Ten principles of counselling: Grounded theory in a mixed methods research project

This grounded theory (GT) study is part of an extensive mixed methods research project to develop general principles for counselling. Nine hundred counselling protocols were examined. The material is characterised by a quantitative amount of data with a qualitative character. The research is based on the systemic-constructivist research paradigm. The variety of perspectives is an important aspect of the work. Therefore, it is important that the entire research process with GT takes place in exchange with other research settings in order to minimise the limitations caused by the perspective of the researchers. During the research process, there was an intensive examination of GT in order to adapt it to the research project. By using the GT to analyse the extensive qualitative material, the actions of the counsellors were observed and 10 counselling principles were developed. This article presents the research process and the findings.     

‘The threat of the Other’: Using mixed quantitative and qualitative methods to elucidate racial and cultural dynamics in the counselling process

This paper examines the use of mixed quantitative and qualitative methods in the study of racial and cultural dynamics in the counselling process. The approach is illustrated by the author's own research which combined quantitative survey instruments with a blend of qualitative methods. Emphasis is given to complex racial and cultural phenomena arising from the qualitative methods of data collection and data analysis, particularly the pervasive experience of ‘threat of the Other’. These phenomena were seen to permeate the counselling interactions both explicitly and implicitly. The emerging racial dynamics are discussed with reference to theoretical concepts which stress the interrelationship between intrapsychic development and sociopolitical issues. The effectiveness of employing pluralistic methods in this field of enquiry is also evaluated.     

Ethical beginnings: Reflexive questioning in designing child sexuality research

Background: Counselling young children referred for sexualised behaviour can challenge therapists' ideas about childhood and sexuality. This area of practice is complex and sensitive, and calls upon collaboration with a range of significant adults in children's lives. Purpose: This paper examines a researcher's process of movement from counselling practice into qualitative research practice, and the use of reflexive questioning to explore ethical issues within the study. Design: Shaped by social constructionist ideas and discourse theory, ethical questions are outlined within the design stage of a doctoral research project on sexuality in children's lives in Aotearoa New Zealand. Limitations: This paper explores ethics in the design of a current study: there are no results or conclusions.     

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.     

Saudi therapists' lived experience of self-awareness

Self-awareness and self-reflection in psychotherapeutic processes have been critical components for effective counselling and psychotherapy. However, little qualitative research in Saudi Arabia has been conducted that aims to explore the therapist's subjective experiences of the self in their professional work. Therefore, the purpose of this phenomenological study was to understand the therapist's self-awareness within psychotherapy, by focusing on the therapist's lived experience of self-awareness and exploring how therapists recognise themselves as an integral component of the therapeutic relationship. Semi-structured interviews were conducted with six experienced and accredited psychologists with at least three years of clinical experience, and the qualitative data were analysed using interpretative phenomenological analysis (IPA). Five superordinate themes emerged from the data; that is, development of the professional self, use of self, self-oriented, supervision and experience. This study provides an understanding of the therapist's self in psychotherapy, as it shows that self-awareness is important for therapists to manage their feelings, thoughts and behaviours in meeting with clients and that it is a valuable resource for a therapist to become aware of and reflect upon the process within oneself. This understanding is integrated into the training programmes in counselling psychology, especially in the areas of self-awareness and personal development.     

The client as a self‐aware agent in counselling and psychotherapy

Clients' recollections of their experiences of counselling and psychotherapy were stimulated using the technique of Interpersonal Process Recall. Their reports were analysed in terms of the grounded theory method of qualitative research. The analysis resulted in the interpretation that the core category of their experience is clients' reflexivity, or self‐awareness and agency flowing from it and returning to it. The focus of this paper is directed at the client's reflexivity in response to the counsellor's operations. Its organizing theme is that how clients respond to counsellors' operations depends on what clients desire and what they feel they can say safely. Particular desires arise from an over‐arching desire either to enter into or avoid inner experience. Moreover, the relation with self is influenced by the relationship with the therapist. This complexity makes it difficult to predict responses to non‐directive and directive counsellor performances alike. Vignettes selected from the participants' reports illustrate the theme. Implications for the practice of counselling and psychotherapy are discussed.     

Observing a client's grieving process: bringing logical positivism into qualitative grief counselling research

This positional paper originates from our need as researcher/practitioners to establish a meaningful epistemological framework for research into bereaved people's journey through loss and grief over time. We describe how the field of grief research has a long and established biological basis, in keeping with a positivist epistemology. However, there has been a diminution of the influence of logical positivism in twenty-first-century counselling research. We argue that in grief counselling research, naturalistic observation of the grieving process within a logical positivist paradigm, remains a valid and valuable construct. We posit an observational protocol for the grief counselling process which minimises the intrusion of research method into the therapeutic process. We offer this as a means of conducting qualitative research within a bereavement counselling service. Further, we suggest that the development of an observational protocol for a client's grieving process has potential implications for developing good practice in grief work.     

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.     

A qualitative study of client experiences of working with novice counsellors

Aims: This paper reports on a qualitative analysis of written accounts by clients who participated in a counselling relationship with beginning-level trainees. The purpose of the study was to explore how clients experience the process of counselling with novice practitioners. Method: Consensual qualitative research was used for data analysis. Findings: Three general thematic categories were identified – client perceptions of self in counselling; client perceptions of the counsellor; and client perception of the counselling process. Conclusions: Overall, the findings suggest that these clients saw the interpersonal qualities and skills of the counsellor as major contributors to their experience. Implications: Clinical training of novices should start by developing the interpersonal and collaborative skills of trainees.     

Between the idea and the reality: A study of the counselling experiences of bereaved people who sense the presence of the deceased

There have been many theories of the process of loss and bereavement, from Freud, to the present day. Early theories of bereavement described a process which, following various stages and associated tasks, ended at the relinquishment of the bond to the deceased. In more recent years theories have taken different directions, identifying how bereaved people re‐learn life, recreate biographies, and continue relationships to the deceased. Some research studies of bereavement have investigated the counsellors’ perspective, but there are very few studies of the client's experience and most studies have focussed on outcomes of counselling. This qualitative study, using semi‐structured interviews, provides an insight into the bereaved client's perspective on the content and process of their counselling experiences. Taking as its focus the client's sense of the presence of the deceased, this study aimed to identify whether or how counsellors facilitate exploration of this experience and which theories they use in client work. The main finding is that 80% of the counsellors were not perceived by participants to have worked with them satisfactorily in relation to their sense of presence of the deceased or in relation to the story of the death itself.     

Chickens or eggs? A follow‐up case study exploring links between physical and psychological impact of Tourette's syndrome and sexual abuse

This follow‐up case study highlights the complex relationship when working at the interface between physical and psychological symptoms. The paper draws upon conversations between an ex‐client and myself, held seven years after the end of our six year therapeutic relationship. Conversational interviews, based upon social constructionist beliefs, led to an unexpected exploration of the client's subsequent diagnosis of Tourette's syndrome (given several years after the end of therapy) and evolved into a struggle to reach a shared understanding of how she now makes connection between her problem with eating in public, her neck and facial tics, and childhood sexual abuse. Our research relationship provided both of us with a rare opportunity to reflect upon how she had made meaning of her counselling and its outcomes. The paper draws attention to the impact of counselling and therapy discourses concerning sexual abuse on the work we did at the time and asks how that work might be different today. It also helps us understand the layers of complexity and ambiguity contained within the client's stories. This multi‐layered case study represents the overlap and ‘messiness’ that mirrors the ‘lived experience’ of the persons involved, and provides an example of how co‐constructed research conversations can evoke stories that create meaning as they are told.     

Counselling marginalised young people: A qualitative analysis of young homeless people's views of counselling

Aims: This study explored young homeless people's views of counselling, with a view to considering how the counselling profession can better meet their needs. Method: A small scale qualitative research project was undertaken in two residential projects for young homeless people. Data was gathered through focus groups and then analysed using grounded theory. Findings: The study revealed a lack of trust in counsellors and counselling, as well as a dislike of the counselling process. Implications for practice: Some suggestions for how best to work with this particularly marginalised client group are discussed. These include ways of making counselling more engaging, raising the profile of the counsellor in the young person's environment and having an awareness of the needs specific to at‐risk young people.     

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.     

A qualitative content analysis of ChatGPT's client simulation role-play for practising counselling skills

Role-play is often used as a pedagogical technique by counsellor educators to help counsellors-in-training (CITs) learn and practise counselling skills. This study used qualitative content analysis to assess the effectiveness of Chat Generative Pre-Trained Transformer (ChatGPT), an artificial intelligence (AI) chatbot, in simulating client role-play to facilitate practising counselling skills. The author used 10 case vignettes to conduct a simulated role-play where ChatGPT was asked to simulate the client and author as counsellor. The results indicated that ChatGPT demonstrated authenticity, consistency, appropriate emotional expression, cultural sensitivity, empathy and self-awareness while portraying the client. However, at times, ChatGPT's responses to the counsellor's questions appeared overly idealised, lacking the authenticity typically observed in real clients. Furthermore, ChatGPT, as a simulated client, lacked non-verbal cues, limiting the overall experience of counselling skill practice. Recommendations for CITs and future research are discussed.     

The significance of psycho‐peristalsis and tears within the therapeutic relationship

This paper represents a heuristic study of the significance of involuntary, intuitive gut responses (psycho‐peristalsis) and tears within the therapeutic relationship. Autobiographical material and qualitative data were gathered from case‐notes and semi‐structured interviews with four client/co‐participants. Data on occurrences of psycho‐peristalsis and tears were collected from 92 clients seen within a six‐year period. Eleven elements of a ‘general constitutional structure of experience’ were identified. A central finding of the study concerns the gut's apparent ability to ‘pick up’, at an unconscious level, significant material that might otherwise have been overlooked. The research suggests some possible clues to the process of unconscious communication and healing, and adds an interesting psychological dimension to recent findings in the fields of neuroscience and cell biology which amount to the discovery of a ‘second brain’ in the walls of the small intestine. These phenomena are examined in the light of theoretical debates in counselling and psychotherapy.     

Qualitatively driven mixed‐methods approaches to counselling and psychotherapy research

Many researchers and clinicians take an ‘either, or’ position regarding factors responsible for change when conducting research. Qualitatively driven mixed methods privilege the qualitative approach and offer the opportunity to generate multi‐dimensional material, permitting a more holistic insight into experiences that can be understood from a combination of epistemological and ontological stances. A qualitatively driven mixed‐methods approach apply a ‘both, and’ position when exploring the elements that produce change or that are under investigation, which can be of particular value to counselling and psychotherapy research. There are various ways of engaging with qualitatively driven mixed methods. Some designs include both qualitative and quantitative components, where the former is the core element. The secondary component may also be qualitative, known as a multimethod design. Yet, other designs mix different qualitative approaches, through the application of different qualitative analyses to the same data (pluralistic qualitative research). This paper discusses the application and value of qualitatively driven mixed methods in counselling and psychotherapy research through the presentation of two research case studies; one which mixes both qualitative and quantitative components to investigate the experiences of pain alleviation following a CBT pain management programme; and one which applies a pluralistic approach to a counselling psychology doctorate exploring the experiences and meanings attached to self‐harming. Through illustration and discussion of the case studies’ mixed‐methods approaches, this paper demonstrates that qualitatively driven mixed methods produce a more enhanced and holistic understanding into phenomena, and therefore a more balanced perspective to counselling and psychotherapy research.     

An initial study of transgender people's experiences of seeking and receiving counselling or psychotherapy in the UK

Background: There are no published empirical research studies exploring transgender people's experiences of seeking and receiving counselling or psychotherapy outside of gender identity clinics within the UK. As a result, counsellors know little about why transgender people seek counselling, who they seek counselling from, and what their experiences are of receiving counselling. Aim: To address this gap in the literature, this study investigated transgender people's experiences of seeking and receiving counselling or psychotherapy outside of gender identity clinics within the UK. Funding for this study was provided by a BACP Seedcorn grant. Method: A mixed method small‐scale qualitative research design was employed, comprising an online survey and five semi‐structured interviews. Findings: Participants tended to seek counselling on two or more occasions and received between 2 and 12 sessions. Participants sought counselling for common psychological concerns as well as gender identity and coming out issues. A fear of being discriminated against and exploring gender for the first time were significant barriers in seeking help. Participants reported mixed experiences of counselling but valued a therapeutic relationship in which they felt affirmed, listened to and understood. Discussion: The findings from this study mirror aspects of previous research conducted in the USA concerning transgender clients' experiences of counselling. However, these findings point to the importance of recognising the potential vulnerability transgender clients experience when seeking counselling and the need for therapists to develop greater awareness, knowledge and competence regarding working with transgender clients.     

(Re)Searching for a client in two different worlds: Mind the research‐practice gap

A criticism voiced by counsellors and psychotherapists is that research does not truly reflect the complexities of therapy. Researchers, on the other hand, accuse practitioners of not attending to research findings and suggest that as a result they engage in an ill‐informed process. This polarised understanding can give rise to the situation where the client is missed, falling into the research‐practice gap. In reality the research‐practice gap gets smaller and smaller every time a practitioner employs — which is often the case — a complex and sophisticated construct system in search of a client's psychological distress. The metaphor of the ‘search’ seems to become a point of connection between the practitioner's search and the researcher's (re)search. As a way of exploring this issue, the paper briefly considers the research‐practice gap and the critique of current research. It argues that counsellors and psychotherapists are themselves engaging in research when they practise therapy since every counselling and psychotherapy session is basically a (re)search process.     

The stresses of learning counselling: Six recent graduates comment on their personal experience of learning counselling and what can be done to reduce associated harm

This paper presents research that examines the negative and stressful aspects of learning counselling and methods for harm reduction. Using an in-depth semi-structured interviewing approach, six people who recently graduated from a UK university counselling programme have commented on their negative experiences of learning counselling and what helped or would have helped to reduce the harmful effects. This research has produced information which indicates that counselling trainees experience significant disruptions in their relationships with their family and friends; that a sizeable number of trainees report feelings of depression and or stress; and that counselling trainers have not addressed these issues effectively. The study concludes with a suggestion that an extra training component could be built into existing training frameworks that focus on the process of 'becoming a counsellor'.