services with teams of 30 or more counselling staff. Children, young people and young adults using these services typically present with highly complex needs spanning mental and physical health, education, social care and practical needs; their feedback is highly positive. Online counselling appears to be a growing area, possibly because of the ease of access outside of working hours and at weekends.

Research Limitations: Information about  VCS counselling services for children, young people and young adults is limited. The sector is also rapidly changing, largely because it has been badly affected by the recent economic downturn and loss of local authority or health funding, leading to many services having to restrict their opening hours, merge or even close. Cost and outcomes data is also patchy.

Conclusions/Implications: More research, in particular to explore the costs and outcomes for service users of VCS and online counselling, is needed.

 

Symposium A - Mick Cooper

Professional Role: Professor of Counselling Psychology
Institution/Affiliation: University of Roehampton
Contact details: Department of Psychology, University of Roehampton
Email: mick.cooper@roehampton.ac.uk

ABSTRACT: symposium A paper 2                                                           

Keywords: school counselling, young people, counselling, education, psychotherapy outcomes, Counselling MindEd

School-based counselling in UK secondary schools: a review and critical evaluation

Aim/Purpose: To provide a comprehensive review of data on counselling in UK secondary schools, looking at service provision, client characteristics, outcomes, client satisfaction, strengths, and areas for development.

Design/Methodology: A systematic search was conducted of primary research in this area, summarised through a narrative review of findings.

Results/Findings: School-based counselling is one of the most prevalent forms of psychological therapy for young people in the UK, with approximately 70,000-90,000 cases per year. School-based counselling services in the UK generally offer one-to-one supportive therapy, with clients typically referred through their pastoral care teachers, and attending for three to six sessions. Around two-thirds of young people attending school-based counselling services are experiencing psychological difficulties at ‘abnormal' or ‘borderline' levels. Clients are typically in the 13-15 year old age range, white, most commonlyfemale; and presenting with family problems or, if boys, anger.

There is emerging evidence to suggest that school-based humanistic counselling is effective at reducing psychological distress. School-based counselling is evaluated positively by service users and school staff.

Key strengths of school-based counselling are that it is perceived as a highly accessible service; and that it increases the extent to which all young people have an independent, supportive professional to talk to about difficulties in their lives. Areas for development include increasing the extent to which practice is evidence-informed, greater use of outcome monitoring, ensuring equity of access to young people from black and minority ethnic backgrounds, increasing service user involvement, and enhancing levels of integration with other mental health provisions.

Research Limitations: Quality of primary data in the field is mixed, particularly concerning service provision, such that it is not possible to establish clear indications of the magnitude of service delivery.  The analysis presented is narrative rather than systematic.

Conclusions/Implications: School-based counselling is one of the major sites of mental health service delivery for young people in the UK. Emerging evidence suggests that it has a large impact on reducing psychological distress in young people, and this is supported by a range of qualitative and quantitative indicators.

 

Symposium A - Sheila Spong

Other Authors: Rachel Waters, Claire Dowd, Charlie Jackson
Professional Role: Senior Lecturer in Counselling; Research Manager Newport Community Counselling Service
Institution/Affiliation: University of South Wales
Contact details: School of Psychology, Early Years and Therapeutic Studies, Lodge Road, Caerleon, Newport, NP18 3QT
Email: sheila.spong@southwales.ac.uk

ABSTRACT: symposium A paper 3                                                           

Keywords: CAMHS, children, young people, attitudes, counselling, Counselling MindEd

Counselling and specialist CAMHS - a special relationship?

Aim/Purpose: This study explores the relationship between specialist CAMHS and counselling services for children and young people in England.

Design/Methodology: Data were collected through 33 semi-structured interviews and an e- survey. Telephone interviews were conducted with 14 specialist CAMHS staff, 15 counsellors/psychotherapists working with children and young people, and four other respondents with a particular knowledge of counselling and specialist CAMHS. 134 members of the BACP CYP Division responded to an e-survey. The specialist CAMHS staff interviewed were a convenience sample recruited through a range of professional contacts of the study team; counsellors (both interviewees and those completing the e-survey) were recruited through emails sent to all members of the BACP CYP Division.

Results/Findings: Reports of the relationship between specialist CAMHS and counselling services for children and young people were very varied. In many instances, specialist CAMHS staff reported valuing counselling services for providing young people with a different type of service and/ or for relieving pressure on specialist CAMHS, though some respondents expressed doubts about the level of training of counsellors. Significant frustration with the relationship with specialist CAMHS was reported by many, but not all, counsellors. Some examples of close and co-ordinated working relationships were reported.

Research Limitations: The interview samples were small and the sample of specialist CAMHS staff was opportunistic. Samples of the two groups were not co-ordinated geographically.

Conclusions/Implications: Relationships between specialist CAMHS and counselling services for children and young people are complex and uneven. Developing and maintaining clear communication, developing personal connections and demonstrating mutual respect were among the factors identified as important to enable these two types of services to work well together.

 

Symposium A - Belinda Harris

Professional Role: Associate Professor in Counselling and Education, University of Nottingham, UKCP Registered Gestalt Psychotherapist
Institution/Affiliation: University of Nottingham
Contact details: School of Education, Jubilee Campus, Wollaton Road, NG3 5BQ
Email: Belinda.Harris@nottingham.ac.uk

ABSTRACT: symposium A paper 4                                                           

Keywords: school counselling, international, children, young people, Counselling MindEd

Locating school-based counselling provision in the UK in a global context. Lessons from a scoping review of school counselling internationally

Aim/Purpose: This study explores the status and prevalence of school-based counselling in 90 countries across the globe.

Design/Methodology: Differentiated search procedures were used to identify countries where school-based counselling is available in state schools. Initially a search of  peer reviewed journal articles written in the English language identified key papers on school-based counselling in 50 countries. Secondly, key authors were contacted to check understanding of the data and request further information. Thirdly, a Google search identified national school-based counselling associations, relevant Government departments and key documentation. Of the 106 countries reviewed, some relevant information was found for 82 countries.

Results/Findings: School-based counselling is well established in 62 countries across the globe and in the early stages of development in a further seven. More school-based counselling is delivered by teachers than by psychologists, professional counsellors or social workers. It is commonplace for school counsellors to have dual training in teaching and counselling or psychology. The majority of school counsellors have received a postgraduate education and are experienced in working with classes and groups of students, as well as with individuals. School counsellors are primarily trained in either relational or cognitive approaches, although there is a trend towards adopting a more pluralistic approach.

Research Limitations: Due to limited resources, the researcher's priority was to develop an overview of provision for each region, rather than a comprehensive picture of provision in all countries. Limited data was found on the numbers of counsellors and schools where counselling is offered in different countries.

Conclusions/Implications: Overall, school-based counselling is developing relatively quickly into an integral part of the education system in many parts of the world. In many other parts it is developing a firm foothold or emerging as a valuable way of supporting learning, as well as a range of health related concerns. The counsellor's work is understood to be specialised, requiring specific training and development opportunities, and involves a range of professional activities and responsibilities within the school setting.

 

Symposium B - Michael Barkham

Other Authors: David Saxon, Jo-Ann Pereira, Louis G Castonguay, William B Stiles
Professional Role: Professor of Clinical Psychology; Director, CPSR
Institution/Affiliation: Centre for Psychological Services Research (CPSR)
Contact details: CPSR, University of Sheffield, Sheffield
Email: m.barkham@sheffield.ac.uk

ABSTRACT: symposium B overview                                                          

Keywords: practice-based evidence, evidence-based practice, psychological therapies, therapist effects

Combining evidence-based practice and practice-based evidence: building a rich, rigorous, and relevant knowledge base for psychological therapies and therapists

The aims of the symposium: The aim of the symposium is to present the potential of combining trials data (evidence-based practice) with routine service data (practice-based evidence) in order to deliver richer and more relevant knowledge base for psychological therapies (e.g., Counselling for Depression; Cognitive Behaviour Therapy) and for effective practice (therapist effects).

Contribution of each symposium paper to the overall theme:

Paper 1:   Sets out how data from routine practice informed the basis for a non-inferiority trial - PRaCTICED - comparing Counselling for Depression with Cognitive Behaviour Therapy within the Sheffield IAPT service, thereby showing the interdependency between trials and practice data. (Barkham)

Paper 2: Presents analysis of therapist effects using practice-based data from the Sheffield IAPT data download, thereby identifying a natural phenomenon - variability - that is often viewed as error in trials. (Saxon)

Paper 3: Presents results from a parallel study to the PRaCTICED trial that investigates the association between specific common factors and effective practice for psychological wellbeing practitioners, counsellors, and cognitive behaviour therapists. The study shows how focusing on common as well as technical components can inform our understanding of effective practice. (Pereira)

Discussants: (Castonguay & Stiles)

Implications of the symposium theme for counselling and psychotherapy theory, research and practice: The symposium focuses on the value of utilising data from routine practice as well as data from trials to yield a knowledge base that is more relevant and robust for practitioners. Findings have implications for therapist training, practice, and supervision in the psychological therapies.

Name  of  the  symposium discussants:  Louis  G  Castonguay  (Pennsylvania State University) & William B Stiles (Miami University)

 

Symposium B - Michael Barkham


Other Authors:
Dave Saxon, Lindsey Bishop-Edwards, Simon Bennett, Peter Bower, Mike Bradburn, John Brazier, Robert Elliott, Lynne Gabriel, Gillian E Hardy, Stephen Kellett, Michael King, Stephen Pilling, Sue Shaw, Glenn Waller
Professional Role: Professor of Clinical Psychology
Institution/Affiliation: Centre for Psychological Services Research (CPSR), University of Sheffield
Contact details: CPSR, University of Sheffield, Sheffield
Email: m.barkham@sheffield.ac.uk

ABSTRACT: symposium B paper 1                                                           

Keywords: PRaCTICED trial, practice-based evidence, IAPT, Counselling for Depression, Cognitive Behaviour Therapy

The PRaCTICED trial: the arguments, aims, and aspirations

Aim/Purpose: This presentation will set out the arguments, aims, and aspirations of the PRaCTICED trial: Pragmatic Randomised Controlled Trial assessing the non-Inferiority of Counselling and its Effectiveness for Depression. There are 3 sections: (1) the arguments that provided the basis for proposing the trial as planned; (2) the aims of the finally agreed research protocol; and (3) the aspirations in terms of the potential yield from the trial data.

Design/Methodology: Data collected over 18 months was drawn from routinely collected outcome measures within the Sheffield IAPT service comprising counselling and cognitive behaviour therapy. Patient data (N = 1,219) and practitioner data (N=94) yielded very small differences between these two approaches.

Results/Findings: The results were used to underpin and inform the design of the PRaCTICED trial with respect to two key features. First, to embed the trial within the routine Sheffield IAPT service, thereby yielding a comprehensive cohort design that would enable a comparison between the results of the trial per se with those within the routine service. Second, to adopt a non-inferiority design in order to compare Counselling for Depression (CfD) with Cognitive Behaviour Therapy (CBT).

Research Limitations: The trial is an outcome study and is yoked with the measures adopted within the IAPT Minimum Data Set. There was limited opportunity to add additional measures due to the mandatory requirement of the IAPT MDS and burden on patients. Process studies arising from the trial will be limited initially but a core body of process tapes will enable subsequent analyses of contrasting and common mechanisms of change in CfD and CBT.

Conclusions/Implications: The context of the PRaCTICED trial provides an exemplar for combining the paradigms of evidence-based practice and practice-based evidence that will enable a focus on treatments and therapists and yield a richer and more relevant knowledge base for therapists and the psychological therapies.

 

Symposium B - David Saxon

Other Authors: Nick Firth, Jo-Ann Pereira, Stephen Kellett, Michael Barkham
Professional Role: Research Associate
Institution/Affiliation: Centre for Psychological Services Research (CPSR), University of Sheffield
Contact details: ScHARR, University of Sheffield, Regent St. Sheffield
Email: d.saxon@sheffield.ac.uk

ABSTRACT: symposium B paper 2                                                             

Keywords: variability, therapist effects, case-mix, multi-level modelling, routinely collected data

Variability in practice: therapist effects in an IAPT service

Aim/Purpose: To determine the size of therapist effects, and variability in effectiveness, while controlling for case-mix. The focus will be on step 3 treatments (counselling and CBT) and depression (PHQ-9) and functioning (WSAS) outcomes. Treatment and therapist variability on treatment endings will also be assessed. A further aim is to present the results of a complex methodology in an accessible and clinically useful way.

Design/Methodology: The dataset comprised a sample from a download of routinely collected IAPT data (June 2010 - Oct 2013). A total of 6707 clients received at least one session with a step 3 practitioner (32 CBT and 32 counselling), while 4837 patients, who received at least two sessions, were included in the effectiveness analysis. Following presentation of descriptives, multilevel modelling (MLM) is used to profile practitioners in terms of effectiveness, while controlling for case-mix. MLM models the hierarchical structure of the data where clients are ‘nested' within therapists and partitions the outcome variance to the client level and the therapist level. The model residuals with their 95% confidence intervals indicate how each therapist differs from the average therapist. Primary analysis considered PHQ-9 outcomes, while secondary analysis considered WSAS outcomes. In addition to controlling for case-mix, the impact of other variables, therapy type, number of sessions and whether treatment ending was planned or not, were also assessed.

Results/Findings: There were significant therapist effects on both PHQ-9 and WSAS of 5.4% and 3.9% respectively after controlling for case-mix variables. There was also therapist variability on client drop-out with an effect of 7.5%. Type of therapy was not a significant predictor in any of the models.

Research Limitations: The routine dataset contains limited information on the therapists.

Conclusions/Implications: By using a methodology that recognises and models the natural structure in the data, the relative effectiveness of therapists, controlling for case-mix, can be estimated. This has implications for the analysis of routine service data and for therapist recruitment and training. Practice may be improved by further study of the features of more effective practitioners.

 

Symposium B - Jo-Ann Pereira

Other Authors: David Saxon, Stephen Kellett, Michael Barkham
Professional Role: PhD student
Institution/Affiliation: Centre for Psychological Services, University of Sheffield
Contact details: Department of Psychology, University of Sheffield
Email: jopereira150@gmail.com

ABSTRACT: symposium B paper 3                                                           

Keywords: common factors, therapist effects, IAPT

The art of practice: examining common factors that contribute to effective practice

Aim/Purpose: Amidst growing research evidence of the significance of the therapists' contribution to patient change, the current study examines key common factors of therapists' resilience, empathy, and mindfulness and how these relate to therapeutic outcomes and effective practice.

Design/Methodology: The study examined mixed quantitative and qualitative data that comprised i) routine practice data from a single service  setting, and ii) data from practitioners within that respective service setting. Routine practice data was obtained from the Sheffield IAPT service with patient outcome scores (n=16931) over the previous  18-months,  on patient levels of depression (PHQ-9), anxiety (GAD-7), and adjustment (WSAS). Thirty-one practitioners completed measures of resilience (CD-RISC), empathy (BES-A), and mindfulness (MAAS) and provided written responses to open-ended questions relating to their personal and professional contribution to their routine practice. Data was studied using single level modelling, multilevel modelling, and thematic analysis.

Results/Findings: Patient improvement was significantly correlated with practitioners' self- ratings of resilience and mindfulness. Although this relationship weakened as a function of increasing the stringency of the index of patient change, the association was more consistent for patients with more severe pre-treatment levels of depression and/or anxiety. Comparisons between top and bottom quartiles showed that relatively more and less effective practitioners were found to significantly differ in levels of mindfulness. Qualitative analysis of practitioner accounts suggest that more and less effective practitioners differed across certain domains including, practitioners' personal therapy received, supervision for their practice, and active processing involving both personal and professional application when providing therapy.

Research Limitations: The current study uses a select group of specific measures including IAPT-mandated outcome measures and limitations relate to the sample being drawn from a single service, which may have unique or specific features.

Conclusions/Implications: Findings suggest that mindfulness and resilience may have a potential role to play in contributing to more effective practice. Accordingly, there is benefit in incorporating these factors into the training of future practitioners from diverse psychotherapy fields.

 

Symposium C - Robert Elliott, Graham Westwell, Micaela Jimenez

Other Authors: Brian Rodgers, Susan Stephen
Professional Role: Professor of Counselling
Institution/Affiliation: University of Strathclyde Counselling Unit, School of Psychological Sciences and Health, University of Strathclyde, 40 George Street, Glasgow, G1 1QE
Email: fac0029@gmail.com

ABSTRACT: symposium C overview                                                         

Keywords: social anxiety, emotion-focused therapy, outcome, change processes

Person-Centred-Experiential therapies for social anxiety: a closer look at outcome and change processes

The aims of the symposium: In previous presentations, we reported large pre-post changes for an outcome study comparing two forms of humanistic-experiential psychotherapy for clients with social anxiety: Person-Centred Therapy (PCT) and Emotion- Focused Therapy (EFT), with significantly large effects on some measures for EFT over PCT. The purpose of this symposium is to present recent, more detailed research focusing primarly on the EFT condition in this study, in order to shed further light on client change processes.

Contribution of each symposium paper to the overall theme: First, Elliott will summarise the previous overall and comparative findings and will then focus on what changed in the EFT condition and when it changed. Westwell will then report on a case comparison study of good and poor outcome cases, comparing them on relationship measures from client and observers, in preparation for more detailed qualitative micro-analyses of therapist responsiveness. Finally, Jimenez will present a new measure of a key element of EFT, emotion scheme change, and will use it to analyse how one socially anxious client with good outcome changed how she accessed and explored her emotions over the course of her therapy.

Implications of the symposium theme for counselling and psychotherapy theory, research and practice: Fine-grained analyses of outcome and change processes have the potential to help us address questions such as when and how clients change, which in turn can teach us how to work more effectively with clients.

 

Symposium C - Robert Elliott

Other Authors: Brian Rodgers, Susan Stephen
Professional Role: Professor of Counselling
Institution/Affiliation: University of Strathclyde
Contact details: Counselling Unit, School of Psychological Sciences and Health, University of Strathclyde, 40 George Street, Glasgow, G1 1QE
Email: fac0029@gmail.com

ABSTRACT: symposium C paper 1                                                           

Keywords: social anxiety, person-centred therapy, emotion-focused therapy, outcome

The outcomes of Emotion-Focused Therapy for social anxiety: a closer look

Aim/Purpose: In previous presentations, we reported large pre-post changes for an outcome study comparing two forms of humanistic-experiential psychotherapy for clients with social anxiety: Person-Centred Therapy (PCT) and Emotion-Focused Therapy (EFT), with significantly large effects on some measures for EFT over PCT. The purpose of this presentation is to present additional, more detailed quantitative results from this study in order to shed more light on the nature of the differences between the two treatments.

Design/Methodology: Using a partially randomised two group pre-post design, we assessed client outcome with fifty-three clients seen for up to 20 sessions of either PCT or EFT, using a battery of outcome measures. Here we report (a) the results of two measures not previously reported, the Self-Relationship Scale and the Health Care Utilization Scale; (b) analyses of subscales of the previously reported measures (CORE-OM, Social Phobia Inventory, Inventory of Interpersonal Problems, Strathclyde Inventory); and(c) results at mid- therapy and 6-month follow-up.

Results/Findings: Clients seen in EFT showed very large improvements in self-affiliation (ES = 1.3 sd), more than clients seen in PCT (comparative ES = .5); they also showed substantial reductions in self-attack and self-neglect. However, clients seen in EFT showed little change in their utilisation of  health care resources. Interpersonally, clients in EFT showed greater assertiveness and connection with other people, reduced behavioural avoidance, fear of social situations, and physiological signs of anxiety. However, these analyses produced no statistically significant differences between PCT and EFT. In general, most client change occurred between mid-therapy (session 8) and post-therapy. Finally, post-therapy gains were maintained at 6-month follow-up.

Research Limitations: The study was only partially randomised; many of the comparisons between PCT and EFT were statistically under-powered.

Conclusions/Implications: While in need of replication, our results are promising and begin to provide justification for using PCE therapies for social anxiety. Self-affiliation improvements may reflect the use of EFT two chair work for internal conflicts and self- soothing. A treatment length of 16-20 sessions appears to be appropriate for clients with social anxiety.

 

Symposium C - Graham Westwell

Other Author: Robert Elliott
Professional Role: Senior Lecturer in Counselling and Psychotherapy
Institution/Affiliation: Edge Hill University
Email: graham.westwell@edgehill.ac.uk

ABSTRACT: symposium C paper 2                                                           

Keywords: adherence/competence, therapist responsiveness, person-centred therapy, experiential therapy, therapeutic relationship

What is the PCEPS measuring that may be related to outcomes in PCE therapy with socially anxious clients?

Aim/Purpose: This study aims to identify the types of therapist responses that contributed to good outcomes in PCE therapy. Therefore, this study will question: ‘What is the PCEPS measuring that may be related to outcomes in PCE therapy with socially anxious clients?'

Design/Methodology: Two groups of three raters (postgraduate students and experienced counsellors) rated 10-15 min therapy segments using the Person-centred and Experiential Psychotherapy Scale (PCEPS), a highly reliable observer completed competence/adherence measure designed to identify competent practice in PCE therapy. PCEPS rater scores were correlated with relational measures (Working Alliance Inventory, Therapeutic  Relationship Scale, Client and Therapist versions).

The outcome data for the 10 clients from the social anxiety arm of the original PCEPS study were used to calculate pre-post residual gain scores, based on which two good outcome and two poor outcome cases were identified. For each of these two clients, data for 2 segments from each 3 therapy sessions was available, allowing the use of exploratory t-test analyses (n=24 segments).

Results/Findings: A full set of results will be presented at the conference as at the time of this submission the analyses had not yet been completed. However, initial analysis revealed that therapists whose clients were high gain cases were rated more favourably by clients on the WAI, and by the raters on the ‘Experiential Process' subscale of the PCEPS. Segments from these therapy sessions will be micro-analyzed using qualitative conversational analysis to identify forms of therapist responsiveness associated with good outcomes.

Research Limitations: The small sample size of n=24 segments limits the statistical power of the findings. A confounding of variables in the original data set may also affect results here. A potential positive bias towards therapists known to the raters may affect the results. Socially anxious clients may have been more interpersonally vigilant toward their therapists than non-socially anxious clients and therefore may have viewed the therapeutic relationship less favourably.

Conclusions/Implications: This study provides initial findings for future studies with a larger sample size. The study potentially identifies aspects of good practice for PCE ways of working with socially anxious clients.

 

Symposium C - Micaela Jimenez

Other Author: Robert Elliott
Professional Role: PhD student
Institution: University of Strathclyde, Glasgow
Contact details: Counselling Unit, School of Psychological Health and Sciences, University of Strathclyde, Graham hills Building, 40 George Street, Glasgow, G1 1QE
Email: mikaela_jimenez@hotmail.com

ABSTRACT: symposium C paper 3                                                           

Keywords: process, emotion scheme elements, Emotion-Focused Therapy, social anxiety

Changes in emotion schemes: a case study of Emotion Focused Therapy for social anxiety

Aim/Purpose: The aim of the present case study is to develop and evaluate a coding system (Client ESRS: Client Emotion Scheme Rating System) that captures the five interconnected elements of the Emotion Focused Therapy (EFT) emotion scheme model: perceptual-situational, symbolic conceptual, body sensations, reported emotion and motivational-behavioural (Elliott et al., 2004). Client ESRS is grounded in EFT theory that says that emotion schemes change as a result of awareness, elaboration and transformation of the five interconnected elements. In addition, the Client ESRS also assesses the manner in which these elements appear, that is, whether they are (a) pre-experiential (b) non- experiential (c) experiential (d) experiential/change processes.

Design/Methodology: Client ESRS was applied to transcripts  of three sessions (early, middle and late) from a good outcome case involving a female client with social anxiety. Each emotion scheme coding unit was coded in regards to the emotion scheme elements that appeared and the manner in which these elements were processed.

Results/Findings: Preliminary quantitative results indicate that most units were dominated by a focus on a single type of element. However, the frequency of each element differed across therapy sessions. We found that perceptual/situation elements were more frequent during the initial therapy session, whereas more needs/wants/wishes were expressed during the middle session. Also, the results indicated that when various emotion scheme elements were expressed together, they tended to be more organized and also more often combined with a reported emotion during the middle phase than in the beginning of therapy. Qualitative exploration of the data suggested that the change process mode appeared more frequently late in therapy.

Research Limitations: The findings cannot  be generalised to a larger  population. The Client ESRS requires further testing and replication with other clients. It is also very labour- intensive.

Conclusions/Implications: This case study is a beginning phase of developing and testing a coding system for client emotion scheme change. Although the results of this study are only preliminary, it sheds light regarding the processes that change during psychotherapy. The Client ESRS can be used by psychotherapists to identify missing emotion scheme elements, which they can then encourage clients to explore.

 

Symposium D - Jane Simms, Anne Moorhead, Jill Hendron

Professional Role: Psychologist and Lecturer in Counselling
Institution/Affiliation: University of Ulster
Contact details: 17E 06 School of Communication, University Of Ulster, Jordanstown Campus, Shore Road, Newtownabbey, County Antrim BT37 0QB
Email: j.simms@ulster.ac.uk

ABSTRACT: symposium D overview                                                      

Keywords: helping relationships, post-traumatic stress, post-traumatic growth, vicarious impact, therapeutic communication

"I've never talked about it" - the fear of connection in the helping relationship: a Northern Irish perspective on ‘troubles' related trauma

The aims of the symposium: In this symposium, the series of three research based papers will highlight the role of communication and barriers to effective therapeutic engagement and intervention, across helping relationships when working with individuals experiencing post- traumatic stress and growth. The first paper will provide a review using a systematic approach into communication barriers and challenges within formal and informal helping relationships among survivors of traumatic stress, and provide recommendations to support effective communication. Two of the papers will focus specifically on research on post- traumatic stress and post-traumatic growth carried out in Northern Ireland. By drawing upon research within the Northern Irish context, the aims of the symposia are (1)  to share information regarding the barriers and challenges of working therapeutically with individuals experiencing complex and unresolved psychological trauma, (2) to gain a better understanding of the specific skills that enhance effective therapeutic communication, and (3) to highlight good practice when working therapeutically with individuals suffering from chronic and complex trauma.

Contribution of each symposium paper to the overall theme: Dr Moorhead will present a review using a systematic approach into  communication barriers  and challenges within formal and informal helping relationships among survivors of traumatic stress, and provide recommendations to support effective communication. This paper will provide counsellors and practitioners evidence-based guidance and recommendations on how to support effective communication among survivors of traumatic stress. Dr Simms reports on findings from her case study research on features of traumatic growth amongst individuals suffering from chronic PTSD and the implications of this when working therapeutically with clients. Dr Hendron will report on findings from her dual methodology research project, which focuses on the impact upon clergy as an informal trauma support resource.

Implications of the symposium theme for counselling and psychotherapy theory, research and practice: The authors contend that Northern Ireland provides a unique perspective on the issues facing individuals who have suffered chronic and complex trauma, many of whom who have never spoken about it and when they do, struggle to articulate and voice their thoughts and feelings. Drawing upon communication, psychological and counselling theory, research and practice, the symposia illustrates the challenges to working effectively in a therapeutic context and highlights how a therapeutic climate can be established and maintained.

Name of the symposium discussant: None

 

Symposium D - Anne Moorhead

Professional Role: Lecturer
Institution/Affiliation: University of Ulster
Email: c/o j.simms@ulster.ac.uk

ABSTRACT: symposium D paper 1                                                         

Keywords: relationship, trauma, communication, issues

Communication within relationships among trauma populations

Aim/Purpose: To provide a review of the research into communication within relationships among traumatised populations and recommendations to support effective communication.

Design/Methodology: This paper is a review using a systematic approach. A systematic search of the literature was conducted using electronic databases and manual searches to locate peer-reviewed studies published between January 2003 and November 2013. The searches were performed using the following defined search terms:  "relationship" AND "communication" AND "trauma". The inclusion criteria were (1) primary focus on communication interactions among individuals who experienced trauma; (2) original research studies, (3) published between January 2003 and November 2013, and (4) all study designs. The exclusion criteria were (1) studies not in English, (2) literature reviews, dissertation theses, review papers, reports, conference papers or abstracts, letters (to the editor), commentaries and feature articles. The identified studies were evaluated to identify the communication issues, barriers, benefits and variables within relationships among individuals who have experienced trauma.

Results/Findings: The communication issues within relationships among traumatised populations were identified and will be discussed, such as "not willing to speak", "timing" and "environment". Communication barriers and benefits among individuals who have experienced trauma will be considered. The communication variables to support positive relationships will be explored such as "trust" and "empathy".  Based on these findings, recommendations will be provided to support effective communication within relationship among individuals who have experienced trauma.

Research Limitations: The limitations include the findings are only based on primary research studies, and the nature of literature reviews indicate areas for further research rather than firm conclusions.

Conclusions/Implications: The communication issues, barriers, benefits and variables within relationships among individuals who have experienced trauma will be presented. This paper will provide Counsellors and practitioners with recommendations on how to support effective communication within relationship among individuals who have experienced trauma.

 

Symposium D - Jane Simms

Professional Role: Psychologist and Lecturer in Counselling
Institution/Affiliation: University of Ulster
Contact details: 17E 06, School of Communication, Jordanstown Campus, Shore Road, Newtownabbey, County Antrim, BT37 0QB
Email: j.simms@ulster.ac.uk

ABSTRACT: symposium D paper 2                                                         

Keywords: post-traumatic growth, post-traumatic stress, political conflict, therapeutic relationship, case study

Features of post-traumatic growth amongst victims of the Northern Irish ‘troubles': Is it possible? A case study analysis

A
im/Purpose: Northern Ireland has one of the highest rates of posttraumatic stress disorder in the world due to the political conflict, colloquially referred to as the ‘troubles'. Yet, little is known as to whether those who have experienced a ‘troubles' related trauma have been able to psychologically grow. The aim of this study was to adopt an idiographic approach that permitted the exploration of potential post-traumatic growth themes within personal experience narratives, amongst three victims of the Northern Irish ‘troubles'.

Design/Methodology: A case study approach was adopted comprising three participants of which two were male and one female. They were recruited from a local ‘Victims' organisation. All had endured extensive physical and psychological injuries resulting in chronic and debilitating health problems. Semi-structured interviews were carried out comprising 7 questions that were developed in accordance with Tedeschi's and Calhoun's (2008) framework, which comprises five domains: (1) New possibilities; (2) Greater appreciation for life; (3) Personal strength; (4) Spiritual change; (5) Relating to others.

Results/Findings: Findings reveal that certain features of growth are evident in the domains of a greater appreciation of life, changed relationships, new possibilities and personal strength. Changes in the growth domain relating to religion and spirituality set the three cases apart.

Research Limitations: The case study approach is limited in that the ideographic nature of it restricts generalisations. The sample is representative only of one section of the community who have been psychologically traumatised as a result of the ‘troubles'. Future research should seek to conduct quantitative and qualitative research on a larger sample with victims from across the political divide.

Conclusions/Implications: Features of PTG are prevalent amongst individuals who have experienced a ‘troubles' related trauma and these can co exist with longstanding symptoms of posttraumatic stress. These findings highlight the importance of clinicians focusing on the personal meanings that have been generated from the traumatic events and how these have been harnessed in way to generate hope and benefit even in the midst of ongoing political conflict and psychological pain.

 

Symposium D - Jill Hendron

Professional Role: Lecturer
Institution/Affiliation: University of Ulster
Contact: c/o j.simms@ulster.ac.uk

ABSTRACT: symposium D paper 3                                                         

Keywords: trauma, vicarious impact, clergy, relationships, support

God and trauma: clergy as informal trauma support resources

Aim/Purpose: As a result of the province's turbulent history the lives of many of its inhabitants have been overshadowed by traumatic events and the mental health of the population has been negatively impacted (Cairnes & Darby, 1998). Those who live through and beyond these traumatic experiences may seek support from informal sources such as faith leaders (Hendron et al., 2012). For many the local cleric may be the first point of
contact in the immediate trauma aftermath and during the following weeks, months and years. The aim of this study was to explore the secondary traumatisation experiences of clergy as informal support resources for individuals and communities who experience trauma.

Design/Methodology: Mixed methodology. 3 year funded mixed methods research project. Stage 1: 226 serving Irish clergy completed a researcher designed questionnaire regarding trauma exposure, training and support. Stage 1 participants were recruited via postal contact from details listed on the Church of Ireland website. Participants also completed the Professional Quality of Life V (assessing secondary traumatic stress; burnout and compassion satisfaction). Data was analysed using SPSS 18. Stage 2: In-depth interviews with 16 clergy. Stage 2 participants were recruited from Stage 1 participants willing to contribute at Stage 2 and further sampled via defined quartiles for levels of STS & EI. Data was analysed within an Interpretative Phenomenological Analysis framework using Nvivo software.

Results/Findings: Results indicate clergy themselves are being impacted as result of these support relationships. Individuals and communities forming special relationships with clergy prior to and after trauma experiences may place clergy at increased risk of vicarious impact. Results also suggest the experiences of secondary traumatic stress and vicarious traumatisation may be more distinct than previously considered.

Research Limitations: The study examined the experiences of faith leaders working within only one of the four main Irish churches.

Conclusions/Implications: Important implications regarding care for informal resources of trauma support, Relationships that could be strengthened between informal ‘gate keepers' and more formal service providers to provide a holistic approach to client care are discussed.

 

Symposium E - John McLeod

Other Author: Mick Cooper
Professional Role: Professor of Psychology
Institution/Affiliation: University of Oslo
Contact details: Department of Psychology, University of Oslo, Pb. 1094, 0317 Oslo, Norway
Email: john.mcleod@psykologi.uio.no

ABSTRACT: symposium E overview                                                        

Keywords: outcome, pluralistic therapy, process, values

Research on pluralistic therapy

The aims of the symposium: Pluralistic therapy is an approach that reflects research evidence that there exists a diversity of possible change processes, and that  effective therapy involves active engagement with clients around identifying and implementing their preferred way of working. The aim of this symposium is to present examples of current research into the process and outcome of pluralistic counseling and psychotherapy, and issues around the training of practitioners using this approach.

Contribution of each symposium paper to the overall theme: The first paper, by Mick Cooper, presents an overview of the design and results of a collaborative study of the effectiveness of pluralistic therapy for depression. This is followed by a presentation by Patricia Joyce of preliminary findings of a randomized controlled trial of pluralistic counselling for young people with issues around addiction. The third paper, by Mick Cooper, focuses in more detail on an analysis of the experiences of clients in the collaborative study  of pluralistic therapy for depression. The final paper in the symposium  addresses  issues around the characteristics and experiences of practitioners of pluralistic therapy. Paper 4, by Ellen Tilley, comprises a qualitative study of the values that influence pluralistic practice. This paper provides a reflexive commentary on underlying themes in the symposium as a whole, by highlighting value positions and dilemmas associated with this form of therapy.

Implications of the symposium theme for counselling and psychotherapy theory, research and practice: A pluralistic framework for therapy practice represents a potentially important means through which the profession can begin to (a) resolve issues around competition between different schools of practice, while at the same time (b) providing a flexible and resourceful way of  being responsive to client  preferences. The network of researchers and practitioners involved in the development of pluralistic therapy is committed to the value of a wide range of research methodologies. The symposium demonstrates some of the ways in which a rich knowledge base for practice can be constructed through theoretically-guided and strategic use of different forms of inquiry.

Name of the symposium discussant: None

 

Symposium E - Mick Cooper

Other Authors: John McLeod, Biljana van Rijn, Tony Ward, Ciara Wild
Professional Role: Professor of Counselling Psychology
Institution/Affiliation: University of Roehampton
Email: mick.cooper@roehampton.ac.uk

ABSTRACT: symposium E paper 1                                                          

Keywords: pluralistic therapy, integrative psychotherapy, depression, treatment outcomes, meta-therapeutic communication

The outcomes of pluralistic therapy for depression

Aim/Purpose: The aim of this open-label trial was to assess the acceptability and outcomes of a pluralistic therapeutic intervention for depression.

Design/Methodology: The study adopted a multisite, non-randomised, pre-/post- intervention design. Participants experiencing moderate or more severe levels of depression (as assessed by a score of 10 or greater on the Patient Health Questionnaire depression scale, PHQ-9) were offered up to 24 weeks of pluralistic therapy for depression: a collaborative integrative practice oriented around shared decision making on the goals and methods of therapy. Of the 42 participants assessed, 39 (92.9%) completed two or more sessions. Participants were predominantly female (n = 28, 71.8%) and white (n = 30, 76.9%), with a mean age of 30.9. The principal outcome indicator was improvement and recovery on the PHQ-9 and Generalized Anxiety Disorder 7-item (GAD-7) scale.

Results/Findings: Of the completer sample, 71.8% of clients (n = 28) showed reliable improvement and 43.6% (n = 17) showed reliable recovery. Effect sizes (Cohen's d) from baseline to endpoint were 1.83 for the PHQ-9 and 1.16 for the GAD-7. Larger reductions in anxiety were associated with greater number of sessions and planned endings.

Research Limitations: As an uncontrolled trial, effectiveness or efficacy cannot be established, though the use of standard measures provides the opportunity to compare against commensurate interventions. The relatively small sample size limits generalizability. Adherence to pluralistic practice was assessed using a self-report measure, rather than client or observer ratings.

Conclusions/Implications: Initial indications suggest that pluralistic therapy for depression has adequate outcomes, retention rates, and levels of acceptability. Refinement and further testing of the approach is recommended.

 

Symposium E - Patricia Joyce

Other Authors: Mick Cooper, Mark Elliot
Professional Role: Phd student
Institution/Affiliation: University of Roehampton
Email: patriciajoyce225@btinternet.com

ABSTRACT: symposium E paper 2                                                          

Keywords: addiction, pluralistic therapy, qualitative, randomised controlled trial, young people

A comparison of pluralistic counselling and counselling as usual for young people with addiction issues

Aim/Purpose: To evaluate the effectiveness of pluralistic therapeutic approach for young people with issues relating to addiction.

Design/Methodology: A randomised controlled trial was conducted with 50 young people between the ages of 13 and 24, who presented for counselling with addiction as a primary issue. Once assessed, clients were allocated to either counselling as usual, or counselling utilising a pluralistic approach. Principal outcome measures at review and end of counselling were the YP-CORE, the Strengths & Difficulties Questionnaire (SDQ), and a  measure of substance usage. Both groups of participants were also invited to take part in a semi- structured interview at the end of the counselling process, to explore the changes they experienced as a result of the counselling interventions. Counselling as usual consisted of weekly counselling based on the Skills for Health competences for humanistic therapy. In the pluralistic counselling condition, treatment as usual was enhanced by the use of a pluralistic framework: (i) goals of therapy were discussed and recorded at each session and an open dialogue around how these goals could be met was undertaken; (ii) the Young Person's Therapy Personalisation form and Session Rating Scale were used to adjust the therapy process to the young person's needs.

Results/Findings: YP CORE data show a statistically significant increase in the mental health in participants receiving a pluralistic intervention'. That is, at the moment it's not significant for the control group, but we wait and see. Findings from SDQ are less conclusive at this stage. When exploring the feasibility of conducting this form of RCT, findings indicate that only small numbers of young people referred to the service did not wish to be part of the study or withdrew consent subsequently with little ‘drop-out' after assessment and attendance being comparable with earlier research in this field. Counsellor issues reflect difficulties in extending their therapeutic menu and adjusting to working in this way

Research Limitations: Due to limited resources, the trial is not fully-powered, and therefore may be subject to type-II errors. The pluralistic intervention is also in its early stages of development.

Conclusions/Implications: Through the collection of both quantitative and qualitative data, the study provides new understanding of the issues involved in specifically tailoring therapeutic interventions to young people. This is the first direct comparison of a pluralistic therapeutic approach against counselling as usual.

 

Symposium E - Mick Cooper

Other Authors: Pavlina Antoniou, John McLeod
Professional Role: Student, Professional Doctorate in Counselling Psychology
Institutional affiliation: University of Strathclyde and Glasgow Caledonian University 
Email: panton10@caledonian.ac.uk

ABSTRACT: symposium E paper 3                                                          

Keywords: client perspective, depression, helpful factors, pluralistic therapy, qualitative

Client-identified helpful factors in pluralistic therapy for depression

Aim/Purpose: To identify the views of clients regarding what has been helpful or hindering for them in the therapy they have received

Design/Methodology: Consent was obtained from all clients in a study of pluralistic therapy for moderate to severe depression, to participate in follow-up interviews. In-depth, structured Change Interviews were conducted with 8 clients. Clients were invited to take part in Change Interviews in order of completion of therapy. Recruitment continued until a sufficient sample had been attained. Interviews were carried out by telephone or face-to- face, and took place following the end of treatment.  Client  descriptions of helpful and hindering aspects of therapy were transcribed and subjected to thematic analysis, using multiple independent coding of data followed by dialogue between members of the research team until consensus was achieved.

Results/Findings: Only a small number of descriptions of hindering factors were generated by participants. Helpful factors could be classified into a number of broad domains: therapist- related, client-originated, and helpful therapeutic activities. The relevance of the sub-themes uncovered within  these domains is discussed in relation to (a) the aims and procedures of pluralistic therapy, and (b) findings of previous research into helpful factors in therapy.

Research Limitations: The number of participants in this study is low, and findings need to be interpreted with caution. The study could further benefit from the exploration of the therapists' perspectives of helpful therapeutic factors.

Conclusions/Implications: The findings of this study contribute to enhancing our understanding of depressive clients' therapeutic experiences, and provide support for the hypothesis that pluralistic therapy facilitates engagement in a diversity of change processes.

 

Symposium E - Ellen Tilley

Other Authors: John McLeod, Julia McLeod
Professional Role: MSc Student
Institution/Affiliation: University of Abertay Dundee
Email: etilley89@gmail.com

ABSTRACT: symposium E paper 4                                                          

Keywords: counselling, pluralism, psychotherapy, theoretical orientation, values

Values issues associated with training and practice in pluralistic counselling

Aim/Purpose: To identify the values espoused by counsellors who embrace a pluralistic model of practice; and to explore the nature of the issues or challenges that pluralistic counsellors experience in relation to values dilemmas that arise in their work with clients.

Design/Methodology: Semi-structured interviews were used to invite 12 participants, recruited from a network of pluralistic practitioners and trainees. A snowballing recruitment strategy was used to gain access to participants across at all stages of counsellor development from novice to expert. The interview schedule invited reflection on the individual's values as a pluralistic counsellor, including recalling and describing counselling episodes in which their own values did not match the client's values and value negotiation took place. The transcripts were analysed using a method of thematic analysis, involving independent auditing.

Results/Findings: Participants viewed their personal values to be compatible with the values that they perceived pluralistic counselling to hold. Participants chose pluralism as a modality because they found a similarity between their personal values and the values of pluralistic counselling. The values that were most widely emphasised included: the importance of interpersonal relationships, no one right way of being, power balance, honesty, and embracing research evidence. Participants illustrated how working with their values allowed them to work with their clients collaboratively, in a manner that engendered methods for change that suited their client's unique needs. A number of values dilemmas were also identified.

Research Limitations: The findings of  this study need to be interpreted with caution, because the sample of participants may not be representative of the wider pluralistic therapy community.

Conclusions/Implications: This research gives some insight to the values held by pluralistic counsellors, and the challenges that pluralistic counsellors face in reference to value dilemmas. This information contributes to the further development of training in pluralistic counselling. This research also highlights the need for future research in the area of values in counseling, in order to develop a better understanding of distinctive value positions associated with different approaches to therapy.

 





 










































































 














 





 

                                                                                                                                                                                                                              
 
       
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