This study set out to explore the part played by counselling in the lives of parents afflicted by child-to-parent violence, in response to a perceived lack of literature in the area. It is a qualitative study with data generated from audio-recorded, semistructured interviews, which were subsequently analysed using Interpretative Phenomenological Analysis guidelines. Three participants explored their experiences facing child-to-parent violence, focusing upon the interventions offered, in particular counselling. Master themes from the data clustered around ‘living with abuse’, ‘negotiating a way through’ and ‘support’. An emergent theme was ‘unhelpful service interventions’, which contrasted with the theme of ‘helpful individuals’. A common emergent theme was the persistence of abuse from the child. Just as interventions appeared to depend upon how practitioners conceptualised child-to-parent violence, so too the response of participants depended on the meaning made of their different experiences. Participants’ experiences of counselling also emerged from how they had conceptualised their situations. Implications for practice indicate the need for a non-judgemental stance by counsellors to counter parental self-blame, and a greater clarity when supporting parents who are caught in a dilemma about their rights to personal safety.
The aim of this research project was to investigate promotion of physical activity (PA) in general practice in Malta, by analysing Maltese general practitioners’ (GPs’) beliefs, attitudes and self-reported practices. All Maltese GPs were invited to participate in this postal survey, whereby data was collected using a validated questionnaire about PA in general practice. The main outcome measures included knowledge, role perception, confidence, barriers and frequency of PA promotion, feasibility of different PA promotion strategies and GPs’ PA levels. The response rate was 53% (156 replies out of 296). Although role perception was high, PA promotion was generally low (52% promoted PA to < 30% of patients), with GPs more likely to promote PA if they perceived it as relevant to the patient’s condition. Only 19% of GPs knew the national PA recommendations, with those who did being somewhat more likely to promote PA to > 30 patients/month than those who did not (59% vs. 41%, p = 0.082). GPs were more confident in giving general PA advice than suggesting specific PA programmes, and a relationship was found between confidence and frequency of promoting PA (p = 0.005, r = 0.226). There was also a relationship between GPs’ PA levels and frequency of promoting PA (p = 0.038, r = 0.168). The most common barrier was lack of time, while brief counselling during consultations was considered most feasible. Initiatives are required to increase knowledge about PA recommendations and PA promotion among Maltese GPs. Due to numerous advantages and GPs’ hypothetical support, a framework in which GPs recommend increased PA and offer referrals to a PA counsellor could be ideal. However, research is required about how to implement such a framework. PA promotion by GPs could have a significant public health impact, particularly since physical inactivity and obesity levels are very high in Malta.
This research investigates the experiences of bilingual (Welsh-English) counsellors providing therapy in their mother tongue (Welsh) and in their non-mother tongue (English). The data was gathered from an in-depth semi-structured interview with five participants from North and West Wales who described Welsh as their mother tongue and it was analysed using Interpretative Phenomenological Analysis (IPA). The findings demonstrated that the therapists recognised differences when counselling in Welsh and in English. The participants experienced a different sense of self depending on the language spoken and described a pre-existing understanding and sense of ease that emerged when they counselled clients who shared the same mother tongue as themselves. Consequently, this facilitated the development of safety and trust that arose when they provided therapy to clients in their first language. The results highlighted how the familiarity of the language of training and the passage of time benefits how the therapists conceptualise their counselling abilities. The study found that aspects such as the therapists’ lack of linguistic proficiency and a need to make an extra effort in their less familiar and/or less confident languages can hinder the counselling relationship. However the research demonstrated that their bilingualism enhanced the therapy by offering more flexibility and choice to clients. These findings support existing literature on the topic and also provide new insights into Welsh first language therapists’ experiences of working bilingually.
Gibbon, Kim (University of Liverpool (Chester College of Higher Education), 2002-10)
This research was designed to investigate the effect of miscarriage on the psychological health of women. Two hypotheses are tested. First, that miscarriage produces anxiety, depression, post-traumatic stress, and symptoms of post-traumatic stress disorder at rates significantly higher than those found in the general population. Second, that certain life experiences or predisposing factors, when preceding a miscarriage, produce anxiety, depression, post-traumatic stress, and symptoms of post-traumatic stress disorder at significantly higher rates than found in women who have not had such an experience. Data was gathered using two standardised and one purpose designed questionnaire. Women who suffered miscarriage were sent the questionnaires one month post miscarriage. A control group of women attending gynaecology outpatient clinics also completed the questionnaires where appropriate. The findings of the research are that there is significant evidence supporting both hypotheses. Miscarriage has a significant impact on the psychological state of women, here looking at anxiety, depression, intrusion and avoidance. Women certainly suffer from post-traumatic distress, and as this is a subset of post-traumatic stress disorder (PTSD), further work may show PTSD to be of significance. There is a complex of predisposing factors which can point to vulnerability to such response, as well as factors which although unrelated might have been expected to be significant. Miscarriage should therefore be taken seriously as a psychological issue by counsellors, health professionals and society in general. Counselling should be offered and note taken of predictors of response, as well as of the individual's context and understanding of their situation. Cognitive concepts may well be important in understanding these psychological responses and in structuring counselling responses.
Johnson, Geraldine (University of Chester, 2013-12)
Since the early 1990s, the counsellor’s world has become increasing professionalised and politicised requiring counsellors to fulfill ever more increasing obligations and responsibilities in order to practice. Counsellors undergo extensive training, adopt ‘ethical frameworks for practice’, are insured for purpose, commit to regular supervision and undergo regular CPD. They often volunteer or work with marginalised clients from some of the hardest to reach communities. There is a huge demand for counselling, yet career prospects for counsellors are both bleak and at the mercy of government policy and national economics. Using the data from 8 semi-structured interviews, this qualitative, phenomenological research explored counsellors’ experiences and perceptions of the evolving political and professional climate. The data was transcribed and analysed using the constant comparative method and found counsellors entered training from a position of confidence believing themselves to be the right type of person for a career in counselling. However, the training process was difficult to manage, with many strands to the learning and they felt unsupported and overwhelmed. Counsellors had polarised experiences of placements, finding unprofessional practice in some placements, whilst others were reported to be very professional, exceptionally well run and emotionally supportive to them. Counsellors struggled to find paid employment, exacerbated by government’s massive funding of IAPT to the Health Service. They saw their own voluntary organisations lose funding, apply redundancy measures and reduce counsellor delivery hours. The government’s planned statutory regulation of counsellors and psychotherapists however, was viewed with optimism, anticipating that it would provide them the necessary validity to work professionally as a counsellor. The research offers the opportunity for a longitudinal study, to explore participants’ existing experience within the current political and professional climate. It also contributes to the body of research tracking the trajectory of the political and professional development of the counselling profession.
The theory of death drive has been controversial from the very start. It has been identified as a myth that had been out of favour in modern psychotherapy and counselling. Such is the dynamism of this ‘dead subject’ that it has been infused with life from 1920 to 2011; as this study will show sometimes by its adherents other times by its dissidents. Through this heuristically informed literature-based research, I endeavour to show the impact of the death drive on the present psychotherapy and counselling literature. Within much of the literature the death drive is perceived as a destructive or daemonic force, only achieving quiescence and Nirvana through addiction. Three emerging themes of Aggression, Quiescence and Narcissism have been further elaborated in chapters 4, 5 and 6. Written from a psychodynamic perspective, with keeping in mind its roots in psychoanalysis, this study concludes that like the phenomenon of death in life, the death drive is also inescapable in counselling and psychotherapy. By not getting mentioned in training and with covert references in literature its ‘unconscious pressure’ is difficult to ignore.
This is a small-scale qualitative research study of 32 participants, drawn from private counselling practitioners who charge a fee for counselling/psychotherapy. It examines their experiences and perceptions around the fee transaction in the therapy room, in an attempt to explore whether a taboo remains in this area. The symbolic nature of money, the fee and its manifestations in the behaviours of counsellors and clients are examined, together with the roles value and self-worth play in the therapeutic journey of the client. Likewise, the counselling practitioner’s journey within the sphere of private practice is scrutinised in the light of his/her professional journey towards establishing an ethical counselling business. The findings that emerge are: (1) Counsellors face tensions by charging a fee; (2) Charging a fee signifies a contracted professional business service; (3) Charging a fee can be therapeutic; (4) The fee transaction has an impact on the therapeutic relationship; (5) Money in therapy is symbolic; (6) The counsellor undergoes a personal journey to feel comfortable charging fees. Recommendations from this study include adequate preparation of practitioners for private practice, through business training on counselling courses and specific personal development of practitioners to address their own issues around money. It is also recommended that knowledge and expertise is shared across related professions, e.g. money coaches and debt counsellors. Those mental health problems associated with debt such as, depression, relationship problems and potential suicides should be addressed openly by therapists in an attempt to reduce the financial ignorance which may be perpetuated by “money blindness” of therapists and clients alike, in an attempt to reduce the stigma of the financial conversation in today’s society.
Humphreys, Marjorie R. (University of Liverpool (University College Chester), 2006-10)
A heuristic investigation was undertaken in which four counsellors who live with a significant amount of chosen contemplative silence in their lives were interviewed in order to explore the impact, if any, that their way of life had on the therapeutic relationship. The in depth, open ended interviews took the form of the narrative enquiry. As the ‘bricoleur’ my analysis was based on an emergent design utilizing heuristic methodology. The literature search which revealed a paucity of previous material demonstrates that silence in the lives of counsellors enhances their way of being with clients, making them more self aware and able to relate at a deeper level. The interviews discovered that whilst there were a number of benefits to the counsellor, there were also some difficulties to address. The benefits were an increased self-awareness, relational depth, mindfulness and acceptance. The difficulties raised were that the subject of contemplation or meditation is a difficult area to verbalize, there is a reticence to be transparent about it, and that there are occasions when the fact that the counsellor has access to something that is not understood by the client this may impair the counselling relationship. Findings are presented in the form of individual depictions of each of the four co-researchers, a composite depiction and a creative synthesis. Further research would be beneficial to explore this phenomenon in more depth.
This research study investigates the role of mother-tongue in counselling Welsh clients and within the therapeutic relationship. It is a qualitative study using Interpretative Phenomenological Analysis (IPA) as its mode of inquiry and analysis. Four participants who described Welsh as their mother-tongue from the North Wales region were interviewed individually using an in-depth semi-structured interview. Data analysis followed that described by Smith, Flowers, and Larkin (2009). The study found that all participants described mother-tongue as an important aspect of counselling and the counselling relationship. The results demonstrated that the more familiar a language is to the client the easier it is to talk about personal experiences and emotions. It also highlighted the role language plays in the client’s identity and culture, and that it is important for the therapist to accept and understand the client’s background and their struggle to communicate in order to create a facilitative relationship, and a safe environment for counselling. The study found that aspects such as searching for the right word or having meaning get lost in translation as barriers to counselling. In addition, and in particular with reference to the bilingual context of the Welsh speaking participants it was found that language was used to create closeness or distance to an issue, discovering hidden issues, and allow for flexibility and choice. This study provides an insight into the role of mother-tongue in counselling with Welsh clients and may have something to offer counsellors working in other bilingual contexts.
This small scale qualitative study explores an aspect of counselling that textbooks describe as often challenging for the counsellor, that of counselling an angry couple. The particular focus of this study is the experiences and meanings of counsellors who have identified that this aspect of their counselling work has had an impact upon them. Data was collected from five experienced counsellors, using semi-structured interviews. This was analysed using Interpretive Phenomenological Analysis. Five main themes emerged, these being labelled: childhood experiences, the disrupted self, a responsibility to manage, managing the impact and the developed self. The findings are consistent with the limited literature available and offer a valuable insight into the voice of the counsellor, a perspective that has been the subject of sparse research. The study indicated that counsellor discomfort with anger within the counselling room was frequently related to childhood experience within the family of origin. The analysis found that client anger commonly resulted in physical sensations in the counsellor, and that although experience moderated the feelings of anxiety experienced by the novice counsellor, some anxiety or discomfort continued to be present. Counsellors could also occasionally experience difficult feelings related to their own unresolved conflict or doubt. The results suggest that perceiving couple conflict heightens the counsellor’s sense of responsibility, which fuels a need to contain the emotional impact within the room and to hold the self of the counsellor safely in the face of emotionally strong forces. Managing the impact upon the self of the counsellor can continue after the session with the couple. In the long term however, the work can lead to both professional and personal growth. The relevance of the study outcomes to supervision, training and counsellors’ understanding of their own relationship with anger is discussed.
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