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Helpful and unhelpful aspects of school-based humanistic counselling and pastoral care in secondary schools

Overarching aim

The project is working to understand why some clients benefit more than others from school-based humanistic counselling (SBHC). The ETHOS process model of SBHC¹ suggests that it's the client’s ability and willingness to talk about their genuine emotions and experiences, facilitated by the counsellor’s interventions and qualities, that's fundamental in bringing about change. 

Study 1 - Helpful and unhelpful aspects of school-based humanistic counselling (SBHC) compared to pastoral care as usual (PCAU): Thematic analysis using data from the Experience of Service Questionnaire (ESQ).

Young people in both the SBHC and PCAU arms of the ETHOS trial completed the ESQ either in relation to their counsellor (SBHC) or to their primary pastoral care figure (PCAU). Qualitative answers to the questions 'What was really good about your care?' and 'Was there anything you didn’t like or anything that needs improving?' will be thematically analysed, and compared. Comparing helpful and unhelpful factors in both conditions will identify the unique elements of the counselling relationship that client’s value, while also establishing whether these elements are consistent with those proposed in the ETHOS model.

Study 2 - Comparing two pragmatic case studies of SBHC: a good outcome case vs a poor outcome case.

Two SBHC cases from the ETHOS trial will be systematically compared using the Individual Case Comparison method², a type of pragmatic case study. Process measures will be applied to therapy transcripts from each case to investigate the impact of the counsellor’s activities on the client’s willingness and ability to talk about emotions and experiences. Subsequently, on their outcomes. Specifically, this study is interested in:

• which therapeutic strategies, interventions, and counsellor qualities, positively influenced the client’s involvement and depth of emotional experiencing?
• which ones hindered it?
• is this consistent with the model?
• will the client’s involvement and depth of emotional experiencing predict their outcomes, as the process model would suggest?

"I've adopted a mixed methods approach, and to enable triangulation of the data, the project is comprised of two studies that'll investigate the assumptions made in the ETHOS model."

Development of a competency framework for person-centred experiential therapy for post-traumatic stress (PCE-PTS)

Until now, humanistic therapies have not been given the recognition, or approval that they might warrant within this field. Despite existing research proposing that relational therapies contribute to good outcome cases, there is not a defined set of competences that can be tested using a RCT methodology. The study, delivered in two parts, will provide evidenced based outcome research demonstrating the impact of person-centred experiential therapy within the field of trauma counselling. 

NICE approved therapies for trauma are CBT and EMDR. These therapies are time-boundaried, exposure focused or based on cognitive modification strategies, and while suitable for PTSD, their efficacy when working with complex trauma presentations has been questioned. By providing the necessary research evidence it is hoped that person-centred therapy will become a NICE approved therapy for people who are dealing with the psychological impact of traumatic events. It can then be made more widely available and accessible to those that require it, through IAPT and NHS practitioners.

This research will bridge the widening gap between the medical model language of diagnosis, dysfunction and disorder, and the person-centred language of growth. It specifically looks at understanding how person-centred therapy facilitates post traumatic growth, providing a researched evidence base that will examine its effectiveness and efficacy. It helps to ensure that humanistic therapies become approved therapies for trauma.

The methodology is designed to develop an articulation and understanding of the necessary competencies, when working with these clients. The competency framework will be researched using good outcome cases and developed ideographically, creating a standardised baseline for good practice. The tangible outcome of this research and proposed impact will be a manual and training course deliverable to humanistic therapists wishing to work within this field. It will ensuring that traumatised clients are receiving the best possible therapy, to facilitate a higher proportion of good outcome cases.

"Receiving the studentship is such an incredible opportunity for me. I am committed to achieving what I have set out to do, and I am delighted to do it with the support of the Ïã¸ÛÁùºÏ²Ê¾«×¼×ÊÁÏ and the Centre of Human Flourishing at The University of Nottingham. Having worked with many clients who have experienced trauma, this work is dedicated to them and their sheer determination to recover and grow."

The role of competences in person-centred experiential therapy and their impact on the effectiveness of counsellors

Person-centred experiential therapy (PCET) is based on a humanistic model of brief psychological therapy developed to help adult clients who are experiencing depression, and is delivered in England within the Improving Access to Psychological Therapies (IAPT) service. Within IAPT, PCET is labelled Counselling for Depression (CfD). Since 2011, five-day CfD training courses have been delivered by a select number of university centres, followed by supervision and assessment of recordings of live PCET sessions.

Trained PCET counsellors working in IAPT services are using the model in their everyday practice and there is a need for the effectiveness of this training to be evaluated, in terms of both therapist competences and client outcomes. The proposed research will investigate these two critical aspects of the effectiveness of the PCET model using qualitative and quantitative methodologies.

Qualitative methods will be used to investigate the delivery of PCET training, focusing on similarities and differences between training sites, and in particular on the role of person-centred and emotion focused competences. It will also explore the experience of trainees, and the impact of training on their competences. PCET competences will be further examined through the analysis of session recordings from the PCET arm of the PRaCTICED trial, which compared PCET with CBT, by contrasting good and less good client outcome cases with specific reference to clients experiencing more severe depression.

Quantitative methods will be used to measure potential differences in client outcomes for therapists pre- and post-training in PCET as compared with general counselling.

"The research will be carried out in collaboration with the training centres and will bring a specific focus to the key components of PCET. The aim will be to capture the challenges in PCET training and delivery of the model, provide recommendations to training providers and counsellors, and to determine the potential therapeutic gains for clients in response to PCET."

Black British men’s perceptions of therapy: A grounded theory study

Potential research questions

• What are the perceptions of Black British men towards therapy?
• What are Black men’s thoughts and perspectives on therapy?
• What are the implications for Psychotherapeutic theory and practice?

Overarching aim

There has been a recent surge of interest into the mental health and wellbeing of men, and their corresponding coping mechanisms. Although research in the UK is starting to acknowledge men’s challenges to engage in therapy, studies have yet to explore or consider Black men’s perceptions of therapy.

The overarching aim for my proposed qualitative study is to contribute literature focusing on Black British men’s general, individual and collective perceptions of therapy. Precisely, these will be themes that emerge from questions probed in regards to thoughts and perspectives of therapy; and in what way the psychological processes of Black men’s perspectives towards therapy have implications for psychotherapeutic theory and practice. 

"I am honoured to be given the opportunity to produce research at this level, with the backing of the Ïã¸ÛÁùºÏ²Ê¾«×¼×ÊÁÏ, on an under-represented area in psychotherapy. This opportunity will help to shed light on the area of men and therapy, with the aim of providing practitioners with insight in to positive practices to better engage men in psychological therapies."

The role of therapeutic alliance in psychological therapies for adolescent depression

Abstract

While the efficacy of psychotherapy has been established, little is known about how therapeutic change is facilitated, especially in adolescence. The therapeutic alliance is considered an active agent of change across most psychotherapies.

This study aims to:

1. investigate if early alliance predicts symptom change in psychotherapy for adolescents with depression, and whether patients’ characteristics moderate the alliance–outcome relation
2. compare trajectories/patterns of alliance during treatment and explore their relationship to symptom change
3. describe the development of the alliance, including ruptures and resolutions, and explore how patients and therapists negotiate this over treatment.

The setting for this study is the Improving Mood with Psychoanalytic and Cognitive Therapies (IMPACT) trial, in which 465 adolescents with diagnosis of major depression were randomised to receive cognitive-behavioural therapy, short-term psychoanalytic psychotherapy and brief psychological intervention. Data includes audio recordings of therapy sessions, patient and therapist evaluated alliance, a battery of outcome measures and in-depth qualitative interviews with patients and their therapists. The use of self-report, observational and qualitative data will allow a mixed-methods, multi-perspective, longitudinal description of the alliance and its link to psychotherapy process and outcome.

"I am very excited to undertake research in psychotherapy in collaboration with Ïã¸ÛÁùºÏ²Ê¾«×¼×ÊÁÏ, due to our common interest in improving counselling and psychotherapy for young people with relevant research. Studying more closely specific dimensions of change, such as therapeutic alliance, might help to gain a better understanding of psychotherapy change mechanisms and outcomes, which would impact upon and improve the provision and delivery of psychological therapies for adolescents."