Emotional wellbeing in parents of disabled children
We talk to Joanna Griffin about her research
Please tell us about your experience of undertaking research (your aims, procedure, outcomes)?
When my eldest son was born, he was diagnosed with cerebral palsy and learning disability. I suddenly became aware of the world of disability that I hadn’t really known much about before and the struggles that many parents had with their mental health, dealing with the limited services and support as well as coming to terms with an unexpected diagnosis.
My experience led me to realise that there was an information gap on parent carer wellbeing, so I applied to the Metanoia Institute to do a doctorate (the DPsych by Professional Studies). I didn’t want to write a thesis that sat on a dusty bookshelf, I wanted something very practical and pragmatic that would be useful to parent carers and practitioners – to gain a better understanding of what’s going on for parents and what they need to support their emotional wellbeing.
Once I started the DPsych and had access to the academic library, I realised that there were loads of studies about poorer mental health and the risks to parent carers but very little of that information was getting out into the wider world – to the very people it concerned - so that was really frustrating.
I’m now in my third year of the doctorate and have interviewed 18 parent carers. I wanted to empower parent carers, bringing their voice to the forefront of research by asking them “what do you do that helps maintain and support your emotional wellbeing?” I was looking at what people were managing to do, shifting the focus to a strength-based one - the ways in which people are managing, even though it is tough - combining lived experience and theory in a practical way. I wanted to share these skills and strategies so other people can learn from them as well.
What impact have the findings from your research had on your practice?
What I like about research is how you’re constantly oscillating between a helicopter view of seeing the bigger picture and then focusing down into tiny little details, and you’re moving between those two positions. I think that’s such a helpful skill for practice because you have to see a client in their context (so the helicopter view really helps with that) - you can’t just look at the person in a psychological vacuum - as well as going into the minutiae of a person’s experience.
I’d say it goes both ways – skills that I’ve gained from being a counselling psychologist really helped with the research process and vice versa. It’s given me a different perspective [as a practitioner] because also, in the research, I found I was more directive than I would be in practice, because I was really trying to find something out and had limited time. So, I was less person-centred in some ways, but I could see that at times that was really useful and effective.
Why would you recommend that other practitioners also undertake or engage with research?
I think in a way most counsellors (hopefully) are already doing a type of research with their clients. For example, when they bring an issue to counselling that the counsellor doesn’t know much about they should be going out and researching and understanding a little bit more about the context - you’re exploring to gain greater understanding. That curiosity is vital in practice and research.
I also think practitioners should realise there are lots of different ways of doing research. I wonder whether sometimes people are wary of the quantitative statistical approach but you can do case studies or narrative approaches, which may feel more closely related to your practice. I’m taking an interpretive phenomenological approach which allows me to really get into deep, rich exploration of participants’ experiences.
So, I think people need to get over the clichéd idea of research and realise just how wonderfully creative it can be. Counselling practitioners can bring a lot to the research field by showing the value of personal, idiographic, qualitative data. It brings research to life a bit more. There’s a place for a variety of different approaches – and it all adds to life’s rich tapestry.
Last chance to catch up with our online Research Conference
Research for psychotherapists
A team of international psychotherapists have created a YouTube channel to highlight psychotherapy research that is relevant to clinicians. Watch their latest vlog about the extent to which large sudden improvements during psychotherapy can predict overall positive outcomes.
What are clients’ experiences of different psychological therapies for depression?
An analysis of 37 studies representing 671 patients sought to gain a comprehensive understanding of their experiences of psychological therapies for depression.
Three main themes emerged, the first of which was the role of therapy features and setting. It was found that in group therapy, smaller groups were preferable as they facilitated better discussions. Clients also expressed feeling less stigmatised in remote therapy compared to face to face therapy.
The second theme, therapy processes and how they impact on outcomes revealed that a key process most commonly referred to was clients gaining new insights to help re-frame emotions and problems. Furthermore, across all modalities, it was found that behavioural changes inspired by therapy directly improved mood and take-home materials were particularly useful for ongoing work between sessions.
The third theme, therapy outcomes (benefits and limitations) revealed that across all modalities and modes of delivery, the end of therapy was experienced as loss with client reporting feeling more alone after therapy ended. The findings of this study give practitioners an in-depth insight into clients’ perspectives in order to maximise the benefits of therapy while minimising any adverse feelings that may arise in therapy.
Therapist effects depend, in part, on the psychological treatment care setting
Psychological intervention outcomes differ according to the therapist providing the intervention (known as the therapist effect). A sample of routine clinical data from 26,814 patients found that therapist allocation seems to be more important for outcome in some types of care context compared to others, therefore therapist effects cannot be assumed to be universally applicable.
Therapist effects were four to eight times greater in primary care, compared with university, voluntary, and workplace settings. The authors suggested that one reason for the observed differences in therapist effects may be due to the NHS having a more varied patient population compared to voluntary services for example which may specialise in working with specific populations, for example addiction services.
The context‐specific nature of therapist effects and therefore the variable association between therapist and client outcome should be considered in the planning and delivery of psychological care.
The impact of client social class on diagnosis and treatment in a consultation
This study explored the impact of social class biases on the diagnosis and treatment of clients by psychological and psychotherapeutic NHS professionals.
156 professionals watched a video representing a consultation with either an ‘upper’ or ‘lower’ class client played by actors. They were then asked to complete measures on class self-awareness and clinical reasoning (perceived severity of difficulties, diagnosis assigned, level of clinical risk and treatment).
The results showed little difference between the two client social class conditions in clinical reasoning, however there was a higher likelihood of the ‘lower’ class client receiving a diagnosis of ‘alcohol or substance misuse disorder’. Practitioners viewing the ‘lower’ class client video also had higher scores surrounding self-awareness of their own potential class biases in relation to the consultation. The lack of difference in clinical reasoning between the class groups may therefore be due to the impact of therapist reflection on their own class biases. Practitioners may also benefit from further training and reflection on biases related to substance use and social class.
BACP research resources
Take a look at the Good Practice in Action (GPiA) resources we've put together to aid your research. These cover both practical aspects like writing research proposals and case studies or doing literature searches, to specific topics like supervision or digital technology.
The September 2020 issue of Counselling and Psychotherapy Research (CPR) explores the experiences of psychotherapists working remotely during the COVID-19 pandemic. There is also a special section on research methods which includes articles on methodological integrity and the importance of relational skills in research. It's free to access with your membership log in.
All seven of our specialist divisional journals are now free online for all members, so take a look at these for perspectives on working with different client groups.
Are you interested in participating in research?
Our research noticeboard features current research projects by BACP members who are looking for participants. You can also post your own project.
Views expressed in these articles are the views of the writer and not necessarily the views of BACP. Publication does not imply endorsement of the writer’s views. Reasonable care has been taken to avoid errors but no liability will be accepted for any errors that may occur.