John Lees

Reflexive action research: Developing knowledge through practice

This paper gives an overview of different ways of conducting counselling and psychotherapy research. An approach to research is described which overcomes the research-practice gap: reflexive action research. It is argued that this approach to research is particularly appropriate and relevant for practitioners since it draws upon skills and awareness necessary for clinical work, and can complement positivist methods of research which are already well established in the profession. The wider use of systematic clinical case studies is suggested as a means of promoting the reflexive action research approach. Further consideration of issues of validity and reliability is required on the part of those intending to apply this approach within the field of therapy research.

Counselling and psychotherapy in dialogue with complementary and alternative medicine

ABSTRACT Counselling and psychotherapy is attracting government interest and intervention, for instance the proposal to regulate the profession by the Health Professions Council. Many therapists see this as a threat to its fundamental principles due to the fact that government policy is influenced by the medical model and managerialism. This article looks, in particular, at the relationship between the therapy profession and the medical model. It concludes that the concerns about the current plans for regulation make some important points but that the proposed changes have created possibilities for developing a vision for the future of the profession. This article will enter this debate and will argue, in particular, for the cross-fertilisation of ideas between therapists and such humanistically orientated approaches to medicine as complementary and alternative medicine (CAM). The argument will be developed with reference to one form of CAM, known as anthroposophic medicine and therapy.

Practitioner-Based Research: Power, Discourse and Transformation

Practitioner-Based Research is concerned, in particular, with the research which is undertaken by healthcare practitioners and the evidence which they generate as a result of investigating their practice. In so doing it recognizes that, as well as working in academic life, practitioner researchers are often working as practitioners outside the Academy. It argues that the work of practitioner researchers has a significant contribution to make to healthcare research and so needs to be disseminated further in order to create balanced research communities within the healthcare professions.This book will help academic researchers to broaden the limited ontological and epistemological perspectives of their research. It will also encourage healthcare practitioners who have not been trained academically to develop their research skills and to realize that they are actually researching in their practice on a day-to-day basis. Finally, it will provide a degree of transparency about therapeutic processes to help clients and patients to see aspects of professional practice and development which are usually hidden from them. The contributors cover a wide range of themes, such as the limitations of academic life and conventional medical models; ethics; the importance of imaginative writing and the use of story; metaphor and myth; the importance of personal transformation in the professional development of healthcare workers; and the relevance of belief and spirituality to healthcare research.

Narrative approaches in mental health: Preserving the emancipatory tradition

Narrative approaches have exercised an emancipatory influence within mental health. In this article, it is suggested that there is a risk that the emancipatory tradition associated with narrative may be co-opted through contemporary mental health strategy by a narrow agenda which promotes a particular Western and neoliberal form of citizenship. This may limit the way recovery can be imagined by equating it solely with the future-orientated individual who strives, above all, to be economically independent. To resist this, it is suggested that narrative in mental health should be approached with recourse to therapeutic thinking which promotes a relational ethos of ‘recovery together’. The ‘recovery together’ model is subsequently considered in relation to narrative research on temporal understandings which have been conducted in disability studies and in the area of chronic illness. These studies point towards the value of a relational orientation towards well-being in the present, rather than fixating on future goals. It is suggested that a relational philosophy of the present might be usefully incorporated into narrative approaches when working therapeutically with people suffering from mental distress. It is argued that this might enable users and practitioners to extend the available narrative templates and to imagine recovery in diverse ways which support personal transformation and, ultimately, contribute to social change.

A history of psychoanalytic research

This paper surveys the history of psychoanalytic research from Freud until the present day and identifies a dominant research stream which has existed since Freuds day. It then identifies two further stands of research and concludes by elaborating briefly on an approach to research which I have referred to as psychotherapeutic.

An approach to counselling in GP surgeries

Abstract A discussion of the various elements which influence counselling in GP surgeries - clients, organizational culture, and the counsellors professional development. The article will examine these elements in the light of some basic psychodynamic theory. It will argue that there are aspects of working in this setting that are common to all situations, and that there are also aspects which are unique to each setting.

Dreaming the research process: a psychotherapeutic contribution to the culture of healthcare research

This paper challenges the neglect of psychotherapeutic methods in therapy research and discusses the use of methods arising directly from therapy practice to generate research data. Recent developments in therapy research culture are critiqued in order to contextualise the present contribution. The research design and methodology evolve from the scrutiny of a dream sequence, using Jungian analytic techniques as a means of data analysis. Methods familiar in psychotherapy practice are found to generate data and offer a meta-commentary on the research process, also enabling the researcher to continue a journey of individuation through healing splits between binary opposites of internal and external, psychological and spiritual, research and practice. Stories emerging from one individuals experience may resonate with others and suggest different ways of engaging in reflexive research practices, which can contribute to healing a perceived split between therapy research and practice.

Cognitive-behavioural therapy and evidence based practice: past, present and future

In this article I look at the fact that cognitive-behavioural therapy and evidence-based practice are currently favoured by the Government and healthcare authorities and that this is a cause for anxiety and concern amongst some therapists. I argue for developing an approach to current debates about these approaches to clinical practice in the counselling and psychotherapy profession based on the principles of the evolution of consciousness. In particular I take the view that our understanding of such developments can be transformed if we adopt a broader evolutionary perspective.

Developing therapist self‐understanding through research

This paper explores the application of reflexive action research in practice by examining a piece of the authors previously published work. A process of inquiry is described that involves reflexively engaging with original formulations in order to further continuing professional development. Guidelines for conducting this kind of research are described.

Microphenomena research, intersubjectivity and client as self-healer

This article describes an approach to counselling and psychotherapy which complements dominant discourse approaches to clinical evaluation based on New Public Management systems which underpin the Improved Access to Psychological Therapies scheme within the field of therapy. It is based on an approach to research and practice development which I will call practitioner microphenomena research. In order to demonstrate the method, I will examine an extract from a single case study of a client with major depressive disorder from the point of view of intersubjective theory and a little-known approach to therapy called anthroposophic psychotherapy based on the work of Rudolf Steiner. I will show how the two clinical methods are well suited to examining the microphenomena of practice and can be integrated into a coherent whole. A central feature of the account will be the anthroposophical view about the central importance of our individuality or ‘I’ which has similarities with the Jungian self but is still distinct from it.