Naomi Moller

Preventive Resources and Emotion Regulation Expectancies as Mediators Between Attachment and College Students' Stress Outcomes

In this study the authors examined both preventive psychological coping resources and negative mood regulation expectancies as potential mediators between parental attachment and two types of stress outcomes: stress symptoms and stress-produced emotions. Data were collected from 390 college students and separate structural equation models were tested for the outcomes of stress symptoms and emotions. Results suggested that for both models, as hypothesized, preventive resources and negative mood regulation expectancies functioned as mediators. Further, there was evidence that these results were similar for the model in which stress symptoms were used as an outcome, as well as the model in which stress-produced emotions were used as the outcome. Implications for a more complete understanding of psychological resources promoted by secure attachment are discussed. Copyright 2006 by the American Psychological Association.

Risky business or safety net? Trainee perceptions of personal therapy: a qualitative thematic analysis

Participation in personal therapy during training is required by British accreditation bodies for counselling psychology as well as by most psychotherapy trainings. By contrast, trainee clinical psychologists are not required to undertake personal therapy, although they may elect to. Prior research in Britain and the US suggests that practitioners have a wide range of motives for entering therapy as well as motives for not doing so (Norcross & Connor, 2005). This study addresses the fact that no research to date has specifically explored what individuals beginning their counselling psychology, clinical psychology and counselling training think and feel about participation in personal therapy during training. Data from open-ended questionnaires was analysed using inductive thematic analysis. Two main themes were identified. These consisted of: ‘Personal therapy helps me to be a better practitioner’, and ‘Personal therapy costs me’. The study results are considered in light of the limited prior research and recommendations for training are made.

New students’ psychological well-being and its relation to first year academic performance in a UK university

Abstract Aims: This study (1) profiled the well-being of first year students entering one UK university, and (2) explored whether initial well-being and year end academic performance were correlated. Method: A total of 117 students (mean age 21, 67% female) completed the Rosenberg Self-Esteem Scale, Clinical Outcomes in Routine Evaluation-General Population, and Liebowitz Social Anxiety Scale; academic achievement data were collected from academic records. Results: Almost a quarter of the sample reported quasi-clinical levels of psychological distress and moderate to very severe social anxiety. Quasi-clinical levels of psychological distress were associated with low self-esteem and social anxiety. No statistically significant links were found between well-being as assessed at the beginning of the first year and academic achievement at the end of the first year. Discussion: The failure to find a link in this study between initial well-being and academic performance at the end of the first year suggests tha...

Defining Infidelity in Research and Couple Counseling: A Qualitative Study

Infidelity can destroy relationships, but there is long-standing debate in the field about how best to define the construct. A clear definition of infidelity is important theoretically, empirically, and therapeutically; however, research on the topic is limited. This study explores how seven experienced couple counselors define infidelity on the basis of their work with heterosexual couples presenting with this issue. Thematic analysis was used to analyze interview transcripts and research findings suggest a rich web of conflicting definitions of infidelity for couples counselors and, in their accounts, clients. The findings support an understanding of infidelity as socially constructed and the implications of this for the field are discussed.

‘Eating disorders are not about food, they’re about life’: Client perspectives on anorexia nervosa treatment

Poor success rates and high levels of dropout are common features in the treatment of anorexia nervosa. Using semi-structured interviews, this study elicited the views of 12 women who were recovered, or in recovery, for anorexia nervosa and had received treatment. Results derived from a thematic analysis revealed the women’s high degree of dissatisfaction with treatment and their perception that the treatment system is overly focused on, and driven by, food and weight. In contrast, what the women really wanted was to be seen and treated as a ‘whole person’ and to have a ‘real’ relationship with their therapist.

“If I See Somebody … I'll Immediately Scope Them Out”: Anorexia Nervosa Clients’ Perceptions of Their Therapists’ Body

Although people with eating disorders are known to observe and assess body related stimuli, research has yet to explore these behaviors in the therapy room. Consequently, practitioners do not know if their bodies are having an impact on their clients or the therapy process. This lack of knowledge is problematic given the poor recovery rates and high levels of drop-out in eating disorders treatment. Using semi-structured interviews this study investigated the beliefs and experiences of 11 women diagnosed with anorexia nervosa or bulimia nervosa with a history of restricting, who had received counseling from a female therapist. Results derived from thematic analysis suggest that the patients not only observed, speculated, and made assumptions about their therapists’ bodies but also that their assumptions and speculations had the potential to influence both their beliefs about the therapists ability to help them, and their willingness to engage in therapy.

“The relationship past can't be the future”: couple counsellors' experiences of working with infidelity

Infidelity is both common and difficult to work with therapeutically, but little research to date has examined the experiences of those who work with this presenting problem. This study explores couple counsellors’ experiences of working with couples affected by infidelity. Semi-structured interviews were conducted with seven experienced couple counsellors working for a nation-wide relationship counselling organisation in the United Kingdom. A thematic analysis of the interview transcripts revealed a shared pattern of experiences and challenges, providing greater insight into the specific constellations and difficulties practitioners face when working with issues around infidelity. Practical implications for working with this presenting problem are discussed as well as the potential impact of counsellors’ own implicit theories on their practice with infidelity.

Recording therapy sessions: What do clients and therapists really think?

Aims: Recording therapy sessions has become part of routine practice amongst trainee psychotherapists. To date most research has focused on the benefits of recording sessions to support clinical supervision. There are few data about the benefits or risks for clients. This study aimed to explore the views of clients who had had their therapy sessions recorded and therapists who had recorded sessions. Design: Five clients and 25 therapists completed a qualitative survey, the results of which were analysed using thematic analysis. Findings: All clients and several therapists reported that the recording devices are soon forgotten. Both therapists and clients reported the benefits of recording as being purely for the therapist with none identified for clients. Conclusions: It was observed that clients perhaps did not always understand how recordings were used, suggesting the need for clearer practice guidance.

The good, the bad and the uncertainty: Trainees' perceptions of the personal development group

AbstractBackground: Views about the purpose and role of personal development groups (PD group) in the counsellor training process are varied. Some argue they enhance self-awareness, self-exploration, the ability to be congruent and, ultimately, that they make for better practitioners. Others argue there is no clear evidence for such benefits and that they can actually be damaging to trainees. Aims: This study aimed to explore the beliefs of 25 trainees enrolled on counselling diploma or counselling psychology doctoral courses. It looked in particular at their perceptions of the purpose of PD groups and their expectations regarding support, difficulties and the scope of their participation. Method: Data was collected using open-ended questions in an anonymous survey and was subjected to a thematic analysis. Results: Trainees appeared to hold mixed – and sometimes conflicting – views about the PD group. For some it was a positive endeavour that facilitated learning about self and clients, and helped in the ...

How should we evaluate research on counselling and the treatment of depression? A case study on how the National Institute for Health and Care Excellence's draft 2018 guideline for depression considered what counts as best evidence

Abstract Background Health guidelines are developed to improve patient care by ensuring the most recent and ‘best available evidence’ is used to guide treatment recommendations. The National Institute for Health and Care Excellences (NICEs ) guideline development methodology acknowledges that evidence needed to answer one question (treatment efficacy) may be different from evidence needed to answer another (cost‐effectiveness, treatment acceptability to patients). This review uses counselling in the treatment of depression as a case study, and interrogates the constructs of ‘best’ evidence and ‘best’ guideline methodologies. Method The review comprises six sections: (i) implications of diverse definitions of counselling in research; (ii) research findings from meta‐analyses and randomised controlled trials (RCTs); (iii) limitations to trials‐based evidence; (iv) findings from large routine outcome datasets; (v) the inclusion of qualitative research that emphasises service‐user voices; and (vi) conclusions and recommendations. Results Research from meta‐analyses and RCTs contained in the draft 2018 NICE Guideline is limited but positive in relation to the effectiveness of counselling in the treatment for depression. The weight of evidence suggests little, if any, advantage to cognitive behaviour therapy (CBT) over counselling once risk of bias and researcher allegiance are taken into account. A growing body of evidence from large NHS data sets also evidences that, for depression, counselling is as effective as CBT and cost‐effective when delivered in NHS settings. Conclusion Specifications in NICEs updated guideline procedures allow for data other than RCTs and meta‐analyses to be included. Accordingly, there is a need to include large standardised collected data sets from routine practice as well as the voice of patients via high‐quality qualitative research.