Bringing the self into family therapy training: personal and professional consultations with trainee families

The qualifying level of training in family therapy at Bristol University requires trainees to attend three ‘therapeutic consultations’ with their families with a recognized systemic practitioner, to consider issues pertinent to their development as therapists. This innovation is synchronic with the course philosophy which foregrounds the training in the development of ‘self’. Survey results on the consultations suggest that trainees report significant ‘news of difference’ and all recommend it as a mechanism for other trainees. The consultants also affirmed the value of the sessions they have facilitated. The paper describes the practicalities of how the consultations are organized.     

'The power of being seen': an interpretative phenomenological analysis of how experienced counselling psychologists describe the meaning and significance of personal therapy in clinical practice

There is a widely acknowledged lack of clarity in psychotherapeutic training about the role of personal therapy in developing practitioner competence. This paper presents part of a wider ongoing qualitative study exploring the role that personal therapy plays in the clinical practice and training of experienced counselling psychologists. Results derived from an interpretative phenomenological analysis suggest that personal therapy is valued mainly as a means of enhancing reflectiveness within clinical work. Detailed examination of a subset of the data offers scope for exploring how this process may occur within therapy, and points to the potential significance of early attachment experiences in the development and amplification of participants' reflective capacities. A possible theoretical framework is proposed and implications for future research discussed.     

What if prospective clients knew how managed care impacts psychologists' practice and ethics? An exploratory study

Modal responses to items from a recent survey of independent practitioners regarding the impact of managed care on their practices and ethics (Murphy, DeBernardo, & Shoemaker, 1998) were presented to participants as the responses of a hypothetical independent practitioner. Participants were asked to consider seeing this hypothetical practitioner both before and after being informed of the practitioner's responses to the managed care survey. Results indicate that when participants were informed of the practitioner's views toward managed care, their own attitudes toward therapy changed significantly. Specifically, compared to uninformed participants, informed participants were significantly more likely to believe that managed care would have a negative impact on treatment and significantly less likely to see an independent practitioner, use insurance benefits, expect to benefit from treatment, expect to form a strong working relationship, and trust that the practitioner would work in their best interest. Implications regarding ethics and informed consent are discussed.     

Mental Health Professionals and Assisted Death: Perceived Ethical Obligations and Proposed Guidelines for Practice

Modal responses to items from a recent survey of independent practitioners regarding the impact of managed care on their practices and ethics (Murphy, DeBernardo, &; Shoemaker, 1998) were presented to participants as the responses of a hypothetical independent practitioner. Participants were asked to consider seeing this hypothetical practitioner both before and after being informed of the practitioner's responses to the managed care survey. Results indicate that when participants were informed of the practitioner's views toward managed care, their own attitudes toward therapy changed significantly. Specifically, compared to uninformed participants, informed participants were significantly more likely to believe that managed care would have a negative impact on treatment and significantly less likely to see an independent practitioner, use insurance benefits, expect to benefit from treatment, expect to form a strong working relationship, and trust that the practitioner would work in their best interest. Implications regarding ethics and informed consent are discussed.     

Sexual counseling and therapy

Abstract

This article is an edited version of four interviews conducted with Dr. Ivan Boszormenyi-Nagy in the Spring of 1980. The interviews ranged in content from Dr. Nagy's early training and influences to the theoretical and clinical foundations of contextual family therapy. This article focuses on the major constructs of contextual family therapy. Since this approach is often viewed as highly theoretical and conceptual in nature, it may be helpful to the practitioner to see how Dr. Nagy uses these constructs in a clinical situation. As a practitioner, I have found his theory extremely useful in conceptualizing the family system, and also in developing a treatment strategy. Hopefully, the questions asked of Dr. Nagy in these interviews will be of interest to other family therapists who are concerned with the clinical aspects of family therapy theories.     

Mastery or mystery? Therapeutic writing: A review of the literature

Recent developments in online support and counselling suggest that the users of chat rooms, for example, or the Samaritans' e-mail 'listening' service, have already discovered the power of writing as a self-help vehicle. Developments in computer-mediated counselling and therapy are essentially text-based and client-driven. The therapeutic use of expressive and reflective writing is not widely recognised in British counselling and therapy circles. The empirical foundations for the therapeutic uses of the literary arts are, however, well established. This review aims to map the use of 'writing therapy' by drawing together cross-disciplinary research and practitioner reports which might support the place of writing as a creative therapy in its own right, whether as an adjunct to face-to-face counselling or as a self-help tool.     

Sociopolitical Activist or Conversational Partner? Distinguishing the Position of the Therapist in Narrative and Collaborative Therapies

In this article, we explore the similarities and differences of two contemporary family therapy approaches: narrative and collaborative therapies. These therapies are contrasted by describing positioning of the narrative practitioner as sociopolitical activist and the collaborative practitioner as conversational partner. The article begins with a brief overview of the two therapies. Subsequently, we outline their epistemological genealogies and the practice similarities that arise from the theoretical assumptions underpinning these therapies. The remainder of the article addresses the theoretical and therapeutic differences in narrative and collaborative approaches reflected in the positioning of therapist as either sociopolitical activist or conversational partner. While narrative and collaborative approaches share more similarities than differences in relation to their emphasis on the constitutive characteristics of language, focus on sociorelational contexts, and critique of singular objective truths, prominence is given to the starker contrasts in narrative and collaborative understandings of politics, power, dialogue, and discourse. It is proposed that by outlining some provocative contrasts between narrative and collaborative approaches, new conversations and generative practices will emerge in the therapy room.     

A trans-disciplinary study of the therapist's self

Participation in personal therapy during training is required by British accreditation bodies for counselling psychology as well as by most psychotherapy trainings. By contrast, trainee clinical psychologists are not required to undertake personal therapy, although they may elect to. Prior research in Britain and the US suggests that practitioners have a wide range of motives for entering therapy as well as motives for not doing so (Norcross &; Connor, 2005). This study addresses the fact that no research to date has specifically explored what individuals beginning their counselling psychology, clinical psychology and counselling training think and feel about participation in personal therapy during training. Data from open-ended questionnaires was analysed using inductive thematic analysis. Two main themes were identified. These consisted of: ‘Personal therapy helps me to be a better practitioner’, and ‘Personal therapy costs me’. The study results are considered in light of the limited prior research and recommendations for training are made.     

Professionalism in career guidance and counselling – how professional do trainee career practitioners feel at the end of a postgraduate programme of study?

This paper explores the extent to which students on a vocational postgraduate programme identify with characteristics and competences that define a professional career guidance and counselling practitioner. Literature suggests professionalism in careers work is characterised by a focus on the needs of the client with the practitioner in a facilitative role. Competences are often couched in developmental terms, with practitioners moving from inexperienced to experienced. Students identified the most valued characteristics as adherence to professional values and ethical standards with an emphasis on person-centred practice. They recognised that competence was a developmental process, characterising themselves as at an early stage on completion of their course. Supporting the client took precedence over issues such as advocating for the profession, supporting employers and social responsibility. Generally, students saw completing a programme of study either as a beginning to a process of development of professionalism or as part of their professional development.     

Oneself in practitioner research,with Vygotsky and Bakhtin

Practitioner action and reflection are understood as central to practitioner research in this paper. While Vygotskian-based premise highlights instructional practices and intervention as central to practitioner understanding, Bakhtin-based dialogical premise draws on relational constructs and attend to practitioner being, answerability and authorship. Vygotskian and Bakhtinian units of analysis used are viewed as means with which to conceive practitioner action/reflection and build a community of practitioners. Taken together, practitioner knowing is found inextricable with practitioner ontology, making practitioner research of ongoing instructional practices more human in line with Dewey.     

Scientist and practitioner role preferences: The undergraduate dilemma

Research on preference for the scientist and practitioner roles in psychology has focused mainly on professionals and graduate students. The current study focused on undergraduates in a formative stage of career development to determine whether scientist and practitioner preferences could be indentified using instrumentation such as the Scientist-Practitioner Inventory (Leong & Zachar, Journal of Counseling Psychology, 38, 331- 341, 1991). The results indicated that comprehension of terminology within the field may affect students' indication of preference and that the divergence of preference seen in studies using professionals and graduate students does nto exist among undergraduate students. These finding could be due to a lacak of comprehension of terminology used to determine preferences. The need for an instrument that accurately measures undergraduate preferences for scientist and practitioner activities is clearly indicated to determine scientist or practitioner role preferences.     

“Not a little Mickey Mouse thing”: How experienced counselling psychologists describe the significance of personal therapy in clinical practice and training. Some results from an interpretative phenomenological analysis

The British Psychological Society's Division of Counselling Psychology currently specifies a mandatory period of personal therapy for trainees. However, evidence for the role of personal therapy in developing practitioner competence is sparse. This paper presents part of a wider ongoing interpretative phenomenological analysis exploring how counselling psychologists describe the meaning and significance of personal therapy in clinical practice and training. Detailed examination of a subset of data from this study suggests that personal therapy is valued as a vehicle for a genuine, often extremely intense relationship with the therapist, through which participants become able to establish authentic emotional contact with themselves and their clients. Whilst most participants felt that personal therapy should remain an obligatory part of the training curriculum, they were ambivalent about specifying its aims or evaluating its outcomes. Results are discussed in terms of the importance of establishing a sense of integrity and authenticity within the personal therapy experience and are tentatively situated within a possible theoretical framework drawing on current developmental literature.     

Sacred and secret stories in professional knowledge landscapes: learner agency in teacher professional learning

Set in a schooling practitioner research context, this article critiques instrumental forms of teacher professional development. An account of teacher professional learning and development is provided, as an inter-relational construct, where teachers reflect on practice to inquire into their students’ learning and foster their own and others specific interests and talents in creative ways. In an Aotearoa/New Zealand context, teachers are mandated to inquire into what their students need to know and understand, the strategies required for teachers to attain these learning goals, and how effective the approach implemented is in enhancing student learning. Emerging from qualitative case study research, a teacher’s narrative account of a student-initiated critical thinking episode in a secondary science classroom is analysed to demonstrate sacred, secret and cover stories of professional knowledge landscapes. Findings highlight the importance of agentic teacher-enacted forms of practitioner inquiry that support critical and collaborative reflective practice.     

Ethics and practices of re‐presentation: Witnessing self and other

Context: The challenge of producing ethical representational practices is of critical interest to both practitioner‐researchers and research theorists. For practitioners becoming researchers a central ethical question may be how to manage a relational presence in writing their research, in ways that acknowledge participants, the research relationship, and a researcher's own subjectivity. Focus: The article offers examples from practitioner research to illustrate and theorise how researcher subjectivity is managed through the use of witnessing practices as a representational strategy. Witnessing practices – translated into counselling research from narrative therapy – offer researchers a strategy to take up a reflexive, relational presence in research reports. Discussion: Researcher witnessing honours the contributions of research participants as well as making visible the shaping effects of the research on a researcher's life. Through witnessing self and other, and thus declaring presence, privilege and partiality, re‐presentational ethics are made transparent.     

Social Construction and Materiality: The Limits of Indeterminacy in Therapeutic Settings

By drawing parallels between the courtroom testimony of a Christian Science practitioner and an intersession conversation between systemic family therapists, I critique the abstract idealism of language-centered social constructionism. I argue that social constructionist inquiry that highlights the indeterminacy of meaning without a corresponding emphasis on the responsive embodied practices of family members glosses over the material conditions shaping the politics of interaction. The implications of this problem are discussed as they relate to the setting of family therapy, where social construction theory is often used to guide practical interventions.     

Development of a model for spiritual assessment and intervention

A multidisciplinary model for making spiritual assessments and interventions is described. The practitioner bases these assessments and interventions upon knowledge gained from philosophy, theology, physiology, psychology, and sociology. Specific assessments are made in the areas of spiritual development and seven practical dimensions of spiritual care. The patient's life experiences, events, and questions shape the nature of spiritual care as the practitioner works toward assisting the patient to maintain or expand the level of spiritual functioning.She is a recipient of a National Institute of Mental Health Academic Award. This award provided funding during the time this article was written.     

Evidence based practice: A guide for counsellors and psychotherapists

There has been an increasing tendency for healthcare policy makers and managers to require that all forms of therapy are supported by rigorous research evidence. This paper, which has also been distributed as an Information Sheet to all members of the British Association for Counselling and Psychotherapy (BACP), provides a practitioner‐oriented introduction to evidence‐based practice, with suggestions for further reading on this topic.     

Photography as a therapeutic tool for substance abuse clients who have a history of sexual abuse

Symptoms of sexual abuse among persons in substance abuse treatment facilities may be difficult to recognise since presenting symptoms frequently mirror those associated with substance abuse. Additionally, treatment may be difficult due to a lack of previous verbal processing and shared negative defence mechanisms that are resistant to traditional talking therapy. The use of photography is presented here as a method of treatment initiation and exploration for substance abuse clients who have a history of sexual abuse. The paper reviews rationale, advantages, current applications and practitioner concerns associated with the use of photography as a therapeutic tool.     

Evaluating the effectiveness of counselling in primary care: Taking a fresh look

One criticism voiced by counsellors and psychotherapists is that research does not reflect either the culture or values of therapy. Researchers, on the other hand, accuse practitioners of not attending to their findings, and the implication is made that the latter engage in treatment processes that are ill‐informed. These polarised understandings give rise to the situation where the client — and his or her development — fall into the practice‐research gap. In more recent studies of counselling in primary care, an attempt has been made to offer new perspectives for interpreting and understanding findings, and the relative value — and limitations — of different research questions and methods. They provide just a few examples of how practitioner‐researchers in the future may ask more precise questions, yet reflect on their findings from a broader set of viewpoints.     

Developing research‐informed practitioners – an organisational perspective

Background: Two current trends are making it increasingly important for counsellors and psychotherapists to be more engaged with research. Evidence of effectiveness is being increasingly demanded by those who fund our therapies and also by our clients. Meanwhile therapy research is offering practicable ways for therapists to improve their practice. Therapy organisations have an opportunity, perhaps even a duty, to meet the research needs of their members. Methods: This paper reports on a survey conducted by the UK Council for Psychotherapy (UKCP) to help it plan the activities of its Research Faculty. Findings: Key findings from the survey were that the most common ways of UKCP practitioners engaging with research were through reading, discussions with colleagues and doing research. Engaging with research collaboratively with other therapists, having more time, and access to user‐friendly web‐based research resources and updates, were the factors most commonly cited as supporting practitioner engagement with research. Conversely, lack of time, difficulties accessing resources and materials and feeling not competent were the major barriers to practitioner engagement with research. Discussion: Implications for therapists, for training, and for therapy organisations are considered.