• Bridging the Gap: Developing an Adapted Model of Pluralistic Counselling and Psychotherapy for Boys (Aged 11-16 Years) Who Present with Specific Learning Difficulties

      Reeves, Andrew; Gubi, Peter; Tebble, Gary (University of ChesterUniversity of Chester, 2019-09-30)
      Objective: Young people who present with specific learning difficulties face many challenges and barriers when accessing effective, adjusted and helpful therapeutic intervention and mental health support. The objective of this research was to develop and produce a theoretical model of adapted pluralistic therapy and to address the practice and research gap, through using this therapeutic intervention and the use of therapeutic feedback with boys in psychotherapy. Design: The philosophical underpinning of the study was grounded in a pluralistic and social constructionist stance, which dovetailed and guided the selected systematic case study design (Cooper & Dryden, 2016; Widdowson, 2011).A concurrent mixed methods design was implemented, with a concurrent embedded strategy and an integrative method used for combining the data sets (Iwakabe & Gazzola, 2009; Creswell, 2009). A dual role paradigm of therapist/researcher, client-participant was adopted and embedded within a multiple case study approach, which utilised a grounded theory analysis (Strauss & Corbin, 1990). The dual role was ethical and professionally managed through evaluating the ethical risks of researching with own clients, exploring issues of informed consent including the use of parental consent, the use of rolefluency, strong boundaries, working with levels of self-disclosure, protecting children and avoiding harm, managing confidentiality, outlining benefits for participating in the research and through ongoing clinical and research supervision. Findings: A theoretical framework established from the grounded theory process, indicated that an adapted pluralistic approach had been approved and implemented. This included the development of collaboration and shared understanding through a meta-therapeutic communicative approach (shared-decision making), where therapeutic focus, activities and concepts were also established, in order instigate a reduction of psychological distress and mental health concern. Alongside the pluralistic framework, the use of therapeutic teaching and the emergence of a therapeutic-educational stance was identified as an essential feature of the process. The theoretical model identified consisted of various elements of therapeutic practice, but was centred on four distinct pillars; therapeutic foundation and the creation of a collaborative and pedagogical culture, the development of construction and learning, the development of assimilation and expression and the emergence of therapeutic change and development through the awareness of therapeutic insight. Four key pathways were also highlighted throughout the grounded theory process, which included the empowerment pathway, the engagement pathway, the expression pathway and the enhancement pathway, all of which give the therapeutic process direction and movement. The adapted pluralistic model of practice resulted in a reduction in participant’s psychological distress relating to their presenting issues, with quantitative findings suggesting that both therapeutic reliability change and clinical change was present for most of the participants. Implications: The study has noteworthy relevance for both the psychological professions and the allied fields, including the educational setting. It is also particularly relevant for any professionals working with boys who present with specific learning difficulties and are in the special educational needs grouping, who may be willing to adopt a more pluralistic and adaptive approach.