Dissertationen zum Thema „Counselling“

Psychotherapy has traditionally described religious counselling in a negative manner since it was felt such practices perpetuated rather than dealt with mental health problems. This research set out to examine if differences existed between the practices of Christian and non-Christian therapists and the consequences if they did. A uniquely constructed questionnaire was sent to a number of therapists, but a very low return rate was received from non-Christian therapists possibly reinforcing the underlying anti-religious hostility expressed by this group. From the total of twenty seven returns received, liberal and nominal Christians were combined with the non-Christians making a (renamed) non-committed group of fifteen therapists. Twelve remained in the (renamed) committed Christian group. Data obtained from the questionnaire indicated a number of differences between the two groups. Differences were found in styles of therapy, religious beliefs, and ethical practices. Following the questionnaire, two therapists from each group were interviewed to gain further insight into the results and responses obtained. Both Christian and one non-Christian therapist were supportive of the research, but for different reasons. Christian therapists felt it was needed to educate others whereas the non-Christian therapist used it to educate herself. The remaining non-Christian therapist expressed marked hostility toward the research perhaps reflecting the opinions of the majority of therapists who did not participate in this research. Six clients also returned a questionnaire, enabling some insight from a client's perspective to be gained. This indicated that what therapists stated they would do and what either actually happened or was believed to be happening, did not always match. This study may be greatly flawed, however, due to the small number of therapists being studied and its being conducted in a small geographical area. This research serves to raise more questions for future research rather than give statements of general fact.

This study presents how Indian counsellors in urban India work with Western counselling methods with Indian clients. The study is categorised as part of the cross-cultural counselling research field where a major assumption is that counselling methods are part universal, part contextual. This study explores how counsellors in Bangalore culturally adapt Western methods. The method used is qualitative semi-structured interviews with seven counsellors at Parivarthan Counselling, Training and Research Centre in Bangalore. The theoretical framework in this study is based on New Institutional Theory, with constructs such as Glocalisation, Translation, and finally Cultural Preparedness to understand the context of the counselling profession in Bangalore. Results show that the Bangalore counsellors meet clients that are culturally prepared for short-term and advice-oriented counselling. The clients are part of a context where family and spirituality are of great importance. The counsellors use Western counselling methods only but adapt their approach and language with indigenous elements and emphasise the individuality of each client. They use a person-centred and an integrative approach, in which they are informed by several Western counselling methods, but do not use them dogmatically. The individuals’ needs and the relationship between counsellor and client is emphasised. Parivarthan Counselling, Training and Research Centre is part of a complex organisational field with influences from India, the East as well as from the West.

This dissertation offers a critical account of the process I have used to change and reconstruct my counselling practice. Viewed through the lens of modernity heroin addiction resembles a storm of personal and social problems that drives the redemptive qualities of personal growth out of the reach of individuals. Conventional approaches to treatment perceive heroin addicts to be problematic individuals whose behaviour and other social and cultural issues are diminished in importance by their overwhelming need to satisfy their dependency. Within such notions treatment interventions, including counselling, are predominantly conceived in terms of a biomedical model that focuses upon discipline and control. The dissertation recognises that such approaches leave little space for individual acts of meaning. The dissertation critically and creatively explores the issue of drug addiction from the perspective of my work as a counsellor. I will discuss my feelings, emotions and thoughts to reflect how I might use lived experience to change how I counsel individuals addicted to heroin. Living and working in Stockton I have developed a strong awareness and understanding of its history and social spaces. It is an area in gradual decline characterised by social inequality and deprivation. The dissertation examines the consequences for my practice of counselling in such a context of social disadvantage. The meanings embedded in the everyday life of heroin addicts provide an opportunity for me to appreciate the kind of life being lived but also allow me to develop a different way of counselling that seeks to redress the damage done by social inequalities and addiction to heroin. I will argue that the traditional values of client-centred counselling autonomy-fidelity, justice, non-malfeasance and beneficence-need be rejected and replaced by an approach that encourages emancipatory social change. The dissertation draws upon a Goethean approach to science that encourages the use of imagination to gain an understanding of experience and provides the basis for a different way of knowing. Such a way of knowing is expressed through the use of photographic images interwoven with written text; together these narratives seek to throw open the conventional organization of counselling in order to contest the unequal social distribution of resources.

There has been little Australian research on the religious and spiritual values of counsellors � one study only, published by Cross and Khan in 1983. However, this issue is an important one, as counsellors' values may influence their clients and the need of clients may require the attention of the counsellor to religious and spiritual issues. This study consisted of two surveys in which the religious and spiritual beliefs and values of Australian counsellors were examined. The first study addressed some root questions concerning the relevance of religion and spirituality to psychologists and therapists in the counselling situation. The queries concerned (a) the recognition and acceptance by counselling practitioners of the religious/spiritual dimension of a person, (b) whether religious issues, values and beliefs were seen as an integral part of psychotherapy and (c) the degree to which these practitioners saw themselves as religious or spiritual. To answer some of these root questions, the initial objective of the field study was to survey psychologists and therapists in Canberra using the Batson and Ventis (1982) Religious Life Inventory, because this was a framework for identifying the ways in which a person was religious. Added to this were some demographic questions and questions regarding the relevance of religion to work. A poor response rate led to the surveys being sent also to Sydney and Melbourne. Results from this first survey were limited. The term "religion" was found to be far more complex than at first realised, and hence objectives were modified for a second survey. The second survey focussed on perceptions of spirituality of Canberra counsellors. The survey questions were based on the studies by Shafranske and Gorsuch (1984) and Shafranske and Malony (1990). Added to these questions were demographic questions and open questions dealing with personal insights, experiences with symbols, rituals and myths. Ideas for questions were also taken from studies on religion in Australia, including Bouma and Dixon (1986) and the Australian Values Study Survey (1983). The data was analysed first by tabling frequencies, then by cross-tabulating selected variables and computing the chi-square statistic for each cross-tabulation to determine whether the relationship was significant at the 0.05 level. Results suggested that the majority of Canberra practitioners not only perceived spirituality as important to their personal life and clinical work, but also regarded themselves as spiritual people and believed in a transcendent Being and Life Force. Most saw their spirituality as entirely personal and had little connection with organised or traditional religions. Within the counselling relationship approximately half of the counsellors were willing to discuss religious issues, and nearly 90% to discuss their clients' spirituality. Female counsellors were much more likely than male to discuss a client's religious beliefs with them; other differences between the sexes were less marked. The high response rate in this study together with the significant findings indicate the value of further research in this area on a broader scale.

The research focused on the counselling service provided by a major national N-1 organisation. The main aim was identification of managerial mechanisms that might be instituted to facilitate the development of workplace counsellors.It comprised of three main studies which utilised both quantitative and qualitative methods. Over a period of eight months,corresponding quantitative data were collected after each new counselling session from six hundred and ninety-four clients and forty-six counsellors.In addition, qualitative data in the form of case notes were obtained from the counsellors, forty-three of whom also completed Levenson's (1981) Locus of Control questionnaire. In the first study,quantitative questionnaire data from both clients and counsellors were analysed in order to investigate discrepancies between the two groups that might identify a means of focus for managing the service. Statistical exploration of sociodemographic features that might be implicated as potentially confounding variables in the assessment of counselling effectiveness and client satisfaction was also undertaken, and the proposition that non-respondents perceive less benefit from the service was indirectly explored. A dditionally,the relationship between some of the Rogerian core qualities and client perceptions of benefit was investigated. In the second study,qualitative data from counsellor notes were examined in order to establish the type of notes produced and to consider ways in which counsellors might be encouraged to focus on counselling process rather than content. As a result an instrument was developed which provides a tool to facilitate counsellor development within a professional supervisory re lationship, inside or outside of the organisational context. The third study was designed to investigate counsellors' own locus of control and their perceptions of their clients' primary loci. Objectives of the study included comparison of the two measures and exploration of relationships between locus of control and other issues of interest to the research such as client perception of benefit from counselling, perceived use of Rogerian core variables and results on the process measure. The findings of the studies and their implications for counsellor development are fully discussed and suggestions for future research are provided.

Adolescent peer counselling as a social support strategy to assist adolescents to cope with stress in their peer group provides the focus for the present thesis. The prosocial behaviour of providing emotional and psychological support through the use of helping conversations by young people is examined. Current programs for training adolescent peer counsellors have failed to discover what skills adolescents bring to the helping conversation. They ignore, actively discourage, and censor, some typical adolescent conversational helping behaviours and idiosyncratic communication processes. Current programs for training adolescent peer counsellors rely on teaching microcounselling skills from adult counselling models. When using this approach, the adolescent peer helper training literature reports skill implementation, role attribution and status differences as being problematic for trained adolescent peer counsellors (Carr, 1984; de Rosenroll, 1988; Morey & Miller, 1993). For example Carr (1984) recognised that once core counselling skills have been reasonably mastered that young people " may feel awkward, mechanical or phoney" (p. 11) when trying to implement the new skills. Problematic issues with regard to role attribution and status differences appear to relate to the term 'peer counsellor' and its professional expectations, including training and duties (Anderson, 1976; Jacobs, Masson & Vass, 1976; Myrick, 1976). A particular concern of Peavy (1977) was that for too many people counselling was an acceptable label for advice giving and that the role of counsellor could imply professional status. De Rosenroll (1988) cautioned against creating miniature mirror images of counselling and therapeutic professionals in young people. However, he described a process whereby status difference is implied when a group of adolescent peer counsellors is trained and invited to participate in activities that require appropriate ethical guidelines including competencies, training, confidentiality and supervision. While Carr and Saunders (1981) suggest, "student resentment of the peer counsellor is not a problem" they go on to say, "this is not to say that the problem does not exist" (p. 21). The authors suggest that as a concern the problem can be minimised by making sure the peer counsellors are not 'forced' on the student body and by providing opportunities for peer counsellors to develop ways of managing resentment. De Rosenroll (1988) acknowledges that the adolescent peer counsellor relationship may fall within a paraprofessional framework in that a difference in status may be inferred from the differing life experiences of the peer counsellor when compared with their student peers. The current project aimed to discover whether the issues of skill implementation, role attribution and status differences could be addressed so that adolescent peer counselling, a valuable social support resource, could be made more attractive to, and useful for adolescents. The researcher's goal was to discover what young people typically do when they help each other conversationally, what they want to learn that would enhance their conversational helping behaviour, and how they experience and respond to their role as peer counsellor, and then to use the information obtained in the development of an adolescent-friendly peer counsellor training program. By doing this, the expectation was that the problematic issues cited in the literature could be addressed. Guided by an ethnographic framework the project also examined the influence of an adolescent-friendly peer counsellor training program on the non-peer counsellor students in the wider adolescent community of the high school. Three sequential studies were undertaken. In Study 1, the typical adolescent conversational and communications skills that young people use when helping each other were identified. In addition, those microcounselling skills that young people found useful and compatible with their typical communication processes were identified. In Study 2, an intervention research process was used to develop, deliver, and evaluate an adolescent-friendly peer counsellor training program which combined typical adolescent helping behaviours with preferred counselling microskills selected by participants in Study 1. The intervention research paradigm was selected as the most appropriate methodology for this study because it is designed to provide an integrated perspective for understanding, developing, and examining the feasibility and effectiveness of innovative human services interventions (Bailey-Dempsey & Reid, 1996; Rothman & Thomas, 1994). Intervention research is typically conducted in a field setting in which researchers and practitioners work together to design and assess interventions. When applying intervention research methodology researchers and practitioners begin by selecting the problem they want to remedy, reviewing the literature, identifying criteria for appropriate and effective intervention, integrating the information into plans for the intervention and then testing the intervention to reveal the intervention's strengths and flaws. Researchers then suggest modifications to make the intervention more effective, and satisfying for participants. In the final stage of intervention research, researchers disseminate information about the intervention and make available manuals and other training materials developed along the way (Comer, Meier, & Galinsky, 2004). In Study 2 an adolescent-friendly peer counsellor training manual was developed. Study 3 evaluated the impact of the peer counsellor training longitudinally on the wider school community. In particular, the project was interested in whether exposure to trained peer counsellors influenced students who were not peer counsellors with regard to their perceptions of self-concept, the degree of use of specific coping strategies and on their perceptions of the school climate. Study three included the development of A School Climate Survey which focused on the psychosocial aspects of school climate from the student's perspective. Two factors which were significantly correlated (p<.01) were identified. Factor 1 measured students' perceptions of student relationships, and Factor 2 measured students' perceptions of teachers' relationships with students. The present project provides confirmation of a number of findings that other studies have identified regarding the idiosyncratic nature of adolescent communication, and the conversational and relational behaviours of young people (Chan, 2001; Noller, Feeney, & Peterson, 2001; Papini & Farmer, 1990; Rafaelli & Duckett, 1989; Readdick & Mullis, 1997; Rotenberg, 1995; Turkstra, 2001; Worcel et al., 1999; Young et al., 1999). It extends this research by identifying the specific conversational characteristics that young people use in helping conversations. The project confirmed the researcher's expectation that some counselling microskills currently used in training adolescent peer counsellors are not easy to use by adolescents and are considered by adolescents to be unhelpful. It also confirmed that some typical adolescent conversational helping behaviours which have been proscribed for use in other adolescent peer counsellor training programs are useful in adolescent peer counselling. The project conclusively demonstrated that the adolescent-friendly peer counsellor training program developed in the project overcame the difficulties of skill implementation identified in the adolescent peer counselling literature (Carr, 1984). The project identified for the first time the process used by adolescent peer counsellors to deal with issues related to role attribution and status difference. The current project contributes new information to the peer counselling literature through the discovery of important differences between early adolescent and late adolescent peer counsellors with regard to acquiring and mastering counselling skills, and their response to role attribution and status difference issues among their peers following counsellor training. As a result of the substantive findings the current project makes a significant contribution to social support theory and prosocial theory and to the adolescent peer counselling literature. It extends the range of prosocial behaviours addressed in published research by specifically examining the conversational helping behaviour of adolescents from a relational perspective. The current project provides new information that contributes to knowledge of social support in the form of conversational behaviour among adolescents identifying the interactive, collaborative, reciprocal and idiosyncratic nature of helping conversations in adolescents. Tindall (1989) suggests that peer counsellor trainers explore a variety of ways to approach a single training model that can augment and supplement the training process to meet specific group needs. The current project responded to this suggestion by investigating which counselling skills and behaviours adolescent peer counsellor trainees preferred, were easy to use by them, and were familiar to them, and then by using an intervention research process, devised a training program which incorporated these skills and behaviours into a typical adolescent helping conversation. A mixed method longitudinal design was used in an ecologically valid setting. The longitudinal nature of the design enabled statements about the process of the peer counsellors' experience to be made. The project combined qualitative and quantitative methods of data gathering. Qualitative data reflects the phenomenological experience of the adolescent peer counsellor and the researcher and quantitative data provides an additional platform from which to view the findings. The intervention research paradigm provided a developmental research method that is appropriate for practice research. The intervention research model is more flexible than conventional experimental designs, capitalises on the availability of small samples, accommodates the dynamism and variation in practice conditions and diverse populations, and explicitly values the insights of the researcher as a practitioner. The project combines intervention research with involvement of the researcher in the project thus enabling the researcher to view and report the findings through her own professional and practice lens.

Adolescent peer counselling as a social support strategy to assist adolescents to cope with stress in their peer group provides the focus for the present thesis. The prosocial behaviour of providing emotional and psychological support through the use of helping conversations by young people is examined. Current programs for training adolescent peer counsellors have failed to discover what skills adolescents bring to the helping conversation. They ignore, actively discourage, and censor, some typical adolescent conversational helping behaviours and idiosyncratic communication processes. Current programs for training adolescent peer counsellors rely on teaching microcounselling skills from adult counselling models. When using this approach, the adolescent peer helper training literature reports skill implementation, role attribution and status differences as being problematic for trained adolescent peer counsellors (Carr, 1984; de Rosenroll, 1988; Morey & Miller, 1993). For example Carr (1984) recognised that once core counselling skills have been reasonably mastered that young people " may feel awkward, mechanical or phoney" (p. 11) when trying to implement the new skills. Problematic issues with regard to role attribution and status differences appear to relate to the term 'peer counsellor' and its professional expectations, including training and duties (Anderson, 1976; Jacobs, Masson & Vass, 1976; Myrick, 1976). A particular concern of Peavy (1977) was that for too many people counselling was an acceptable label for advice giving and that the role of counsellor could imply professional status. De Rosenroll (1988) cautioned against creating miniature mirror images of counselling and therapeutic professionals in young people. However, he described a process whereby status difference is implied when a group of adolescent peer counsellors is trained and invited to participate in activities that require appropriate ethical guidelines including competencies, training, confidentiality and supervision. While Carr and Saunders (1981) suggest, "student resentment of the peer counsellor is not a problem" they go on to say, "this is not to say that the problem does not exist" (p. 21). The authors suggest that as a concern the problem can be minimised by making sure the peer counsellors are not 'forced' on the student body and by providing opportunities for peer counsellors to develop ways of managing resentment. De Rosenroll (1988) acknowledges that the adolescent peer counsellor relationship may fall within a paraprofessional framework in that a difference in status may be inferred from the differing life experiences of the peer counsellor when compared with their student peers. The current project aimed to discover whether the issues of skill implementation, role attribution and status differences could be addressed so that adolescent peer counselling, a valuable social support resource, could be made more attractive to, and useful for adolescents. The researcher's goal was to discover what young people typically do when they help each other conversationally, what they want to learn that would enhance their conversational helping behaviour, and how they experience and respond to their role as peer counsellor, and then to use the information obtained in the development of an adolescent-friendly peer counsellor training program. By doing this, the expectation was that the problematic issues cited in the literature could be addressed. Guided by an ethnographic framework the project also examined the influence of an adolescent-friendly peer counsellor training program on the non-peer counsellor students in the wider adolescent community of the high school. Three sequential studies were undertaken. In Study 1, the typical adolescent conversational and communications skills that young people use when helping each other were identified. In addition, those microcounselling skills that young people found useful and compatible with their typical communication processes were identified. In Study 2, an intervention research process was used to develop, deliver, and evaluate an adolescent-friendly peer counsellor training program which combined typical adolescent helping behaviours with preferred counselling microskills selected by participants in Study 1. The intervention research paradigm was selected as the most appropriate methodology for this study because it is designed to provide an integrated perspective for understanding, developing, and examining the feasibility and effectiveness of innovative human services interventions (Bailey-Dempsey & Reid, 1996; Rothman & Thomas, 1994). Intervention research is typically conducted in a field setting in which researchers and practitioners work together to design and assess interventions. When applying intervention research methodology researchers and practitioners begin by selecting the problem they want to remedy, reviewing the literature, identifying criteria for appropriate and effective intervention, integrating the information into plans for the intervention and then testing the intervention to reveal the intervention's strengths and flaws. Researchers then suggest modifications to make the intervention more effective, and satisfying for participants. In the final stage of intervention research, researchers disseminate information about the intervention and make available manuals and other training materials developed along the way (Comer, Meier, & Galinsky, 2004). In Study 2 an adolescent-friendly peer counsellor training manual was developed. Study 3 evaluated the impact of the peer counsellor training longitudinally on the wider school community. In particular, the project was interested in whether exposure to trained peer counsellors influenced students who were not peer counsellors with regard to their perceptions of self-concept, the degree of use of specific coping strategies and on their perceptions of the school climate. Study three included the development of A School Climate Survey which focused on the psychosocial aspects of school climate from the student's perspective. Two factors which were significantly correlated (p<.01) were identified. Factor 1 measured students' perceptions of student relationships, and Factor 2 measured students' perceptions of teachers' relationships with students. The present project provides confirmation of a number of findings that other studies have identified regarding the idiosyncratic nature of adolescent communication, and the conversational and relational behaviours of young people (Chan, 2001; Noller, Feeney, & Peterson, 2001; Papini & Farmer, 1990; Rafaelli & Duckett, 1989; Readdick & Mullis, 1997; Rotenberg, 1995; Turkstra, 2001; Worcel et al., 1999; Young et al., 1999). It extends this research by identifying the specific conversational characteristics that young people use in helping conversations. The project confirmed the researcher's expectation that some counselling microskills currently used in training adolescent peer counsellors are not easy to use by adolescents and are considered by adolescents to be unhelpful. It also confirmed that some typical adolescent conversational helping behaviours which have been proscribed for use in other adolescent peer counsellor training programs are useful in adolescent peer counselling. The project conclusively demonstrated that the adolescent-friendly peer counsellor training program developed in the project overcame the difficulties of skill implementation identified in the adolescent peer counselling literature (Carr, 1984). The project identified for the first time the process used by adolescent peer counsellors to deal with issues related to role attribution and status difference. The current project contributes new information to the peer counselling literature through the discovery of important differences between early adolescent and late adolescent peer counsellors with regard to acquiring and mastering counselling skills, and their response to role attribution and status difference issues among their peers following counsellor training. As a result of the substantive findings the current project makes a significant contribution to social support theory and prosocial theory and to the adolescent peer counselling literature. It extends the range of prosocial behaviours addressed in published research by specifically examining the conversational helping behaviour of adolescents from a relational perspective. The current project provides new information that contributes to knowledge of social support in the form of conversational behaviour among adolescents identifying the interactive, collaborative, reciprocal and idiosyncratic nature of helping conversations in adolescents. Tindall (1989) suggests that peer counsellor trainers explore a variety of ways to approach a single training model that can augment and supplement the training process to meet specific group needs. The current project responded to this suggestion by investigating which counselling skills and behaviours adolescent peer counsellor trainees preferred, were easy to use by them, and were familiar to them, and then by using an intervention research process, devised a training program which incorporated these skills and behaviours into a typical adolescent helping conversation. A mixed method longitudinal design was used in an ecologically valid setting. The longitudinal nature of the design enabled statements about the process of the peer counsellors' experience to be made. The project combined qualitative and quantitative methods of data gathering. Qualitative data reflects the phenomenological experience of the adolescent peer counsellor and the researcher and quantitative data provides an additional platform from which to view the findings. The intervention research paradigm provided a developmental research method that is appropriate for practice research. The intervention research model is more flexible than conventional experimental designs, capitalises on the availability of small samples, accommodates the dynamism and variation in practice conditions and diverse populations, and explicitly values the insights of the researcher as a practitioner. The project combines intervention research with involvement of the researcher in the project thus enabling the researcher to view and report the findings through her own professional and practice lens.

This thesis presents a qualitative study of genetic counselling. Using a combination of semi-structured interviews and conversation analysis, it focuses on the role, function and structure of genetic counselling and on its status as medical or counselling work. Semi-structured interviews are used to ascertain genetic counsellors' accounts or perceptions of the nature of their role, their views on client expectations, and genetic counselling clients' perceptions and expectations of the same. Conversation analytic study of recorded genetic counselling consultations is used to identify whether or not they possess an overall shape and whether they appear conversationally as a counselling or a medical interaction. Rose's (1998, 1999) sociological work on the growth of the therapeutic community and the techne of 'psy' provides a framework for a discussion on the strength of the genetic counselling profession's association with a Rogerian counselling philosophy and on the potential difficulties this may bring. The questions are raised; does genetic counselling have many similarities to "personal, emotional or psychological" 'counselling' at all? And is this alliance with the counselling community either fair or possible for the professionals involved? The results were as follows. First, that the genetic counselling consultations in this corpus do not present with one unique overall shape that can encompass all interactions. Second, that the accounts of the genetic counsellors and clients in this sample, and the conversation analytic study of the recorded consultations, suggest that genetic counselling is primarily a medical-based activity and that this is what clients want. Third, that genetic counselling has a number of dissimilarities to psychotherapeutic counselling that suggest it is not so much 'counselling' as using counselling skills, and finally, that the tensions incurred in fulfilling medical-type tasks within what is ostensibly a 'counselling' role are neither fair nor practical for the professionals involved.

The central theme of this thesis is infertility. It links different areas of my work as a chartered counselling psychologist working with clients experiencing difficulties conceiving. I currently work in private practice specialising in this area. Previously I worked as an NF counsellor at the Assisted Conception Unit of the Lister Hospital in London. Although the term `infertility' is commonly used, being `infertile' means a total absence of reproductive function and this condition is rare (HFEA, 1999). The majority of people presenting with difficulties in conceiving actually have `sub-fertility', where one or more parts of the reproductive system are impaired. Throughout this thesis the term `infertility' is used to refer to both infertility and sub-fertility. I initially became interested in the psychological impact of infertility when a number of close friends started having difficulties conceiving. I observed that whilst there was a wealth of medical support available, psychological and emotional support was somewhat lacking. This led me to reflect on the counselling psychology of infertility. After conducting a review of the infertility literature it became apparent that research contributions from counselling psychologists were somewhat scant. The main body of literature is comprised of contributions from nurses, medical practitioners, clinical psychologists and counsellors working in the field. Part of my motivation in undertaking this degree was to establish the role that counselling psychology can play in the field of infertility. Linked to this, was the motivation to make a difference and raise the profile of infertility within the field of counselling psychology. The thesis focuses on three different areas of infertility that are all linked to the practice of counselling psychology with this client group. Firstly there is an exploratory piece of research. It focuses on the psychological and emotional impact of the infertility experience and the role of counselling. Secondly there is a case study. This is reflexive exploration which focuses on some of the challenging issues that I encountered in my clinical work with an infertile female client. Finally there is critical review of the literature that explores infertility and counselling from a historical perspective. The review places infertility in a historical context so that the complex psychological aspects of the infertility experience today can be more fully understood and appreciated. An overview of each section is now provided.

Two hundred and eighty participants (113 Chartered Counselling Psychologists, 167 trainees in Counselling Psychology) took part in the project, conducted over 4 years, which aimed at explicating perspectives on what constitutes the discipline of Counselling Psychology. A range of studies employing diverse methodologies are reported which contribute to the overall aim of the project. Research was conceptualised and executed within the constructivist framework and drew heavily upon the Kellian view of the person as co-participant in the research enterprise, capitalising on the human capacity to generate and reflect upon meaning. The results of a series of studies contributing to this project gave rise to an evolving conceptualisation of what constitutes the phenomena of Counselling Psychology from the perspective of both trainees and independent practitioners. Counselling Psychology was described in terms of 5 broad conceptual categories: Counselling Psychologist Contribution; Psychological Theory / Model; Client Contribution; Ethical Codes and Practices; and The Therapeutic Relationship. Amongst the subsidiary findings of the project it was noted that trainees' anticipation of counselling psychology becomes more discriminating and stable with practice experience. The findings of the project are expressed in terms of their implications for achieving the informed consent of consumers of counselling psychology services, the training and education of would-be counselling psychologists, and the monitoring and enhancement of quality standards and evaluation of practice.

The study examined rape counselling, with particular emphasis on countertransference reactions experienced by the counsellors of rape survivors. Four subjects participated in semi-focused, open-ended interviews, which were taped and transcribed verbatim. The phenomenon of countertransference was discussed, and countertransference reactions identified and examined. The management of empathic strain, in order to sustain empathic inquiry and therapeutic efficacy, was discussed. The main results of the study included the identification of common victim themes, and the feelings evoked in the counsellor in the therapeutic relationship. These included feelings of anger, hopelessness, helplessness and sadness, particularly in the counselling of children, who may be HIV positive as a result of the attack, and victims of chronic abuse. Challenges of rape counselling included shortcomings in the system, and rape myths which trivialize the crime and blame the victim. The need for education and enlightenment of both the public and magistrates on the deleterious effects of rape was emphasized by all subjects.

The purpose of this study was to explore whether Indian counsellors and psychotherapists in the UK practice in an indigenous way with their Indian clients. The aim was to find out more information about the different types of Indian indigenous interventions that may currently be used by these professionals. The study also bridges the gap in the literature about the lack of research on the practical uses and applications of Indian indigenous counselling skills in the UK.The study reports data from six face-to-face open-ended semi-structured interviews with Indian counsellors who have been trained in Western psychotherapeutic approaches and have knowledge of Indian psychotherapeutic approaches. The research was analysed using Interpretative Phenomenological Analysis (IPA). Firstly, the analysis concluded the use of several Indian indigenous interventions used by the participants, such as Prekshadhyan which can be used for psychosomatic pain relief, Jain virtue of forgiveness which can be useful for working with sexual abuse, use of spirituality and cultural beliefs for bereavement, and so on. Secondly, the analysis identified some of the most common barriers to therapy (e.g. stigmas and taboos) experienced by Indian clients in the UK, and it provided suggestions on how to overcome these. Finally, the analysis suggested factors that therapists should pay attention to (e.g. client context and use of Indian languages) in order to maximise Indian clients’ engagement in therapy and to minimise their exclusion from it.

Aim: To evaluate the clinical effectiveness of a counselling psychology service in primary care. Method: Comparison of SCL-90R and HAD scores of a group of clients in treatment with those of a control group receiving GP-only care, at four points in time; and with scores while waiting for treatment. The design combines elements of an open trial with elements of a randomised controlled trial, although full randomisation was not possible in practice. The results are expressed in terms of numbers of cases and effect size, as well as in terms of test scores, in an attempt to indicate levels of clinical as well as statistical significance. Comparison of number of visits made to general practitioners by participants in each group during the six months before and after treatment. Results: The results indicate that the service was clinically effective: clients improved significantly after treatment on the scales used, the numbers of 'casee decreased significantly, and the number of visits to the general practitioners also dropped. Compared to the control condition, the treated clients did better on all these indicators, but the difference between the two groups was not great enough to show statistical significance at the 0.1% level required by the use of multiple planned tests, or on MANOVA, although on the major indicators (SCL-90R GSI and HAD Depression and Anxiety) significance was reached at the 5% level. The overall effect size was coculated to be 0.32. As it was 15 greater than zero, it indicates that the service's interventions were more effective than GP-care, but the magnitude of the effect was in the small to medium range. Conclusions: The results of the research demonstrate that the counselling psychology service under study was clinically effective. On all indicators used, clients of the service improved over the period of treatment, and did so to a greater extent than patients in the control condition. However the advantage over the control group was not sufficient for statistical significance at the level required, and this is reflected in the relatively moderate effect size.

Thesis (MSc (Clinical Psychology)) -- University of Limpopo, 2010.
The Clinical Psychology training program at the University of Limpopo (Medunsa Campus) is based on the theoretical paradigm of General Systems Theory. The functioning of systems in terms of patterns, structure, organization and relationships can therefore also be applied to the trainee and his/her partner relationship system which is characterized by circular patterns of interaction. Ernst (2008) states that within the context of General Systems theory it became evident that the trainee does not function in isolation but as part of a system. The trainee undergoes significant changes throughout the training year if training is effective and this in turn may also impact on the trainee's partner relationship. This investigation was done to establish the effect of a DVD Counselling Programme on the partner-relationship of the trainee in Clinical Psychology with his/her partner/spouse. This is done in order to provide feedback to the trainers of the Clinical Psychology training at Medunsa. This may also possibly assist in establishing a more scientifically founded aid for the trainees in Msc. Clinical Psychology and their partners/spouses. It was a qualitative research project, in which person centered interviews were held with participants and thematically analyzed by three independent clinicians. The entire research project and findings are contextualized in accordance with General Systems Theory. The results indicated that the DVD had a moderate effect on 4/6 of the sample population that reported that their relationship improved in respect of the nature and quality based on mutual understanding, emotional closeness, obtaining of relational skills, effective communication and awareness regarding the impact of the training year on their relationship. The impact of the DVD was somewhat limited in that not all the participants watched it and the manner iIi which some of the trainees approached their partners/spouses, which may have had an effect on how the DVD is received and experienced.

Aim. This thesis explores how magical thinking is construed by counselling psychologists working in independent practice in Britain. It considers how magical thinking within counselling psychologists relates to working therapeutically with clients who engage in magical thinking. Background. Magical thinking has been widely researched by a number of disciplines. This includes some applied fields of psychology, but not counselling psychology. Method. In-depth semi-structured interviews were conducted in Britain between July 2011 and February 2012. The purposive sample consisted of eight volunteer chartered counselling psychologists occupying different points on the Magical Ideation Scale (Eckblad and Chapman, 1983). Qualitative data analysis was guided by combining van Manen’s (1990,2002) hermeneutic phenomenology and Romanyshyn’s (2007) alchemical hermeneutics. Findings. Six major themes were identified: therapeutic work; identity and belonging; health and illness; art and science; development, evolution, and transition; sacred and secular. Conclusion. All participants to varying degrees demonstrated magical thinking and had worked with it in their clinical practice. However, their talk about it was linked to feelings of stigma and shame, and fear of judgement by others in the profession. Their approach to working with magical thinking was therefore often hidden. As such, lack of open discussion appears widespread. This means this area of practice will lack training and support, and any clear consensus on good practice. Overcoming barriers to discussing magical thinking within counselling psychology therefore seems an important area for future development. This thesis has made an original contribution in opening up that dialogue.

This portfolio contains a selection of work completed for the Practitioner Doctorate in Counselling Psychology at the University of Wolverhampton. It contains three dossiers: Academic, Therapeutic Development and Research. The Academic Dossier contains papers that were submitted for the following • modules: 'Life-span Approach' and 'Issues and Ethics'. The Therapeutic Development Dossier contains an essay exploring three years of placements ('Supervised Practice') and an essay reflecting on my professional development (,Professional Issues'). Finally, the Research Dossier contains a literature review, a research report and critical appraisal. Confidentiality of clients, research participants and their families have been protected throughout the portfolio. Individuals' names and places have been changed and any potentially identifying information has been omitted or anonymised. Client studies, process reports and all raw data (including interview transcripts) are available in the Confidential Attachment which has been submitted separately and is not available to the public. The work within this portfolio demonstrates my journey from a theory-led, orientation-specific therapist to a client-led, integrative therapist who is continually learning and growing. Within the preface I hope to apply Prochaska and DiClemente's (1986) Stages of Change Theory to my own journey to help demonstrate this change (see Figure 1 below). This is a model I have increasingly attempted to use to inform my therapeutic practice, along with Egan's Skilled Helper Model (2002). The Stages of Change model provides a framework through which we can understand the different stages an individual goes through during the process of any change in attitudes, beliefs and behaviour. The notion of the stages demonstrates that for most a change in behaviour occurs gradually and over time. It must also be recognised that this is a dynamic process and that an individual can move between the stages at different rates and also return to earlier stages. When reflecting on my time completing the Doctorate, I feel that during the last three years I have changed in many areas of my life. My therapeutic stante, my way of interacting with clients and my understanding of working with different client groups have all gone through a process of change which I feel fits in with the Stages of Change model. The work throughout this portfolio will hopefully exhibit how changes have occurred and have helped me become the Counselling Psychologist I am today.

This thesis is presented in four parts: an introduction, a critical literature review, an empirical research study, and a case study. The first part introduces the thesis and highlights the linking theme of ethical practice. It also clarifies the provenance of the research study, introduces the researcher, and comments on the writing style of the thesis. The critical literature review examines the ways in which ethics have been applied to counselling psychology. Firstly, the literature asserting the value-laden nature of therapeutic practice is explored. This is followed by a consideration of principle ethics, the frameworks through which principles have been applied to practice, the advantages of virtue ethics, cultural ethics, and finally the increasing focus on social ethics. The review concludes that a closer engagement with moral philosophy would be beneficial for counselling psychology. The empirical research study explores counselling psychologists' perspectives on professionalism. Following a pilot study involving two participants, fourteen counselling psychologists were interviewed by means of semi-structured interviews. The interviews were transcribed and analysed using social constructionist grounded theory methodology. An overall theme of ethical practice in its widest sense emerged from the data. The main findings were an "arc" of professional identity that emerged from participants' histories of work in social contexts and positions of dissent; a pattern of professional identity involving a stable central core of ethical practice and a penumbra of professional legitimacy; and the identification of tensions between the perspectives of the participants and traditional forms of professionalism. The research concludes that ethical practice is the defining factor of participants' professionalism. Habermas's theory of communicative rationality is suggested as ,a philosophical basis for ethical practice and as an appropriates substitute for the scientist-practitioner model. I The case study explores therapeutic work with a student who had been refused refugee status. It considers the development of a therapeutic relationship in a context of fear and powerlessness. It also reviews the ethical obligations of being a witness in therapeutic and judicial processes.

Controlled drug use is a phenomenon that has been described by previous researchers. There are few such studies which explore the clubbing or gay/bisexual populations . Research frequently looking at gay/bisexual men's drug-taking fails to acknowledge the possibilities of controlled drug use. This study takes a qualitative approach to the data in an attempt to explore the phenomenon as it exists. Eight men who identified as gay/bisexual and took drugs on a controlled basis participated in semi-structured inteNiews. Interpretative Phenomenological Analysis (IPA) was used to analyse the data which indicated master themes emerging from the participants' communicated experiences. These themes related to intra-psychic; identity/interpersonal interaction; and temporal processes. Results show that not all gay/bisexual men's drug use follows a usage-addiction pattern and that controlled drug use is possible. Participants indicated that they were able to control their drug use through an interaction of personality traits, social factors and self-knowledge or monitoring. It is posited that the research enhances the understanding of controlled drug use, especially within the gay/bisexual clubbing sub-culture. Furthermore, it clarifies strategies that could be useful for other drug-taking populations who wish to control their drug use. The cycle of and the reasons for the drug-taking behaviour are possible routes for further research.

This thesis comprises four sections which are as follows: a preface, a critical literature review, an empirical research study and a case study. The first section provides an introduction to the thesis. Within this section, I highlight how the evolution and construction of the research area facilitated the development of the other components within this thesis. I also illustrate how the structure of the sections within this thesis demonstrates the evolution of the research topic area. Finally, I comment upon the writing style I have adopted within this thesis. The critical literature review explores the current status of sex offender treatment programmes within the UK, and the implications this has upon the rehabilitation of rapists. Within this review, I critically explore the literature which details the theoretical underpinnings and effectiveness of sex offender treatment programmes within prison and community settings. I argue that the rapist is a distinct type of sex offender who requires specific, tailored treatment interventions. I attempt to review whether or not the specific rehabilitative needs of the rapist are being addressed within the current status of sex offender treatment programmes. In the empirical research study, I adopt a social constructionist epistemology which is informed by a critical realist position. I explore the discourses of unmarried secondgeneration South Asian women, with regard to their disclosure processes within their families and communities. I questioned four unmarried South Asian women using semi-structured interviews. The interviews were transcribed and the women's talk was analysed by a method of discourse analysis. The analysis of the women's talk revealed four discourses of disclosure practices: political discourse, disparity discourse, conflict discourse and discourse of individualism and collectivism. Further analysis of the emerging discourses revealed various subject positions and implications for subjectivity and practice. The research study concludes with a section detailing reflections and recommendations for practice emerging from the analysis of the women's discourse. The case study is a reflexive exploration of therapeutic work with a South Asian female client. In this case study, I illustrate working within a cognitive behavioural approach whilst facilitating the client's disclosure within therapy. I also highlight how the therapeutic relationship is affected by the client's disclosure processes.

Introduction; The inflammatory bowel diseases (IBD), Crohn's disease (CD) and ulcerative colitis (UC), affect well over 100,000 people in the United Kingdom Health related quality of life (HRQOL) is influenced by many factors in IBD including; the nature and severity of the disease, socio-economic factors, age, psychological well-being as well as· the efficacy and complications of treatment. Pilot Studies; Quality of life was assessed in 140 IBD patients (70 CD/70 UC). Diarrhoea was, not surprisingly, the most commonly reported physical symptom in both CD and UC and impaired faecal continence caused great social disability, with 72% CD patients and 68% UC patients reporting urgency or incontinence. Over a third of all patients reported occupational problems associated with their disease. Anxiety, but not depression, was common in the CD group and a major source of anxiety in many cases was lack of information. Three-quarters of patients felt additional information would have enabled them to cope with their chronic illness. It is a common perception that the provision of psychological support, such as the use of counselling skills, may alleviate many of the psychosocial problems associated with IBD, but this has not yet been proven. Hypothesis: That a nurse led counselling service improves HRQOL in IB D patients. Study Group/Design: Fifty patients with CD (aged 16-64, 33 females), 50 UC patients (aged 17-60, 26 females), 50 healthy volunteers (HV, aged 17- 61, 27 females) and a disease control group comprising 28 psoriatic arthritis (PS) patients (aged 22-66, 16 females) undeiwent structured interviews and completed a range of questionnaires measuring several facets of quality of life and psychological well-being (Hospital Anxiety and Depression Score (HAD), Attitudes and Preferences (AP), Styles and Strategies (SS) and Short-form 36 (SF36)). Patients with IBD were then randomised to receive either a counselling package or routine clinical follow-up. The counselling package consisted of disease specific information and teaching of stress management techniques, based on the "Challenge to change" programme devised by Dr. Derek Roger at the University of York. HRQOL scores were compared on entry at 6 and 12 months. Results; At baseline the scores for all questionnaires were within the nonnal range in the UC, PS, and HV groups. However CD patients recorded significantly higher anxiety scores (p