Digests - March 2012
- The initial significance of a client's disclosure may diminish over the course of therapy.
- Attitudes to psychotherapy found to vary widely and incorporate participants' culture, background experiences and attachment style.
- Benefits of recording counselling sessions outweigh the drawbacks for trainees.
- Counsellors need to be mindful of specific nuances of online counselling work with young people.
- A sense of privilege in sharing clients' experiences, however working with male victims of female-perpetrated domestic violence is described as presenting challenges for counsellors.
- School counselling is viewed as a valuable intervention by those young people who have experienced it.
- A perceived relationship between the manifestations of altruism and counsellor success.
- Clients appear happier than their therapists when routine outcome measurement (ROM) is used.
1. The initial significance of a client's disclosure may diminish over the course of therapy.
Intending to examine how a particular client disclosure came about and what made it important to the client, Jane Balmforth and Robert Elliott analysed a significant therapy event involving a client's disclosure of childhood abuse using Comprehensive Process Analysis (CPA). This was the first of a series of CPA studies that the authors have conducted.
The analysis identified therapist invitation and client universalisation as the key elements of the disclosure event. The client gained insight into how the earlier abuse had affected her life, linking it to the victimisation that was her primary reason for seeking therapy and to her relationship with her mother. The therapist facilitated the event by following up the client's hints, trusting the strength of the alliance, and staying close to the client's frame of reference. In this paper, the authors share some of their learning from this analysis including that some disclosures of abuse play a supporting rather than central role in the therapy and that clients may process disclosed material in between sessions.
'I never talked about, ever': A comprehensive process analysis of a significant client disclosure event in therapy
Jane Balmforth & Robert Elliott
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2. Attitudes to psychotherapy found to vary widely and incorporate participants' culture, background experiences and attachment style.
'Rather than just saying that people have a stigma about seeking psychotherapy, we need to think more complexly about personality, culture and context when we think about attitudes toward psychotherapy.' This is a conclusion from Clara Hill and colleagues' study looking at the attitudes of undergraduate students who had never been in therapy, about psychotherapy.
Interviews with 12 participants were analysed using consensual qualitative research. Alongside results that describe participants' beliefs about the roles of client and therapist, and ideas about the benefits and barriers associated with seeking therapy, this paper describes attitudes and beliefs not previously found in the literature. Participants' responses suggested openness towards the range of concerns that therapy may help for others rather than for themselves. Hill et al also find an association between attachment style and attitude to therapy.
Attitudes about psychotherapy: A qualitative study of introductory psychology students who have never been in psychotherapy and the influence of attachment style
Clara E. Hill, Dorli B. Satterwhite, Maria L. Larrimore, Aliya R. Mann, Victoria C.
Johnson, Rachel E. Simon, Alexandra C. Simpson & Sarah Knox
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3. Benefits of recording counselling sessions outweigh the drawbacks for trainees.
Exploring counselling students' perceptions of the effects of recording counselling sessions on themselves, their clients and on the counselling process, the authors of this study found that participants perceived the process of recording to be anxiety promoting and initially having an effect on their ability to be completely present during counselling. However they also found it extremely beneficial to their development of effective skills.
Counselling students from five educational settings in New Zealand participated in focus-group or individual interviews, which were analysed using a process of constant comparison. Although all participants described being distracted by recording sessions, most noted that their confidence increased over time. Gossman and Miller explore the implications for continuing the practice of recording and playing back interviews in counsellor-education and suggest strategies to improve the use of recording in counsellor education programmes and supervision.
'The third person in the room': Recording the counselling interview for the purpose of counsellor training - barrier to relationship building or effective tool for professional development?
Marion Gossman & Judi H. Miller
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See also Forthcoming Issue 'To Record or Not To Record' by Andrew Reeves
4. Counsellors need to be mindful of specific nuances of online counselling work with young people.
The therapeutic alliance is a concept that has received a great deal of attention within face-to-face counselling and links have been made between the creation of strong alliances and successful therapeutic outcomes. Terry Hanley examines the therapeutic alliance when counselling services are offered online to young people in this paper. The findings are presented through a composite fictional story - Jane's story - which incorporates the issues that the young people involved in this study identified as important to them.
Fifteen young people participated in online interviews for this study, and Grounded Theory techniques were used to analyse the data. A core category of 'client service match' was identified with three subcategories relating to participants' experiences of creating good quality relationships. Hanley shows that while the themes can be viewed as a chronological process similar to face-to-face counselling, there are nuances that are specific to online work.
Understanding the online therapeutic alliance through the eyes of adolescent service users
Terry Hanley
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5. A sense of privilege in sharing clients' experiences, however working with male victims of female-perpetrated domestic violence is described as presenting challenges for counsellors.
A distinct lack of recognition of male victimisation was seen as hampering work with clients and the professional and personal impact of their work included changes in their perceptions of women. These are some of the findings of this study which aims to provide an understanding of counsellors' experiences of working with male victims of female-perpetrated domestic abuse
Hogan and colleagues adopted a qualitative research design and conducted semi-structured interviews with six counsellors with experience of working with male victims. Using Interpretative Phenomenological Analysis (IPA) to analyse the data, ten over-arching themes emerged.
The authors conclude that this understanding may be helpful in the development of more effective strategies for counsellors and counselling agencies to employ to encourage successful working with male victims, whilst increasing awareness of male victimisation.
Counsellors' experiences of working with male victims of female-perpetrated domestic abuse
Kevin F. Hogan, John R. Hegarty, Tony Ward & Lorna J. Dodd
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6. School counselling is viewed as a valuable intervention by those young people who have experienced it.
The young people in this study had very positive views of the counselling they received, and associated counselling with a number of positive changes. Helpful aspects of counselling focused mainly on having the opportunity to talk and 'get things out' with a counsellor whose personal qualities made talking easier.
Aiming to investigate young people's views on the effects of school-based counselling, and what they found helpful and unhelpful, Rosemarie Lynass and colleagues used a pluralistic research design. They conducted 11 semi-structured interviews using an adapted version of Robert Elliott's Client Change Interview and the data was analysed using thematic analysis. The findings suggest that improvements were not only apparent on an interpersonal and emotional level, but that there was also clear evidence of behavioural change.
A thematic analysis of young people's experience of counselling in five secondary schools in the UK
Rosemarie Lynass, Olga Pykhtina & Mick Cooper
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See also Research News: Evaluation of the Welsh School-based Counselling Strategy: Final Report available now
7. A perceived relationship between the manifestations of altruism and counsellor success
This study explores a model for the development of altruism from the perspective of counselling trainees. The findings have direct implications for examining the way counselling students are trained, claim the authors, who additionally suggest a need for further investigation into the relationship between altruism and counsellor effectiveness.
Aiming to examine the applicability of a proposed model of the development of altruism, or unselfish caring for others, as perceived by counselling students in the UK, Jacqueline Swank and colleagues conducted semi-structured interviews with eight counsellors-in-training. They analysed the data using open coding and axial coding and developed a theoretical model based on the axial coding categories. Their findings addressed the four factors proposed in the model of altruism, and additional themes. Despite the majority of participants supporting the relationship between altruism and counsellor effectiveness, not everyone agreed that altruism was helpful in the counselling relationship.
Manifestation of altruism: Perceptions among counselling students in the United Kingdom
Jacqueline M. Swank, E. H. Mike Robinson & Jonathan H. Ohrt
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8. Clients appear happier than their therapists when routine outcome measurement (ROM) is used.
Although therapists were initially resistant to ROM in principle, through practice and over time, they could see the benefits of Clinical Outcomes in Routine Evaluation with computer software (CORE-Net). By contrast, clients were more positive about using ROM and they particularly liked the visual representations of their mental state.
These are some of the conclusions of this first qualitative study looking at the perceptions of both psychological therapists and their clients in the use of CORE-Net where instant visual feedback for session tracking was given on a computer screen in the therapy room at each therapy session.
Nine therapists participated in focus groups and clients were interviewed individually, face-to-face. The inductive analysis of the data identified six overarching themes. The authors recommend that the implementation of ROM needs to include comprehensive training of therapists, ongoing clinical supervision and coaching forums at regular intervals to assist therapists in integrating ROM into their clinical practice.
Therapists' and clients' perceptions of routine outcome measurement in the NHS: A qualitative study
Gisela Unsworth, Helen Cowie & Anita Green
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