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Research Conference 2015  

14562_posters 2015.jpg14564_powerpoints 2015.jpg


 

BACP's 21st Annual Counselling and Psychotherapy Research Conference entitled 'Understanding professional practice: the role of research' took place on 15 – 16 May 2015 at East Midlands Conference Centre, Nottingham.

 

Click here for an evaluation of this year's conference

Abstracts

 

Pre-Conference Workshop

Presenter: Professor John Norcross, Ph.D., ABPP

Professional Role: Distinguished Professor of Psychology
Institution/Affiliation: University of Scranton, USA
Email: john.norcross@scranton.edu
ABSTRACT: pre-conference workshop

Changeology: Tailoring the Stages of Change to the Individual Client

The evolution of psychotherapy and the science of behavior change call for integrative, evidence based treatments tailored to the individual client. Backed by 30 years of research, this workshop provides effective methods for adapting the treatment method and the therapy relationship to the stage of change. You will learn to rapidly assess the stages (precontemplation, contemplation, preparation, action, maintenance) and then to match change catalysts specific to that stage.

"Doing the right thing at the right time" is the key to efficient change.

By the end of this workshop, you will be able to:
- assess reliably a client's stage within 1 minute
- implement specific, research-supported change catalysts according to the stage of change
- tailor your relationship to the client's stage

 

Friday Keynote

Presenter: Professor John Norcross, Ph.D., ABPP
Professional Role: Distinguished Professor of Psychology
Institution/Affiliation: University of Scranton, USA
Email: john.norcross@scranton.edu

ABSTRACT: keynote presentation (Fri, 09.15-10.15)

Creating a new therapy for each client: where practice and research converge

Psychotherapy is a treatment method and a healing relationship fit to the individual client; however, only in the past two decades has sufficient research been conducted to operationalize these noble intentions into robust matching guidelines. This invited address will review the meta-analytic research and clinical practices compiled by an interdivisional APA task force on effective methods of adapting psychotherapy to individual patients. We will consider six client dimensions (reactance level, stages of change, preferences, culture, coping style, religion/spirituality) that can be used to tailor treatment, as well as some promising directions (attachment style, expectations) for doing so. In this way, practice and research converge in evidence-based responsiveness that demonstrably improves treatment success.

Saturday Keynote

Presenter: Professor Glenys Parry
Professional Role: Professor of Applied Psychological Therapies
Institution/Affiliation: University of Sheffield
Email: g.d.parry@sheffield.ac.uk

ABSTRACT: keynote presentation (Sat, 09.15-10.00)

First do no harm: how to make therapy safe as well as effective

Many people benefit from counselling and psychotherapy; by any of the criteria used in health services research they have been shown to be effective in helping people improve their wellbeing and quality of life. However, like many other effective interventions in health care, therapy carries risks as well as benefits. Psychotherapy researchers have not made safety a priority; we are very poor at recording and reporting adverse events during therapy and adverse outcomes after therapy. Although negative effects have been discussed for over 50 years, the field has not progressed much in understanding their revalence, ypes and causes. To be effective, practitioners need to believe in what they do, but this can lead to complacency and ignorance of how to detect and prevent negative effects.

I shall report on a research project from the University of Sheffield which explored this topic from three perspectives; 1) the experience of clients and therapists and their views of why therapy fails, 2) which factors predict negative outcomes and how therapists vary in their outcomes when these factors are taken into account, and 3) a statistical meta-analysis of whether people have a higher risk of a bad outcome after psychological therapy than those randomly assigned to no-therapy control groups. From these results and from others' work, I critically examine the evidence on the risk of harm from therapy to summarise what is known (and not known) about the prevalence, causes and mechanisms of bad therapy process and outcomes. I shall describe ways in which psychological therapies research and practice can improve to reduce the risks of harm, and outline a future research strategy for testing the impact of these improvements. Finally I suggest some simple, practical ways counsellors and therapists can protect their clients from therapy-induced harm.

The following abstracts are ordered alphabetically by First Author surname:



Marie Adams

Presenter: Dr Marie Adams
Professional Role: Module Leader: Professional Knowledge and Review of Personal and Professional Learning
Institution/Affiliation: Metanoia Institute
Email: marie.adams@metanoia.ac.uk
ABSTRACT: paper (Sat, 14.25-14.55)

Keywords: therapists, vulnerability, pain, refuge, time-out

Work as a refuge: therapists working through physical and emotional pain

Aim/Purpose: This presentation focuses on one aspect of research into the personal lives of therapists and the impact on their clinical work. The paper provides an opportunity to look at the implications of physical and psychological pain as they pertain to therapists' effectiveness and their ability to empathise.
Design/Methodology: This was a qualitative study into the personal lives of forty therapists across three countries, the UK, Canada and Australia. Ten psychotherapists in four major traditions were interviewed. While the interviews were semi-structured, the focus was on whether the participants had ever experienced a period, or incident, in their personal lives they believed had impacted their work. Had they experienced depression since beginning work? If faced with the same crisis again, would they manage it the same way? The data were analysed using a mixed IPA, thematic approach.
Results/findings: Twenty-four of the forty therapists interviewed admitted they had experienced periods of depression since beginning work as clinicians. Therapists also spoke of experiencing physical pain, facing bereavement and suffering difficulties in their home lives. Often they used work as a refuge from pain, some clinicians claiming it deepened their empathy, while others admitted it could also interfere with their ability to attune to their clients.
Research Limitations: This was a qualitative study and therefore the data was open to personal interpretation.
Conclusions/Implications: How can we determine when our personal experience of pain is interfering with our work as therapists? We may find relief in working, but our clients may not be receiving our full attention. We may avoid certain areas of discussion, or feel ashamed that we are as vulnerable as our clients. Clinicians sometimes feel pressured to continue working in order not to let their clients down, and there are often financial implications when forced to give up work.Pain can act as a catalyst to a deeper empathy towards others, but it may also interfere with our ability to contain and remain attuned to our clients. In light of this complexity, how do we tell the difference?

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Linda Beech

Presenter: Linda Beech
Other Author: Kate Smith
Professional Role: Counsellor
Institution/Affiliation: St Andrews University
Email: ljb24@st-andrews.ac.uk
ABSTRACT: paper (Sat, 14.25-14.55)

Keywords: student counselling, effectiveness, CORE-OM, outcomes, presenting issues

A naturalistic evaluation of outcomes of a university-based student counselling service

Aim/Purpose: This research study aimed to evaluate the effectiveness of a university service offering individual face-to-face counselling using demographic, process and outcome (CORE-OM) measures.
Design/Methodology: This study used quantitative analysis carried out on anonymised data collected on 533 student clients accessing the service, with a total of 2361 sessions. Demographic data, attendance, and presenting issues were examined for an impact on reliable and clinically significant improvement (RCSI), and reliable improvement (RI) according to change in CORE score over therapy (effect size).
Results/Findings: The findings revealed that attendance at this service resulted in RI in 59% of cases, and RCSI in 34%. A wide range of presenting issues was identified, the most common being anxiety, depression and academic issues. Results suggest that counselling is most effective for students who present with low- to mid-severity CORE-OM scores, and while reliable attendance appears important, the number of sessions did not impact on outcome.
Research Limitations: This exploration of a counselling service used historic data, and as such gives an overview of the service provided, using standardised measures. Some of the limitations of this are the self-reported ratings of issues, and ambiguity of DNA endings and of using single presenting issues as categorical measures.
Conclusions/Implications: The strength of this study is that it presents the outcomes of student counselling provision for a wide range of presenting issues. Results suggest the utility of training student counsellors in a flexible and pluralistic approach to practice, and also provide evidence of the need for funding in higher education towards emotional and psychological support.

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Kelly Birtwell & Dr Linda Dubrow-Marshall

Presenters: Kelly Birtwell & Dr Linda Dubrow-Marshall
Other Authors: Dr J Raw, T Duerden & A. Dunn
Professional Role: Clinical Research Recruitment Facilitator
Institution/Affiliation: Manchester Mental Health & Social Care Trust
Email: kelly.birtwell@mhsc.nhs.uk
ABSTRACT: paper (Sat, 11.30-12.00)

Keywords: Parkinson's disease, mindfulness, depression, stress, coping

The impact of Mindfulness-Based Stress Reduction (MBSR) on depression, anxiety and stress in people with Parkinson's disease

Aim/Purpose: To evaluate the impact of an 8-week Mindfulness-Based Stress Reduction course (MBSR) on people with Parkinson's disease (PD) experiencing depression, anxiety and stress, or difficulty coping with PD.
Design/Methodology: The study used a mixed methods design, the primary outcome measure was the Depression Anxiety and Stress Scale (DASS-21). 13 participants with PD were recruited and 6 completed the full MBSR course. Minor adaptations were made to the course to meet the specific needs of patients with Parkinson's, e.g. shorter practices, and the body scan while sitting instead of lying down. Data was collected at baseline, week 8 week (upon completion of the course) and week 16. Patients with Parkinson's were involved throughout the life of the study,including the study design stage, providing comments and feedback on questionnaires and the intervention itself.
Results/Findings: Statistically significant improvements were seen in self-reported depression, anxiety and stress as measured by the DASS-21 at week 8 and week 16. Results from some domains of the Parkinson's Disease Questionnaire 39 (PDQ39) showed improvements, although not statistically significant, and other domains showed worsening of symptoms. Results from the Mindful Attention Awareness Scale (MAAS) showed little change. In qualitative follow-up questionnaires all participants reported they would recommend the mindfulness course to other Parkinson's sufferers. Reasons for dropping out included scheduling conflicts, unexpected ill health, and one participant did not wish to continue with the MBSR course. 4 participants withdrew before the course began, and 3 participants withdrew after the first session. Some participants who withdrew asked if they could rejoin the MBSR course at a later date but this was not possible.
Research Limitations: Interpretation of the results is limited by the small sample size and lack of control group.
Conclusions/Implications: This study supports previous findings that mindfulness-based interventions could benefit people with Parkinson's disease experiencing non-motor symptoms. In spite of the high drop-out rate this study indicates the intervention is acceptable to patients. Further research using larger sample sizes is required. Future research could also involve carers and could look at tailoring the intervention more specifically to people with Parkinson's.

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Pamela Campbell

Presenter: Pamela Campbell
Professional Role: MSc Student (completed) and lecturer
Institution/Affiliation: University of the West of Scotland/Glasgow Caledonian University
Email: Pamela.campbell@uws.ac.uk
ABSTRACT: paper (Sat, 13.50-14.20)

Keywords: counselling, psychotherapy, education, effectiveness, student

The effectiveness of student counselling services in Higher and Further Education: a systematic review of the research evidence

Aim/Purpose: To evaluate the best quality research evidence from a range of sources on the effectiveness of student counselling services in Higher and Further Education. Main purpose of the study was to provide an update on a previous review (Connell, Cahill, Barkham, Gilbody and Madill, 2006).
Design/Methodology: A hierarchy of evidence approach was taken consistent with Cochrane EPOC Review Group (2014). A wide arrange of designs were evaluated including uncontrolled prepost designs, randomised control trials, quasi controlled studies, case studies and qualitative designs. Eight electronic databases, including PsychINFO and Medline were searched revealing nearly 20,000 citations. The review identified and summarised the best quality research on effectiveness of student counselling and psychotherapy.
Results/Findings: There was preliminary evidence that therapy was effective for student counselling populations. However, the evidence base associated with student counselling was dominated by pre-post deigns of low quality.
Research Limitations: The systematic review was conducted by one researcher.
Conclusions/Implications: Future research needs to be more coordinated, more focused in the breadth of area covered, and raised in terms of methodological quality to permit conclusions to be drawn and recommendations to be implemented at government and service level. In the context of limited resources and increasing demands for an evidence base, there is a strong argument for government supported funding to deliver a coordinated UK national study to evaluate student access to routine student counselling and establish its effectiveness. This would be comparable to current government initiatives looking at models of improving access to psychological treatments.

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Valentina Chichiniova

Presenter: Valentina Chichiniova, MA
Other Authors: Marvin McDonald, PhD
Professional Role: Clinical Counsellor
Institution/Affiliation: Trinity Western University, Canada
Email: valentina.chichiniova@gmail.com

ABSTRACT: methodological innovation paper (Fri, 15.30-16.00 and Sat, 12.05-12.35)

Keywords: dissociation, dissociation research protocols, trauma/PTSD research protocols,
idiographic analysis, item-analysis

Enhancing methodology for investigation of trauma and dissociation: findings from a randomized control trial comparing trauma therapies for sexual assault victims

Background and introduction: Reviews of empirical, clinical, and theoretical resources on trauma and trauma therapies suggest that dissociative experiences frequently follow traumatic experiences (Vermetten et al., 2007; van der Hart et al., 2006). Recent international research has identified substantial underreporting and/or underdiagnoses of dissociative symptoms in medical, mental health, and general populations. Clinical research needs to assess dissociation systematically and broadly to strengthen empirical background for health care. However, research design and measurement of dissociation poses distinctive challenges. This presentation will summarize adaptations in clinical research methodology for projects in which assessment of
dissociation plays an important feature of the design. Nature of the methodological innovation/critique being proposed: Script-driven symptom
provocation (SDSP) protocols (Lanius et al., 2001, 2004) involve the systematic triggering of there-experiencing of trauma during data gathering. Dissociative responses are frequently among the symptoms provoked by the procedure. SDSP was employed in a study comparing trauma therapies for sexual assault survivors. The design incorporated mixed method strategies, including systematic coordination of quantitative and qualitative assessment of dissociation. The proposed methodological principles are illustrated through an indepth analysis of data from several components of this study. The Impact of Event Scale-Revised (Weiss & Marmar, 1997) was examined in relation to clinical observations, patterns of self-report, and neurological assessment at idiographic levels of analysis. Methodological recommendations deriving from these analyses include screening and recruitment of participants with a history of trauma or dissociation, psychometric evaluation and adaptation of standardized instruments, proactive cultivation of collaborative and clinical relationships with research participants, and systematic strategies for idiographic data analysis.
Conclusion and relevance to counselling and psychotherapy research practice: The findings indicated the need for further innovations in clinical research protocols for trauma survivors. Idiographic analyses revealed clinically meaningful complexity in self-reported dissociation, which was largely concealed by traditional group-based statistical procedures. The proposed changes in research protocols for dissociation are critical for identifying masking processes and treatment effects as they emerge in trauma therapy, thus leading to enhancements for research methods and clinical practice.

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Prof Mick Cooper

Presenter: Prof Mick Cooper
Other Author: Dr Fani Papayianni
Professional Role: Professor of Counselling Psychology
Institution/Affiliation: University of Roehampton
Email: c/o mick.cooper@roehampton.ac.uk

ABSTRACT: paper (Sat, 12.05-12.35)

Keywords: meta-therapeutic communication, pluralistic therapy, collaboration, negotiation, psychotherapy process research

Meta-therapeutic communication: What, when and how do therapists talk to clients about the process of therapy?

Aim/Purpose: The purpose of the study was to investigate the nature of meta-therapeutic communication (MTC) in therapy. MTC has been articulated and advocated within the pluralistic approach, and can be defined as moments of negotiation between therapist and client on the process of therapy. In this project, we were specifically interested in identifying: When do therapists meta-therapeutically communicate with their clients? What is the focus of meta-therapeutic communication?
Design/Methodology: Thirteen pluralistic therapists, working with 39 clients experiencing depressive symptoms, were asked to briefly describe on their post-session note forms 'any moments of negotiation/collaboration around the goals/tasks/methods of therapy', and to indicate when in the session they occurred. Their responses were then thematically analysed using an inductive approach, to identify the main foci of MTC, and the principal times at which it occurred.
Results/Findings: The study identified three main dimensions of meta-therapeutic communication. The first regarded the time at which MTC took place. Categories of time included start of session, within session, end of session, review session/point, and final session. The second dimension involved the content of the MTC. Categories of content included goals,tasks/methods, content/focus, understandings/formulation, progress, client experience. The third
dimension was the temporal focus of the MTC: that is, the time period on which it was focused. Categories of temporal focus were previous sessions, current session, next session, therapeutic work as a whole, outside of session, ending.
Research Limitations: The research was conducted as part of a small pilot study, so generalizability is limited. The question also lacked precision, and therefore more precise data may have been missed. It is also possible that the answers were biased by the researchers' own perspectives.
Conclusions/Implications: The research provides psychological therapists with an understanding of the times in which meta-therapeutic communication may be used -- and appropriate -- in therapy. Such knowledge may facilitate further opportunities for dialogue, collaboration and negotiation around the goals, tasks and methods of therapy, potentially contributing to more fruitful therapy outcomes.

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A. Elizabeth Crunk, E. H. "Mike" Robinson, III, Paulina Flasch & Sandra Robinson

Presenters: A. Elizabeth Crunk, E. H. "Mike" Robinson, III, Paulina Flasch & Sandra Robinson
Professional Role: Doctoral Student (Counselor Education, UCF)
Institution/Affiliation: University of Central Florida
Email: elizabethcrunk@knights.ucf.edu
ABSTRACT: paper (Fri, 14.00-14.30)

Keywords: bibliotherapy, children's literature, children, counseling, meta-analysis

The efficacy of bibliotherapy for children: a meta-analysis

Aim/Purpose: Bibliotherapy is the use of literature, film, or other media to promote understanding and facilitate problem solving related to one's therapeutic goals (Marrs, 1995). Children's literature, for example, may be used in counseling or in the classroom to foster emotional growth and help children cope with difficult life situations (Goddard, 2011; Robinson & Curry, 2005). Bibliotherapy is used to address a variety of child issues (Heath, Sheen, Leavy, Young, & Money, 2005); however,outcome studies of bibliotherapy have produced mixed results. This paper will report findings of a meta-analysis on the effectiveness of bibliotherapy as a therapeutic tool for children.
Design/Methodology: Consistent with meta-analytic design (Smith & Glass, 1977), the researchers will synthesize quantitative findings of outcome studies of bibliotherapy for children. To be included in this meta-analysis, studies must have met the following criteria: (a) utilized an intervention that corresponds to the above definition of bibliotherapy, (b) included children and adolescents exclusively, (c) utilized a comparison or control group, and (d) provided data that were
amenable to meta-analytic procedures. At this stage in the study, approximately 25 studies have been reviewed, identified with PsycINFO, PsycARTICLES, ERIC, and Web of Science.
Results/Findings: Preliminary findings indicate that bibliotherapy for children is (a) more effective than control groups when used as a standalone treatment intervention, (b) more effective than control groups when used as a preventive intervention, and (b) most effective when used as an adjunct to psychotherapy.
Research Limitations: This study is limited by: (a) a shortage of quantitative outcome studies of bibliotherapy for children, (b) broad inclusion criteria, and (c) primary studies that vary in methodological rigor.
Conclusions/Implications: To the researchers' knowledge, this will be the first meta-analytic review of outcome studies on bibliotherapy for children exclusively. As such, this study will contribute more conclusive evidence for the efficacy of bibliotherapy with children. This study also highlights best practices for practitioners across a variety of settings who may use books and other media as therapeutic tools with children.

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Mehboob Dada

Presenter: Mehboob Dada
Other Authors: Reyhan Yaprak, Debra Powell
Professional Role: Trainee Counsellor
Institution/Affiliation: LC&CTA (Lewisham Counselling and Counselling Training Associates)
Email: mehboobdada@gmail.com,  reyhan_yaprak@yahoo.co.uk, and magictouch1965@hotmail.co.uk
ABSTRACT: poster (Fri, 10.20.10.45)

Keywords: ethnicity, racism, microagression, recognition-trauma, effectiveness.

Black and Minority Ethnic (BME) trainee counsellors' reflections on our training experience and the implications for practice

Aim/Purpose: To explore and understand how issues of ethnicity and racism were both experienced and addressed in our counselling training through the personal experiences of the researchers themselves. The research was motivated by our own processes whilst undertaking practitioner training and aimed to draw on the personal/interpersonal impact of our lived realities with the purpose of highlighting any implications for future/effective training in the profession.
Design/Methodology: Three BME counsellor trainees (Turkish/Asian/Caribbean, Male/Female, Heterosexual/Gay, Muslim and Christian) undertook the research; using a semi-structured questionnaire to reflect upon our individual processes during our training, the outcomes of which were then discussed in a research group process. Thematic analysis of our data ensued, informed by the Duquesne Method of Empirical Phenomenology (Moustakas, C (1994) in McLeod, J. (2001) p.40-46), common ideas and threads were identified and anomalies noted; our thematic data analysis was verified and agreed by an independent research practitioner.
Results/Findings: Analysis of our data highlighted:
• Racism at a personal and institutional level is a common theme and experience.
• Whilst our training was a positive learning experience about self and identity, it also brought to the fore recognition-trauma and reinforced the inadequacy of the training process; highlighting deeply rooted prejudices and/or internalised racism.
• Despite an enabling facilitative space being created, we still felt silenced; this illuminated the degree of internalised trauma or inherited racism, or both.
Research Limitations: Small sample group; in order to fully explore/test the implications of our research a larger study needs to be undertaken.
Conclusions/Implications: Our research indicates, that whilst our training on ethnicity and diversity as BME counsellor trainees was effective, greater reflective opportunities are called for in order to better support BME trainees. Critically, our research indicates the need for concerted institutional support to enable and facilitate a learning environment supportive of BME counsellor trainees; this needs to be of paramount concern to trainers; and research on how to create such support needs to ensue.

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Elaine Davies

Presenter: Elaine Davies
Professional Role: Clinical Team Manager  Hereford IAPT
Institution/Affiliation: 2gether NHS Trust, Hereford
Email: Elaine.Davies2@glos.nhs.uk
ABSTRACT: paper (Fri, 16.05-16.35)

Keywords: talking therapies, employability, collaboration, partnership

What do employers of the talking therapies expect from the newly qualified? How could training institutions adapt?

Aim/Purpose: The aim of this study was to make a small contribution by exploring employers requirements of the newly qualified in talking therapies based on the impact of their employment experiences.
Design/Methodology: A qualitative thematic analysis study was adopted by interviewing 8 employers of talking therapies across England and Wales. These employers representing a range of disciplines (counselling, CBT, psychology and mental health nursing) across the statutory, private and voluntary sectors were self-selected and initially approached by email/telephone. Semistructured interviews were conducted face-to-face and via telephone which focused on employers' thoughts about the 'readiness to practice' in the newly qualified and whether there were any gaps when leaving an academic institution.
Results/Findings: Early findings at this juncture indicate that employers state that the newly qualified are lacking in knowledge of assessment including risk assessment, working briefly, clear contracting, understanding the organisational structure, policy and procedures, insights into the presenting problem and experience of technology and electronic note taking. All of which hinders employability.
Research Limitations: Although a small scale study this research has captured a number of employers across orientation and disciplines. It is a good place to start critical conversations and further research.
Conclusions/Implications: The implications to the newly qualified seems unjust and could lead to disillusionment. Good practitioners could leave the profession. Employers and training institutions of the talking therapies would benefit from collaboration in course design in view of the findings that
newly qualified are not fit for employability and that employers are not willing to employ them.

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Ani de la Prida

Presenter: Ani de la Prida
Professional Role: Lecturer, Person-Centred Therapist, MA Student
Institution/Affiliation: Renew Counselling/University of East London
Email: delaprida@sky.com

ABSTRACT: poster (Fri, 10.20-10.45)

Keywords: digital media, technology, iPad, person-centred art therapy, young people

A qualitative study of experiences of using digital technology through using an iPad in therapy

Aim/Purpose: The therapeutic use of digital technology appears largely neglected to date. By introducing an iPad into clinical practice using person-centred art therapy skills, this study explores the potential of digital media in therapy.
Design/Methodology: As little is currently published on this topic the study chose to explore both client and therapists experiences. An art app was introduced via the iPad into the researchers clinical practice, from which a purposive sample of four participants, including two children were recruited. Both adult participants were counsellors. Ethical issues were addressed in a number of ways including clinically supervised participant selection, age appropriate communication and interviewing clients who had completed therapy. The study included analysis of participant interviews, clinical notes and pre-recorded interviews with four digital art therapists. All data was transcribed and analysed using conceptual mapping and thematic analysis to identify themes
including therapeutic process and influencing factors. Results/Findings: The researcher found that clients used the iPad in a variety of unforeseen ways
in sessions, for example digital gaming. All participants reported experiencing reduced inhibition and increased spontaneity in sessions, whilst adult participants reported surprise at experiencing the iPad as potentially preferable to using traditional art materials. The unique properties of digital media facilitate a wide range of therapeutic expression and actions, potentially promoting the therapeutic process across age groups. This study found that client and therapist willingness to use digital media in therapy is influenced by a number of factors such as generation, culture and fear.

Research Limitations: This study explored breadth of experience, therefore depth of analysis of some themes, such as ethical issues was limited.
Conclusions/Implications: This study concludes that digital media has diverse therapeutic potential across age groups,with specific relevance for younger clients. It suggests that the integration of digital technology can be beneficial to the therapeutic process, whilst highlighting various potential ethical issues. The study argues that integration is necessary, otherwise counselling risks being perceived as outside of mainstream, and in particular youth culture. A
growing range of digital media, for example virtual realties, has promising potential and more research is urgently needed.

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Colette T. Dollarhide

Presenter: Colette T. Dollarhide, Ed.D., NCC, ACS, LPC/S
Professional Role: Associate Professor, Counselor Education
Institution/Affiliation: The Ohio State University
Email: dollarhide.1@osu.edu
ABSTRACT: workshop (Fri, 14.00-15.00)

Keywords: qualitative research, methodology

Understanding qualitative research methodologies: improving research for professional practice


Relevance of the workshop to counselling and psychotherapy research: Many of the questions that researchers hope to answer are not directly quantifiable. This restricts researchers' methodological options for conducting important research in counselling and psychotherapy. Through discussion and examples, participants will appreciate the applicability of qualitative research in terms of meaningful insights into counselling process and outcomes. This workshop is
designed to provide direct comparison between three qualitative methodologies: grounded theory (Charmaz, 2006; Corbin & Strauss, 2008), henomenological (Giorgi, 1985; Moustakas, 1994), and case study (Merriam, 1998). Participants will personalize their learning through audience examples and questions.
The aims of the workshop: In this workshop, the presenters juxtapose three qualitative methodologies in terms of appropriate research questions, sampling strategies, data collection, data analysis, limitations, and results. By understanding the advantages and limitations inherent in each qualitative approach, participants will be able to determine if qualitative methodology will fit their research agenda. If it is appropriate for their research, participants can conduct their own qualitative research more confidently and competently. How the workshop will be structured: The discussion will begin with examples from the
audience of "interesting questions" that cannot be quantified. Then the three qualitative methodologies will be presented using the examples provided by the attendees, and participants will all join in the examination of each research approach. In the end, participants will see how each example can be researched using one or more of the three methodologies.
Key points for discussion: Researchers in counselling and psychotherapy often do not feel comfortable either conducting or evaluating qualitative research. Each of the three qualitative methods presented has advantages and limitations, and researchers need to understand the use and scope of each method to produce valuable and meaningful research in counselling. Using examples from the audience of interesting questions allows participants to personalize their
learning.
Who will benefit from attending the workshop? Anyone who conducts or reviews research in counselling and psychotherapy: practitioners, doctoral students, faculty, professional journal reviewers, and general professional journal readers.

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Paulina Flasch, Elizabeth Crunk, Edward Robinson & Sandra Robinson

Presenters: Paulina Flasch, Elizabeth Crunk, Edward Robinson & Sandra Robinson
Other Authors: Jesse Fox, Dodie Limberg Ohrt & Jonathan Ohrt
Professional Role: Doctoral Student (Counselor Education, UCF)
Institution/Affiliation: University of Central Florida
Email: paulinaf@knights.ucf.edu
ABSTRACT: paper (Fri, 15.30-16.00)

Keywords: altruism, caring, therapeutic relationship, beginner counselors, qualitative study

Beginner counselors and their clients' experiences of altruistic caring in counselling sessions

Aim/Purpose: Caring in the purest form is known as altruism. Since altruistic behavior has a direct positive effect on others (Andre, Louvet, & Deneuve, 2012), it is hypothesized that counselors, who are altruistic, consequently have a direct positive effect on their clients. This presentation will introduce the audience to a qualitative study that utilized interviews to explore the experiences of first-time counselors and their clients.
Design/Methodology: The researchers utilized a phenomenological research methodology to better understand the lived experiences of first-time counselors (n = 10) and their clients (n = 10) in relation to altruistic caring in counseling sessions. Counselors and their clients were recruited in the program counseling clinic during counselors' first/second clinical practicum experiences.
Results/Findings: Clients who experienced higher levels of altruistic caring in counseling sessions reported they: (a) felt truly understood and heard, (b) experienced the counselor as acting in their best interest and not having their own agenda (c) felt their counselor was not "in it" for the grades or external rewards. Several components related to counselors' experiences of altruism: (a) natural/biological (b) social, (c) religious and (d) cognitive components. Clients who experienced deeper/higher levels of altruistic caring in sessions tended to view counseling favorably, stay in counseling longer, felt they were getting better, felt cared for, and experienced hope for the future. Additional findings will be discussed.
Research Limitations: Research limitations include those typical for phenomenological research: (a) a lack of generalizability, (b) potential researcher bias and limited bracketing, (c) small and localized sample, and (d) social desirability in participants' answers.
Conclusions/Implications: Potential implications include better understanding how caring experiences manifest in counseling sessions, which can be tracked long-term and explored with client outcomes. Furthermore, this will help inform training and practice.

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Paulina Flasch & Jessica Haas

Presenters: Paulina Flasch & Jessica Haas
Professional Role: Doctoral Student (Counselor Education)
Institution/Affiliation: University of Central Florida
Email: paulinaf@knights.ucf.edu
ABSTRACT: poster (Fri, 10.20-10.45)

Keywords: Jewish identity, anti-Semitism, university students, psychological impact

Exploring Jewish students' lived experiences on college campuses: a phenomenological study

Aim/Purpose: Anti-Semitism on college campuses increased threefold during 2014, often linked to anti-Israel protests or student movements. While Jews account for less than 2% of individuals in the United States (Pew Research Center, 2013) 12% of Americans hold anti-Semitic beliefs (ADL, 2014). Hate crimes against Jews remain higher than hate crimes against any other religious group in the United States, accounting for 66% of religiously-motivated hate crimes in 2014 (FBI, 2014).
The purpose of the study was to better understand Jewish students' lived experiences on campus, specifically in terms of how they experience the college climate, anti-Semitism, and Jewish identity, and to increase counselor/psychotherapists' awareness.
Design/Methodology: The researchers utilized a phenomenological qualitative methodology to interview participants about their lived experiences as Jewish students on campus. Students were recruited from campus organizations, snow-ball sampling, social media, and in community organizations.
Results/Findings: Themes were found through hierarchical coding following Moustakas (1994) procedures. Internal Processes encompassed the following categories: (a) Jewish Identity, and (b) Jewish Culture. External Processes encompassed the following categories: (a) Support, (b) Jewish Community, (c) Anti-Semitism, and (d) Israel. Existential Processes encompassed (a) Changed Worldview.
Research Limitations: Research limitations include those typical for phenomenological research: (a) a lack of generalizability, (b) potential researcher bias and limited bracketing, (c) small and localized sample, and (d) social desirability in participants' answers.
Conclusions/Implications: Jews are often wrongly assumed as an assimilated White majority and as a solely religious rather than a cultural group. Their challenges are widely unknown by counselors. Sue, et.al. (1992), defined multicultural competency as including (a) awareness; (b) knowledge; and (c) skills. Thus, counselors/psychotherapists have a responsibility to understand Jewish realities to be multiculturally competent and to adequately tackle unique issues that Jews might face and bring in to counseling (e.g., Schlosser, 2006).

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Matthew Flynn

Presenter: Matthew Flynn
Other Authors: Mary Dunn, Vicki Osmond, Sarah Palmer & Darren Monsiegneur
Professional Role: Higher Professional Diploma in Counselling student
Institution/Affiliation: LC&CTA – Lewisham Counselling and Counsellor Training Associates
Email: c/o christine.brown@lcandcta.co.uk
ABSTRACT: poster (Fri, 10.20-10.45)

Keywords: youth, dysmorphia, self-esteem, severity, humanistic

Therapists' experience of young people with Body Dysmorphic Disorder (BDD) and the implications for counselling practice

Aim/Purpose: To explore therapists' experience of young people presenting with BDD, how this compares with any existing guidelines for working with this client group and the resulting implications for counselling practice.
Design/Methodology: Three therapists working in the field were interviewed. These interviews were semi-structured and audio recorded. Our data was thematically analysed, informed by the principles of phenomenology (Moustakas, 1994). Our research was conducted in accordance with BACP guidelines for research in counselling practice (Bond, 2004).
Results/Findings: Our findings, based on the views of practitioners, indicate that young people with BDD experience low self-esteem, suicidal thoughts/feelings/actions, self-mutilation and an impaired ability to interact socially. BDD also emerges as a 'hidden disorder' with severe/intense
impact on sufferers. Our findings additionally highlight that there common underlying issues affecting young people with BDD not reported/noted in adult clients; issues such as a lack of nurturing and high family dysfunction .
Research Limitations: Time and resources were limited; as was our respondent sample. We were unable to ethically interview clients; on-going support could not be offered, if required, due to a lack of funding and resources.
Conclusions/Implications: Our findings, seem to illuminate the severity/impact BDD has on young people and how important it is that practitioners in the field are aware of the associated risks and underlying issues associated with BDD in this client group. Our findings also strongly indicate that therapists' need to have profound acceptance of the clients' personal experience/view of the disorder before a truly successful therapeutic alliance can be formed. Currently no published humanistic research exists regarding the treatment of BDD in young people however; our findings suggest that Humanistic Models – especially the Person-Centred Approach – appear to be effective in treating young people with BDD.

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Anna Louise Fry

Presenter: Anna Louise Fry
Professional Role: Counsellor/PhD Student
Institution/Affiliation: University of Huddersfield
Email: u1166877@hud.ac.uk
ABSTRACT: poster (Fri, 10.20-10.45)

Keywords: micro-aggressions, sexual minority, lesbian, bisexual, mental health

Sexual orientation micro-aggressions and the experiences of self-identified lesbian and bisexual women

Aim/Purpose: Sexual minority micro-aggressions are everyday verbal, behavioural or environmental insults which can be intentional or unintentional, conscious or unconscious which convey insulting or disparaging messages towards sexual minority individuals.
Design/Methodology: The current study is a qualitative phenomenological exploratory investigation, using critical narrative analysis to analyse semi-structured interviews, of the experience of sexual minority micro-aggressions within and between lesbian and bisexual women and also between heterosexual individuals and these two groups (n=6). Only two interviews were reported due to project constraints. The typology of sexual minority micro-aggressions defined by Sue (2010) was utilised to identify themes within the data, endorsement of hetero-normative culture, sinfulness, homophobia, Heterosexist language/terminology, over sexualisation, assumption of abnormality and denial of individual heterosexism and two additional microaggressions identified by Platt and Lenzen (2013) under-sexualisation and micro-aggressions as humour.
Results/Findings: Both interviewees were found to experience micro-aggressions from heterosexual individuals, and lesbian women. There was no indication that the lesbian participant experienced micro-aggressions from bisexual women. The endorsement of hetero-normative culture was found to be a significant micro-aggression experienced by both lesbian and bisexual participants however, the bisexual participant experienced more micro-invalidations than the
lesbian participant. A further theme was identified, endorsement of homo-normative culture.

Research Limitations: Only two participant interviews were included due to the constraints of the project brief. Due to the subtle nature of micro-aggressions, focus groups may have been a more appropriate method than semi-structured interviews, in order to facilitate individual recollections of micro-aggressions which may have previously been ignored or not recognised. Participants were white British, working class and therefore data is not necessarily transferable to multiple minority groups. Participants were known to the researcher.
Conclusions/Implications: Implications for future research, mental health care providers and policy makers specifically in terms of guidance for the reduction of prejudice and discrimination are discussed. Reflections on power and privilege are essential for service providers, counselling training programmes and practitioners. Multiple minority identities require individual approaches to health care (NICE, 2014). Future research into the cause and effect of sexual minority microaggressions would inform these multiple minority approaches.

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Dr Andy Fugard

Presenter: Dr Andy Fugard
Other Authors: Prof Mick Cooper, Dr Jo Pybis, Dr Katherine McArthur, Peter Pearce
Professional Role: Lecturer
Institution/Affiliation: Research Department of Clinical, Educational and Health Psychology, University College London
Email: a.fugard@ucl.ac.uk
ABSTRACT: paper (Sat 10.55-11.25)

Keywords: adolescent psychotherapy, psychotherapeutic outcomes, practice-based research network, school counselling

Estimating effectiveness of school-based counselling: using data from controlled trials to predict improvement over non-intervention change


Aim/Purpose: There is accumulating evidence that participation in school-based counselling is associated with significant reductions in psychological distress. However, this cannot be taken as evidence that school-based counselling is effective, as improvements may have happened without the intervention. The purpose of this study was to develop a method of estimating the amount of 'natural' change that might be expected in young people who would attend school-based counselling, such that the effects of the intervention over-and-above this amount could be identified.
Design/Methodology: Young Person's CORE (YP-CORE) scores from 74 participants allocated to waiting list control conditions in four pilot trials of school-based counselling in the UK were reanalysed using multilevel regression models, and a formula was found for estimating the outcomes for young people were they not to receive counselling. This was termed their Estimated Nonintervention Outcome (ENO), and could then be compared against the young person's Actual Outcome (AO), to give an Estimated intervention Effect (EE).
Results/Findings: The formula for the ENO was 4.17 + 0.64 × baseline score. Using this, we calculated a mean EE for 256 young people in a cohort evaluation study of school-based counselling, which showed that the counselling was associated with large and significantly greater change than would be expected without the intervention (Cohen's d = 0.91).
Research Limitations: The principal limitation of the method developed and illustrated in this paper is that the control data comes from a population that will inevitably be different from those in the cohort studies for which it is being used as a simulated control. The relatively small number of control participants also limits the accuracy of the formula for calculating ENOs, and may account for the lack of a time effect. We also used data from a set of studies that was found to be significantly heterogeneous.
Conclusions/Implications: The method presented in this paper is a simple method for improving the accuracy of estimations of treatment effectiveness, helping to adjust for changes due to spontaneous recovery and other non-treatment effects.

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Tracey Fuller

Presenter: Tracey Fuller
Professional Role: Associate tutor and research student
Institution/Affiliation: Sussex University
Email: tf90@sussex.ac.uk
ABSTRACT: poster (Fri, 10.20-10.45)

Keywords: school counselling, ethical dilemmas, multi-professionals

Can I trust you? Ethics considerations for school counsellors in information sharing and multi-professional working

Aim/Purpose: This ESRC funded project addresses the ethical considerations raised by school counsellors sharing information about young people with other professional colleagues in school contexts, for example, because of child protection concerns. It will explore the factors that influence school counsellors' professional practice on information sharing and explore young people's views on such sharing. Its aim is to explore perceptions of 'how' to ethically share information about young clients.
Design/Methodology: It takes a case study approach based at six + 1 'Place2Be' project secondary schools in London. The research is influenced by Flyvberg's (2002) re-working of Aristotle's concept of phronesis or 'practical wisdom'. It will explore the school counsellors' contextual experiences, subjective views and practical knowledge of how to maintain therapeutic relationships when sharing information. Semi-structured interviews will be carried out with school counsellors (n=6) designated child protection teachers (n=6), and a focus group of young people will be convened from a further Place2Be project school. Sections of school counsellor's, teachers and young people's interviews will be analysed using a thematic narrative approach on four levelslinear
narrative, relational, emotional and a cross-analysis of connections across different narratives (Landman,2012).
Results/Findings: Initial consultation with school counsellors highlights both the complexity and stressful nature of responding to ethical dilemmas. This consultation suggests that counsellor relationships with designated child protection teachers may be crucial to managing such dilemmas and any resulting information sharing processes.
Research Limitations: This is a small scale case study exploring perceptions of a small sample of school counsellors, teachers and young people. It aims to generate contextual qualitative data rather than generalised knowledge.
Conclusions/Implications: Jenkins and Palmer suggest there is currently little research about how school counsellors apply ethical principles to their practice with children (2012). Further, there is a lack of research on how young people want their information to be shared. Exploring these aspects is vital if school counselling is going to be further embedded in educational contexts.

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Mike Gallant

Presenter: Mike Gallant
Professional Role: Senior Teaching Fellow (Counselling and Psychotherapy)
Institution/Affiliation: University of Warwick
Email: mike.gallant@warwick.ac.uk
ABSTRACT: methodological innovation paper (Sat, 13.50-14.20)

Keywords: creative practitioner inquiry, moments of meeting, therapeutic relationship, relational depth, process research

Somatic knowledge and the unthought known: a creative practitioner inquiry into 'Moments of Meeting' in psychotherapeutic relationships

Background and introduction: 'Moments of Meeting' (ineffable moments of intense relational depth, with a deep sense of connection and intimacy) have been recognised as potentially significant psychotherapeutic events since at least the 1950's, and continue to be of interest to counselling process researchers regardless of their core modality. As an essentially 'word-free' experience within therapy, the author was interested in an explication of these phenomena without recall to spoken language or written text, whilst at the same time recognising that this posed a potentially insurmountable issue in the ethical requirement of dissemination of any 'knowledge' created.
Nature of the methodological innovation/critique being proposed: Creative Practitioner Inquiries can take numerous forms (Speedy & Wyatt, 2014) and lend themselves to participative and bricoleur methodologies with 'catalytic validity' (Lather, 1986). Beginning with over 40 participants in 2009 this inquiry uses a heuristic approach to each of a series of hermeneutic cycles, and is inevitably a work-in-progress. The concept of using transitional objects with which
we may be better able to uncover our own (and possibly others') somatic knowledge (cf. Bondi, 2014) and 'unthought known[s]' (Bollas, 1987) led to the creation of sculpture as elicitation and expression, through performance as dissemination, to reflective and poetic forms of writing: all of which will be included in this presentation. Conclusion and relevance to counselling and psychotherapy research practice: Innovative methods may be necessary to ensure progress towards creating an evidence base for a psychotherapeutic practice that the author regards as both a science and an art. This research is an on-going attempt to add to therapists' understanding of 'moments of meeting' with their clients, and an exploration of how art can add to the substance of scientific inquiry.

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Mike Gallant

Presenter: Mike Gallant
Other Authors: Lisa Anthony, Catherine Date, Marie Jefsioutine & Alison Paris
Professional Role: Senior Teaching Fellow
Institution/Affiliation: University of Warwick
Email: mike.gallant@warwick.ac.uk
ABSTRACT: poster (Fri, 10.20-10.45)

Keywords: counsellor/psychotherapist training, research, mature students, creative methodologies, longitudinal

Research? What do you mean, research? An exploration of counselling and psychotherapy students' experiences of undergraduate research

Aim/Purpose: Research has become an increasingly important element in the training of professional counsellor/psychotherapists. In a profession often taken up as a second career, with many students having no previous experience of higher education, this is often a challenge for both students and trainers. This qualitative small-scale research project with Warwick University students aims to contribute knowledge around counselling/psychotherapy students' attitudes to, and experiences of, research.
Design/Methodology: This longitudinal project aims to discover how students' attitudes change during their undergraduate training: their relationship with research; the word, the product, the process and the value of research evidence in practice. At the beginning of each academic year students are asked to reflect on their thoughts and feelings about research and, rather than writing down these thoughts immediately, are asked to express this in the form of a small plasticine sculpture. This artefact is later used as an elicitation piece to consider (in less than 500 words):

how does it represent my feelings and thoughts about 'research'; what about my understanding of the word 'research'; what research means in practice for me as a trainee counsellor; what have I learnt through this creative and reflective process?

Initial interim thematic analysis of data from a self-selecting sample of n≈40 across 3 cohorts (≈30% of total students) will be followed in future years by longitudinal cohort studies (n≈15 per cohort).
Results/Findings: Early responses appear to suggest that a majority of students feel overwhelmed by the apparent complexities of research, though many move beyond this over the 3 or 4 years of their training to become great advocates of research as an integral part of professional practice.
Research Limitations: This is a small-scale project in one training environment, and with the intention to make curriculum changes in the light of ongoing findings rather than maintain constancy.
Conclusions/Implications: This inquiry may inform the approach/facilitative style of trainers and curriculum developers on this particular course and, possibly, other courses with a similar mature student intake.

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Farhan Ghafoor

Presenter: Farhan Ghafoor
Other Authors: Debbie Trownson, Billy Gardiner, Veronica Kiondo & Estelle Alwan.
Professional Role: Trainee Counsellors
Institution/Affiliation: LC&CTA Lewisham Counselling and Counsellor Training Associates.
Email: c/o christine.brown@lcandcta.co.uk
ABSTRACT: poster (Fri, 10.20-10.45)

Keywords: self-harm, young people, counsellors' experiences

Counsellors' experiences of working with young people who self-harm and how this can inform counselling practice

Aim/Purpose: Self-harming in young people is reported to be on the increase (NICE 2011) Therefore, counsellors working in the field are highly likely to encounter young clients presenting with this issue. Our research aimed to explore counsellors' experiences of working with this client group. Our purpose was to illuminate any specific dynamics/challenges counsellors face when working with young people who self-harm and how any such challenges can be overcome to better ensure a successful therapeutic outcome.
Design/Methodology: Six semi-structured audio recorded interviews took place with counsellors working in the field. Our data were analysed thematically - informed by the principles of empirical phenomenology (McLeod 2001). The BACP Guidelines for research in the field were followed (Bond, 2004).
Results/Findings: Counsellors stressed the general importance of transparent and open communication with young client/s, and in the following specific ways:

Informing the client when his/her disclosure/s needed to be shared within a multi-discipline team.
 Suicide risk assessment.
 Being mindful of suicidal idealization.
 Discussing infection prevention (from cuts and other self-inflicted wounds).

The majority of our respondents identified themselves as person-centred practitioners but stated in order to work effectively they utilized certain techniques taken from other modalities. Several respondents reported that their own personal experiences impacted on them when working with this client group:

 Over identification with the client due the counsellors' own teenage identity struggles or having children of the same age.
 Living in the same locality as clients brought up the need to maintain strong external boundaries.


Therefore, high levels of, guidance support and supervision for the counsellor/s were identified as paramount.

Research Limitations: Our research focused solely on counsellors' experiences and views. The respondent sample was small and therefore our conclusions need to be further explored/researched.
Conclusions/Implications: Our findings suggest that clear working guidelines and minimal first aid knowledge is vital for counsellors in order to maximize client/counsellor safety. A counsellor's willingness to openly explore the young person's unique experience of self-harm and the counsellors' ability to withstand the clients' disclosures is indispensable, as is high levels of support and supervision for the counsellor/s.

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Nigel Gibbons

Presenter: Nigel Gibbons
Professional Role: Focusing-Oriented Psychotherapist, Counsellor; tutor on MSc Creative writing for therapeutic purposes, and Diploma in Counselling; writing facilitator
Institution/Affiliation: Metanoia Institute; Network Counselling and Training
Email: nigelgibbons.counselling@virginmedia.com
ABSTRACT: poster (Fri, 10.20-10.45)

Keywords: action research, practitioner development, focusing, writing interventions, bodily-based practice

Bodies at work: using action research as a way of developing embodied creative writing practices for use in counselling

Aim/Purpose: Creative writing exercises were developed in the style of Focusing (Gendlin 1996, Purton 2004, Perl 2004), for instance writing from the felt sense of a situation, to see if they might help counselling clients deepen their sense of their ongoing experiencing. An action research methodology was used to see if this was a helpful method for practitioner development and the development of interventions.
Design/Methodology: Over three action research cycles (Reason 1998, McIntosh 2010, Leitch and Day, 2000) a group of three counsellors worked with the researcher as co-researchers to explore the impact of three writing exercises per session. During the meetings the co-researchers wrote and then had audio-recorded "conversations" talking about the effectiveness, helpfulness, or problems. This allowed the researcher to further develop exercises in between each cycle. Subsequently the writing done was analysed using the seven point Experiencing Scale (Klein et al, 1969, Hendricks 1986) for level of experiencing shown, compared to a sample piece of control writing done at the beginning of the first session. A thematic analysis was used on the recorded conversations (Braun and Clarke, 2006).
Results/Findings: The study suggested that the interventions were helpful in raising experiencing levels; that the exercises could be helpful to counsellors in their practice; and that an action research methodology is one which counsellors might use to help develop their professional practice. The Experiencing Scale may be a useful tool to enhance the development of counsellors' professional practice.
Research Limitations: The action research methodology used a small number of participants, and this limits any generalisability of the study. The methodology, by working with three coresearchers, is limited in its validity. The research is suggestive rather than conclusive.

Conclusions/Implications: The use of an action research group has potential to help counsellor development. Creative writing using a Focusing approach may be helpful in enhancing therapy. An understanding of the Experiencing Scale may be of help to therapists in developing their professional practice.

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Dr Shelley Gilbert, MBE

Presenter: Dr Shelley Gilbert, MBE
Professional Role: CEO and Clinical Director of a charity
Institution/Affiliation: Grief Encounter
Email: shelley@griefencounter.org.uk
ABSTRACT: paper (Fri, 11.05-11.35)

Keywords: loss, grounded theory, bereaved young people, grieving process, emotionally based
model

Bridging research and practice: using grounded theory to explore the experiences of bereaved young people and offer ideas for improved support

Aim/Purpose: This research aimed to explore the under-researched area of the lived psychological and emotional experiences of parentally bereaved young people to gain a better understanding of the core processes that underlie the personal meaning of the premature parental death for individual bereaved participants, whilst observing both the challenging and helpful aspects of support. There has been little research carried out which seeks to understand the
meaning and complexity of the individual's world through the analysis of their personal account of events and experiences.
Design/Methodology: Eleven parentally bereaved young people, principally identified by a secondary school in North London, participated in the study. Semi-structured interview questions, a nationally validated measure CORE-YP and a creative activity were used to elicit the responses of the participants. Grounded theory based on Charmaz's social constructivist approach was used to analyse the findings.
Results/Findings: Five superordinate themes were identified: Losses; Disrupted identities; Struggling to make sense of grief; Role of others; and Finding a new kind of normal. The researcher also identified two overarching themes: time and ambivalence. The research highlights the extent to which young people are affected by the premature death of a parent. The findings demonstrate that grieving is an individual process, yet there are common threads that can be
drawn together in order to provide a framework for grief's trajectory. This involves an emotionally based theory, which searches for the feelings behind the behaviours; a model of young person's grief which is fluid and allows for a transitional phase between the survival phase of trauma and the more cognitive processing phase. The goal should be adjustment; acceptance will come as a byproduct.
Research Limitations: This is a small-scale individually based study, with no control group, which offers a psychotherapeutic approach to the interpretation of the data and does not claim exclusivity from other possible interpretations.
Conclusions/Implications: Bridging research and practice, recommendations are made on how best to support this often overlooked group of vulnerable young people using a multisystem model. This includes family support programmes at bereavement organisations, counselling support, a new information guide for bereaved young people, a model for bereavement support and a bereavement training programme for professionals. Recommendations are also made for further research and dissemination of information on best practice.

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Stacey Goldman

Presenter: Stacey Goldman
Other Authors: Dr Alison Brettle & Dr Sue McAndrew
Professional Role: Counsellor
Institution/Affiliation: University of Salford
Email: talkingtherapies@aol.com
ABSTRACT: paper (Fri, 15.30-16.00)

Keywords: client perspective, counselling, depression, effective therapy, IPA

A client focused perspective of the helpful/unhelpful aspects of Counselling for Depression (CfD)


Aim/Purpose: CfD is described as a manualised form of psychological therapy specifically designed for counsellors working within the Improving Access to Psychological Therapies [IAPT] programme. The purpose of this study is two-fold; Firstly, the study explores the model of CfD from the perspective of the client. Secondly it will inform the counselling profession of what is taking place in this therapy as perceived by the client. As no previous study has considered CfD from a client perspective this study gives voice to the client enabling them to convey their understanding of what they perceive is helpful or unhelpful therapy. In addition, this study will make an original contribution both to the knowledge base regarding CfD and its effectiveness and to the professional practice of counselling.
Design/Methodology: This research study focuses on eight clients' perceptions of CfD. Clients receiving CfD complete a Helpful Aspect of Therapy questionnaire after each counselling session then attend a semi-structured interview when sessions have concluded. This is a qualitative study using Interpretative Phenomenological Analysis because the ideographic aspect values each individual narrative and the contribution each makes towards a larger account from a small group of people sharing their experience of the phenomena being studied.
Results/Findings: Preliminary findings show that clients perceive this model of therapy as helpful. Often the therapy is described as "amazing". Helpful aspects reported are; talking to someone who is non-judgemental; someone outside of their family and friends who creates a safe space for them to talk; and a counsellor who will listen and be unbiased. Unhelpful elements reported relate to environmental aspects and a dislike of the administration at the start and end of therapy.
Research Limitations: The therapy is not yet widely available and finding services where counsellors are using the model has proved difficult resulting in a small sample size.
Conclusions/Implications: Clients report liking this therapy because of its ability to work on what matters to them in a way that feels supportive. Practitioners can be reassured that CfD is helpful to their clients.

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Dr Phil Goss & Prof William West

Presenters: Dr Phil Goss & Prof William West
Professional Role: Senior Lecturer in Counselling & Psychotherapy
Institution: University of Central Lancs. / University of Manchester
Email: william.west@manchester.ac.uk
ABSTRACT: paper (Fri, 14.00-14.30)

Keywords: spirituality, religion, pastoral care, Buddhist, Jungian

Perspectives of Jungian influenced therapists and Buddhists on spiritual issues in counselling

Aim/Purpose: There has been debate over the years around the how well counsellors work with client issues involving religion and spirituality and a somewhat similar debate around the role of counselling skills within religious pastoral care. Some people 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 project aimed to open up a dialogue between a group of Jungian influenced therapists and Buddhists involved in pastoral care.
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 Buddhists discussed their understanding of counselling within their pastoral work whilst the group of Jungian influenced therapists listened carefully; Stage Two; the Jungian influence therapists discussed their understanding of spirituality and religion within their work whilst the Buddhists pastoral care workers listened; 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 Central Lancs.
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: spirituality, its meaning, developing it and talking about it in therapy; what do we mean by God, self and other cultural questions; doing Buddhist pastoral care; Jungian therapy practice; comparisons and differences between therapy and pastoral care; the practice and its dilemmas including experiencing 'we' space; and professional identity and spiritual affiliation.
Research Limitations: The study included only Buddhist Pastoral care workers and Jungian influenced therapists; and the sample size was small.
Conclusions/Implications: The findings have implications around working with clients exploring spirituality in counselling and pastoral care.

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Dr Stephen Goss

Presenter: Dr Stephen Goss
Professional Role: Principal Lecturer
Institution/Affiliation: Metanoia Institute
Email: stephenpgoss@googlemail.com
ABSTRACT: poster (Fri, 10.20-10.45)

Keywords: practitioner-research, DPsych, motivation, researcher-experience, facilitation

Developing counselling as a practitioner-researcher: the experience of undertaking the 'research journey' for mid-career practitioners in counselling and psychotherapy

Aim/Purpose: Against a context of increasing research awareness and activity among mid-career counselling and psychotherapy practitioners, and growing awareness of the value of 'professional entrepreneurialism', this poster offers exemplars from extensive accounts of the experience of conducting original research and creating useful contributions to professional practice.
Design/Methodology: Participants (n.=10) provided detailed qualitative narratives of their experience of conducting major research leading to distinct, innovative products of significance for their professional setting. Themes and significant individual motivational factors, challenges and experiences are identified.
Results/Findings: This convenience sample of experienced practitioners nurtured a strong desire to build on their expertise and contribute to the profession while adding to their professional standing. Accounts differed sharply from the image of 'ivory tower' research as remote from practice or straitjacketed by standard academic forms and highlighted practical usefulness, defined by each practitioner-researcher for themselves. Facilitated reflexive identification of the researcher's personal and professional priorities and passions was frequently significant with topics and methodologies changing, sometimes radically,
towards improved fit with personal life history and direction and maintaining motivation required the work to be personally satisfying. Openness to diverse research methods, with skilled specialists to guide their usage, was helpful as was the privileged 'insider-researcher' perspective. Style and structure of facilitation carried special importance for aspiring practitioner-researchers already highly skilled in their field but possibly new to research. Despite requiring commitment, the 'research journey' was described as immensely rewarding in both personal and professional terms.
Research Limitations: Sample size limits transferability and normative statements. Accounts provided only from personal practitioner-researcher perspectives to preserve their individual character. All participants attended the post-qualification DPsych programmes run by the Metanoia Institute and may not represent experience at other institutions whose practices may differ substantially.
Conclusions/Implications: With suitably structured support and facilitation, sufficiently flexible to foster personal and professional passions, there is potential for more experienced practitioners to undertake studies simultaneously capable of making significant original contributions to professional practice and add to their own professional standing.

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Dr Jan Grove

Presenter: Dr Jan Grove
Professional Role: Visiting Research Fellow in Counselling and Psychotherapy
Institution/Affiliation: Newman University
Email: j.a.grove@btinternet.com
ABSTRACT: methodological innovation paper (Fri, 11.05-11.35 and Sat, 14.25-14.55)

Keywords: research, outsider, same-sex couples, sexual identity model, reflexivity

Researching a marginalised group: reflections on being an outsider

Background and introduction: Reflective practice is now common across a range of disciplines (Etherington, 2004) requiring self-examination and exploration of the impact of the researcher on the research and vice versa (Finlay, 2003). The aim of this paper is to review and reflect on the practical and personal issues involved in 'representing the other' (Wilkinson & Kitzinger, 1996), drawing on experiences of research into same-sex couple counselling by a straight identified researcher.
Nature of the methodological innovation/critique being proposed: Researchers into LGBT topics are often assumed to be LGBT themselves (Clarke & Peel, 2007) raising questions of whether or not to 'come out' as heterosexual (Izzard, 2004). Therefore, aspects of researching a community as an outsider have an impact on how the researcher presents themselves. Reflections are linked to the researchers own heterosexual identity development (Mohr, Fassinger, & Daly, 2006), and on the participants' responses. The selection of inclusive terminology that defines participants presents contradictions and challenges in relation to social constructionist and anti- oppressive approaches. For example, whilst recognising the power adherent in being privileged as a heterosexual in society, there is a risk of assuming that LGBT people form a homogeneous group (Clarke & Peel, 2007).
Conclusion and relevance to counselling and psychotherapy research practice: Researching as an outsider requires a reflection on power and the impact of self-disclosure, together with a sensitivity to identity and language. This will be a process for each researcher at that moment in time, and at that stage of their own development. Researchers working as an outsider can use heterosexual identity development models to inform their thinking about engaging with potential participants. The use of language that is inclusive needs to be developed with reference to the impact on members of marginalised communities, and the focus of the research.

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Sarah Hamilton

Presenter: Sarah Hamilton
Professional Role: Director and Psychotherapist
Institution/Affiliation: Anchor Counselling
Email: sjhamilton89@gmail.com
ABSTRACT: paper (Fri, 16.05-16.35)

Keywords: courage, therapeutic change, client experience

The Courage Cycle: the client's experience of courage in therapy, and its relationship to therapeutic change

Aim/Purpose: Client factors are known to be highly influential in therapy outcomes, but are relatively little researched. To improve professional practice, therapists need to develop a better understanding of what resources the client may bring to therapy, and how those may influence the results of therapy. This paper explores one potential client resource – courage – and examines to what extent, and how, that might be related to therapeutic change.
Design/Methodology: This is a qualitative study using Interpretative Phenomenological Analysis to examine semi-structured interviews with eight individuals, who were asked questions about their experience of courage as a client in therapy. Participants were white British, aged from 31-62, three men and five women, with experiences of therapy ranging from seven weeks to six years, from at least three different modalities.
Results/Findings: Analysis of the interviews elicited various factors around 'experiencing', 'needing' and 'enabling' courage in therapy, which crystallised into a model of how the client's courage interacts with the therapeutic process: the "Courage Cycle". The model proved to be an accurate, resonant and catalytic concept when tested against participants' own experiences.
Research Limitations: Further research is needed to investigate the applicability of the Courage Cycle model across a wider range of cultures and therapy modalities.
Conclusions/Implications: The client's courage is shown to be strongly associated with achieving positive outcomes in therapy, particularly with the client finding a transformative confidence, strength and vitality in the process of change. The Courage Cycle offers several insights for professional practice, including highlighting the importance of helping the client explore their sense of 'purpose' in therapy, and showing how the therapist's provision of safety and acceptance can be an active catalyst for change and growth in the client.

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Suzy Hansford

Presenter: Suzy Hansford
Professional Role: PhD Student and private practitioner
Institution/Affiliation: University of Leeds
Email: suzy.hansford@btinternet.com
ABSTRACT: poster (Sat, 10.05-10.30)

Keywords: language, relational depth, understanding, therapeutic relationship, communication

Does the meaning we make from language have an impact on the establishing and maintenance of the therapeutic relationship?

Aim/Purpose: This is PhD research currently being undertaken. It explores how we understand each other through a shared language which has huge diversity of meaning. It will inform the ways in which counsellors, psychotherapists and other healthcare workers communicate with clients in
order to make best the interaction. The focus is on counselling, but it is anticipated that the findings will have significance across healthcare. It explores the unique meanings of language and whether a mismatch in understanding leads to a lack of attunement between client and counsellor. The research links into attachment theory and relational depth.

Design/Methodology: The project will use narrative research methods, interviewing counsellors and clients to examine experiences of being understood/misunderstood. The counsellors will be recruited from the researcher's professional networks and the 'clients' from counselling training
courses where trainees are required to have a significant amount of therapy. The researcher will also be a participant in the research, exploring her own experiences of awareness of language difference. At the time of writing no interviews have taken place, as the project is not yet at that stage. It is anticipated that the sample size for clients and counsellors will be around five of each, to ensure the project remains manageable. The data will be analysed for experiences, and will examine whether different factors, eg, age, gender, non-native speakers etc, influence the ways in which clients engage with therapy. Theanalysis methods are not yet clearly, as it is anticipated that they will emerge from the data, and data collection. The researcher will allow openness to working with what emerges, as with the therapeutic process.
Results/Findings: As a current project, there are no findings yet it would be unwise to try to predict what they might be. So far the project has revealed a scientific linguistic focus in the literature, which does not fit with narrative methods of counselling research. It is intended that this methodology will provide valuable insight into the importance of 'story-telling' approaches to counselling research, using language as the driver.
Research Limitations: The size of the sample limits the project to reflect the time available.
Conclusions/Implications: The project will give insight into communication and barriers to
communication.

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Liz Harrison

Presenter: Liz Harrison
Professional Role: BA (Hons) Student person-centred counsellor and psychotherapist
Institution/Affiliation: University of Warwick
Email: lizharrison.counselling@gmail.com
ABSTRACT: paper (Fri, 11.05-11.35)

Keywords: person-centred, online, suicide, 'way of being', reflexivity

Can I be me? The experience of the person-centred counsellor working with suicidal clients online

Aim/Purpose: Research highlighting the experience of working as an online person-centred therapist is extremely scarce. The aim of this study was to explore the experiences of person centred counsellors working through the online medium of text (both synchronous and asynchronous) and the impact on their 'way of being' when confronted with risk. It is hoped that the outcomes will inform person-centred therapists about how they may feel about translating their
approach and 'way of being' online.
Design/Methodology: Ethical approval was granted by the University of Warwick in line with BACP guidelines for research. A narrative approach was taken to unstructured interviews and analysis. Participants were selected purposively based on commitment to the person-centred approach online and membership of BACP. Five participants were interviewed and interviews were transcribed verbatim and sent to participants for checking. A reflexive research journal was kept throughout the study to record personal experiences to reveal researcher subjectivity.
Results/Findings: Narrative analysis revealed that the person-centred counsellors in this study have their own unique 'way of being' online. However, therapists vary in how risk in the online relationship may impact on their 'way of being'. Key themes emerged that related to therapist relational factors, therapist congruence, therapist 'professional wisdom' and working creatively. The 'online silence' within synchronous communication and the inability to check out risk 'in the moment' with asynchronous communication were highlighted as key concerns for some participants.
Research Limitations: This exploratory study had a small sample size. A larger sample or a different approach to data collection and analysis may enhance and expand the research findings. My subjective experience of the process was an important learning outcome and will undoubtedly have some impact on the findings according to narrative methodologies.
Conclusions/Implications: This research indicates that it is possible for person-centred therapists to translate their approach online and to work with risk. However, working online is different from working face to face and may have its own specific challenges and impacts on self when encountering risk. Professional online training, awareness of the needs of a suicidal client and having ethical procedures in place to address risk may aide therapist confidence in working online.

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Catherine Hayes

Presenter: Catherine Hayes
Other Authors: Dr Gillian Proctor & Dr David Murphy
Professional Role: Assistant Professor
Institution/Affiliation: University of Nottingham
Email: Catherine.hayes@nottingham.ac.uk
ABSTRACT: paper (Fri, 14.35-15.05)

Keywords: counselling for depression, education, training, qualification

What factors predict successful completion of the Counselling for Depression (CfD) training programme?

Aim/Purpose: The aim of this study was to examine what factors predict the likelihood of successful completion of the Counselling for Depression training programme.
Design/Methodology: We have used quantitative methods to test for the statistical significance of predictor variables on the outcome of Counselling for Depression training. First we reviewed and codified the application details for three cohorts of trainees (N=34). These were coded according to
the training background, years of post-qualifying experience, quality of case study at application, BACP/ UKCP accreditation and number of years in an IAPT setting. Successful outcome was measured by assessing the number of months spent from course to completion, number of tapes submitted successful on first attempt and by calculating a mean score for Person-Centred Experiential Psychotherapy Scale (PCEPs) across all submitted session recordings.
Results/Findings: Those who completed CfD training in fewer rather than greater number of months also submitted fewer taped session recordings. Likewise, those submitting fewer taped session recordings scored higher on the PCEPs. The PCEPs score for the end of course peer counselling DVD recorded session was statistically negatively correlated with number of months post-qualifying experience as a therapist. We used a linear regression to assess the predictive power of each variable on the successful outcome criterion variables. The analysis showed that only theoretical approach statistically significantly predicted successful outcome. This was for the length of time in training variable. Those whose original qualifying course was person-centred were
more likely to complete CfD training in less time than those from integrative and more generally humanistic course trained therapists.
Research Limitations: The limitations of this study are the small sample number of participants.There are also limitations to the system for codifying the predictor variables for training and quality of case study.
Conclusions/Implications: The implications from this study refer mainly to the recruitment and training for future candidates for CfD. Findings from the study can be used to inform potential applicants on the likelihood of successful completion of the course based on prior training and other factors. The study also highlights possible changes to the requirements for course entry.
Possible implications could also include a greater person-centred theoretical focus to the CfD courses.

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Gary Herrington

Presenter: Gary Herrington
Other Author: Jon March
Professional Role: Psychotherapy Student Researcher
Institution/Affiliation: Vaughan Centre for Lifelong Learning, University of Leicester
Email: gary.herrington@btinternet.com
ABSTRACT: paper (Fri, 16.05-16.35 and Sat, 10.55-11.25)

Keywords: unexpected disclosure, childhood sexual abuse, trainee experience, vicarious traumatisation, post traumatic growth

Post traumatic stress or post traumatic growth: trainee therapists' responses to unexpected disclosures of childhood sexual abuse

Aim/Purpose: Awareness of childhood sexual abuse (CSA) has risen through a proliferation of historic celebrity cases unveiled in the press, leading to an increase in adult survivors seeking help with, but often without disclosing, their CSA history. Extant research considers trainee therapists' experience of unexpected disclosures of CSA, but little considers the experience of trainees without a history of CSA. This research aims to deeply understand that experience.

Design/Methodology: The construction of meaning is often critical in treating adult survivors of CSA. This, together with the gap in the literature, suggested a grounded theory methodology based in a constructivist paradigm. Seven therapists, of varied modalities, participated in semistructured interviews which were transcribed and analysed using open and axial coding together with theoretical sampling. 2 participants were interviewed using Skype due to time and distance constraints.

Results/Findings: Findings show trainee therapists' experiences fall into four domains. These are given below with key themes/categories:
Experiencing Trauma
o Experiencing traumatic disclosure / Experiencing shock / Surprise of disclosure
o Doubting Professional Self / Feeling inept or unskilled
o Containing therapist / Using supervision

Witnessing Trauma
o Witnessing client trauma / Witnessing scale/detail of client trauma
o Witnessing client trauma / Witnessing dissociation / flashbacks
o Witnessing client trauma / Witnessing traumatic disruption
Impact on Therapy
o Maintaining professional boundaries / Managing boundary dilemmas
o Managing therapeutic process / Being client led
o Getting alongside the client / keeping the secret secret
Impact on Therapist
o Experiencing traumatic disruption / Changing personal behaviour
o Retaining traumatic experience / Persisting feelings outside sessions
o Experiencing personal - professional growth / Witnessing client growth

Research Limitations: This MA research was time and size limited, possibly affecting the breadth
of analysis. However considerable consistency was found between participants. The purposive
sample may have skewed results, as participants recruited in this way are less likely to report
negative results.
Conclusions/Implications: Findings from this research contribute to professional practice by
suggesting ways in which trainees can improve therapy outcomes, better manage their experience
of unexpected disclosures and key issues that could be addressed in training.

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John Hills

Presenter: John Hills
Professional Role: Practicing counsellor and PhD candidate
Institution/Affiliation: The University of Leeds
Email: johnhillsmusic@hotmail.com
ABSTRACT: paper (Sat, 15.00-15.30)

Keywords: psychosoma, chronic pain, alexithymia, somatoform illness, first person methods

User narratives in psychosomatics and alexithymia: an autoethnographic study

Aim/Purpose: User narratives can generate new insights into alternative treatments and recovery, as well as empowering users to take an active role in their own care (Cohen, 2008). The author has suffered from chronic jaw pain since the age of 18 and at 32, undertook an autoethnographic study for his MA dissertation, aiming to understand better the underlying patterns in which the jawpain flares up and its origins in the author's life history. For example, why did the pain seem more intense in certain situations; what was being activated? Furthermore the author wished to generate useful ideas for working with chronic pain with an apparent somatoform dimension when it is presented in a therapeutic setting.
Design/Methodology: The design was autoethnographic and the raw data were gathered in the form of diary entries, dream material and the revisiting of certain significant biographical events. Meaning-making involved an iterative process; producing emergent content, themes, and interpretations (Roth 2012). The supervisory relationship generated content that would not have been possible had the author reflected alone (a phenomenon observed by Collin and Karsenti, 2011). The research took on a cyclical pattern in which passages of writing underwent critical analysis and deconstruction which then informed the next cycle of re-writing (Freshwater and Rolfe 2001).
Results/Findings: The author generated several 'cognitive footholds' which helped make sense of the pain. It was discovered that those situations in which the pain flared up are the same in which the author is unable to otherwise identify or connect with the emotional content, a state known as alexithymia, marked by the discovery of mysterious 'black holes' in the author's emotional experience.
Research Limitations: As an 'n=1' study, it is not clear which of the findings of this study are directly applicable to other sufferers of somatoform illnesses or alexithymia. However, as a piece of first person research, the subjective material and its insights may be relatable to by other readers and indeed fellow counsellors and psychotherapists.
Conclusions/Implications: As a practicing counsellor, the author has found himself more confident in working with body presentations such as chronic pain or chronic fatigue and exploring the personal contexts that might be present.

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Yue On, Ho

Presenter: Yue On, Ho
Professional Role: Family therapist trainee
Institution/Affiliation: Kwai Chung Hospital, Hong Kong
Email: hyofion@hotmail.com
ABSTRACT: poster (Fri, 10.20-10.45)

Keywords: marital and family therapy, clinical practice, action research, single case study, attachment theory

Reflections and learning from the practice of marital and family therapy: a single case study of a couple with insecure attachment

Aim/Purpose: The purpose of this study was to examine the difficulties experienced by trainee family therapists when they encounter couples with insecure attachment during counseling.
Design/Methodology: Cycle of action research (identifying, planning, acting and reflecting) was employed with 9 sessions of in-depth unstructured interviews, in which Bowenian family therapy and emotion-focused therapy were conducted for an individual case of a married couple. Qualitative content analysis was used.
Results/Findings: Two primary themes are emphasized throughout the study: 1) The role of therapist i) being flexible when choosing approach, ii) from modern to postmodern approach; 2) Insight gained into emotion-focused therapy practice: be more patient to access vulnerability. Adult attachment appeared to have a strong impact on relationship quality. Couples with insecure attachment appeared to experience lower levels of marital satisfaction and more marital conflicts.
Research Limitations: The limitations of this study were the sole focus of the individual case and the findings might be affected by selection bias of the participant.
Conclusions/Implications: Findings from this case study suggest that trainee family therapists should acknowledge the complexity of problems, be self-reflective and be adaptable to change when counseling couples with insecure attachment.

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Loveday Hodson

Presenter: Loveday Hodson
Other Author: Dr Clare Symons
Professional Role: Trainee Psychotherapist/Counsellor
Institution/Affiliation: University of Leicester
Email: lch8@le.ac.uk
ABSTRACT: poster (Sat, 10.05-10.30)

Keywords: premature endings, termination, qualitative study, therapeutic alliance

The elusive client: how therapists' experience premature endings to counselling relationships

Aim/Purpose: In an ideal world, endings to therapy are carefully planned events, negotiated between client and therapist. Yet a considerable number of therapeutic relationships are ended abruptly and unilaterally by clients. Premature endings (or premature terminations) are increasingly recognised as an important aspect of therapists' experience. The subject area has, however, been the subject of limited research. Although a number of studies have tried to determine the frequency of premature terminations and the factors that help to predict premature terminations, little is known about how therapists themselves experience such endings. This study explores how therapists come to understand and make sense of premature endings.
Design/Methodology: Draws on a small-scale qualitative study based on nine semi-structured interviews analysed using thematic analysis. The participants are practising therapists who are members of a recognised professional organisation and who have experience of client-initiated premature terminations.
Results/Findings: Client-initiated premature endings generate in therapists a whirlwind of powerful emotions. The findings tend to suggest that the loss of a real relationship is mourned. The theoretical confusion and gaps that apply to endings leave therapists in a sea of confusion when processing them. A theoretically 'incomplete' ending is normal, yet participants felt blindsided by CIPEs. The drive to explain that which may be inexplicable leads the therapist into a difficult world of speculation and blame. Supervision plays a key role in shaping therapists experience of CIPEs, usually, although not always, a role that is helpful. The findings also point to a conundrum at the heart of the therapeutic relationship: it must navigate between a sense of timelessness and inevitable obsolescence.
Research Limitations: The study is small-scale and based on a convenience sample. Participants worked in a limited range of settings – for example, only one participant worked in private practice. Participants that put themselves forward may have particularly unresolved experience of unplanned endings.
Conclusions/Implications: It is hoped that this poster presentation will contribute to our understanding of how therapists experience and process client-initiated premature endings.

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Laura Hordern & Ian Dixie

Presenters: Laura Hordern & Ian Dixie
Other Authors: Fahima Ali, Frey Case-Leng, Kevin Jones, Lisa Hayter, Zaziah Wood
Professional Role: HPD in counselling students/volunteer counsellors.
Institution/Affiliation: LC&CTA
Email: c/o christine.brown@lcandcta.co.uk

ABSTRACT: poster (Sat, 10.05-10.30)

Keywords: hypersexual behaviour, narcissism, intimacy, compulsivity

Does the experience of counsellors suggest there are links between hypersexual behaviour and narcissistic personality disorder; if so, what are the possible implications for practice?

Aim/Purpose: Recent research by Carpenter et al. (2013) investigated the comorbidity of Hypersexual Disorder (HD) and personality disorders; amongst their diagnosed HD research participants, the most common co-diagnosis was Narcissistic Personality Disorder (NPD). Our research aimed to further explore these apparent links with the specific purpose to provide greater understanding of the dynamic interplay between HD and NPD and the potential implications
for/impact on the counselling alliance.
Design/Methodology: Following the BACP guidelines for research in counselling and psychotherapy (Bond, 2004), semi-structured, audio-recorded interviews were carried out with three counsellors working with clients diagnosed with HD. A thematic analysis informed by the principles of phenomenology (Safranski, 1998) was employed to give a full descriptive picture of the counsellors' experiences.
Results/Findings: Our findings indicate that clients presenting with HD display a number of similar traits - as outlined in the DSM V for the diagnosis of NPD - suggesting a link/overlap between the two disorders. Traits Common to both HD and NPD are: risk taking behaviours; attention seeking behaviours; difficulty forming relationships and intimacy problems; grandiosity; a sense of entitlement; vacillating between extremes.
Research limitations: Our research was time and resource limited. Clients could not be directly interviewed for ethical reasons: insufficient resources/funding to provide ongoing support if needed.
Conclusions/Implications: Our findings lead us to suggest that the personality traits of clients who present with HD are consistent with much of the criteria for the diagnosis of NPD. An increased awareness of these links could benefit counsellors' understanding of the potential issues that NPD traits in a client/s may bring to the counselling alliance; such as vacillating between extremes, grandiosity and issues with relationships and intimacy. Further research is
recommended in order to test if our findings are accurate.

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Wendy Hoskins & Lisa Bendixen

Presenters: Wendy Hoskins & Lisa Bendixen
Professional Role: Associate Professors
Institution/Affiliation: University of Nevada, Las Vegas
Email: Wendy.hoskins@unlv.edu
ABSTRACT: paper (Fri, 15.30-16.00)

Keywords: counsellor education, counselling students, epistemology, theory, training

Student epistemological beliefs of counselling and theory choice

Aim/Purpose: Graduate level counsellor education involves a variety of learning experiences and instructional methods designed to help new counsellors integrate theory and practice. In order to better prepare counsellor educators to work effectively with counselling students, the aim of this study is to explore the development of beliefs about counselling epistemology and theory of choice among beginning level counselling students.
Design/Methodology: Fifty-seven students participated in this study during their first semester. Each student participated in a course that focuses on an understanding of basic counselling theories, understanding the student's views of counseling, and the process of building collaborative relationships. Investigators adapted and used a version of a topic-specific measure of epistemological beliefs developed by Braten and Stromso (2004). This measure contains 49 items based on a 10-point Likert scale and includes four dimensions of epistemological beliefs related to counseling. Students were also asked to identify one of three theoretical umbrellas that seemed to fit their personhood best. Pre and post measures were compared using paired-samples t tests.
Results/Findings: The Simple Knowledge dimension showed a significant increase in mean indicating that students viewed counseling knowledge as more complex at the end of the course than they did at the beginning. The means for the Certain Knowledge dimension also increased indicating shifts in students' beliefs about the relative and constructive nature of counselling knowledge. In addition, analyses indicate that 30% of the counseling students changed their
theoretical choice at the end of the course to a Humanistic theory.
Research Limitations: The research is small scale limiting generalizability. Additionally, there is a lack of current counselling related epistemology research to draw from.
Conclusions/Implications: Obtaining information on students' beliefs provide a more topic specific view of counselling epistemology and may offer educators better chances to effectively reach their students. Also encouraging were the shifts in counseling knowledge that were apparent in the students at the end of the course. Learning about and challenging students views of counseling brought about important change.

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Jon Howarth

Presenter: Jon Howarth
Other Author: Dr Clare Symons
Professional Role: Post Graduate Student
Institution/Affiliation: University of Leicester
Email: jon_howarth@hotmail.com
ABSTRACT: paper (Sat, 10.55-11.25)

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 was to understand the humour styles of therapists and to explore whether there is a relationship between humour style and attitude toward the use of humour in therapy. The research aimed to discover whether therapists have a predominant humour style and how this compared to the general population. The study also investigated the relationship between the therapists' demographic variables their humour style and their attitude to the use of humour with a client.
Design/Methodology: The research utilised an online questionnaire that asked 40 questions in a Likert scale format. The 32 questions that measure humour styles were a replication of The Humour Styles Questionnaire (HSQ) developed and validated by Martin et al (2003). A sample of approximately 1,500 therapists were invited to participate who were randomly selected from the members listed on the BACP website, 268 responses were received.
Results/Findings: Results indicated that there is a statistically significant difference in humour styles between the non-therapist sample used in the original research (Martin et al 2003) and the therapists that took part in this study, this was particularly pronounced in the case of the Aggressive humour style. There were also found to be some significant differences in counsellors' attitudes toward the use of humour in therapy between the integrative and psychodynamic
modalities and between experienced and inexperienced counsellors.
Research Limitations: The limitations of the study include the inherent subjectivity of self-report tests and the fact that the additional questions developed to measure attitude to humour were not tested in the same rigorous manner as the original HSQ.
Conclusions/Implications: The study determined that therapists' humour styles appeared to be congruent with the role of being a therapist. There were additional conclusions that contribute to understanding professional practice. First, it may be beneficial for therapists to explore and understand their own humour style and what this may mean for their practice. Second, the research revealed that therapists thought humour to be an essential tool in therapy however inexperienced therapists were less comfortable in its use, therefore there may be a case for the use of humour to be integrated into therapist training programmes.

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Charlie Jackson

Presenter: Charlie Jackson
Other Authors: Jo Pybis, Andy Hill & Karen Cromarty
Professional Role: Research Officer
Institution/Affiliation: BACP
Email: charlie.jackson@bacp.co.uk
ABSTRACT: paper (Sat, 12.05-12.35)

Keywords: practice research network (PRN), children and young people, routine outcome data

Feasibility and acceptability of collecting routine outcome data across a practice research network (PRN)

Aim/Purpose: This paper reports the experience of practitioners engaged in BACP's Children and Young People Practice Research Network (CYP PRN). CYP PRN was set up in 2011 and now has over 400 members. As members of the Child Outcomes Research Consortium, data collected via CYP PRN can be analysed alongside that of CAMHS services. The findings presented here aim to provide information about the feasibility and acceptability of this approach.
Design/Methodology: Members of CYP PRN were contacted via a regular network e-bulletin and asked if they were interested in participating in a pilot project involving the collection of routine outcome data, and the use of an electronic platform (COMMIT) for storing that data. 34 members of the network expressed interest and five services were randomly selected to participate. Participants attended a training day where they were familiarised with the COMMIT platform and the protocol for the study. Additionally, four voluntary sector services participating in a separate study using COMMIT for data capture were approached to take part in this feasibility study. Semistructured interviews exploring the acceptability of the approach were conducted with four practitioners and a thematic analysis was undertaken.
Results/Findings: To date, 30 practitioners, from five individual services are using this approach and feeding data in to the COMMIT system. Preliminary descriptive analyses of quantitative data will be presented. Interview data suggest that practitioners found the training clear and supported the idea of developing further online training. Most practitioners felt that COMMIT was easy to use, despite some technical issues; however, they felt well supported by BACP when issues did arise. Suggestions for improvement were offered and fed back to the developers.
Research Limitations: This is a small feasibility study, therefore preliminary outcomes need to be interpreted with caution. The principle aim of this study was to assess the feasibility of implementing this approach to the collection of routine outcome data in a PRN setting.
Conclusions/Implications: Practitioners were generally positive about using the COMMIT system, which suggests that this practice-based approach could be rolled out across the wider PRN to build on the evidence base for counselling for children and young people across a range of settings.

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Antony Johnston

Presenter: Antony Johnston
Professional Role: Doctoral Student/Principal Lecturer
Institution/Affiliation: University of Roehampton/University of the Arts London
Email: a.johnston@arts.ac.uk
ABSTRACT: paper (Sat 11.30-12.00)

Keywords: practice as research, discourse analysis, truth and justice, autonomy and heteronomy

In what way do psychotherapists regard practice as research?

Aim/Purpose: This paper will present findings from an initial phase of research conducted as part of a Pscyh. D. in Counselling and Psychotherapy at the University of Roehampton. The research aims to explore how therapists regard their practice as a research practice. The notion of 'practice as research' aims to describe how practitioners conceive their 'clinical practice' as research; a literature review revealed three key conceptions of practice as research: an early Freudian, scientist-practitioner and modern psychoanalytic. This investigation is important because of recent debates regarding the effectiveness of counselling and psychotherapy and the ways in which practitioners are expected to be able to evidence their practice.
Design/Methodology: As part of the initial phase of research 4 interviews with experienced psychotherapists were conducted. Recruitment drew upon a 'snowball'/'chain referral' sampling method as it attempted to surface approaches to practice that proved highly specific. Interviews were unstructured and explored how interviewees understood their practice as research. Interviews lasted for between 50-70 minutes. Following verbatim transcription, interviews were coded according to the discourse analytic approach outlined by Kendall and Wickham (1999).
Results/Findings: The analysis revealed how these therapists situated themselves within certain discourses, whether phenomenological, humanistic, positivist or psychoanalytic and often posed their conception of research in response to what was perceived as dominant and unhelpful discourses that currently define what is therapeutic. The analysis provides insights in terms of how therapists understand their own practice as well as how this relates to broader trends such as regulation and mental health service commissioning.
Research Limitations: The study is limited because of the small sample, but also because the methodological approach drawn upon does not attempt to draw general conclusions.
Conclusions/Implications: The research provides insight into the specific ways that psychotherapists think about their practice as research and how this is informed with wider debates concerning what is therapeutic. Considering the stories of these therapists will help others reflect upon their own practice and perhaps provide insight into the effects of significant discourses that enable such insights to take shape.

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Claudia Kempinska-Hill

Presenter: Claudia Kempinska-Hill
Other Author: Dr Clare Symons
Professional Role: Psychodynamic Counsellor/Psychotherapist
Institution/Affiliation: University Of Leicester
Email: claudiahcounselling@yahoo.com
ABSTRACT: paper (Fri, 11.40-12.10)

Keywords: therapeutic frame, boundaries, psychodynamic counselling, trainees

"We're human, not robots!" How novice psychodynamic practitioners manage challenges to the therapeutic frame

Aim/Purpose: The purpose of this research is to investigate the ways in which novice psychodynamic therapists manage challenges to the therapeutic frame, exploring the impact the challenge itself has on the work and how these are managed with the client. In addition, the research aims to investigate the external support therapists seek in order to manage challenges to the frame.
Design/Methodology: This qualitative study involved face-to-face semi-structured interviews with ten psychodynamic practitioners who were in training or who had qualified within the last two years. The interviews were audio recorded, transcribed verbatim and analysed using Grounded Theory
Results/Findings: Analysis of the data yielded three themes: having an awareness of the challenge and addressing it with the client, being aware of the challenge but not addressing it immediately, and thirdly, being aware of the challenge but feeling deskilled or anxious and therefore unable to address the challenge. Participants described various processes that affected how they managed these challenges: positive and negative countertransference reactions, the external support received by the therapist, and the ethical implications of addressing the challenge with the client. Addressing the challenge with the client immediately or in subsequent sessions had a positive impact on the therapeutic relationship and deepened exploration of client material.
Research Limitations: Ten participants were interviewed for this study due to time constraints, therefore saturation could not be reached, limiting the claims the findings make. Findings are further limited by the use of convenience sampling meaning that some of the participants were already known to the researcher. This research did not look at the long-term impact of how challenges were managed, either in relation to outcomes or to client experience.
Conclusions/Implications: This research contributes to our understanding of the professional practice of novice psychodynamic practitioners whose countertransference reactions can negatively impact on the effective management of challenges to the frame. This research also demonstrates the importance of openness in supervision and personal therapy as key to novice practitioners' professional development and in providing an opportunity to address client material.

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Richard Kettley

Presenter: Richard Kettley
Professional Role: Counsellor
Institution/Affiliation: Sherwood Psychotherapy Training Institute
Email: richardkettley@hotmail.co.uk
ABSTRACT: poster (Sat, 10.05-10.30)

Keywords: IPR, phenomenological, person-centred, trainee therapist, body language

Using IPR and phenomenology in person-centred research

Aim/Purpose: to explore the relevance and effectiveness of IPR (Interpersonal Process Recall) as a data collection method in a phenomenological study of person-centred trainee therapists' awareness of their own body language and its possible impact on the therapeutic relationship
Design/Methodology: Person-centred trainee therapists were invited to participate and to find a peer on their course who would act as a client-participant. A short clinical skills dyad session was set up and was video recorded. This was played back to the therapist-participant in an IPR (Kagan, 1980) session (and audio recorded). Following the IPR session, a short semi-structured research interview was undertaken (also audio recorded). The interview focused on aspects of reflexivity and congruence. The audio recording formed the data for a phenomenological process adapted from Spinelli (2005).
Results/Findings: The results produced 5 themes around awareness: of inner experiencing; of own separateness; of movement toward being in relationship; of body language communicating Rogers' conditions, particularly congruence; and of richness/diversity and ambiguity/complexity of body language in the therapeutic relationship. The researcher perceived IPR to be useful in tracking and exploring the trainee therapist's congruence and transparency as they started a client session. The video recording used afforded opportunities for trainee therapists to explore their body language, as well as what they felt they held back, leading to an evaluation of the congruence and transparency of their verbal and nonverbal communication.
Research Limitations: The sample was small (3) and there was little cultural diversity (all white female). The researcher had to double up as Inquirer for IPR sessions for practical purposes. This focused on person-centred trainee therapists, but is potentially relevant to other modalities.
Conclusions/Implications: IPR facilitates self-discovery and self-learning of participants, and supports subsequent research questions exploring reflexivity especially around areas of congruence. Its holistic approach was consistent with a phenomenological exploration of person centred counselling in practice, and the use of video playback facilitated the trainee therapists' own meaning–making around their body language and its impact. Body language concerns inner experiencing and psychological contact. It can convey the therapist's genuineness and contribute to the quality of the therapeutic relationship.

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Dr Venetia Leonidaki

Presenter: Dr Venetia Leonidaki
Professional Role: Clinical Psychologist
Institution/Affiliation: Camden and Islington NHS Trust
Email: venetia.leonidaki@nhs.net
ABSTRACT: methodological innovation paper (Fri, 16.05-16.35)

Keywords: critical appraisal, literature review, qualitative synthesis, qualitative integration, interview studies

Critical appraisal evidence in psychotherapy: the introduction of a new appraisal tool for interview studies

Background and introduction: There is a range of approaches to the use of appraisal guidelines in qualitative research (QR). Drawing on the author's experience of appraising critically studies for an under-preparation qualitative review in psychotherapy research, a new qualitative appraisal tool was developed.
Nature of the methodological innovation/critique being proposed: This paper presents this tool for consideration and discusses its potential practical utility and theoretical implications for the field of QR in psychology/psychotherapy. The development of the presented tool included the following stages: 1. A distillation of the most relevant appraisal criteria found in widely-used published guidelines for QR in psychology and social/health sciences 2.Tailoring the selected
criteria to the distinct methodological and theoretical aspects of interview-based studies in psychotherapy research 3. Piloting earlier drafts of the tools via using them for a provisional evaluation of the studies included in the under-preparation literature review mentioned above 4. Refining the latest draft of the tool via receiving feedback by colleagues. The 56 appraisal criteria of this newly developed tool are organised under nine different domains: 1.Context and Purpose. 2. Recruitment. 3. Situating the sample. 4. Data collection. 5. Analysis/Findings. 6. Auditability/Credibility. 7. Impact and value. 8. Reflexivity.9.Ethics. For the purpose of comparative appraisal, a total score, which aims to capture the overall methodological quality of an appraised
study, could be calculated.
Conclusion and relevance to counselling and psychotherapy research practice: This tool is highly suitable for the evaluation of interview-based studies and for assisting with the appraisal process in integrations of qualitative evidence using relevant methodology in psychotherapy/psychology. More broadly this tool could be treated like an inspiring, plastic and adaptable prototype offering an alternative approach to critical appraisal in QR via the introduction of specialised and highly operationalised criteria and it could become a useful pedagogical tool. Safeguards against the uncritical use of the tool, which could reduce the complex process of critical appraisal to a tick-box exercise, are also discussed.

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Feylyn Lewis

Presenter: Feylyn Lewis
Professional Role: Doctoral Research Student
Institution/Affiliation: University of Birmingham
Email: FML402@bham.ac.uk
ABSTRACT: poster (Sat, 10.05-10.30)

Keywords: young adult carers, identity development, therapy, psychological risk, emerging adulthood

Exploring the identity development of the young adult carer and its implications for therapeutic practice

Aim/Purpose: This research aims to explore the effects of caring on the identity development of the young adult carer.
Design/Methodology: As a part of an ongoing doctoral research project, qualitative semistructured interviews with young adult carers aged 18-25 currently living in the United Kingdom will be conducted; the target sample size is 30-40 participants. Participants willl be currently providing unpaid care, support, or assistance to a family member who has a health condition requiring care (e.g., physical and learning disabilities, mental illness, chronic health issue (HIV-AIDS), and substance misuse). A thematic analysis will direct the research methods, as the researcher is interested in interpreting themes that are largely driven by existing theory (the theories of identity formation conceptualized by Erik Erikson and James Marcia in the context of the theory of emerging adulthood as conceptualized by Jeffery Arnett).
Results/Findings: It is known that young adult carers are at risk for a variety of adverse psychological effects from caring, including stress, anxiety, and depression. They also report higher rates of bullying and social isolation that could have a negative effect on their emotional well-being. Little is known, however, about the effect of caring onto the young adult's identity formation. Initial findings will be presented on the impacts of caring onto their identity development and their sense of self, as well as an overview of the psychological impacts of caring.
Research Limitations: The participant sample will be drawn from those affiliated with young adult carers projects, so the initial findings will only represent those who are receiving support through a carers project, perhaps impacting generalizability.
Conclusions/Implications: This research will provide practitioners with an awareness and understanding of the identity issues facing young adult carers, allowing for better preparation and competence in practice. These initial findings will also provide directives for more effective counselling sessions with young adult carers, based upon an understanding of the unique needs of young adult carers as it relates to their psychosocial development and psychological risk.

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Dr Jane Macaskie, Dr Bonnie Meekums & Tricia Kapur

Presenters: Dr Jane Macaskie, Dr Bonnie Meekums (lead author) & Tricia Kapur
Professional Role: Teaching Fellow in Counselling & Psychotherapy
Institution/Affiliation: University of Leeds
Email: j.f.macaskie@leeds.ac.uk
ABSTRACT: paper (Fri, 12.15-12.45)

Keywords: scoping review, reflective methods, counselling skills teaching, interpersonal process recall, reflecting teams

Reflective methods in counselling/psychotherapy training: a scoping review of Interpersonal Process Recall and Reflecting Team methods

Aim/Purpose: To scope the existing literature on the use of interpersonal process recall (IPR) and reflecting teams (RT) as methods for teaching counselling/psychotherapy skills, to inform and develop pedagogical practice.
Design/Methodology: A five stage framework (Arksey & O'Malley, 2007) was used to scope the literature. 1.) The research question was identified as: What is known from the literature about the use of IPR and RT as pedagogical methods for counsellor/psychotherapist training? 2.) Relevant studies were identified from four databases: ASSIA, ERIC, MEDLINE and PsychINFO. 3.) Study selection was carried out on the basis of inclusion and exclusion criteria: research population – only counsellors/psychotherapists undertaking initial training; type of paper – only original research or reviews of original research. 4.) The resulting data were charted. 5.) The data were summarised and reported.
Results/Findings: None of the literature identified is UK-based, most being North American. Many papers were theoretical not research-based and did not meet our inclusion criteria. Six papers on IPR and two on RT were included. IPR is found to be a useful tool for reflective practice rather than initial skills development and hence more relevant for later stages of training. The RT literature focuses on developing skills and reflective practices for couple, family and group therapy, rather than individual therapists. RT methods are reported to develop narrative and collaborative
practices. The voice of students as consumers of these methods is represented by the third author.
Research Limitations: This study is a scoping not a systematic review of the literature. Some of
the included papers displayed methodological flaws.
Conclusions/Implications: There is a need to assess the potential of these pedagogical methods
in the UK therapy education context. Both methods have potential for developing reflective
collaborative practices in individual therapist education. Protocols for their use are suggested.

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Sam Martin

Presenter: Sam Martin
Other Author: Professor Sue Wheeler
Professional Role: Counselling/Psychotherapy Student
Institution/Affiliation: Leicester University
Email: sfmartin_2000@hotmail.com
ABSTRACT: paper (Fri, 12.15-12.45)

Keywords: men, depression, counselling, masculinity, discourse analysis

'How can you be strong all the time?' Constructions of masculinity in the first counselling session of male clients

Aim/Purpose: This study aimed to explore the dominant discourses in the first counselling session of male clients and how masculinity was constructed within the session.
Design/Methodology: Recordings of the first counselling sessions of six male clients, seen at a University Counselling and Psychotherapy Research Clinic, were listened to, transcribed and analysed for the dominant discourses in the session. A Foucauldian method of discourse analysis was used to examine how the male clients constructed masculinity in the session.
Results/Findings: Twelve dominant discourses were identified in the talk. These were grouped into three main discursive areas: talk about counselling, identity, and emotion. Counselling was constructed by male clients as a safe space to open up, often the only safe space. Outside the counselling room, feelings and emotions were constructed as shameful. Opening up about feelings in counselling was attributed to femininity. There was also a lack of agency attributed to the decision to seek counselling. Depression was constructed as a change in identity; male clients talked about no longer being outgoing/sociable/promiscuous/rational. Many clients talked about a lack of expressing emotions, by some this was constructed as a strength but by other clients restricted emotionality was constructed as a barrier. Male clients expressed a desire to cry to show how they cared.
Research Limitations: There was a difficulty reconciling notions of the individual self in the 'therapy world', with an analysis focused on exploring cultural and social forces. No attempts were made to analyse why male clients were depressed, rather how they talked about being depressed to the counsellor, and the context of their statements.
Conclusions/Implications: This research contributes to professional practice by highlighting a desire for male clients to be more in touch with their feelings, rather than abiding to constrictive stereotypes. Psychotherapists and counsellors can be aware of the importance of providing an encouraging, facilitating environment where the struggle for men to express emotions is acknowledged and worked with.

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Sherri Matthews

Presenter: Sherri Matthews
Other Author: Dr Clare Symons
Professional Role: Trainee counsellor/psychotherapist
Institution/Affiliation: University of Leicester
Email: sem52@le.ac.uk
ABSTRACT: poster (Sat, 10.05-10.30)

Keywords: door handle comment, therapeutic frame, psychodynamic counsellors, frame management, symbolic communication

How do psychodynamic counsellors experience and understand clients' door handle comments: a thematic analysis

Aim/Purpose: The purpose of the study is to explore counsellors' experiences of significant material clients disclose as they are leaving the session. Previous research has suggested there may be many possible motivations behind a client's 'door handle comment', therefore how a counsellor chooses to respond at this moment may vary depending on this. When confronted with a such a comment the counsellor has the task of deciphering the latent meaning of the comment as well as managing their countertransference response and emotional conflict. Due to the potential for breaches of ethical boundaries at the end of the session, coupled with increased transference and countertransference, it is of great importance to investigate how counsellors manage challenges to the frame at this time, and work with it therapeutically.
Design/Methodology: This research uses data from semi-structured face-to-face interviews with 12 psychodynamic counsellors in practise, with varying levels of experience. The main areas of focus are the counsellor's countertransference reaction, their response at that moment, how the frame is managed, and their understanding of the door handle comment and how it is subsequently worked with. Transcriptions are analysed using thematic analysis. The University of Leicester has granted ethical approval for the study.
Results/Findings: The preliminary findings suggest that door handle comments were generally experienced as surprising, unexpected and anxiety provoking. Participants were more likely to act on their countertransference responses to these comments than in earlier parts of the session. These moments provided rich information relating to the clients' dynamics which when effectively addressed and worked with facilitated the therapeutic process.
Research Limitations: The research only examines the experiences of psychodynamic counsellors, research with therapists of different theoretical orientations may offer different perspectives on working with clients door handle comments.
Conclusions/Implications: The study aims to provide valuable insight into psychodynamic counsellors' experience of clients' door handle comments. It is hoped this will enhance psychodynamic counsellors' understanding of this phenomenon, and offer some guidance for professional practice for working therapeutically when the frame is challenged in this way.

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Dr David Murphy

Presenter: Dr David Murphy
Other Authors: Harriet Barnett, Emma Castledine, Nisha Irfan & Lily Enescu
Professional Role: Programme Leader, Person-Centred Experiential Counselling and Psychotherapy
Institution/Affiliation: University of Nottingham
Email: david.murphy@nottingham.ac.uk
ABSTRACT: paper (Fri, 11.40-12.10)

Keywords: personal therapy, training therapy, mandatory therapy

A systematic review of the literature and evidence for mandatory personal therapy in counselling and psychotherapy education: a progress report

Aim/Purpose: Rooted in theoretical assumption, personal training therapy is thought to enhance efficacy of individual therapists. Course providers and accrediting bodies often mandate personal training therapy as requirement for qualification and registration. As a costly process, elucidation of the facts is required to justify the practice. This paper reports on progress of a systematic review of literature for mandatory personal training therapy.
Design/Methodology: Elsevier, Google Scholar, Psych Info, Springer, Web of Science and Wiley databases were systematically searched for English language journal papers and other published works reporting findings from qualitative or quantitative empirical research on 'mandatory personal training therapy'. References lists were also searched and the process repeated until no further new studies were identified. Where available, data on study design, participant demographics, professional group, psychotherapy training approach, methodological quality were recorded.
Outcomes were assessed for impact on psychotherapy trainees' practice and development and were classified into a range of criteria.
Results/Findings: A total '592' studies were identified and following a review of abstracts, 497 were removed as they did not meet the inclusion criteria. The full text versions of 97 studies are currently under review. From the references lists of these a further 42 potentially relevant studies were identified. A review of results is currently ongoing and the presentation will report on a synthesis of findings from qualitative studies, and will explore the impact of personal training therapy.
Research Limitations: The limitation of this study is that a number of the studies included in the review are methodologically weak. There are no randomised controlled trials of the effects of mandatory personal training therapy making the interpretation of findings difficult to infer.
Conclusions/Implications: Personal training therapy has an impact on the development of the professional self of the psychotherapist. However, it is not possible to conclude that the effectiveness of individual therapists is enhanced through personal training therapy. A true experiment using randomization is needed.

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Catherine L. O'Riordan

Presenter: Catherine L. O'Riordan
Professional Role: Integrative Counsellor & Psychotherapist
Institution/Affiliation: Sherwood Psychotherapy Training Institute
Email: phaedo1964@yahoo.co.uk
ABSTRACT: paper (Sat 15.00-15.30)

Keywords: client's experience, reconnecting, hidden aspects-of-self, relational-developmental, safe intervention

The clinical importance of understanding the client's experience of reconnecting with hidden aspect-of-self for an effective therapeutic outcome

Aim/Purpose: To better understand and map the client's experience of discovering and reconnecting with hidden aspects-of-self within the context of Integrative Psychotherapy and to use this map to outline a safe and effective approach to working relationally-developmentally with clients at this critical phase when internal defences are at their highest.
Design/Methodology: A qualitative methodology was adopted allowing a deep relationship-based inquiry consistent with the philosophical principles of Integrative Psychotherapy. A literature review contextualized the study within relevant research demonstrating the clinical importance of further inquiry into the experience of reconnecting from the client's first-person perspective. Research participants were self-selecting and either qualified or Humanistic-Integrative Psychotherapists in training. Seven one to one, semi-structured interviews were conducted and participants were asked to describe their experience of discovering and reconnecting with hidden aspects-of-self or their inner-child within the context of Humanistic/Integrative Psychotherapy. Participant descriptions were analyzed using Giorgi's Descriptive Phenomenological Method.
Results/Findings: Three discrete stages were identified which map-out the early phase of the client's phenomenal experience of reconnecting with previously hidden parts: the Liminal, Emergent and Reconnecting stages. The findings suggest two distinct ways the client discovers and reconnects with aspects-of-self that were previously hidden: 1) through a felt-sense of 'something important but not understood' and 2) through recollecting past experiences that were
hitherto too psychologically big for them to process alone. It is recommended that if client's are helped to first reconnect with their felt-sense of 'something importance but not understood' and then proceed to process developmentally experienced traumatic experiences this approach creates a safer, more effective and efficient intervention.
Research Limitations: Participant descriptions were retrospective; participants shared a vocabulary that may have biased the research; not enough scope to display the participant descriptions and researcher reflexivity.
Conclusions/Implications: For clients whose relational needs have been chronically overlooked proactive inquiry into the client's internal experience needs to be a key focus of therapy. It is safer and more effective to help to first reconnect with their 'relational needs' and only then to help clients process and recover from traumatic experiences; this approach helps to off-set the binding power of shame and reduce the risk of retraumatisation.

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Wendy Padley

Presenter: Wendy Padley
Other Author: Dr Miriam Isaac
Professional Role: Student Psychotherapist
Institution/Affiliation: University of Leicester
Email: wp32@student.leicester.ac.uk
ABSTRACT: poster (Sat, 10.05-10.30)

Keywords: motivations, counselling training, counsellor background, self-development, psychodynamic

What has brought you here? An exploration of what has led psychodynamic practitioners to train in professional practice

Aim/Purpose: This research aims to explore the motivations of psychodynamic psychotherapeutic practitioners' decisions to train. Previous research has shown that a lack of awareness of therapists own motivations can lead to an unconscious attempt to resolve personal difficulties through therapeutic relationships. Such difficulties may include, for instance, managing intimate relationships, and unresolved issues around attachment.
Design/Methodology: Nine qualitative, semi-structured interviews with qualified psychodynamically trained participants, self-selected from invitations sent to counselling agencies and services. Participants are encouraged to consider motivations by thinking about the context of their own history, training and practitioner experience. Participants are also asked to reflect on whether any particular events or person has had any influence on the decision to train in this
profession. Participants are not limited by gender, age, ethnicity or length of time in practice. Thematic analysis will be applied to the data.
Results/Findings:
Preliminary results show that motivations for training include:
 Strong influences from early childhood. These include difficult relationships and developing ways of meeting parental needs and 'mood managing' for the parent, often the mother.
 A psychotherapeutic way of working can come from an unconscious desire for reparation for earlier relationships.
 Practising psychotherapy can allow for initial or further personal development and exploration
Methods by which therapists have become aware of their motivations:
 Mainly through personal therapy (course based and non-course based).
 Through client work and supervision.
 Largely, not through instructional training itself.
Research Limitations: This research focuses on psychodynamic therapists, and research with therapists trained in other theoretical orientations may offer different insights.
Conclusions/Implications: It is anticipated that this research will contribute to professional practice by highlighting motivations to practise and adding knowledge which may be valuable for training and selection processes, and also for supervision purposes. Practitioners are also encouraged to reflect on personal and professional awareness and insight, both individually and within supervision.

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Peter Pearce & Dr Andy Fugard

Presenters: Peter Pearce & Dr Andy Fugard
Other Authors: Professor Mick Cooper (Roehampton University) & Sarah Osman (Metanoia
Institute)
Professional Role: Head of Faculty
Institution/Affiliation: Metanoia Institute
Email: peter.pearce@metanoia.ac.uk
ABSTRACT: paper (Fri, 11.40-12.10)

Keywords: school-based counselling, young people, person-centred, educational outcomes

An exploration of the impact of school-based person-centred counselling on educational and socio-behavioural factors within three inner city London secondary schools

Aim/Purpose: This supplementary study uses data from the participants of the Align RCT of school-based person-centred counselling (SBPCC) to explore the relationship that a term of SBPCC has with pupil achievement and attainment projections, attendance and socio-behavioural indices (use of time out, detention, behaviour support, possible exclusions etc). It hopes to add to the efficacy outcome data by exploring the impact that school-based counselling has on educational factors: pupil achievement and attainment.
Design/Methodology: The three collaborating schools in Align have given access to their educational progress and estimates of future performance, attendance, socio-behavioural and other data for all participants in both the intervention and control arms of the Study. This data from each group is compared for pupil progress across subjects, estimates of future performance, levels of attendance, use of time out, detentions, behaviour support, exclusions etc. to ascertain the impact on the levels of these various indices of the counselling intervention compared with the control waiting list pupils. Both groups have access to every other school initiative throughout this time. Adapted change interviews were conducted with all participants in both parts of the project at 6 and 12 weeks and at 6 months and 9 months follow up. This interview data will be used to highlight any other variables that have changed during this time and which may have contributed to variance in the educational indices.
Results/Findings: Both teaching staff and clients did identify an attendance and educational impact of counselling for individual students within explorative qualitative findings. However, examining the quantitative variables on attainment and attendance, there were no statistically significant differences between school-based counselling and pastoral care as usual. This likely because the study, as a pilot for a full powered RCT, was underpowered.
Research Limitations: The Align sample size is small (n=60) and the participating schools are all in highly diverse, inner London areas of significant deprivation so there may be limitations to how any findings can be generalised to other UK school settings.
Conclusions/Implications: Almost all school variables are reported to have small effects, with the challenge for school leadership being to create 'synergistic effects'; the accumulations of small effects in the same direction. So, if the data from this study shows that investing in school-based counselling support for young people with emotional and behavioural difficulties can help them even in a small way to improve engagement with education and achieve academically this would have important policy implications.

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Devon Perfect

Presenter: Devon Perfect
Other Authors: Andy Hill & Dr Jo Pybis
Professional Role: former BACP Research Intern
Institution/Affiliation: BACP
Email: devon.perfect@bacp.co.uk
ABSTRACT: paper (Fri, 16.05-16.35)

Keywords: IAPT, step 3 psychological therapies, choice, outcomes, users

Choice of therapies in IAPT: an overview of the users' availability of therapies and preliminary outcomes

Aim/Purpose: Though there are large amounts of data collected and reports published by IAPT, there is a paucity of evidence comparing the outcomes across the NICE recommended step-3 therapies: cognitive behavioural therapy (CBT), interpersonal psychotherapy (IPT), couples therapy, person-centred/humanistic therapy and psychodynamic psychotherapy. This paper compares and reports outcomes on therapies for which sufficient data are available. In addition we also report descriptive data on the extent to which each therapy is utilised, by whom, and for what presenting issues.
Design/Methodology: Ethical approval was granted by the University of Sheffield and the study was conducted according to BACP ethical guidelines for research. Approval was obtained from the Royal College of Psychiatrists to conduct a secondary analysis of data collected as part of the National Audit of Psychological Therapies (NAPT) published in November 2013. The secondary analysis centres on 51,183 records of individuals who had received treatment within an IAPT service. Demographic analysis was conducted to investigate the characteristics of individuals' receiving the different types of therapy and Multi-Level Modelling (MLM) used to compare outcomes across the therapies where sufficient data were available.
Results/Findings: The key findings of this report illustrated that large IAPT services offer more choice of therapy than the small and medium services. Counselling was offered by services of all services and was more commonly offered than CBT in small services (83.3% of services). Aside from counselling, the provision of the other step 3 therapies was minimal in all sizes of service. Preliminary MLM analysis suggests that counselling has equivalent outcomes to CBT on PHQ-9 scores, but in fewer sessions.
Research Limitations: As a secondary study, the research team had no input into the design of the original data collection, limiting the scope of the study to the data available.
Conclusions/Implications: The predominance of CBT in IAPT services and the poor availability of the other therapies recommended by NICE at step 3 is a cause for concern. The fact that outcome data on the different therapies are routinely collected in IAPT services makes comparative analyses possible. However, thus far few studies of this kind have been carried out. This study demonstrates the feasibility and utility of this type of analysis, in the hope that it may spawn further research in this area.

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Dr Sara Perren

Presenter: Dr Sara Perren
Other Authors: Hugh MacPherson, Stewart Richmond
Professional Role: Psychotherapist, Practitioner Researcher
Institution/Affiliation: University of York/The Tuke Centre, York.
Email: sperren@thetukecentre.org.uk
ABSTRACT: paper (Fri, 11.05-11.35 and Sat, 13.50-14.20)

Keywords: counsellling, acupuncture, randomised controlled trial, depression, primary care

Using counselling or acupuncture for depression in primary care. The findings of the ACUDep randomised controlled trial

Aim/Purpose: Depression is a significant cause of morbidity. Many patients in primary care want non- pharmacological therapies. Systematic reviews of acupuncture and counselling for depression in primary care have identified limited evidence. The aim was to evaluate humanistic counselling versus usual care and acupuncture versus usual care for patients who continue to experience depression in primary care.
Design/Methodology: In a randomised controlled trial, 755 patients with depression (BDI-II score over 20) were recruited from 27 GP practices in the North of England. Patients were randomised to one of three arms using a ratio of 2:2:1 to acupuncture (302), counselling (302), and usual care alone (151). The primary outcome was the difference in mean Patient Health Questionnaire (PHQ-9) scores at 3 months and at 12 month follow-up. Analysis was by intention-to-treat. PHQ-9 data were available for 614 patients at 3 months and 572 patients at 12 months. Patients attended a mean of ten sessions for acupuncture and nine sessions for counselling. Counsellors were trained in humanistic counselling. To delineate the counselling intervention the trial used humanistic
competences developed by Roth and Pilling (2009).
Results/Findings: Compared to usual care, there was a statistically significant reduction in mean PHQ-9 depression scores at 3 months for acupuncture and counselling. Differences between acupuncture and counselling were not significant. At 9 months and 12 months, improvement was sustained, but because of improvements in the PHQ-9 scores in the usual care group, acupuncture and counselling were no longer significantly better than usual care.
Research Limitations: The trial did not identify which aspects of counselling or acupuncture were responsible for beneficial effects. The study focused on people with moderate to severe depression. We do not know about effectiveness for people with mild depression.
Conclusions/Implications: Both acupuncture and counselling was associated with significantly reduced depression after three months. While further research into optimal interventions for the treatment of depression with acupuncture and counselling is merited, this RCT could contribute to evidence for the 2015 revision of the NICE Depression Guideline.

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Sarah Perry

Presenter: Sarah Perry
Other Author: Simon Carpenter
Professional Role: Chartered and Clinical Psychologist
Institution/Affiliation: Independent
Email: sarahperrycornwall@gmail.com
ABSTRACT: paper (Fri, 12.15-12.45)

Keywords: evaluation, participation research, young people

A pilot project to explore how young people would measure the effectiveness of a counselling service and the development of a new outcome measure

Aim/Purpose: The aim of this study was to support a group of young people to evaluate the evaluation procedures within a counselling service for children and young people who had experienced abuse.
Design/Methodology: This project used cooperative inquiry as a research approach. This entailed actively involving young people as partners or participants rather than the subjects of research. The counselling service had a consultation group made up of 6 to 12 members aged between 10 and 17 years. These members were invited to take part in the project and 8 young people (4 boys and 4 girls) said they would like to. This group attended training workshops in research methods so that they could evaluate evaluation procedures within the counselling service.
Results/Findings: One of the main outcomes from the workshops was young people's critique of some of the most widely used outcome measures available to evaluate the effectiveness of counselling. It was decided that it would be useful to look at the qualitative comments written on the Service Feedback Form completed by 178 young people over the last three years The group arranged the comments under themes in order to capture the main ways in which clients felt counselling helped. The comments that they felt best reflected these themes were included in a new questionnaire which was shared with the service's therapists, some minor amendments made and it was agreed that it would be piloted for 6 months. To date 31 young people have completed the questionnaire. Good response rates, little missing data and varied responses to the items indicate this questionnaire is suitable for this client group.
Research Limitations: There were difficulties and limitations with doing participatory research, primarily in terms of resources (time and funding) to carry out such projects and to respectfully consider young people's own priorities, commitments, abilities and goals.
Conclusions/Implications: The questionnaire developed by young people differed from other questionnaires used to assess the effectiveness of therapy and service satisfaction in that it was explicit about the actual benefits of therapy to young people, as perceived by themselves and expressed in their own words. Some of the challenges around participation research will be explored.

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Barbara Rayment

Presenter: Barbara Rayment
Other Authors: Prof Mick Cooper, Dr Jo Pybis, Andy Hill & Dr Cathy Street
Professional Role: CEO of national charity
Institution/Affiliation: University of Roehampton
Email: Barbara@youthaccess.org.uk
ABSTRACT: paper (Sat 11.30-12.00)

Keywords: young people, young adults, voluntary sector, counselling, outcomes

Counselling for young people and young adults in the voluntary and community sector: outcomes and demographics from a practice research network

Aim/Purpose: To produce and disseminate reliable evidence on the profile of service users and the outcomes of counselling in the community-based settings of voluntary sector (VS) Youth Information, Advice and Counselling Services.
Design/Methodology: Eight local VS organisations have been recruited to implement a suite of measures recognised in the Children and Young People's Improving Access to Psychological Therapies programme. Operating under an agreed protocol, the agencies are collecting on a 'session by session' basis the outcomes of counselling with young people aged 11-25 years using the YP-CORE (11-16 years) and CORE-10 (17-25 years). Agencies are also collecting data on the range and severity of issues presented by young people and young people's satisfaction with the services provided.
Results/Findings: The study began in July 2014. By end of March 2015, an initial analysis of 230 cases suggests that baseline levels of psychological distress for young people in VS organisations may be higher than those in school-based counselling; that counselling in the VS is associated with significant reductions in levels of psychological distress; and that young people have very high levels of satisfaction with the services offered.
Research Limitations: There is no control group in this study. However, other nationally available data for some of the measures used will assist comparability between the findings in this study and other datasets.
Conclusions/Implications: The research aims to produce a national dataset to support improved understanding, particularly amongst policymakers and commissioners about the range and levels of needs of young people engaged in counselling within the VS, and to demonstrate through a robust practice-based study, the impact of counselling on young people's mental health.

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Stephanie Revell & Joe Hinds

Presenters: Stephanie Revell & Joe Hinds
Professional Role (SR): Senior Lecturer/ PhD student
Institution/Affiliation: University of Cumbria / Canterbury Christ Church University
Email: Stephanie.revell@cumbria.ac.uk
ABSTRACT: paper (Sat, 12.05-12.35)

Keywords: student preferences, nature, help seeking behaviour, walk and talk, outdoor therapy

Walk and talk therapy – how students' attitudes to help-seeking behaviour, environmental identity and preferences for therapy can inform practice

Aim/Purpose: There are a growing number of therapists in the UK who offer walk and talk therapy despite relatively few clients who request it. This disparity suggests more needs to be understood about client's preferences for therapy and how therapists might respond to these. Additionally, exploration into individual's environmental identity may provide valuable insight into how relevant walk and talk therapy might be for particular clients. The present paper is therefore advocating both a pluralistic and practice based research stance.
Design/Methodology: An on-line survey was conducted and hosted by Qualtrics. A mixed method approach was used, with the questionnaire utilising three validated quantitative measures as follows: General Help Seeking Questionnaire (Rickwood, Deane, Wilson & Ciarrochi, 2005); Psychotherapy Preferences and Experiences Questionnaire (Clinton & Sandell, 2011); Environmental Identity Scale (Clayton, 2003). Quantitative data was analysed using hierarchal
regression to see to what extent we could predict participant's willingness to go outdoors. Additionally, short answer questions provided qualitative data which were analysed using thematic analysis. Purposeful sampling of H.E. students across UK Universities was employed.
Results/Findings: Results indicate that participant's (N = 164) willingness to engage in therapy outdoors was predicted by their environmental identity. Overall, 69% of participants indicated favourably towards participating in walk and talk.
Research Limitations: Although some degree of limitation will undoubtedly be apparent from utilising a student cohort, there are also a range of demographics associated with a large university catchment enabling some broad and implementable conclusions to be drawn. Moreover, it may be argued that the mixed method approach employed here generates triangulated data thus, to some extent substantiating the findings.
Conclusions/Implications: Walk and talk is an emergent activity within the UK therapeutic field. Through understanding more about how potential clients seek help and their preferences related to therapeutic interventions and nature, walk and talk practitioners can be more informed about how to concur with a client led and informed approach.

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Brian Rich

Presenter: Brian Rich
Other Author: Professor Sue Wheeler
Professional Role: Counsellor
Institution/Affiliation: University of Leicester
Email: brian_rich@hotmail.com
ABSTRACT: paper (Fri, 12.15-12.45)

Keywords: dreams, countertransference, therapists, clients, supervision

Tread softly, for you tread on my dreams: therapists' experiences of dreaming of clients

Aim/Purpose: The aim of this study was to explore therapists' dreams, which were related to aparticular client. It sought to identify themes in the manifest content, examine the context in whichthe dreams occurred, explore the meaning therapists made of the dreams and investigate how
therapists processed them.
Design/Methodology: Semi-structured, face-to-face interviews were conducted with ten therapists (eight women, two men) trained or training within a range of theoretical orientations (six psychodynamic, two integrative, one person centred, one gestalt). Participants were recruited by advertising at public events and by recruitment materials cascaded via personal contacts.Interviews were audio-recorded, transcribed and analysed using thematic analysis.
Results/Findings: Thirteen dreams were reported by participants and included the manifest appearance of a client or were associated to a particular client. Four domains were identified: 'Dreams', 'Conflict, Confusion and Cul-De-Sacs', 'Collaboration and Connection' and 'Handling Dreams'. Reported dreams were typically therapists' first experiences of dreaming of a client and mostly occurred during training. Dreams reflected waking concerns of therapists and occurred during emotionally intense and challenging periods of therapy. Supervision was typically used to explore dreams, contain competence anxieties and gain insight and clinical skills.
Research Limitations: This is a small scale study of thirteen dreams and so can not be seen to be representative of all therapists' experiences of dreaming of clients. Participants were predominantly women and most were influenced by psychodynamic theory. Analysis of data was undertaken solely by the lead author, increasing the risk of researcher bias.
Conclusions/Implications: Therapists' dreams of clients reflect waking concerns and can be used to improve awareness of themselves and their relationships with clients. Therapists could, therefore, pay greater attention to dreams related to clients. Supervision can be a beneficial space to explore these dreams and enhance professional development and practice.

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Maria Rogerson

Presenter: Maria Rogerson
Other Author: Dr Clare Green
Professional Role: Counsellor/Psychotherapist
Institution/Affiliation: University of Leicester
Email: mariajrogerson@gmail.com
ABSTRACT: paper (Sat, 13.50-14.20)

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

'It's not an homogenous problem so no one body of theory accounts for it all'. Working with clients who somatise – the challenges and opportunities!

Aim/Purpose: Researching practice is a major force in shaping therapists' understandings and therapeutic engagement. This study explores the challenges and opportunities experienced by psychodynamic counsellors/psychotherapists in working with clients who somatise, including their impact on understanding clients' difficulties, the therapeutic relationship and process.
Design/Methodology: This qualitative study was approached from a hermeneutic phenomenological perspective, capturing participants' first-hand 'lived' experience of working therapeutically with clients who somatise. In-depth, face-to-face, semi-structured interviews were carried out with ten experienced psychodynamic therapists. Data were analysed using interpretative phenomenological analysis (IPA).
Results/Findings: The themes revealed by participants concerned (A) the therapeutic encounter; (B) professional factors; and (C) context factors affecting professional practice. Findings highlighted that clients' perception of self and others posed significant relational and therapeutic challenges, manifesting a dependent-resistant pattern of relating. Moreover, clients' trajectory towards a more integrated sense of self was aided by a) an integrated body-mind response in treatment which was characterised by a longer engagement phase, building alliance, moment by moment monitoring and responding, body-focussed attunement and delaying interpretations; b) repair of a relationship, as lived out in the relationship with the therapist, and in which attending to
transference and countertransference exchanges were central.
Research Limitations: Results cannot be generalised to all contexts or the wider therapeutic population due to the small and orientation-specific sample of participants. Including therapists from different theoretical orientations may have yielded a richer picture.
Conclusions/Implications: This research contributes to professional practice through the recommendation of an integrated Body-Mind approach when working with clients who somatise. Additionally, it points to the reparative function of the relationship with the therapist as a fundamental part of clients' body-mind integration and the integration of their sense of self. These factors enhance client engagement and practice outcomes. Furthermore, an integrated body-mind
approach could help reframe conceptualisation, therapists' training, practice contexts and structuring of services.

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Anja Rutten

Presenter: Anja Rutten
Professional Role: Senior Lecturer in Autism/private practice counsellor
Institution/Affiliation: Sheffield Hallam University
Email: a.rutten@shu.ac.uk
ABSTRACT: paper (Sat 10.55-11.25)

Keywords: autism, Asperger syndrome, therapeutic relationship, grounded theory, client experiences

'If you don't get me, I don't need you to'. What clients with Asperger syndrome say about making therapy work

Aim/Purpose: Asperger syndrome (AS) is a form of autism. Despite high levels of mental health difficulties, clients with AS are not often referred for therapy and when they are, therapy is not always useful or helpful. Whilst academic literature increasingly reports good outcomes, client accounts are underprivileged and not as positive. This study aims to give voice to clients with AS, in particular how they make sense of what helps and what hinders.
Design/Methodology: Six people with AS participated in semi-structured interviews, using a modified version of the open-ended Change Interview. Participants were recruited via adverts on support group websites and emails to existing contacts. Interviews focused on helpful and hindering experiences in therapy. Interviews were analysed using constructivist Grounded Theory.
Results/Findings: Participants report some helpful or even life-changing therapeutic experiences. This was made possible because they were received inclusively by their therapist and reasonable adjustments in therapy were made. Other experiences were distressing because participants could not relate well to the therapist and did not feel inclusively received. This led to increased distress and therapy often ended badly. Others stay in therapy despite their distress and use compensatory strategies to accommodate therapists' lack of inclusion in order to create therapeutic gains.
Research Limitations: The participants in this study may not be representative of all clients with Asperger syndrome. Although interviews yielded very rich data, saturation of categories has not yet been achieved.
Conclusions/Implications: This study suggests that at least a proportion of clients with AS appear to feel more distressed as a result of engaging with therapy. Some then continue to make therapy work, but do this through a route of moulding themselves to what therapy offers, rather than having reasonable adjustments made for their Asperger syndrome. This suggests that processes involved in therapy for this group of clients need to be better understood in order not to harm clients. Inclusive practice issues are rarely addressed with this population, but appear central to good therapeutic experiences.

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Karen Sarai

Presenter: Karen Sarai
Other Author: Susan Hajkowski
Professional Role: Counselling and Psychotherapy student
Institution/Affiliation: University of Leicester
Email: karen_sarai@hotmail.co.uk
ABSTRACT: poster (Sat, 10.05-10.30)

Keywords: older adults, residential care, counselling, transition, emotional impact

The ache for home: an investigation into the emotional impact of moving into residential care for older adults and how counselling might help ease this transition

Aim/Purpose: Moving into residential care in later life can be a significant and life-changing event. The prevalence of late-life depression, particularly amongst those in residential care, remains a concern yet access to counselling and psychotherapy for older adults continues to be a challenge. This study aims to explore the emotional impact of moving into residential care for older adults and the ways in which they consider counselling may have helped to ease this transition for them.
Design/Methodology: This study is based within an individual care home and focuses on the experiences of a small number of older adults who have recently moved into care. Focused ethnography is to be used to explore this shared experience of transition and the psychological challenges it presents from the participants' perspectives. Short-term field visits will include observations and qualitative interviews with between four and seven participants. Participant views on counselling and in what ways they may have found this helpful leading up to and during the transition will also be sought. Thematic analysis of the data will be used to identify key patterns and themes.
Results/Findings: Preliminary results indicate that the emotional impact of moving into residential care is highest when older adults are uninvolved in the decision-making process. These individuals are left feeling disorientated, disempowered and dejected. Awareness and understanding of counselling amongst this group is limited and access to counselling is poor.
Research Limitations: The research sample proposed is small and limited to the experience of residents in one individual care home.
Conclusions/Implications: It is hoped that this study will add to the existing body of knowledge around the counselling needs of older adults and particularly of those in residential care, both of which are recognised as areas in need of further research. It is hoped that the research will lead to a better understanding of the support needs required for those making this transition, and potentially lead to improved services for other older adults making this transition in the future.

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Aaron Sefi, Zehra Ersahin & Dr Terry Hanley

Presenters: Aaron Sefi, Zehra Ersahin & Dr Terry Hanley
Professional Role: Service Development Manager
Institution/Affiliation: Xenzone
Email: aaron@xenzone.com
ABSTRACT: paper (Fri, 14.35-15.05)

Keywords: online counselling, goal-based outcomes, face-to-face comparisons, practice-based evidence, children and young people

What types of goals do young people articulate and achieve in online counselling, and how do these compare to those in face-to-face counselling?

Aim/Purpose: Research examining online youth counselling is in its infancy and has predominantly focused upon the inner workings of online therapeutic relationships. Its effectiveness has received less attention, which can be partially attributed to the complex nature of the online environment. A pilot study indicated limitations to use of outcome measures designed for face-to-face services, and a goal-based outcome measure was designed for online use.
Design/Methodology: This project examines the routine evaluation data of an online counselling service for young people (Kooth.com), alongside equivalent data from its face-to-face services. A goal-based outcome measure was devised and training in its use given to all staff in the service. Between November 2013 and July 2014, 1137 goals articulated by 505 young people were recorded from online service, and 360 goals from 202 young people in face-to-face services.These goals were analysed and codified using grounded theory. They were further analysed to compare 'distance travelled' by type of goal, and medium of counselling.
Results/Findings: Three major types of therapeutic Goals were identified. These were 'intrapersonal goals', 'interpersonal goals' and 'Goals on self-relating to others'. These could be further broken down into a further 10 subcategories and 28 categories. These types showed some correlation across mediums, but differences are discussed, as is correlated distance travelled.
Research Limitations: Whilst this project offers illumination upon goals young people bring to counselling, further analysis is required to cross fertilise distance travelled data with other outcome measures.
Conclusions/Implications: The codified 'types' of goals proved similar to the taxonomy of goals provided within the Berne Inventory of Therapeutic Goals. There were however some differences - specifically in relation to the frequency of goals around personal expression, and developing support networks. These may be explained by the client group (young people) and the medium (online) and indicates further areas for comparative research.

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Marta Shepherd

Presenter: Marta Shepherd
Professional Role: Counsellor
Institution/Affiliation: University of Leicester
Email: marta.shepherd@wp.pl
ABSTRACT: poster (Sat, 10.05-10.30)

Keywords: countertransference, personal issues, wounded healer

"It's like I'm sitting in front of myself": an exploration of therapists' experiences of countertransference when working with parallel client issues

Aim/Purpose: This study endeavoured to explore therapists' experiences of countertransference when the client's material touches on their personal issues. It aimed to examine the impact of countertransference originating in personal history on the therapist and on the therapeutic process. The study also focused on therapists' coping strategies.
Design/Methodology: The methodology employed was qualitative, using data obtained from individual semi-structured interviews. Nine therapists of various theoretical orientations participated in the study. Collected data were analysed using the grounded theory.
Results/Findings: The findings indicate that participants' experience of countertransference when working with parallel client issues was intense and had a significant emotional impact on them. Interviewees reported working hard in the session trying to contain the emotions and not to disconnect from the client. There were accounts of different reactions to the client like anger, jealousy, sympathy and pull to help. Some therapists felt deskilled, anxious and guilty about their emotional struggle and its impact on the process. Interviewees found supervision most helpful in coping with the experience, as well as reflective practice, peer support and personal therapy. Some participants felt the parallel was so intense they considered referring the client on.
Research Limitations: Participants were of White British origin and they were mostly female. The topic could be experienced as sensitive. Participants' responses regarding the impact of their feelings on the therapeutic process could be skewed by the self-serving bias.
Conclusions/Implications: Work with parallel client issues requires particular attention and preparation from practitioners, as well as additional support from supervisors. Therapists could be alerted to a potential impact of personal origins of countertransference and risk of enactments. Supervisors could consider allowing space for supervisees to explore more deeply the role that their personal material may play in the therapeutic relationship. Trainers could apply the findings by raising awareness among trainee therapists about challenges of working with parallel client issues that could happen to any practitioner.

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Beverley Spalding, Jan Grove & Alison Rolfe

Presenters: Beverley Spalding, Jan Grove & Alison Rolfe
Professional Role: Independent Counsellor
Institution/Affiliation: Newman University, Birmingham
Email: rnbee@talktalk.net
ABSTRACT: paper (Fri, 11.40-12.10)

Keywords: Black and Asian counsellors, race, counselling process, White clients, thematicanalysis

An exploration of Black and Asian counsellors' experiences of working with White clients

Aim/Purpose: This research draws attention to some of the dynamics at work within the Black and Asian counsellor and White client dyad. There have been studies investigating the White counsellor and black client (Dos Santos and Dallos, 2012) and (Tuckwell, 2001). However, studies examining Black and Asian counsellors working with White clients are minimal in this country.
Design/Methodology: Ethical approval was sought and gained from Newman University research ethics committee. A qualitative design was used; eight Black and Asian participants were recruited through a counselling agency, Newman University and the Black and Asian therapist network. Face to face semi-structured interviews were conducted, they were transcribed and analysed using thematic analyses (Braun and Clarke, 2006).
Results/Findings: Three themes emerged from both Black and Asian counsellors: colour blindness, skin colour and counselling process. Colour blindness was identified on counselling training programmes where counsellors felt their visible difference was overlooked. Counsellors' skin colour was accentuated through preconceptions, racist comments and shocked reactions from White clients in initial meetings. During the counselling process some counsellors felt they needed to ensure that White clients knew they were competent practitioners and there was also uncertainty surrounding the acknowledgement of difference during the therapeutic process. 'Race' was prominent in all three themes therefore suggesting it is always present in the Black and Asian counsellor's work.
Research Limitations: This research was based on a small number of Black and Asian and a dual heritage counsellor, which were confined to the Birmingham area. The research may also have been influenced by the fact that the researcher is inexperienced and is also a Black counsellor.
Conclusions/Implications: Black and Asian counsellor's race can have an impact on the therapy process when working with White clients. This study has confirmed some of the complexities surrounding racism in the counselling room. It has also exposed inadequacies in the basic training of Black and Asian counsellors and a need for better awareness surrounding potential difficulties when working with White clients.

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Mark Stancombe

Presenter: Mark Stancombe
Professional Role: Psychotherapist, Lecturer/Tutor in Counselling, Researcher
Institution/Affiliation: University of Derby
Email: mstancombe@move-forward.org
ABSTRACT: paper (Sat, 11.30-12.00)

Keywords: abuse, perpetrator, victim, therapist, survivor, impact

The impact on male therapists when working with adult female survivors of childhood sexual abuse

Aim/Purpose: This research investigates the impact on male therapists when working with adult female survivors of childhood sexual abuse. The research records the experiences of male counsellors when counselling female survivors of childhood sexual abuse, in order to understand how this impacted upon them personally and how it informed their practice. The research also aims to identify any common findings that might further inform the counselling profession as a whole and stimulate further study.
Design/Methodology: This study was conducted using a Phenomenological methodology via an in-depth, face-to-face, taped one hour interview with each participant, using a semi-structured question format. Three male therapists currently working with adult female survivors were recruited as volunteer participants through a BACP research invitation. Recordings were transcribed in order to faithfully report each participant's subjective experience and the findings were then analysed to identify any common themes.
Results/Findings: Three main themes emerged from the findings, reflecting experiences shared by all the participants (Triangulation).
Theme 1 – Notable traumatic impact on the therapist of hearing the abuse and the corresponding
need for effective training, supervision and self-care.
Theme 2 – Heightened awareness by participants of the significance of gender in both
transference and counter-transference when working with female survivors.
Theme 3 – Strong gains in overall professional confidence and learning felt from working with this
client group.
Research Limitations: Given the strength of triangulated findings even from this small study it suggests the potential value to the profession of a wider follow-on study.
Conclusions/Implications: Themes emerging from the research include the traumatic impact on Male therapists of hearing about the abuse from this client demographic and how training had not prepared them for this. Supervision was identified as a key element in managing self-care and gender transference was recognised as an important factor in the therapeutic and potentially reparative healing relationship.

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Tracey Thomas

Presenter: Tracey Thomas
Other Author: Jon March
Professional Role: Counselling and Psychotherapy MA student
Institution/Affiliation: University of Leicester, Vaughan Centre for Lifelong Learning
Email: tt90@student.le.ac.uk
ABSTRACT: poster (Sat, 10.05-10.30)

Keywords: psychotherapy, humour, client, in-session impact, case study

The true word in jest: an analysis of the impact of clients' humour in therapy

Aim/Purpose: Clients' use of humour is important to understand due to its impact on successful functioning and coping with ordinary human difficulties. There is relatively little literature considering humour in psychotherapy and within this literature there is only a small body of research evidence much of which has been carried out in North America. This study sets out to fill a gap in the literature by investigating the impact of instances of clients' humour on therapy.
Design/Methodology: The study examines therapy sessions recorded at a university counselling and psychotherapy research clinic alongside weekly outcome measures and process measures (ARM). Purposive sampling was attempted but only one client was found repeatedly using humour in therapy. A case study approach has been taken to investigate this client's experience in depth.
Results/Findings: Many clients use little or no humour in psychodynamic therapy sessions. The case study client uses humour in a clustered way. It is tentatively proposed that humour is used to reduce confronting pain, manage distance from others and divert attention from parts of the client's true self to parts which the client feels more confident in displaying.
Research Limitations: The subjective nature of humour leads to the results being unavoidably influenced by the researcher's own understanding of humour. Case study research cannot be presumed to apply to a wider population without further research.
Conclusions/Implications: It is anticipated that this study will contribute to understanding of the professional practice of therapists when working with clients using humour in therapy by identifying the range of impacts that clients' humour can have so that therapists can work more effectively with the multiple layers of communication within humour.

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Faye Towell

Presenter: Faye Towell
Other Author: Dr Clare Symons
Professional Role: Trainee counsellor/psychotherapist
Institution/Affiliation: University of Leicester
Email: ft61@student.le.ac.uk
ABSTRACT: poster (Fri, 10.20-10.45)

Keywords: military, armed forces, therapists experiences, barriers, techniques

The enemy within: exploring the experiences of therapists when working with members/exmembers of the British Armed Forces

Aim/Purpose: Research indicates (Hoge et al, 2004) that members of the Armed forces find it difficult to ask for help. Much of the research into therapy and military personnel focuses on what prevents them from seeking help. There is little research exploring how this group of people may be helped. The recent conflicts in Iraq and Afghanistan make this a relevant topic for investigation. This research aims to explore the experiences of therapists who have worked with members of the British Armed Forces in order to find out useful strategies and pitfalls in the work along with difficulties and barriers.
Design/Methodology: This study uses semi-structured interviews to examine the experiences of up to 12 counsellors who have worked with members of the British Armed Forces. Themes are identified from the transcribed interviews using Thematic Analysis. Ethical approval has been obtained from the University of Leicester.
Results/Findings: Preliminary findings suggest that having to repeat details of trauma several times to different parties can be difficult and unhelpful for the client. Previous interventions can be problematic and complicate the current work, and building a rapport is especially important with this client group in developing the therapeutic relationship.
Research Limitations: The anticipated limitations to this study are the small sample size and the generalisability of the conclusions.
Conclusions/Implications: It is anticipated that this study will contribute to understanding of the professional practice of therapists working with members of the forces by identifying difficulties and barriers to the work with (ex) military personnel and therefore help to inform the treatment of this group of clients.

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Dr Andreas Vossler & Dr Naomi Moller

Presenters: Dr Andreas Vossler & Dr Naomi Moller
Professional Role: Senior Lecturer in Psychology
Institution/Affiliation: The Open University
Email: Andreas.Vossler@open.ac.uk
ABSTRACT: paper (Fri, 14.00-14.30 and Sat, 15.00-15.30)

Keywords: internet infidelity, online infidelity, cybersex, couple counselling, sex therapy

Perceptions and experiences of internet infidelity: views of couple counsellors and members of the general public

Aim/Purpose: With the Internet and social media now being part of everyday life in the Western world, there are growing opportunities for partners to engage in online behaviours and activities that may be considered unfaithful in the context of a committed relationship (including e.g. cybersex, exchanging sexual self-images, online flirting and dating). This matters because infidelity commonly causes significant relationship distress and can have a negative and deteriorating effect on marriages and families. There is however a lack of information about the actual online behaviour and its impact, and about practitioners' perceptions of and experiences of working with internet infidelity. There is additionally a lack of British research. The aim with this study is
therefore to investigate a) perceptions and experiences of Internet infidelity in the general public in this country, as well as b) couple and sex therapists' perceptions and experiences of working with Internet infidelity in therapeutic practice.
Design/Methodology: Due to the sensitive nature of the topic, an online survey methodology was used. Respondents were couple counsellors and sex therapists recruited through listings of professional organisations (like COSRT, N = 20), and members of the general public (N > 150) recruited through the Open University's Virtual Participant Panel and snowballing. The survey included both closed and open questions. Statistical and content analysis were used for data analysis.
Results/Findings: When asked if they would define a behavior as infidelity, both general public and practitioner respondents classified a wide range of behaviours as infidelity but, broadly, not pornography use or extensive engagement in social media. However, even activities less likely to be defined as infidelity were considered potentially upsetting to a partner by participants. Text responses revealed a complex web of experiences as well as comments from many participants that the internet makes infidelity 'easier'.
Research Limitations: This study is an important step in an under-researched area; the results however will need to be validated and extended with further research.
Conclusions/Implications: The study findings will be helpful to improve the understanding and knowledge of couple counsellors and sex therapists working with Internet infidelity.

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Jenny Watkins

Presenter: Jenny Watkins
Other authors: Jan Grove, Alison Rolfe
Professional Role: Voluntary Counsellor/ Student
Institution/Affiliation: Carrs Lane Counselling Centre/ Headway /Newman University
Email: jenjen1960@hotmail.com
ABSTRACT: paper (Fri, 14.35-15.05)

Keywords: Christian faith, counsellor training, internal conflict, discrimination, thematic analysis

The interface of Christian faith and counselling training: a qualitative exploration

Aim/Purpose: While training as a counsellor the author faced several challenges to her own Christian faith including; changes and challenges to personal faith, ethical dilemmas and the integration of faith with practice. A review of the literature revealed a level of discomfort for counselling trainees of Christian faith, including a fear of revealing their faith in the classroom and during supervision. However, there is limited previous research on the experiences of counselling trainees of Christian faith, and that which does exist is often from the United States of America (USA) or over 10 years old. The overall aims of the research were:
 To explore the impact of counselling training on counselling trainees of Christian faith within the United Kingdom (UK).
 To explore the impact of Christian faith on the experience of trainee counsellors within the classroom, placement and supervision within the UK.

Design/Methodology: A qualitative, phenomenological study used semi – structured interviews, which were analysed with thematic analysis. Five participants were recruited from the authors training establishment and counselling practice and one participant was recruited via word of mouth. All participants were working as voluntary counsellors and working towards an academic qualification or BACP accreditation.
Results/Findings: Two major themes were identified: challenge and opportunity. The challenge related to feelings of difference and discrimination as well as feelings of internal conflict. The opportunity related to their relationship with God and the inspiration and support this gave them in their work. One sub – theme that encompassed both challenge and opportunity related to development of their own counselling model.
Research Limitations: The author acknowledges that being close to the subject matter may have introduced some bias. The nature of the study and the size of the sample are such that the results need to be treated with caution when generalising to a wider population of Christian counselling students.
Conclusions/Implications: An acknowledgement and openness to the faith stances of religious counselling trainees may help all trainees to accept the clients' faith stance as a valid way of expressing their spirituality. This may also diminish feelings of discrimination and difference for Christian counsellors and encourage transparency in training and supervision so that stereotypical views can be acknowledged and challenged.

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Michelle Wynn

Presenter: Michelle Wynn
Other Author: Dr Clare Symons
Professional Role: Trainee Psychotherapist/Counsellor
Institution/Affiliation: University of Leicester
Email: mj161@le.ac.uk
ABSTRACT: poster (Sat, 10.05-10.30)

Keywords: psychotherapy, thematic analysis, premature termination, therapist responses, latent
content.

The elephant in the room: exploring therapists' responses to direct and indirect communications from clients about wanting to terminate therapy unilaterally and prematurely

Aim/Purpose: The ending phase is an important part of the therapeutic work, but this is often cut short or missed out altogether when clients terminate therapy prematurely. This research sets out to explore the ways in which clients communicate their intentions to stop the therapy prematurely (including latent communications), with the aim of making it easier for practitioners to identify these. The research explores how these communications are worked with, or are possibly missed, in the brief remaining time in the work. The research question is: what are therapists' responses to direct and indirect communications from clients about wanting to terminate therapy unilaterally and prematurely?
Design/Methodology: The study makes use of data from a university-based counselling and psychotherapy research clinic, which includes therapists from cognitive-behavioural and psychodynamic orientations. Ethical approval has been granted to access this data. The study uses transcriptions of the ultimate, penultimate and ante-penultimate audio-recorded therapy sessions of seven clients who prematurely terminated therapy. Analysis of these transcriptions is
achieved through thematic analysis.
Results/Findings: No instances were found in the dataset of clients explicitly stating that the current therapy session is the last that they would be attending; all identified instances of client communications are indirect. Preliminary findings indicate that therapists' responses to these communications range from: not addressing the communication at all, to probing and exploring what message the client is trying to impart.
Research Limitations: Therapists' or clients' felt experiences of the therapy are unable to be explored within the remit of this study. This study has the potential to be guided by the researcher's biases and assumptions; the researcher will keep a research journal in order to track these throughout the study to limit and account for these.
Conclusions/Implications: That neither client nor therapist names the client's intention to drop out of therapy suggests that it is the elephant in the room and therefore not legitimised as a valid topic for discussion. The research contributes to practitioners' understanding of how to work with a client who wants to drop-out of therapy and how to best support them with this decision in the remaining time.

SYMPOSIA

 
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Symposium A - Mhairi Thurston

Presenter: Mhairi Thurston
Professional Role: Lecturer in Counselling
Institution/Affiliation: Abertay University
Email: m.thurston@abertay.ac.uk
ABSTRACT: symposium A overview (Fri, 11.05-12.35)

Keywords: research impact, counselling service provision, counselling service development, sight loss, diabetes

Research informed service development

The aims of the symposium: This symposium hopes to engage researchers and counsellors in an applied approach to research. It will illustrate how the impact of small-scale research projects can be maximised through strategic engagement with policy and partnerships. It will give an overview of research projects behind the on-going development of emotional support services for people with sight-loss in the UK. A transferable service development method will be identified which is currently being used to initiate counselling service development for diabetes. Contributions of each symposium paper to the overall theme: The first paper (Thurston) provides an overview of the research strategy and key research projects involved in the continuing development of counselling service provision for people with sight loss in the UK. It suggests a strategic method for service development and identifies strategies for maximising the impact of research projects.

The second paper (Pybis et al) reports the development and findings of a survey designed to map existing counselling service provision for people with sight loss in the UK. This project illustrates the importance of understanding national provision in order to build a case for service improvement and development.
The third paper (Hawkins et al) reports on the opportunities and challenges involved in embedding systematic case study research within RNIB's national telephone counselling service. It will briefly outline research findings to date. This project illustrates the importance of strategic partnerships. It shows how systematic case study research can be embedded within existing services and used as an evidence base for attracting future funding.

The last paper (Smith et al) reports on the development of the counselling for diabetes project, which is based on the counselling for sight loss project. This illustrates the feasibility of using a service development method within a different sector. Implications of the symposium theme for counselling and psychotherapy theory, research and practice: At a time when counselling services are under threat, it is hoped that this symposium will provide a practical example of how the impact of relatively small-scale research projects can be maximised and utilised to contribute strategically to new counselling service
development and provision.

Name of the symposium discussant: Andreas Vossler

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Symposium A - Mhairi Thurston

Presenter: Mhairi Thurston
Other Authors: Kate Smith, John McLeod, Phil Eva
Professional Role: Lecturer in Counselling
Institution/Affiliation: Abertay University
Email: m.thurston@abertay.ac.uk
ABSTRACT: symposium A paper 1 (Fri, 11.05-12.35)

Keywords: counselling for sight loss, systematic case study research, process and outcomes, therapeutic tasks, counselling service provision

Research informed service development: counselling for sight loss overview

Aim/Purpose: These studies represent a body of work identifying the emotional impact of sight loss and developing a client defined task based counselling model. They are part of a larger project aimed at developing and informing counselling service provision for people with sight loss.
Design/Methodology: The specific methodologies reported in this overview are 1. A grounded theory analysis of semi structured interviews with 18 blind and partially sighted participants. 2. Two systematic research case studies, which collected process and outcome data. The case study data were analysed using quasi-judicial and creative consensus methodologies. All the projects were given ethical approval by the university ethics committee. Participants were recruited from sight loss groups.
Results/Findings: The studies showed that sight loss impacted negatively on person's mood, identity and feelings of social connectedness. Helpful therapeutic tasks were identified in the case studies. An initial cross case comparison provided a starting point in the development of a client - defined, task- based model of counselling for sight loss
Research Limitations: Whilst these projects enable us to have a deeper understanding of the emotional impact of sight loss and the helpful aspects of therapy reported by clients with sight loss, the main limitation of the studies is their small sample size. This is problematic in terms of generalizability as there are many different types of sight loss, which may affect people in different ways.
Conclusions/Implications: A client led practice model of counselling for sight loss, based on helpful aspects of therapy is proposed. The strategic benefit of research dissemination, partnerships and engagement in sector policy is considered in terms of counselling service development.

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Symposium A - Jo Pybis

Presenter: Jo Pybis
Other Authors: Mhairi Thurston, Catherine Dennison, Amanda Hawkins, Matt Broom
Professional Role: Research Facilitator
Institution/Affiliation: BACP
Email: jo.pybis@bacp.co.uk
ABSTRACT: symposium A paper 2 (Fri, 11.05-12.35)

Keywords: sight loss, survey, counselling, emotional support, provision

UK provision of counselling and emotional support for people affected by sight loss

Aim/Purpose: This paper presents the findings of a survey exploring current provision of counselling and emotional support for people affected by sight loss across the UK. Research has indicated that people with sight loss want someone to talk to. This study aimed to map current provision at tier 1 (emotional support) and tier 2 (counselling) with the aim of identifying gaps and examples of good practice.
Design/Methodology: An electronic survey was developed and distributed to 149 services identified via the RNIB sightline directory using the search terms 'counselling' and 'emotional support'. The survey was also disseminated via society and organisation newsletters (e.g. Vision2020UK, BACP, RNIB). Services were asked to identify their geographical location, whether they provide counselling and/or emotional support as defined within the survey, and to provide
information about the nature of the interventions.
Results/Findings: 182 services responded to the survey. Services were generally well represented across the UK. There appeared to be fairly good provision of tier 1 services, with 86% of respondents providing this level of support, however tier 2 services were considerably less well represented (45%). Where tier 2 provision was available, this was typically delivered by a qualified person centred or integrative therapist who was a member of a professional body. Accessibility of services was good, and waiting times were typically short (1 – 2 weeks). Clients were accessing services for a range of difficulties, including adjusting to living with sight loss, anxiety (79%), selfesteem (68%) and depression (75%). Over 50% of services who indicated clients presented with
depression or anxiety did not offer counselling, identifying an unmet need.
Research Limitations: It is not clear how generalisable the findings of this study are to all services providing this support across the UK as we are unsure of how many services actually exist. However, considerable effort was made to disseminate the survey widely, and we are confident that the findings are representative.
Conclusions/Implications: There is fairly good provision of tier 1 services, however tier 2 services need developing. There is a need to evaluate current practice and ensure high standards.

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Symposium A - Amanda Hawkins

Presenter: Amanda Hawkins
Other Authors: Mhairi Thurston, Julia McLeod, John McLeod, Kate Smith
Professional Role: Senior Manager
Institution/Affiliation: RNIB Emotional Support Services, London.
Email: amanda.hawkins@rnib.org.uk
ABSTRACT: symposium A paper 3 (Fri, 11.05-12.35)

Keywords: sight loss, systematic case study research, telephone counselling, outcomes, practice -based evidence

Embedding systematic case study research within RNIB telephone counselling service

Aim/Purpose: This pilot study is part of a larger study, which explores the process and outcomes of telephone counselling for adults with who are affected by sight loss. The paper will explore how this large four nations counselling service embedded the research into everyday service delivery and examine the difficulties in doing this and opportunities this gave the service with regards to future funding.
Design/Methodology: Systematic case study methodology was used. 8 sessions of telephone counselling were recorded and transcribed. A range of process and outcome data was collected before, during and after each session. A change interview was conducted at the end and all the evidence was presented into a rich case record before analysis.
Results/Findings: Aspects of implementation for embedding research in to practice include training for staff, the logistics of using measures with this client population, and technicalities around confidentiality and recording data. Initial pilot results show high levels of anxiety and depression on entering the service. NHS measures for anxiety and depression were used and gave initial scores of GAD7 – 17 (Severe Anxiety) and PHQ9 - 19 (Moderate Severe Depression). After 8 sessions of counselling the GAD 7 Score was reduced to 7 (Mild Anxiety) and the PHQ Score reduced to 10 (Moderate Depression). To date the service has been structured around depression, so the results gave opportunity to focus on anxiety. The change interview indicated that whilst it was not important for the counsellor to be visually impaired themselves it was indicated that the organisational expertise was. Specific tasks of counselling were also identified, and can be mapped into previous studies in this area.
Research Limitations: The main limitation of systematic case study research is that n=1.
Conclusions/Implications: The project aims to embed systematic case study research into an established national counselling service collecting and building practice based evidence. The evidence will be used to design a client informed and engaged counselling service for blind and partially sighted people.

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Symposium A - Kate Smith

Presenter: Kate Smith
Other Authors: Mhairi Thurston, P. Eva, Julia McLeod
Professional Role: Lecturer in Counselling
Institution/Affiliation: Abertay University
Email: kate.smith@abertay.ac.uk
ABSTRACT: symposium A paper 4 (Fri, 11.05-12.35)

Keywords: diabetes, long-term conditions, pluralism, NHS, qualitative research

Counselling for adults with diabetes

Aim/Purpose: This research study explores counselling for adults with diabetes. Emotional wellbeing and the absence of mental health problems is strongly associated with glycaemic control, but despite this NHS services in the UK leave this aspect of the disease unaddressed.
The project aims were to explore these emotional needs, and to use case-studies to ascertain how these needs may be met by counselling tasks undertaken during therapy. This approach was used to develop a task-based model for counselling adults with diabetes, which can be used in practice and training.
Design/Methodology: The study used thematic analysis of interviews, and group-based collaborative consensus analysis for case-study data. Twenty adults with diabetes, and twenty NHS staff underwent semi-structured interviews focussing on perceived need for emotional support. Case-studies were carried out on transcripts pluralistic therapy for three counselling clients.
Results/Findings: The findings highlighted the needs of adults with diabetes which related to their experiences of managing the disease, and other issues such as relationships, emotional management, ongoing support and understanding their condition. NHS staff, reported feeling unprepared to manage interactions with patients seeking emotional support. A common theme of breakdowns in communication and attendance for medical care was present for both interviewee groups. Case-study data revealed evidence for the role of counsellors in validating the difficulties experienced by adults with diabetes, and in filling the gap between patient need and NHS provision.
Research Limitations: This exploration of diabetes care provision examined a relatively small group of people. Because of the large range of experiences of people with diabetes, the findings should be considered an illustration of some of the needs and available support, and as such a contribution to the argument for counselling provision for long-term health conditions.
Conclusions/Implications: This study shows the potential of counselling to fill an identified gap in support provision for adults with diabetes.

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Symposium B - Dr Linda Dubrow-Marshall

Presenter: Dr Linda Dubrow-Marshall
Professional Role: Programme Leader, MSc Applied Psychology (Therapies)
Institution/Affiliation: University of Salford
Email: l.dubrow-marshall@salford.ac.uk; ljdmarshall@aol.com
ABSTRACT: symposium B overview (Fri, 14.00-15.30)

Keywords: undue influence, cultic groups, abusive relationships, second generation cultists, counselling

The role of research in guiding professional practice in helping survivors of abusive and cultic relationships

The aims of the symposium: This symposium is aimed to help practitioners to understand the dynamics of undue influence (where a person's behaviours or beliefs are overly influenced by another without due regard) underlying cultic and abusive relationships and the damaging effects these experiences have upon individuals and families, including second-generation members – those who were born and/or raised in abusive groups. Practitioners will be able to use the research to inform their practice in helping clients who may have experienced coercive persuasion to recover their sense of identity and integrity and to reduce psychological distress.
Contribution of each symposium paper to the overall theme: The paper on an overview of research on mental health issues in cultic relationships will lay the overall research framework for understanding what is meant by being on the extreme end of the influence continuum (from mentally healthy to abusive and damaging), the identification of patterns of psychological harm, and the application of the research to developing specialist models of mental health recovery for former members of cultic groups. The paper on the mental health of second-generation adult survivors of 'The Chosen' (a pseudonym) will present quantitative data on some of the contributing factors in the high-demand environment to causing psychological distress. The paper on the effect of counselling on psychological distress in first and second generation former sect members will use quantitative data to highlight specific issues for people raised in high-demand (overly controlling) groups and those who were recruited. The paper on what helps former members to recover from an abusive cult experience will present qualitative data that can inform psychotherapeutic practice.
Implications of the symposium theme for counselling and psychotherapy theory research and practice: The symposium will address the application of both quantitative and qualitative research to counselling and psychotherapy with people who have been raised in or recruited to cultic groups and relationships and will illustrate the use of research informed practice. The findings can be applied across the continuum of influence to improve counselling practice with people who have been distressed by the persuasive influence of others in domestic abuse relationships, bullying and harassment, addictive relationships, and other types of coercion.
Name of the symposium discussant: Professor Rod Dubrow-Marshall

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Symposium B - Dr Linda Dubrow-Marshall & Professor Rod Dubrow-Marshall

Presenters: Dr Linda Dubrow-Marshall & Professor Rod Dubrow-Marshall
Professional Role: Programme Leader, MSc Applied Psychology (Therapies)
Institution/Affiliation: University of Salford (Linda); University of Derby (Rod)
Email: l.dubrow-marshall@salford.ac.uk; ljdmarshall@aol.com; r.dubrow-marshall@derby.ac.uk
ABSTRACT: symposium B paper 1 (Fri, 14.00-15.30)

Keywords: cults, psychotherapy, psychoeducation, undue influence, mental health

An overview of research on mental health issues in cultic relationships

Aim/Purpose: A literature review was conducted to identify empirical research that has specifically investigated mental health issues for people who have been in high demand or cultic groups and abusive relationships and which evidenced effective approaches for recovery in counselling/psychotherapy.
Design/Methodology: The search strategy included keywords such as cult, mental health, psychology, counselling, and influence and used established databases (PsychLit, PubMed, ScienceDirect, etc) across a number of relevant disciplines. Qualitative and quantitative studies and theory and model-building papers were included. Seminal research on the topic (e.g. Lifton, 1961, Singer, 2003) and review articles (e.g. Aranoff, Lynn, & Malinoski 2000) published since 1961 were identified, which led to further relevant empirical research about mental health issues for people raised in cultic groups and psychotherapy outcome studies which evidence efficacious psychotherapeutic approaches to recovery.
Results/Findings: Empirical research was identified which demonstrated that coercive persuasion and undue influence occur over a continuum ranging from mentally healthy to abusive and damaging. Factors which affected the degree of impact on the mental health of members included the degree of coercion in the cultic environment, length of time in the group and its effect on key stages of psychosocial development. Psychological harm was most notably reported in the areas of post-traumatic stress, depression, anxiety, dissociation, and identity issues (Dubrow-Marshall 2010). The positive effect of psychotherapeutic approaches that enhance the individuals understanding of the processes of undue influence and coercion was demonstrated (Giambalvo and Henry 2010).
Research Limitations: The review was undertaken primarily across the disciplines of counselling, psychotherapy and psychology and it is important to expand the scope of the review further and to include research published in language other than English.
Conclusions/Implications: Specialist models of mental health recovery for former members of cultic groups focused on the integration of a psycho-educational model within the psychotherapeutic relationship (Martin 1993, Giambalvo and Henry 2010). Practitioners working with clients who have been in abusive groups or relationships need to be particularly sensitive to issues of power imbalance in the therapeutic relationship and support clients to strive toward autonomy, critical thinking, and a fuller view of self-identity.

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Symposium B - Jill Mytton

Presenter: Jill Mytton
Other Author: Professor Rod Dubrow-Marshall
Professional Role: Researcher
Institution/Affiliation: University of Central Lancashire
Email: jill.mytton@arthio.com
ABSTRACT: symposium B paper 2 (Fri, 14.00-15.30)

Keywords: mental health, second-generation survivors; high-demand groups, group environment

The mental health of second-generation adult survivors (SGA) of high demand groups: a quantitative study

Aim/Purpose: This paper will examine the mental health of SGA survivors of a high demand group that, for the purposes of this paper is called "The Chosen". It will explore some of the factors that might be contributing to distress.
Design/Methodology: A correlational study was conducted using a battery of quantitative measures, including the clinical measures: Symptom Checklist 90 Revised, Inventory of Interpersonal Problems, The Davidson Trauma Scale, and the Wessex Dissociation Scale. The Group Psychological Abuse Scale (GPA) and the Extent of Group Identity Scale (EGIS) were used to assess the group environment and the level of group involvement respectively. The sample was obtained through personal contact with former members, advertisements on websites for former members of cults, and by snowballing. Of the 264 participants who completed the questionnaires, 95 were female and 167 were male.
Results/Findings: The means of the clinical measures and subscales were all found to be significantly higher than the general population norms (p<.001 two-tailed). Significant correlations were found between the GPA and EGIS and all clinical measures. 70% of the sample lost their family on leaving, 27% reported child sexual abuse, and 68% found the experience of leaving traumatic.
Research Limitations: The findings of this research are tentative and indicative only due to research limitations. It is not possible to obtain an entirely random sample of people who left the group and the results may not be valid for the whole population of leavers. Comparison of clinical scales to population norms may not be an adequate comparison.
Conclusions/Implications: There are significant levels of distress covering a wide range of issues, including leaving the group, quality of the relationship with the lost close family, and allegations of child sexual abuse. Correlations between distress and specifics of the group environment coupled with how strongly personal identity was enmeshed with group identity may have implications for causality of the distress, which should be further studied.
Counsellors/psychotherapists need to be sensitive to these difficulties, and to be knowledgeable about the characteristics of high-demand groups in order to be effective in helping clients to recover.

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Symposium B - Lois Kendall

Presenter: Lois Kendall
Professional Role: Writer
Institution/Affiliation: Buckinghamshire Chilterns University College (now Bucks New University)
Email: LoisKendallUK@yahoo.co.uk
ABSTRACT: symposium B paper 3 (Fri, 14.00-15.30)

Keywords: sect, second-generation, counselling, distress, time-elapsed

Does counselling affect the relationship between time-elapsed since leaving a sect and psychological distress in first- and second-generation former sect members?

Aim/Purpose: This study looked at whether the length of time elapsed since leaving a sect wasrelated to the psychological distress levels of former members of extremist authoritarian sects (referred to as sects hereafter). This was looked at for those who had and had not received counselling, and for first and second generation former sect members (second generation refers to those who had spent all or part of their childhood in a sect under 16 years of age and first generation refers to those becoming part of a sect at age 16 or older).
Design/Methodology: This naturalistic study used questionnaires to measure psychological distress levels in former sect members. Participants included 26 second generation and 47 first generation former members acquired from a variety of sources. Given the possible sensitivity of the data, particular attention was paid to ethical issues such as ensuring participants had informed consent in being part of the research, and had the opportunity to receive psychological support if desired. Pearson's correlational analysis was used to analyse the data.
Results/Findings: Significant negative correlations were found between time elapsed since leaving a sect and psychological distress scores for second generation former members who had received counselling, whereas non-significant positive correlations were found for those who had not received counselling. No significant correlations between time elapsed since leaving the sect and psychological distress levels were found for first generation former members regardless of whether or not they had received counselling.
Research Limitations: A low N for the second generation could mean that Type 2 errors occurred in this study.
Conclusions/Implications: The findings from this research while not causally conclusive, nevertheless supports the view that more research is warranted and cautiously indicates that second-generation former members benefit from counselling after sect membership. Perhaps counsellors are more likely to address the sect experience of a second generation former member.
This indicates the importance of addressing the sect experience within a counselling setting and implies that first generation former members may especially benefit from sect specialist counselling.

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Symposium B - Gillie Jenkinson

Presenter: Gillie Jenkinson
Other Authors: Belinda Harris & Peter Gates
Professional Role: Psychotherapist in private practice and doctoral research student
Institution/Affiliation: University of Nottingham
Email: ttxgmje@nottingham.ac.uk
ABSTRACT: symposium B paper 4 (Fri, 14.00-15.30)

Keywords: former cult members, life post cult, helps/does not help, counselling, abusive groups

What helps former cult members recover from an abusive cult experience?

Aim/Purpose: This research gives voice to former cult members' experience post cult and their recovery process.
Design/Methodology: This qualitative study uses an inductive, grounded theory methodology to investigate former cult members' understanding of what helped them recover and of life post-cult, as recorded during unstructured interviews. A specialist convenience sample of 30 (18 women and 12 men) was recruited through advertisement or were attendees at a specialist conference, and by snowballing. NVivo10 software was used to analyse the data.
Results/Findings: The interim findings revealed that former cult members report that life post cult has very particular challenges. Adjustment to life post cult was disorienting as their sense of self 'reinflates' after being restricted and 'squeezed'. A balance of empathic emotional support and psycho-education to aid understanding of the nature of their experience was helpful, along with naming the group as a cult, understanding cult dynamics, and unmasking the cult leader as an imperfect human vs a god. More intense interventions were needed if individuals were not familiar with the society into which they exit, and counselling was not helpful if the counsellor did not understand or acknowledge the cult experience.
Research Limitations: The research is limited by a relatively small sample. There is little academic agreement as to the definition of a cult, and different cults differ in culture and beliefs.
Conclusions/Implications: This empirical study gives voice to the particular needs of, and issues faced by, former cult members. The findings may be valuable to therapists regarding the need for appropriate understanding and empathy, alongside psycho-education, with a view to aid growth and healing of the former member post cult. Findings may be transferable to other survivors of abuse, terrorist organisations, spiritual abuse etc.

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Symposium C - Mick Cooper

Presenter: Mick Cooper
Other Authors: Elizabeth S Freire, Jill Morrison, Robert Elliott & Alex McConachie
Professional Role: Professor of Counselling Psychology
Institution/Affiliation: University of Roehampton
Email: mick.cooper@roehampton.ac.uk
ABSTRACT: symposium C overview (Sat, 13.50-15.20)

Keywords: depression, person-centred counselling, low intensity CBT, RCT, feasibility

Counselling versus Low-intensity Cognitive behavioural therapy for persistent sub-threshold and mild Depression (the CLiCD study): feasibility, outcomes and moderators in a pilot randomised controlled trial

The aims of the symposium: The purpose of this symposium is to report on the key findings from a pilot RCT comparing person-centred counselling against low intensity CBT for clients with persistent sub-threshold depressive symptoms and mild depression. Contribution of each symposium paper to the overall theme:

Paper 1 presents the main findings on the feasibility of the pilot study, as well as initial findings on outcomes.

Paper 2 presents a qualitative analyses of client experiences of the two treatments in the CLICD trial.

Paper 3 goes on to look at moderators of outcomes, examining the role that treatment preferences may have in the outcomes of the two interventions.

Implications of the symposium theme for counselling and psychotherapy theory, research and practice: The treatment of persistent sub-threshold depressive symptoms and mild depression is important because almost all patients who have these for more than two years go on to develop major depressive episodes. The National Institute for Health and Clinical Excellence recommends research into the efficacy of person centred counselling and low-intensity cognitive
behavioural therapy for persistent subthreshold and mild depression. This pilot study aims to inform the design of a full-scale randomised trial which can evaluate the outcomes of low intensity treatments, and lead to more effective interventions for clients with these difficulties.

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Symposium C - Jill Morrison

Presenter: Jill Morrison
Other Authors: Elizabeth S Freire, Chris Williams, Robert Elliott, Alex McConachie & Mick Cooper
Professional Role: Professor of General Practice
Institution/Affiliation: University of Glasgow
Email: jill.morrison@glasgow.ac.uk
ABSTRACT: symposium C paper 1 (Sat, 13.50-15.20)

Keywords: depression, person-centred counselling, low intensity CBT, RCT, feasibility

Feasibility of a randomised controlled trial of Counselling versus Low-intensity Cognitive behavioural therapy for persistent sub-threshold and mild Depression (CLiCD)

Aim/Purpose: To test the feasibility of delivering a randomised controlled trial of the clinical and cost effectiveness of Low Intensity Cognitive Behaviour Therapy (LI-CBT) and Person-Centred Counselling (PCC) for patients with persistent sub-threshold depressive symptoms and mild depression.
Design/Methodology: Pilot randomised controlled trial comparing short-term (six months) outcomes of PCC and LI-CBT. Thirty-six patients were recruited in five GP surgeries in Glasgow and randomised to either eight weekly sessions of person-centred counselling or eight weeks of cognitive-behavioural self-help resources with telephone support. Primary outcome measures were recruitment, adherence and retention rates at six months from baseline. Secondary outcome measures were: (1) changes at 6 months on GRID Hamilton Depression Rating Scale (2) recovery from, or prevention of, depression at 6 months assessed via the Structured Clinical Interview for DSM-IV (3) changes at 6 months on the Patient Health Questionnaire–9, Work and Social Adjustment Scale, Euroquol and SF12v2 MH Enhanced.
Results/Findings: Recruitment was more challenging than expected. The recruitment rate, related to number of patients approached at the GP surgeries was 6.5 %. At six months, over 70% of participants with mild depression at baseline had recovered. Two thirds of participants assessed at six-month follow-up with a diagnosis of persistent subthreshold depression at baseline did not develop major depression. There was no significant difference between treatment groups for both recovery and prevention of depression at six months.
Research Limitations: This is a pilot randomised controlled trial, not powered to provide definitive results.
Conclusions/Implications: This feasibility study has demonstrated that it is possible to identify, recruit and possibly prevent worsening of sub-threshold and mild depression. It suggests that Person-Centred Counselling and Low Intensity Cognitive Behaviour Therapy are potentially effective and their effectiveness should be subject to a substantive randomised controlled study which should include an economic analysis. A future substantive study should have multi-point recruitment including recruitment in General Practice and direct self-referral from the community. It should also include a usual care arm because we do not know what level of improvement might have occurred over time with no active intervention. Follow-up should be longer than six months, preferably 12 months, with consent for longer follow-up.

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Symposium C - Susan Stephen

Presenter: Susan Stephen
Other Authors: Robert Elliott Elizabeth S Freire, Chris Williams, Jill Morrison, Alex McConachie & Mick Cooper
Professional Role: Researcher
Institution/Affiliation: University of Strathclyde
Email: susan.stephen@strath.ac.uk
ABSTRACT: symposium C paper 2 (Sat, 13.50-15.20)

Keywords: client experiences, low-intensity CBT, person-centred counselling, depression, qualitative research

Client experiences of post-treatment change and helpful and hindering aspects of low intensity CBT and person-centred counselling

Aim/Purpose: Qualitative research is a useful way of enriching our understanding of outcome and change processes in counselling and other treatments. In this presentation we offer qualitative analyses of client experiences of the two treatments in the CLICD trial, complementing the quantitative results presented in this panel.
Design/Methodology: Qualitative Change Interviews (Elliott, Slatick & Urman, 2007) with 12 clients (7 in Low-intensity CBT [LI-CBT] and 5 in Person-centred Counselling [PCC]) were conducted by a researcher at the three month follow-up time-point. This was a convenience subsample: all participants were invited and those who agreed to be interviewed were included in this qualitative study. These interviews were transcribed and analysed by the first author using a
modified form of Grounded Theory that emphasised the open coding phase of analysis and allowed for qualitative comparisons between two different subsamples of data.
Results/Findings: Early results indicate that LI-CBT clients were likely to report changes in thought patterns, less irritability (anger, jealousy), increased confidence and sociability, while clients in PCC reported increased self-awareness and self-motivation (pushing self to do more things). In terms of helpful aspects, LI-CBT clients pointed to the simplicity of the self-help materials, the motivating effects of regular phone contacts and the relaxed, accepting manner of the support workers; these enabled clients to successfully apply key understandings from the self help materials. Clients in PCC described how the counsellor's non-judgemental attitude helped them to talk about their issues, enabling them to recognise and change problematic habits. Although clients offered less information about hindering aspects, LI-CBT clients described difficulties in applying the materials and issues affecting motivation, while PCC clients reported some degree of discomfort with lack of direction and a sense that they were engaged in a one-way process.
Research Limitations: Limited data (relatively small number of interviews and repetitive nature of the interviews) mean that the analysis did not reach saturation, i.e., that important client experiences are likely to have been missed.
Conclusions/Implications: The results of these analyses are generally consistent with the two treatment models and are informing planning for a further study.

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Symposium C - Mick Cooper

Presenter: Mick Cooper
Other Authors: Martina Messow, Elizabeth S Freire, Jill Morrison, Robert Elliott & Alex McConachie
Professional Role: Professor of Counselling Psychology
Institution/Affiliation: University of Roehampton
Email: mick.cooper@roehampton.ac.uk
ABSTRACT: symposium C paper 3 (Sat, 13.50-15.20)

Keywords: client preference, depression, low intensity CBT, person-centred counselling, treatment moderators

Treatment preference as a moderator of outcomes for low-intensity interventions for depression

Aim/Purpose: The purpose of this study is to evaluate the role that pre-intervention treatment preferences have on outcomes in an RCT comparing person-centred counselling against low intensity CBT for the treatment of subthreshold and mild depression.
Design/Methodology: Data were available from 36 patients who had been randomised to either eight weekly sessions of person-centred counselling (PCC) or eight weeks of cognitive-behavioural self-help resources with telephone support (CBT). At pre-intervention, participants were provided with brief descriptions of each therapy, and asked to rate on a 1-5 scale how much they would like each intervention, and how much they thought each intervention would help them.
Results/Findings: There were indications of preference effects in both a categorical and linear analysis. Clients who preferred PCC showed greater improvements in the PCC condition compared with the CBT condition, and vice versa, on some of the measures. Similarly, on several of the measures, the more clients preferred PCC, the better they did in this condition; while the more they preferred CBT, the better they did in this condition.
Research Limitations: The small sample size in this study means that any moderation effects must be treated with caution.
Conclusions/Implications: Consistent with previous research, the findings provide tentative indications that clients' preferences for treatments may moderate the successfulness of different interventions. This suggests that it may be more important to take treatment preferences into account when allocating clients to interventions, and that policy-makers should provide a range of treatment options to meet clients' individual preferences.

 
       
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