Terry Hanley

The working alliance in online therapy with young people: preliminary findings

ABSTRACT This paper examines the quality of the working alliance in online counselling relationships with young people. A mixed method approach has been adopted which combines the completion of a self-report quantitative measure (the ‘Therapeutic Alliance Quality Scale’) and qualitative interviews with service users of a UK-based service (Kooth.com). Findings are generally positive, with approximately three quarters of respondents reporting the working alliance to have been of a medium or high quality. To give a more detailed sense of what users found helpful or unhelpful in developing good quality online working alliances, key themes from the interviews are also presented. Finally the implications and limitations of the study are discussed before outlining some thoughts for future development.

Involuntarily childless men and the desire for fatherhood

Objective: This study aims to explore the experience of childless men and the desire for fatherhood. Background: There is little research exploring the desire for fatherhood, with most studies concentrating on couples in infertility treatment. Of those, the majority focus on the women’s experience, a factor that may reflect the gender stereotype and cultural identification of childlessness to women. Methods: A qualitative approach was adopted. A convenience sample of 10 biologically childless men were recruited through the snowball method and interviewed individually. The interviews were transcribed verbatim and transcripts were then analysed using Grounded Theory. Results: A core category, ‘Lifescape’s of childless men: enduring anticipation and expectation in an uncharted world’, divided into three meta themes: Emotive Forces, Extant Agency, and Life Course. The desire for parenthood appeared to peak in the 30s, gradually reduced, but did not cease. The participants also revealed a sense of ‘outsiderness’ in familial, social, and work relationships. Conclusion: Involuntarily childless men reported similar experiences to those in, or who have had, infertility treatment. These included a sense of loss, depression, exclusion, isolation, and risk‐taking behaviour. Over the life course the men also found ways to adapt and reappraise their beliefs concerning themselves emotionally, psychologically and socially. To help understand this process, gender‐role therapy is presented as a possible approach for working with childless men.

A five-year evaluation of the effectiveness of person-centred counselling in routine clinical practice in primary care

Counselling is the recommended treatment for individuals with mild to moderate mental health problems of recent onset. In this evaluation of a primary care counselling service offering person-centred counselling, the Core Outcome Measure (CORE-OM) was administered at referral and at the beginning and end of therapy. A pre-post therapy effect size for 697 individuals over a 5 year period was 1.2. This compares with a waitlist (between referral and pre therapy) effect size of 0.24 for 382 individuals over a three year period. The results indicate that person-centred counselling is effective for clients with common mental health problems, such as anxiety and depression. Effectiveness is not limited to individuals with mild to moderate symptoms of recent onset, but extends to people with moderate to severe symptoms of longer duration.

Developing youth-friendly online counselling services in the United Kingdom: A small scale investigation into the views of practitioners

This study focused upon the development of online counselling services for young people in the UK. It used online forums to host an asynchronous focus group with the intention of bringing together the views of a small sample of counsellors and counsellors in training regarding the subject matter. The focus group lasted a one-month period and initiated 10 threads of discussion and received 41 message postings. These dialogues were analysed using a Grounded Theory approach. Findings suggested that although there is a great potential for offering therapy in this medium, services need to be appropriately regulated and good practice promoted. Issues around where the parameters of regulation should lie are discussed and recommendations for the minimum requirements of training or experience that counsellors working in this field should possess are made.

Understanding the online therapeutic alliance through the eyes of adolescent service users

Abstract Aims: The therapeutic alliance is a concept that has received a great deal of attention within face-to-face counselling. Furthermore, links have been made between the creation of strong alliances and successful therapeutic outcomes. This study examines the therapeutic alliance when counselling services are offered online to young people. Method: Fifteen young people took part in online interviews (utilising synchronous and asynchronous methods), and Grounded Theory techniques were utilised to analyse the data. Findings: A core category of ‘Client-Service Match’ and three subcategories pertinent to the individuals’ experiences of creating good quality relationships with the counsellors were identified: (1) initial engagement, (2) developing rapport, and (3) establishing control. Discussion: The themes elicited are all relevant to the matching process and viewed as a chronological process similar to face-to-face counselling. However, unlike face-to-face work, specific nuances related to the online ...

Adapting cognitive behavioral therapy to meet the needs of Chinese clients: Opportunities and challenges

With the growing influence of China (Chinese people/culture) on the worlds politics, economy, and culture, the psychological wellbeing of Chinese people is becoming increasingly important for both researchers and practitioners. Despite this, the cultural responsiveness of many conventional psychotherapeutic models has often been brought into question. In contrast, cognitive behavioral therapy (CBT) is rapidly becoming one of the most popular approaches in the mental health service industry and has been successfully adapted into many different cultural contexts. The current article is a theoretical discussion of the opportunities and challenges that CBT faces with respect to how it might meet the cultural needs and preferences of Chinese clients. Suggestions for successful cultural adaptation are offered based on existing research and practices. It is concluded that many features of CBT appear to match well with the Chinese cultural perspective. However, despite this promising start further work is needed to focus specifically on its practical effectiveness for Chinese clients.

Practice-based evidence in school-based counselling

Abstract Aims: Counsellors are becoming commonplace within the support structures of secondary schools. To date, research findings from practice-based outcome studies suggest this is a positive move. There are, however, numerous limitations to this work, and this project aims to develop this existing body of literature. Method: Nine 13–15 year olds attending counselling in six school-based services participated in the project – one individual withdrew. A standardised self-report questionnaire (YP-CORE) was collected at four intervals: (1) the point of referral; (2) the onset of counselling; (3) the completion of counselling; and, (4) a two-month follow-up. The change indicated in each of these phases is examined and reported here. Additionally, YP-CORE was completed during each session. Findings: The YP-CORE indicates an improvement in the well-being of this small sample, while waiting for and attending therapy. Further examination of session-by-session data also highlights how pre- and post-outcome data ...

Technically incompetent or generally misguided: Learning from a failed counselling research project

In a world that is becoming consistently more dependent upon technology, this paper intends to urge researchers to be appropriately cautious when designing projects that utilise new media. It does this by frankly discussing a research project that turned out to be a resounding failure due to a lack of forward thinking. The study intended to recreate face-to-face interviews with UK-based Quaker counsellors using email to contact counterparts in the US. A discussion regarding this failure is entered into and suggestions for avoiding similar mishaps in the future are made. Finally the culture of researchers only reporting success stories is challenged.

Education, Welfare Reform and Psychological Well-Being: A Critical Psychology Perspective

ABSTRACT There are established links between education and well-being, and between poverty and education. This article draws on interviews with parents of school-aged children impacted by a policy in the UK commonly referred to as the ‘bedroom tax’. A critical psychology perspective to education is put forward, acknowledging the complex interrelationships between psychological well-being, sociopolitical factors and education.

Examining the complexities of measuring effectiveness of online counselling for young people using routine evaluation data

As mental health services for young people develop, the need for evaluation and audit to justify expenditure follows suit. Counselling is being provided in more and more schools and community settings across the country, and there is an increasing focus on evidence-based funding. Practice-based evidence has an important role to play in fulfilling this requirement, and there are calls for a single outcome measure to be utilised across services. The emerging frontier of online support is receiving steadily greater attention, but as yet it has had little attention with regards to its effectiveness. An existing routine evaluation and outcome measure (Young Person’s Clinical Outcome Measures in Routine Evaluation) was incorporated within other routine evaluation systems within an online support service for young people (Kooth). The findings have been examined, with a view to recommending most suitable evaluation tools for this medium. Initial data suggest that the online service, when compared with equivalent face-to-face data, attracts a wide range of needs and levels of distress, with a high proportion of complex needs presented. Such findings may also reflect the complex nature of the support needs for the client group in question. Capturing appropriately rich data using a range of qualitative and quantitative measures that account for the complex online environment and client group needs to be carefully considered.