Revisiting a meta-analysis of helpful aspects of therapy in a community counselling service

This small scale mixed methods study examines helpful events in a community counselling setting, categorising impacts of events according to Timulak’s [(2007). Identifying core categories of client-identified impact of helpful events in psychotherapy: A qualitative meta-analysis. Psychotherapy Research, 17, 305–314] meta-synthesis of significant events research. Comparisons were made between the types of impacts reported as helpful by clients receiving cognitive behavioural therapy (CBT) or relational integrative counselling. Seventy-five clients identified 291 significant events on 216 Helpful Aspects of Therapy (HAT) forms. The findings broadly reflect all nine impacts identified by Timulak (2007). The study also suggests that a potential new category, ‘voicing’ may exist. Differences between the types of impacts reported as helpful by clients in CBT and integrative therapy showed a higher percentage of CBT clients reporting ‘behavioural change/problem solution’, ‘reassurance’ and ‘client involvement’ as helpful. Differences in other categories were not statistically significant.     

Counsellors' experiences of changing their practice: Learning the psychodynamic‐interpersonal model of therapy

Seven counsellors were interviewed about their experiences of learning and applying a new approach to therapy: the psychodynamic‐interpersonal model. These interviews were analysed using grounded theory — a qualitative approach. Under the core category of ‘changing counselling practice: applying the PI model of therapy’, the material was organised into 10 major categories: difficult feelings; new awareness; therapeutic identity; identifying reasons for choosing how to work; experiencing difficulties in adherence; attributing causes of difficulties; ways through the difficulties; understanding how change in practice occurs; changing interventions; and specific other inputs. Examples from the interviews are used to cast light on the difficulties experienced by counsellors in the process of changing their practice.     

Time‐limited therapy in a Community Mental Health Team setting

This study examines time‐limited therapy in a Community Mental Health Team (CMHT) setting. This work is a key tension for CMHTs who are under pressure to focus on clients with a serious mental illness as a priority as opposed to clients who might be deemed the ‘psychologically distressed’. The development of CMHTs in the UK is described. Limited research on time‐limited therapy in a CMHT setting is identified. Results suggest that time‐limited therapy has a positive impact on the mental health needs of clients referred to a CMHT by GPs. It is concluded that it is appropriate to justify the use of time‐limited therapy in a CMHT‐based setting. Suggestions for further research are made.     

Using a Theory of Change to Drive Human Resource Development for Wraparound

Achieving coherence and integration across staff professional development activities is facilitated when training, coaching and staff evaluation are guided by a clearly articulated program theory or “theory of change” that describes how skillful practice promotes desired outcomes. We focus on a theory of change for wraparound, a widely implemented approach to providing community-based care for children with high levels of mental health and related needs. Training, coaching and staff evaluation efforts within wraparound programs have typically been linked only very loosely to theory. We argue that wraparound’s unique history allowed it to evolve with limited theoretical grounding, and we then describe a theory of change for wraparound, focusing on the major causal routes that are hypothesized to lead to outcomes. Finally, we provide an extended illustration of how the theory can provide the basis for a coherent and integrated approach to developing the skills and capacities of staff members playing key roles in wraparound implementation.     

Teaching and learning the esoteric: an insight into how reflection may be internalised with reference to the occupational therapy profession

This paper is concerned with the ways in which reflective practice is learnt, taught and assessed within the profession of occupational therapy. It utilises individual experiences of reflection of both students and staff members in university and practice placement settings. The discussion places reflection within learning a profession’s way of being and individual learner’s relation to this ‘sense of being’. It concludes that the ‘rote’ way in which reflection is currently used to demonstrate evidence of reflective practice is detrimental to the development of a reflective professional, in this instance, an occupational therapist.     

The challenge of becoming an integrative counsellor: The trainee's perspective

Aim: Integrative therapeutic practice is commonplace within the UK. Counsellors and psychotherapists increasingly report working in this way and numerous training courses have developed which advocate such practice. Despite its popularity, researchers have paid little attention to the impact that such training has upon students. This study therefore explores newly qualified counsellors' reflections of undertaking professional training in integrative counselling. Design: Newly qualified counsellors were invited to take part in a focus group to discuss their training experiences. Two groups were held involving a total of seven people. The data generated was analysed using Grounded Theory. Findings: The core-category ‘The challenge of becoming an integrative counsellor’ was identified. Embedded within this were four sub-categories: (1) ‘training issues’, (2) ‘applied issues’, (3) ‘the development of an integrative theory and identity’, and (4) ‘the impact of integrative training post qualification’. Key findings include the willingness of trainees to tolerate theoretical ambiguity and the discomfort that surrounded not belonging to a pure paradigm community. Discussion: Recommendations are made that trainers and practice supervisors are mindful of the distinct struggles that integrative trainees encounter. Additionally, in response to the isolation that some trainees report, greater use of peer support networks is encouraged.     

The social sources of alienation

As a key concept in the social sciences, alienation refers to various mental states, often identified by such terms as ‘powerlessness’, ‘meaninglessness’, ‘anomic’, etc. Recent advances in sociological theory permit us to indicate systematically the social conditions linked to these states. A simple though exhaustive typology of the social sources of alienation’ is here presented. To illustrate the typology, examples of alienation are drawn from the writings of classical and contemporary social theorists.     

‘A baptism of fire’: A qualitative investigation of a trainee counsellor's experience at the start of training

Background: Belief in the effectiveness of professional counselling and psychotherapy training is widespread and generally unquestioned. Few studies have attempted to understand the changes experienced by trainees, or identified which aspects of professional training programmes assist them in the process of becoming therapists. Aims: to investigate how a trainee counsellor changes at the start of training, and to identify which aspects of a professional counsellor training programme were helpful in instigating and supporting change. Method: the experience of one trainee counsellor, Margaret, was captured through three semi-structured interviews conducted at the beginning, middle and end of her first term. The data were subjected to systematic qualitative analysis. Findings: Margaret experienced significant change during her first term. Each interview revealed a different phase of her development. The core categories were: becoming something new (week 3); growth in therapeutic confidence (week 6); surviving ‘stressful involvement’ through supervision (week 11). Experiential learning, in particular group supervision, was helpful throughout. The presence of real clients was identified as the main driver for change. Conclusion: The findings were found to be consistent with a number of other studies, which suggest that training is potentially painful because of the emotional demands it places on trainees, particularly at the start of practice. Consequently trainees require opportunities for experiential learning, peer support and supportive supervision to assist them in their development, but most importantly, given that supportive supervision can only minimise the harm of stressful involvement (Orlinsky & Ronnestad, 2005), they need early positive experiences with clients.     

A slow unfolding – at double speed: reflections on ways of working with parents and their young children within the Tavistock clinic's under fives service

This paper describes clinical work carried out as part of the Tavistock Clinic Under Fives Service, which offers brief focused psychoanalytically based interventions to families with young children, as well as longer-term work. It elaborates psychoanalyst Annette Watillon's idea that it is the dramatic way in which children enact their (and their family's) predicament in the consulting room which speeds up the process of change. The author clusters clinical cases into three categories, each cluster representing a different kind of ‘dramatic’ enactment and leading to a different kind of intervention relating to the therapist's role, the structure of the interventions and the ‘ports of entry’ for the work. The categories are defined as: ‘child-led drama’ with the therapist in the role of ‘therapeutic observer’; ‘internal parental drama’ with the therapist in the role of ‘therapeutic consultant’; and ‘external parental drama’ with the therapist in the role of ‘therapeutic modulator’. The author defines these categories, illustrating each category with clinical examples.     

Undoing Androcentric Explanations of Gender Differences: Explaining ‘The Effect to be Predicted’

Even if a social category contain women and men, men are often considered the default category members. Such androcentric thinking leads people to explain gender differences in such categories as being ‘about women’ rather than being ‘about men.’ In two experiments (N?=?102) this bias was reversed within the category ‘voters.’ Participants generalized data about women voters to men and data about men voters to women, and explained the resulting gender differences. Explanations always focused on the group whose attributes were predicted, whether such predictions were unconstrained (Experiment 1) or constrained by forced-choice items (Experiment 2). People can reason about gender differences by taking women as the default gender, even within categories that are traditionally normed on men. Implications for the communication of gender differences and the bases of androcentric thinking are discussed.     

The experience of ‘healing stories’ in the life narrative: A grounded theory

‘healing stories' are part of an emergent narrative literature in psychology and counselling. This research explored the subjective experience of ‘healing stories’ within the context of individual's life narratives. A grounded theory (Strauss and Corbin, 1990) method of analysis was used to generate and analyse six participant's life narratives. Analysis of these accounts revealed three categories. The first is the context of struggle that preceded the healing process. participants told of struggle in their relationships with others as well as turmoil in their experience of themselves. The second category, the healing process reflected the participants' growing awareness of life's existential givens (Yalom, 1980). This represented a personal exploration that opened lparticipants to a ‘healing story’ that offered them an insight into choices and possibilities for liberation. The third category illustrated that in the ongoing struggle the ‘healing story’ has continued to provide inspiration in the participants' lived experience as an ‘evoked companion’ (Stern, 1985). This research posited a core dynamic whereby participants' experience of their ‘healing story’ provided not only an initial inspiration that was healing but also, in their ongoing struggle, the ‘healing story’ continued to inspire their lived experience.     

Generalization of positive attitude as a function of subgroup and superordinate group identifications in intergroup contact

The role of category salience in mediating the effects of intergroup contact was examined. One theoretical model proposes that some psychological salience of subgroup categories is necessary to facilitate the generalization of attitude change beyond the immediate contact situation. Another argues that a re‐categorization of the subgroups into a new superordinate category is more beneficial, whilst a third suggests that de‐categorizing the situation entirely is optimal. An alternative view, which combines the first two models, proposes a Dual Identity strategy (simultaneous high superordinate and high subgroup categorization) as an important mediator of the relationship between contact variables and intergroup attitudes. In the study, participants (N = 114) undertook a cooperative intergroup task under four conditions of category salience: ‘subgroup’, ‘superordinate’, ‘superordinate and subgroup’, and ‘no group salience’. Evaluative ratings and symbolic reward allocations both for the groups encountered (contact) and those outside the situation (generalization) provided measures of intergroup bias. Bias within the contact situation was mainly eliminated in all conditions. However, on the more generalized bias measures, only the ‘superordinate’ and ‘superordinate and subgroup’ (Dual Identity strategy) conditions maintained this low level; in the other two conditions intergroup bias resurfaced. A combination of the first two models is proposed. Copyright © 2002 John Wiley & Sons, Ltd.     

Gliding across the liminal space between counsellor and counselling researcher: Using collective biography practices in the teaching of counselling research methodologies

Aims: Drawing on their engagement in a specific collective biography research project, the co-authors aim to demonstrate how the weaving together of creative story-telling and the theory underlining collective biography practices resulted in an understanding of rhizomatic research methodologies from within the process. This paper aims to demonstrate one way in which research methodologies training can become more firmly embedded within counsellor training courses. Method: A collective of counselling students and a session tutor colleague used collective biography practices to research their memories of traversing the liminal space between ‘counsellor’ and ‘counselling researcher’. Alongside the resulting collective stories, a collaborative review of the research process examined our chosen ways of working within the project. Outcomes: Engaging in collective biography practices resulted in an experiential shift from ‘learning to do counselling research’ to ‘becoming counselling researchers’. Weaving together research processes and researcher reflexivity generated personal and professional learning. Ways in which these research methodologies complement core components of counselling training, within and beyond the teaching of research, were identified. Conclusions: Collective biography practices offer a way of introducing non-arboreal creative research methodologies into counsellor training. Careful consideration of potential challenges surrounding the introduction of these practices is required.     

Parenting in youth tennis: Understanding and enhancing children's experiences

ObjectiveThe overall purpose of this study was to develop a grounded theory of optimal parental involvement in youth tennis.DesignA Straussian grounded theory methodology (Corbin and Strauss, 2008, Strauss and Corbin, 1998) was used. Semi-structured interviews and focus groups were conducted with 90 youth tennis players, ex-youth players, parents, and coaches from the United Kingdom. Data were analyzed through a process of open and axial coding, and theoretical integration. Through this process data were broken down into smaller units (concepts), relationships between concepts were identified, and a substantive grounded theory was developed.ResultsThe grounded theory of optimal parental involvement in tennis was built around the core category of ‘understanding and enhancing your child's tennis journey.’ The core category was underpinned by three categories: (a) Share and communicate goals, which referred to the need for parents and children to have the same aims for the child's tennis involvement; (b) develop an understanding emotional climate, which accounted for the need for parents to continually seek to foster an environment in which children perceived parents understand their experience, and; (c) engage in enhancing parenting practices at competitions, which denoted the specific behaviors parents should display in relation to competitive tennis.ConclusionThe theory predicts that consistency between goals, emotional climate, and parenting practices will optimize parenting in youth tennis.     

Radicalization in leadership from over-positioning to trans-positioning

This article explores how the term radicalization might be applied to leaders in a professional and business environment, and is based on three concepts: radicalization, over-positioning, and trans-positioning. Hermans refers to the phenomenon of radicalization as ‘over-positioning’ in terms of dialogical self theory (DST): one I-position dominating the entire system of self. From a theoretical perspective of DST ‘trans-positioning’ is introduced by Van Loon as metaphorically transposing one aspect of a position repertoire to another. The argument is elaborated that trans-positioning can be used in the service of deradicalization for the purpose of opening the system and improving wellbeing.     

Blood brothers,ugly sisters: School counselling and sibling dynamics1

This article explores the particular relevance of sibling dynamics for counsellors working in schools. School, when viewed as a large ‘lateral’ organisation, both reflects and reactivates sibling dynamics. This thinking about school counselling is based on the ‘whole school’ approach, in which a school counsellor works with staff and students, and with organisational dynamics, seeking to understand the unconscious emotional life of the school system, as well as those within it. The initial sections of the article are concerned both with the place of siblings in psychodynamic theory, and with challenges which sibling dynamics present for a counsellor working in a school context. There follow three linked sections in which the invitation to ‘think sibling’ is illustrated with some clinical examples, drawn from the specific context of a boarding school. All identities have been changed and anonymised to protect confidentiality. The article concludes with a discussion of sibling dynamics in practice, within the context of schools.     

What is the Good/ Good of the FORM of the GOOD?

‘Good’ is nothing specific but is transcendentally or generally applied over specific, and specified, ‘categories’. These ‘categories’ may be seen—at least for the purposes of this note—as under Platonic Forms. The rule that instances under a category or form need a Form to be under is valid. It may be tautological: but this is OK for rules. Not being specific, however, ‘good’ neither needs nor can have a specifying Form. So, on these grounds, the Form of the Good is otious. Any rule of the kind, ‘Everything needs a Form, so good needs a Form of the Good’ is mistaken, in that good is not a kind, but a transcendental. To give a Form to the transcendental ‘good’ is a mistake: it is a Rylian category mistake. And the Form of the Good either does no work, or works unprofitably in any but an aesthetic sense.     

Reflecting on a journey of resilience in children’s blood and cancer nursing

Reflective practice is recognised as an integral part of being a highly skilled and successful health care professional. Many benefits have been identified from being a reflective practitioner including the opportunity for critical thinking, growing self-awareness and supporting individual resilience. There is a growing body of literature recognising the negative emotional impact that caring for children with cancer and blood disorders can have on health professionals. Currently there is an emerging interest in a more strengths-based approach focused on maintaining staff wellbeing. Resilience has been suggested as a framework for coping and maintaining wellbeing in areas, like children’s oncology and has been used as a term to describe the ‘surviving’ health professional. This paper explores the first author’s (GA) experiences of being a children’s oncology nurse and paediatric palliative care nurse specialist in the context of existing empirical and theoretical literature, with a particular focus on how GA developed resilience. Reflective examples of practice are used within the context of themes identified from a recent literature review exploring how resilience is defined within empirical literature.     

Counselling young people: Counsellors' perspectives on ‘what works’ – An exploratory study

Aim: Counsellors who work with young people in a range of contexts know that they are not engaging with ‘mini‐adults’. The issues young people bring to counselling are often complex, challenging and wide‐ranging, as adolescents are experiencing times of turbulence and change in their physical, emotional, social and psychological development. This paper focuses on a research project undertaken with five counsellors who work with young people, and asks the question: ‘What works?’ Method: The research project is an in‐depth qualitative study into the counsellor's experience of counselling young people, using a narrative approach. Findings: Four key shared themes emerged: the significance of ‘safety’ in the relationship; building the therapeutic alliance; flexibility and integration relating to theoretical orientation; and the use of creativity. Outcomes: This paper offers counsellors the opportunity to reflect on ‘what works’ and consider the professional knowledge, which underpins their own counselling practice with young people.     

what helps and hinders workers in managing change

This research responds to calls for increased understanding of workers' experiences of their work and work contexts. Informed by positive psychology, this study focused on a seldom‐studied subset of working individuals who self‐identified as doing well with change affecting their work and on strategies that helped or hindered them in doing well, factors that would have helped, and their experiences of change within the context of volatile and changing work situations. Using the enhanced critical incident technique methodology, the authors extracted 790 incidents from 45 participant interviews. These data were organized into the following 10 categories: support from friends and family, support from colleagues, support from professionals, personal attitudes/traits/emotional set, self‐care, internal framework and boundaries, taking action, skill/role competence, management style and work environment, and personal life changes/issues. The implications of these categories for research, theory, practice, and organizations are discussed.