European Journal for Qualitative Research in Psychotherapy
The mission of the European Journal for Qualitative Research in Psychotherapy is to provide an accessible forum for research that advances the theory and practice of psychotherapy in Europe and throughout the rest of the world. We welcome contributions from diverse methodological and theoretical standpoints, as well as relevant literature reviews, critical explorations of methodology, and philosophical research. Submissions of qualitative empirical research are particularly encouraged along with examples of practitioner-orientated work. ISSN: 1756-7599
European Association for Integrative Psychotherapy
The copyright of content in the European Journal for Qualitative Research in Psychotherapy is retained by the author(s), with first publication rights granted to the Journal. Journal articles are published as Open Access under a Creative Commons License which allows free download and use of the articles with appropriate attribution (to both the author and European Journal for Qualitative Research in Psychotherapy) for educational and other non-commercial use.
Creative engagement with the voices of person-centred therapists: Using poetic illuminations to overcome data fragmentation and to highlight the nuances of lived experience
Increasingly, creative forms of data representation are being utilised within qualitative research as a way of gaining deep, varied and nuanced knowledge of a phenomenon (Amos, 2019; Johnson et al., 2013). A poetic illumination (Scott, 2024) is an analytic and representational technique whereby the words of participants are condensed and transformed by the researcher into a poem (Glesne, 1997; Ohlen, 2003; Sanders & Lamm, 2022; Shinebourne, 2012; Sparkes & Douglas, 2007). Using poetry to represent the person can support researchers in creating intricate representations of human life and lived experience whilst also offering the potential to explicitly recognise the engagement of the researcher in the data (Amos, 2019; Johnson et al., 2013; Glesne, 1997). In this paper, we reflect on the first author’s experiences of using poetry to highlight the nuances of lived experience and to overcome data fragmentation (Blundell & Oakley, 2023). It draws on data from the first author’s doctoral research into the lived experiences of person-centred therapists who work with primary-aged children in school-based counselling services.
Copyright (c) 2025 Krystal Scott, Peter Blundell (Author) https://creativecommons.org/licenses/by-nc/4.0
Why do therapists work in prisons, and what is their lived experience of doing so?
The aim of this study is to uncover the lived experience of psychotherapists and counsellors working in prisons and their motivations for doing so. A series of semi-structured interviews with three therapists who have worked in the English prison system were undertaken. An interpretive phenomenological analysis (IPA) method was chosen for this study as it facilitates an understanding of the meanings attributed by participants to their unique lived experience. The close analysis of each interview identified three group experiential themes: the draw to working with prisoners, the need to adapt, and the view of people who commit crimes. Participants felt a strong draw to the work before having any experience working within a prison setting, explicating a specific draw to the types of clients they would be working with. Working in a prison environment was found to be challenging but worthwhile, with a unanimous felt sense of empathy for the people they encountered. Participants believed lived experience to be significantly linked to offending, and their experience of working in prisons enhanced this view. The findings of this study highlight the challenges faced by both therapists and prisoners within prisons, implicating systematic changes which could improve the experience for both.
Copyright (c) 2025 Daniel Robinson (Author) https://creativecommons.org/licenses/by-nc/4.0
Reflecting on qualitative survey psychotherapy research: A feminist phronetic case study
This reflective commentary offers a case study of being an experienced qualitative researcher conducting psychotherapy research as a novice practitioner. I focus on the blending of insider-outsider positions, drawing on a feminist phronetic approach which entails prioritising the particular and the context-specific. In so doing, I foreground the importance of thoroughly reflecting on research processes as a mechanism for linking research to practice. This case study also highlights that, rather than understanding insider-outsider positionality in dichotomous terms, a beyond binary approach can allow for different configurations of the professional self to inform praxis. Moreover, this reflection elucidates the advantages and disadvantages of qualitative survey methods, an underutilised but fruitful method for conducting psychotherapy research.
Copyright (c) 2025 Elizabeth Peel (Author) https://creativecommons.org/licenses/by-nc/4.0
Exploring service users, families, and professionals’ experiences with Open Dialogue in a Portuguese psychosocial rehabilitation unit
Open Dialogue is a collaborative approach that emphasizes the involvement of the person at the center of concern (PCC), their family, and professionals in network meetings to foster mutual understanding and joint decision-making. This study explores the experiences of these three groups during the implementation of Open Dialogue in a Portuguese Psychosocial Rehabilitation Unit. A descriptive qualitative study was conducted with thirteen interviews with four service users, four family members, and five professionals. The participants were selected by purposive non-probabilistic sampling. Data was collected through semi-structured interviews and analyzed through reflexive thematic analysis, using WebQDA software. Four dominant themes emerged: rethinking mental health care, implementation challenges, adherence to principles and impact on PCC, families, and professionals. Challenges included resistance to change, time constraints, and cultural adaptation. Key principles such as flexibility, immediate help, and acceptance of uncertainty were highly valued. Open Dialogue meetings enhanced communication, creating a more humanized therapeutic environment and fostering family involvement and professional collaboration. However, successful implementation requires ongoing training and organizational support.
Copyright (c) 2025 Ana Raquel Ferreira, Raquel Simões de Almeida, Cecília Villares, João G. Pereira (Author) https://creativecommons.org/licenses/by-nc/4.0
Self-definition issues may veil relational needs and fears in negotiations of the alliance
Needs for self-definition and relatedness in psychotherapeutic interaction have been described in theory and research but their role in rupture-repair episodes is still not well understood. The aim of this study was to explore the relational dynamics between therapists and clients during alliance ruptures and repairs through the lens of the concepts of self-definition and relatedness. Nine therapists were interviewed about their experiences in rupture and repair processes. Interview answers were analyzed with theory-informed interpretative phenomenological analysis (IPA) focusing on therapists’ and clients’ needs and expressions of self-definition and relatedness during these processes. Two themes were identified: Ruptures as imbalances of relatedness leading to strains in self-definition and Repair as a restoration of mutual self-definition to create balance in relatedness. The general finding was that ruptures developed as unaware imbalances between therapist and client regarding their needs of relatedness. This imbalance was, however, expressed and handled with behaviors that were oriented around needs of self-definition. After therapist-client negotiations over self-definition issues had come to an end, renewed and more mutual relatedness could be achieved. The findings underline the importance of self-definition and relatedness as fundamental aspects of rupture and repair processes. This study analyses how clients’ and therapists’ different relatedness expectations may be expressed as self-definition problems. After negotiation of ruptures, increased relatedness may ensue. The results can improve therapists’ understanding and handling of rupture and repair processes in therapy.
Copyright (c) 2025 Patrik Karlsson-Söderström, Rolf Holmqvist (Author) https://creativecommons.org/licenses/by-nc/4.0
Facilitating Emotion Focused Skills Training for parents online (EFST-O): Insights about self-disclosure, group dynamics and culture
The Emotion Focused Skills Training (EFST) is a program for parents who want to promote the mental health of their children, and their own. EFST builds primarily on the experiential learning principles of humanistic therapies, such as emotion-focused therapy. There is a raising interest on the potentials of implementing this program in Norway and other European countries, yet there are few qualitative studies addressing the learning experiences that parents have when enrolling the program, or the possibilities and challenges of implementing EFST in different mental health services, and with families with diverse cultural backgrounds. Therefore, the objective of this study was to explore the cross sectorial experiences of adapting and piloting the EFST program to an online and culturally inclusive format (EFST-O). EFST-O consisted of four live sessions in Zoom and EFST video lectures as complementary material. We ensured user involvement with expat and Norwegian families, and diverse public mental health organizations. Participants filled out qualitative questionnaires after the sessions (n=13; n=15; n=11; n=18). Participants (n=9) and collaboration partners from different mental health services (n=6) provided written feedback on the video lectures. We used reflexive thematic analysis and contrasted the data with the fieldnotes of the principal investigator, and anonymous feedback from two psychotherapists who observed the program. Participants described increased awareness and knowledge about emotions and relationships, appreciated the pedagogical tools, and the expertise of the facilitators. They also wished for more interaction with other peers and expressed a need to learn more about parenting and receive additional support. Most participants found the program helpful and inclusive. For some families, culture and couple relationships could have been more emphasized. Perceptions about peer self-disclosure and therapists’ self-disclosure affect group dynamics online and/or onsite, and this is further discussed addressing implications for practice.
Copyright (c) 2025 Olga Lehmann, Nadia Ansar, Valeria Markova, Ottar Ness, Silja Berg Kårstad (Author) https://creativecommons.org/licenses/by-nc/4.0
“It’s not me anymore, it’s him” A hermeneutic-phenomenological analysis of matrescence with implications for counselling and psychotherapeutic practice
NHS England (2024) estimates that perinatal mental illness affects up to 27% of all new mums, yet little explains what is typically experienced mentally when an individual becomes a mother. The void in research infers that matrescence is of little import to the maternal experience and may subsequently contribute to maternal distress as a mother’s expectations do not meet their lived reality. This article aims to better understand the lived experience of matrescence so consideration may be given to its impact on mothers. A hermeneutic phenomenological approach was selected to support an in-depth exploration of matrescence phenomena. Semi-structured qualitative interviews centred around a genogram and creation of clay self-symbols, were conducted with six mothers 8-10 months after their first child’s arrival. Participants were considered low-risk, and included birth mothers and one adoptive mother, from single and dual parent families, in England. The study resulted in four themes: (1) A change of state and a state of change; expresses multi-dimensional and ongoing adjustment (2) Mother matters; explores a paradox of existential mattering (3) M/other merger; reflects relational shifts (4) Prepare to be unprepared; considers the impact of unpredictability, and real and ideal notions. The study's findings contribute toward an emerging conceptualisation of matrescence. Greater understanding may help enable perinatal health-care providers to develop preventative policies and interventions which better support mothers.
Copyright (c) 2025 Helen Davies (Author) https://creativecommons.org/licenses/by-nc/4.0
Copyright (c) 2024 Nollaig Frost https://creativecommons.org/licenses/by-nc/4.0
Qualitative Research: The “good,” the “bad,” the “ugly”
This article explores what constitutes “Good,” “Bad,” and “Ugly” qualitative research towards more fully appreciating of the nature and vision of its project. In the first two sections, I define qualitative research and map variants. Then, after highlighting qualitative evaluation criteria, I explore key issues and themes of what seems to make research “Good,” “Bad,” or “Ugly”. In the latter half of the paper, I focus specifically on four broad types of qualitative research (literature review, phenomenology, narrative-ethnographic research and discourse analysis), critically discussing a good exemplar of each. To make my strategic selections more transparent and show my role in the construction of this paper, reflexive passages are offered. Here, I engage versions of personal/introspective and methodological/contextual reflexivity plus utilise some embodied and ethical reflexivity.
Copyright (c) 2024 Linda Finlay https://creativecommons.org/licenses/by-nc/4.0
Learning from embodied tension: A naturalistic multimodal single case study of nonverbal expressions and interactions in a psychotherapy training process
This multimodal single case study explored how nonverbal communication was handled in a psychodynamic training process. Using a multimodal qualitative method, video recordings of a 39 sessions psychodynamic therapy process (with a female therapist treating a male client with relational issues), parallel supervision sessions, and Interpersonal Process Recall interviews with the client and therapist, were analyzed within the framework of Reflexive Thematic Analysis (RTA). The analysis yielded three themes: a) The therapist’s insecurity seemed to have compromised her capacity to use her own bodily signals to facilitate the exploration of emotions together with the client; b) The therapist and the supervisor were sensitive to the nonverbal cues from the client, but supervision did not explicitly explore how the therapist could use this sensitivity to moderate her own bodily signals and inform her clinical interventions; and c) Supervision supported the therapist in tolerating embodied tension in the therapeutic relationship. This study illustrates the close relationship between therapists’ capacity for emotion regulation and their nonverbal relational skills. A more open exploration of the trainee’s emotion regulation capacities in supervision may have supported her to deal more effectively with her own and the client’s nonverbal expressions.
Copyright (c) 2024 Cecilie Hillestad Hoff, Helen A. Nissen-Lie, Hanne Strømme https://creativecommons.org/licenses/by-nc/4.0
Reflexivity woven through qualitative health research: A researcher's experience
Engaging in a qualitative, autobiographical research project as a nurse researcher, provided a place and space to explore my reflexive ways of being. This article focuses on describing the reflexivity practices in which I engaged throughout a twenty-four-month research study. This article focuses on a reflexivity practice while researching recovery from eating disorders, and while living during the global coronavirus pandemic. Throughout the research project, and in efforts to deepen understandings of the reflexivity experiences, I read related literature and focused on best and promising practices for eating disorder assessment, treatment, and management. I sought to scaffold and find a place to safely approach and respond to the dataset and artifacts. As an expression of reflexivity alongside the research, I journaled and created art as a medium to illustrate my practice. Simultaneously, I engaged in related conversations with trusted peers. In this work I am therefore both a participant and researcher (Roberts, 1982). Guiding this work were my understandings of stories and lived experiences which, in time, allowed me to create and live out new stories. Linda Finlay's (2012) approach to reflexivity informed and guided the project. As well, Dewey's (1934, 1958) writings on art and nature as experience allowed me to be mindful of my reflexivity practices. Finally, Susan Finley's (2011) critical arts-based notions gave me permission to create in multiple mediums as part of the reflexivity process. Four themes emerged from the reflexive thematic analysis: 1) the importance of scheduling time to conduct reflexivity activities and inquire into and understand responses; 2) the importance of spiritual care; 3) the role of trusted, supportive peers can help re-story shame; 3) the process of living out future, educative stories are possible; and 4) a reflexive practice can include embodied responses.
Copyright (c) 2024 Janet L. Kuhnke, Sandra Jack-Malik https://creativecommons.org/licenses/by-nc/4.0
Hermeneutic Existential Phenomenology as a psychotherapeutic and philosophical attunement to educate novice researchers
This paper develops a hermeneutic existential phenomenological (HEP) approach to the research education of novice researchers. Drawing from HEP in psychotherapy and philosophy leads to the identification of the importance of lived experience in educating novice researchers. It demonstrates the significance of responding effectively to existential struggles for embodying and inhabiting the way of being of research with competence and confidence. HEP provides a framework for turning the messiness and chaos of the lived experience of research into opportunities for research education and development. Creating the space for turning the emotional “roller coaster” ride of research into educational opportunities requires the skills of a psychotherapist who enables the novice researcher to stay with and learn to listen to their research doubts and anxieties. These skills are also formulated by existential philosophers who write about being resolute in moments of vulnerability and anxiety. A HEP approach to research education is a contribution that psychotherapy and philosophy have to offer research education in psychotherapy and in general. Working educationally with the existential anxiety of research is useful in any research area that acknowledges the importance of being attuned to lived experience in the process of becoming a researcher.
Emotions, research, hermeneutic, existential phenomenology
Copyright (c) 2024 Steven Segal https://creativecommons.org/licenses/by-nc/4.0
Falling into Glăveanu’s Gap: A lyric essay searching for resilience through creativity
This paper is in two parts comprising a literature review and a creative, non-fiction, lyric essay format to explore interplay between ambivalent emotions, creativity, and resilience. The context is my own state affect between client sessions, as a psychotherapist and researcher. The lyric essay, “Falling into Glăveanu’s Gap,” that comprises the second part of this paper covers a period of great disquiet in my personal and professional life, when adverse life experiences impacted my research, and, as such, formed an integral part of the research itself. My self-search heuristic exploration forms part of a larger, doctoral enquiry into the interplay between ambivalence, creativity, and resilience amongst therapists, examining whether those engaged in creativity experience a greater sense of resilience. Resilience is the antithesis of burnout, a condition which disproportionately affects practicing therapists. This research argues that therapist education, training and continuing professional development provision, would benefit from a stronger focus on therapist emotion and affect, outside of the therapy room. Opportunities for engagement with creativity are recommended to aid the development of therapist resilience and to combat therapist burn-out.
Lyric essay; heuristics; creativity; therapist resilience
Copyright (c) 2024 Helen Noble, Beverly Cole https://creativecommons.org/licenses/by-nc/4.0
A comparison between the concepts of Heuristic Enquiry and Tazkiyat-un-nafs
This article offers a comparison between concepts of heuristic enquiry and tazkiyat-un-nafs, the Islamic concept of self/soul purification and/or reformation of the spiritual heart (qalb). The article outlines key concepts of heuristic research methodology as identified by Moustakas (1990) and Sela-Smith (2002) and elaborated by McCann and Tudor (2024). We reflect on the first author’s experience while undertaking some original research under the supervision of the second author, both of whom share an interest in cultural and religious identity and how this is or is not considered in psychotherapy (Florence et al., 2019; Tudor, 2019). From that original research, in this article, we discuss the concepts of heuristic research as they exemplify heuristic methodology compared with the Islamic practice of tazkiyat-un-nafs, identifying the noticeable differences between them. The article aims to support researchers who consider integrating Islam into their psychotherapeutic research – and, in parallel, their psychotherapy practice; as such, we view this as a contribution to the Islamic psychology and psychotherapy movement.
heuristic enquiry; heuristic self-search inquiry; tazkiyat-un-nafs (purification of the self/soul); Islamic psychology and psychotherapy; qualitative research
Copyright (c) 2024 Georgina Cardo, Keith Tudor https://creativecommons.org/licenses/by-nc/4.0
Conducting psychotherapeutic research with Free Association Narrative Interview
Deciding on methodology and method can be a complex and anxiety provoking task for new researchers and doctoral students. This is a reflexive, first person account of a doctoral journey addressing some key junctions and critical decision-making processes during a doctoral project. The article captures personal and professional considerations throughout a qualitative study into female therapists’ experiences of working with male clients who were sexually attracted to them. The study employed Hollway and Jefferson’s (2008) hybrid method Free Association Narrative Interview (FANI) which involved multiple unstructured interviews with five female participants. FANI offers a framework within which researchers underlying motivations about the research can be explored. This paper aimed to show how FANI method offers a frame for bridging a practitioner-researcher divide (Archard, 2018) by providing an opportunity for practitioners to use their full range of skills and competencies from their clinical work and apply it for the purposes of research.
Relational research: Reflexivity; Working with unconscious processes; Practitioner-research; Psychoanalytically informed research
Copyright (c) 2024 Jasenka Lukac-Greenwood , Sofie Bager-Charleson https://creativecommons.org/licenses/by-nc/4.0
Framing and Transforming Shame: Exploring shame from a person-centred perspective
Shame is a key emotion requiring understanding in therapeutic practice, not only from the perspective of a client but also from that of a practitioner. Shame may be outside or on the edge of awareness manifesting itself in different ways. This study explored shame as understood and experienced by person-centred counsellors and psychotherapists. Semi-structured interviews were undertaken with five person-centred therapists and data analysed using interpretative phenomenological analysis (IPA) which identified two themes: Framing Shame and Transforming Shame. Shame impacts on the efficacy of therapeutic work and supervision. Therefore, approaching shame from a place of principled non-directivity may be helpful for transforming shame in therapeutic work because it supports the therapist to empathically attune to the client, so clients can explore these experiences at their own pace. This paper considers these themes through the lens of person-centred theory, recognising the importance of understanding this master emotion from its source in past events and experiences.
Shame, person-centred, psychotherapy, interpretive phenomenological analysis, IPA
Copyright (c) 2024 David Gwynant Hughes, Dr. Peter Blundell https://creativecommons.org/licenses/by-nc/4.0
“Feeling at home” or not? A qualitative investigation into therapists’ experienced congruence between their personal self and their professional role
Research suggests that conducting psychotherapy successfully involves an integration of professional and personal knowledge on the part of the psychotherapist. The concept of congruence has been used to convey an adaptive fit between the two, but less is known about how this integration is experienced by psychotherapists in their actual therapeutic work. Through in-depth interviews we aimed to explore how therapists experience their personal self as related to their professional role. Sixteen psychotherapists participated in the study, each interviewed twice. Interpretative Phenomenological Analysis yielded the superordinate theme: “Feeling at home” in one’s professional domain. Three constituent themes conveyed both congruence and dissonance between the personal and professional domains: 1) Experienced correspondence between the psychotherapist’s professional and personal selves; 2) How handling personal challenges is reflected in their work as psychotherapists; and 3) How personal issues are experienced as disruptive in relation to the psychotherapist’s professional role. The findings both consolidate and expand on the view of congruence as a predominantly useful state by adding experiential detail to recent models of therapist development. The main implication is suggested to be the need to develop and maintain an active awareness of the potential tension and/or fusion between one’s personal and professional self.
Psychotherapist personal self, congruence, professional self, psychotherapist development, qualitative research
Copyright (c) 2024 Ida Stange Bernhardt, Helen A. Nissen-Lie, Christian Moltu, Marit Råbu https://creativecommons.org/licenses/by-nc/4.0
Exploring the experience of Racialisation and subsequent experiences of psychological therapy for Black and Multi-ethnic clients in Ireland
Research suggests pervasive disparities in mental health diagnoses, levels of care and treatment outcomes for Black or Multi-ethnic service users compared to white service users. This study explores the mental health implications of being racialised and subsequent experiences of psychological services. Studies show that increased race related stressors over time increase the likelihood a person will experience psychological distress. Research also suggests that the personal biases of mental health service providers may impact their competencies and success rate when working with Black and Multi-ethnic clients. In this study, semi-structured interviews were conducted with 10 Black or Multi-ethnic participants who had recently engaged in psychological therapy in Ireland. Data were analysed using the Generic Descriptive Interpretive Qualitative Research Analysis (GDI-QR) approach (Elliott & Timulak, 2021). All participants shared lived experiences of negative mental health implications of being racialised. These were expressed as feelings of not belonging, experiences of racism or discrimination, feeling silenced by cultural and social stigma, and feeling inequitably burdened compared to their white peers. Participants typically reported barriers to access as conflicting values between cultures, previous negative experiences, waitlists, lack of previous knowledge of mental health, and inadequate services for Black service users. Barriers to engagement were mismanagement of racial dynamics and a perceived lack of attunement between service provider and client. Conversely, participants also spoke of growth promoting therapy experiences that strengthened the therapeutic bond. Suggestions for change include adjustment to practice and training for psychologists, in addition to suggestions that could increase accessibility to services for Black and Multi-ethnic service users.
Psychotherapy; Colourblind ideology; Irish Services; Anti-racist practice
Copyright (c) 2024 Karen M. Doyle, Barbara Hannigan https://creativecommons.org/licenses/by-nc/4.0
How female therapists and their patients deal with being a disputable, unimaginable, or occasional Swede: Explorations of similarity of nonprivilege
In this qualitative study, conducted in Sweden, the authors investigated therapists´ experiences of therapeutic dyads in which both therapist and patient identified with a non-normative ethnicity, migration experience, racial identity, or experience of racialization. Inclusion criteria were based on the concepts of "similarity of nonprivilege" (Fors, 2018) and on Mattsson´s (2005) concept of "disputable, unimaginable, or occasional Swedes," inspired by critical whiteness studies. Eight semistructured interviews with female psychologists and psychotherapists were conducted. Findings were illustrated by the Minority Matrix, showing how therapists navigate sameness versus too much closeness, and manage the role of being a bridge between a minority position and Swedish society.
Copyright (c) 2024 Sofia Hörk, Vanja Vujičić, Malin Fors https://creativecommons.org/licenses/by-nc/4.0
“Disclosing the innermost part”: Exploring therapists’ constructions of shame using a story completion method
Previous research on shame has indicated that it is an important phenomenon that can benefit or hinder the therapeutic process, depending on how it is understood and managed by therapists. However, therapists’ conceptualisations of shame have not been explored adequately. This study utilised a novel method of data collection called story-completion to examine how therapists talk about shame, and the impact this can have on how they manage it. Forty-five therapists were asked to complete a story-stem describing a therapist working with a client’s shame via an online survey platform. Foucauldian discourse analysis (FDA) was used to critically analyse participants’ stories. Shame was constructed as a rather problematic emotion that hinders the therapeutic progress by preventing the clients from revealing their “true” self. In these narratives, the therapist’s task was to uncover what is hidden behind shame. Some participants constructed the therapist as an expert, holding the appropriate knowledge to manage it. A counter position was the therapist conceptualised as humane, where they were de-skilled and vulnerable in relation to shame. We invite practitioners to be mindful of the ways that their understanding of emotions, and their role in relation to them, can impact the direction of therapy.
Copyright (c) 2023 European Journal for Qualitative Research in Psychotherapy https://creativecommons.org/licenses/by-nc/4.0
Views about mixed methods research from counselling and psychotherapy research students and supervisors
How do students and supervisors who are actively involved in the process of research view and experience mixed methods research? This study explores views held by counselling and psychotherapy research students and supervisors around mixed methods research, based on a survey reaching 125 respondents. The survey generated both quantitative data from an online survey and qualitative data from free text comments and a story completion approach. Knowledge about mixed methods research was not widespread (59%) although there was a majority view (81%) that qualitative and quantitative research methods could be meaningfully combined. There was a clear majority view (87%) that it is important for researchers in counselling and psychotherapy to have a working knowledge of mixed methods research. Out of 49 story stem replies, 46 were in support of mixed methods. A discussion explores the implications of these findings for training and supervision.
The qualitative evidence-base of relationally-orientated therapy: A critical celebration
In this article, I celebrate and critique the evidence base for relationally-orientated therapy. The central role played by the therapeutic relationship in effective therapy is now supported by an impressive evidence base, but it is mostly quantitative evidence that is privileged. This article attempts a small corrective to widen the lens by presenting 5 categories of qualitative evidence: Qualitative meta-analyses of client experiences of therapy; case studies; qualitative studies of clients’ experience; qualitative studies of therapists’ experience; and discursive studies of interactions and language use. The richness, relevance, and resonance of qualitative methodology is demonstrated by exemplar studies which highlight a special role for exploring under researched areas. However, qualitative researchers face confounding epistemological and methodological challenges in trying to capture the impossible complexity, ambivalence, variability, and ambiguity of relational therapy experiences across different cultural contexts. No methodology (qualitative, quantitative or mixed) can hope to do justice to these questions on its own and both critical reflexivity and humility are needed.
Therapist experiences of congruence in school-based counselling
Congruence is a key counselling concept, perhaps the most important of the therapist provided conditions (Rogers, 1967). Whilst literature on congruence and its use within the therapeutic relationship is rich, there is a lack of research exploring how counsellors understand, experience and offer congruence with children in school-based counselling programmes – the focus of this study. Using hermeneutic phenomenology as a philosophical base, semi-structured interviews were conducted with three person-centred counsellors and one integrative counsellor who currently work with children in a school-based counselling service. The data was analysed using interpretative phenomenological analysis (IPA) resulting in two superordinate themes: Intrapersonal Congruence and Navigating Multiple Terrains. This study suggests that congruence with children in school-based counselling is best understood as an intrapersonal phenomenon. Key findings indicate that conscious non-disclosure of therapist process was central to work with children. This served to protect and enhance the therapeutic relationship. Other findings suggest that the presence of certain aspects of therapist self in the room can impact upon congruence. Therapist personal self-disclosure was essential in facilitating a strong therapeutic alliance with children for one research participant and a central aspect of his experience of congruence with children. Lack of clarity around the unique roles and responsibilities of working in a school setting as a counsellor affected the way therapists experience and offer congruence with children and young people. Implications for training and practice are considered.
A Heuristic Inquiry into my use of Theraplay® with children experiencing the impact of relational and developmental trauma
In this paper, I share my process of conducting doctoral research using Heuristic Inquiry. As a practising Theraplay® counsellor/psychotherapist working with children who are experiencing relational and developmental trauma, I start by locating myself in the research and explain Theraplay as a model. Heuristic Inquiry is then used to examine my own practice, and what this process of research illuminated for me. Specifically, the use of tacit maternal knowing - a way to use maternal wisdom in the professional realm as a de-gendered, de-sexed skill - is theorised. I explain why, in my opinion, trying to understand how and why Theraplay works for children experiencing relational and developmental trauma via a perspective that seeks to find the answer that is generalisable and manualisable is inappropriate for this form of work. This paper will be of benefit to: those wishing to research their own therapeutic practice in a way that honours the uniqueness of the therapeutic relationship between client and therapist; those wishing to use Heuristic Inquiry as a research methodology; those wishing to research using arts-based methods; and practitioners interested in Theraplay as a model of work for this clinical population. It argues that employing creative methods of research is congruent with modes of therapeutic work.
Shared Visibilities: An exploration of the client’s use of imagery on the road to UPSR
This article presents findings from research on the interaction between client imagery and Unconditional Personal Self-Regard (UPSR). Through posing the question “What impact does imagery shared within the therapeutic relationship have on UPSR?”, the researcher - herself a person-centred therapist - explores issues emerging from her own experience of the use of imagery language in therapy, both as client and therapist. The research also addresses a lacuna within the literature of person-centred therapy, where little has been written on the potential use of shared language and clients’ choice of imagery. Data from semi-structured interviews with four women trainee person-centred therapists about their experience of using imagery was analyzed using Interpretative Phenomenological Analysis (IPA). The imagery participants used in their own therapy ranged from physical images drawn by them, to images from dreams or inspired by prayer, reflections on the natural world, and visualisations of the self in different imagined contexts. The discussion suggests that client UPSR is indeed impacted by imagery used in the therapeutic relationship, and that the ability of the client to use their own language in therapy to mediate their experience has a positive impact on the therapeutic relationship. This research contributes a new area of thinking to person-centred work, exploring the role of client language in client-led work, and the benefits for therapists of working with and through the images of their clients.
Personal and relational ideologies of master therapists
This original study used a descriptive and interpretative qualitative approach to analyse interview data from twelve world renowned master therapists and academics. They each have vast amounts of expertise in the profession of psychotherapy as demonstrated through their copious peer reviewed publications, development of therapeutic approaches, and their international contributions to the profession. Results yielded 4 domains including: 1) Personal Ideology; 2) Relational Ideology for Life in General; 3) Relational Ideology in Love and Romantic Relationship; 4) The Rewards and Risks of Personal and Relational Ideologies, with 6 main categories pertaining to the master therapists’ most fundamental values in their lives, careers, relationships, romantic encounters and notably, in how they consider their life’s work as their life’s legacy. Finally, the risks and rewards arising from their ideologies are outlined. Participant accounts included the use of the term “purposeful rebellion” as a means to scientifically challenge flawed ideologies in the psychotherapy field and wider society. They reported experiencing deep, genuine care, and easiness in maintaining professional relationships with colleagues, peers, students, and with their clients. Their professional status feels immensely personal, and with this may come the consequence of an imbalance between work and life, especially in early career while aiming to become established and to influence and shape the profession. These findings overlap and expand upon previous studies of renowned therapists and suggest a synergy when it comes to the ideologies between their personal and professional selves.
Competency model of training in psychotherapy integration
Competency models can be a cornerstone of the development of effective education in psychotherapy. This study aimed to develop a competency model for the Training in Psychotherapy Integration program in the Czech Republic. Method: The model was developed using the principles of cooperative inquiry and action research. Six trainers and three researchers participated in the study. Data were drawn from focus groups and individual interviews held with trainers and from archival materials of the training program. The research process involved several cycles of data collection, qualitative analysis, implementation, and feedback. Results: The Training in Psychotherapy Integration competency model was organized into three domains focusing on the therapeutic relationship, the client, and the therapist. Each domain was further divided into three layers, namely: personal, procedural, and contextual. Conclusion: The Training in Psychotherapy Integration competency model proved useful and contributed to the training program in several respects, providing identity, structure, a path to consensus, and a trainee evaluation tool.
Exploring fathers' experience of their first child's early years: Representations versus reality
This qualitative study explored fathers’ lived experience and meanings of being a first-time father in the United Kingdom. Seven fathers were interviewed, and the resulting data were analysed using Interpretative Phenomenological Analysis (IPA). Two main categories emerged from the analysis: The first captures how fathers’ experiences developed over time concerning: i. how becoming a father was a “natural way of being”; ii. how they were confronted with the differences between reality and their expectations; iii. how they described traditional fatherhood and the compulsory equality in parenting; and iv. about their willingness to be involved as a modern father. The second master theme describes the challenges faced by fathers including how fathers: i. cope with tiredness; ii. have undesirable feelings, including fear, worry and uncertainty; iii. lack acknowledgement and feel some resultant shame; and iv. experience guilt when they were not physically present for their children. This research discusses the impact of both their understandings (including representations) of fatherhood and how fatherhood is subjectively experienced. It is recommended that therapists attend to these changing experiences in order to offer appropriate psychotherapeutic approaches and tools to fathers.
How storytelling impacts students in their psychotherapy training
The use and impact of storytelling in counselling and psychotherapy training was explored using a mixed-methods approach. An online survey completed by 30 therapists and 12 counselling tutors produced both quantitative and qualitative data. The latter were analysed using Reflexive Thematic Analysis (RTA). Therapists and tutors all agreed that the use of story was important, or extremely important, in the training room. Case studies and clinical anecdotes were the type of story preferred by a majority of learners. Four themes were created from the RTA process. The first was story for Making Meaning, in worldly, personal, and universal ways. The second was Activating Learning, where story brought theory to life, helped concepts make sense, and embedded learning. The third theme was I Will Survive, where clinical and personal stories from a tutor demonstrated how a practitioner could struggle and overcome mistakes. The fourth theme was Quality of Presence, where the tutor-student relationship emerged as a vital component in modelling the skills, attitude and presence required to be a therapist.