Tuesday, March 20, 2007

Toward Evidence-Based Training: Draft Protocol for Research on the Effects of Counselling Training

Entry for 19 March 2007:

I’ve spent quite a bit of time over the past month working on a research protocol for evaluating counselling training. Julie Folkes-Skinner, a PhD student from the University of Leicester, and I are preparing to do a study of the effects of our Person-Centred Counselling Diploma here. Today the teaching staff of the three diploma courses here agreed in principle that it would be OK to go ahead with some version of this research. Here is an outline of what we are discussing doing:

It’s a mixed method study, with the following research questions:
(1) What are the effects of counselling training on trainees, specially: (a) trainee therapeutic involvement and experienced professional growth; and (b) trainee level of experienced flexible, congruent functioning.
(2) How do trainees experience their training, specifically: (a) what changes do they experience over the course of training?; (b) what do they find helpful in their training?; and (c) what do they find unhelpful in their training?
(3) Can the effects of training be detected in trainees’ clients’ experiences of counselling, including therapeutic alliance, client outcomes and counselling-related changes, and helpful and hindering aspects of their counselling.
There are three nested study components:
A. A large (n=25) quantitative study of the effects of the training on student professional and psychological functioning.
B. A smaller (n=8) qualitative study of a group of counselling unit students’ experiences of the training, done at the end of the years’ training on the fulltime course (and possibly also after years 1 and 2 on the parttime course)
C. A pair of intensive case studies in which student trainees are repeatedly qualitatively interviewed throughout the year (before seeing clients, at the end of the first, second and third terms, while the process and outcome of their work with two of their clients is tracked qualitatively and quantitatively in the Research Clinic.
Trainee Instruments: The instruments proposed for use by the trainees include:
1. The new Trainee version of the Common Core Questionnaire (CCQ) being developed by Soti Grafanaki and me, based on previous research by David Orlinsky and the Collaborative Research Network of SPR. This instrument measures trainee theoretical orientation, perceived progress, therapeutic skill, interpersonal manner, in-session mood, sources of learning, therapeutic difficulties and coping strategies, and personal functioning. Among other things, these subscales measure quality of therapist involvement (Healing Involvement vs. Stressful Involvement), quality of experienced professional development (Progress vs. Stagnation). (Used in all 3 study components.)
2. The Strathclyde Inventory, a quantitative self-report measure of person-centred functioning, following Carl Rogers’ theory, developed by Beth Freire (with some help from Mick Cooper and me). (Used in all 3 study components.)
3. Training version of the Change Interview, developed by Julie Folkes-Skinner and me, a qualitative interview asking trainees about their experiences of the training course, including changes so far, ratings of those changes, and helpful and unhelpful factors in the training. (Used in study components B & C.)
Client Instruments. In addition, trainees in study component C (the intensive case studies) would also track the therapy experiences of at least two of their clients seen in the new research clinic, in order to assess their clients' experience of the therapeutic alliance (Working Alliance Inventory), the outcome of the counselling (CORE Outcome Measure), and experiences of therapy (Client Change Interview).

Possible Supervisor instrument. Finally, Soti and I are also working on a Supervisor version of the CRN Common Core Questionnaire, which we hope to use for one or more of these components. At this point, the instrument needs to be pilot tested, and further discussions are needed with supervisors, because I suspect that this element is going to be a harder sell than the other things.

Comments, suggestions and reactions are invited on this project!

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