Wednesday, May 30, 2007

Currents of Evidence; Meta-Analysis Started

In the April 28, 2007, issue of Science News, there is a really interesting article about flotsam. The article quotes an oceanographer named Richard Thompson (no relation to the folk musician I assume) as saying, “with oceanographers, the more data the better.” In the face of sceptics, He is trying to justify his careful study of flotsam, bits of junk that float around in the North Pacific , such as accidentally spilled loads of children’s tub toys (e.g., rubber ducks) and Nike running shoes – in order to study the paths of ocean currents, such as the Pacific Subarctic Gyre.

This struck me as a really nice metaphor for the kind of psychotherapy research I like to do: to collect lots a data in order to follow the client’s currents, to see where and how they go, where they pop up again. In this process, it seems to me, we need all the data we can get, or at least all that we know what to do with (and then some, because you never know when you might figure out more cool things to do with your data). For reasons I find myself totally unable to fathom, many people don’t like this approach at all, and even consider it to be “junk science”. This strikes me as unimaginative, narrow and wasteful.

We have started the meta-analysis project, Beth and I primarily, but with input along the way from Mick. Beth is carefully and independently re-doing all the analyses I previously did for the previous 4 generations of the person-centred/experiential therapy meta-analysis. This is exciting because, with support from a grant from the British Association for the Person-Centred Approach, we will be able to check our calculations and ratings for reliability and substantially increase the size of our sample of studies. The approach to meta-analysis we are using makes use of as much of the available data as possible, as part of a strategy of following multiple lines of evidence, including client pre-post change, client change in comparison to no-treatment controls, and client change in PCE therapies in comparison to clients in other therapies. That is, we follow the fancy cruise ships (randomized comparative studies), the old-fashioned freighters (controlled studies vs. no-treatment or waitlist conditions), and even the floating bits of flotsam (one-group pre-post studies). We will put all these things together, and see where it takes. Of course, by this time, we have a pretty good already, because I have been around this gyre a few times previously. But this time, it will be done more systematically, and this time will benefit from Beth’s attention to detail and suggestions for looking at the data more from a classical person-centred perspective.

The Long Light

Entry for 30 May 2007:

Yesterday (29 May) we reached 17 hours of daylight. The sun now rises at quarter to five in the morning and sets at quarter to 10 in the evening. When I get up, the day is already hours old. In the evening, I sit in our living room, near the big bay windows, and work, waiting for the night to finally come. I remember how special it was growing up in California when the midsummer sun didn’t set until 8:30, and then, moving to Toledo, how amazing it was to see the sun setting at bit after 9 in June. But here, in Scotland, the light at this time of year is longer still and the night is very short. Mostly, I love this, but sometimes, I miss the Moon.

Sunday, May 27, 2007

Scenes from Pentecost Sunday at St. Mary’s

Entry for 27 May 2007:

1. I rode my bicycle to St. Mary’s for the first time, following my usual walking route done Great Western Road. I’m not very happy with the route, which involved stopping to go up and down curbs and riding in traffic on Great Western Road. Even riding slowly, it still only takes 10 min.

2. We are given small candles as we enter; what are these for? Oh, there’s a baptism and it’s Pentecost (tongues of fire etc. During the Baptism, I watch the woman in standing in front of me spend most of the time making sure that her inquisitive but somewhat unfocused 3 year son doesn’t burn himself or one of the adults standing around him. I identify with the mother’s desire to allow her son to experience the flame while still making sure no one catches fire!

3. After communion, the Choir sings James MacMillan’s piece, A New Song. I’ve now heard it 4-5 times (I picked up a recording of it a few weeks back), but this time I listen more analytically really enjoying the way the voices of choir slide around in melismas, and the pause toward the end of the vocal section.

4. After the service, Franny and I begin a discussion of her idea for starting some kind of growth group at the church. We agree in principle that we would like to do this together.

5. After church, I talk to girl who looks to be about 10 and who is reading Terry Pratchett’s Montrous Regiment. We have fun discussing Pratchett and I tell her about Vernor Vinge’s references, in his recent book Rainbows End, to Terry Pratchett as a major entertainment brand 15 years from now. She thinks that sounds pretty cool.

6. Overhearing me asking about bicycle routes, a youngish-looking university student named Miriam takes me on a better bicycle route back to Hyndland. We are doing fine until it begins to rain. The route is great, but we are soaked by the time we get to our destinations.

Ken Howard Dream

Entry for 27 May 2007:

This morning, before waking (after the Sun came up at 4:45), Ken Howard came to me in a dream. I have just given one of my ambitious, quick overview presentations at a conference, like the one I did a couple of weeks ago at the BACP research conference, and Ken comes up to me to give me some feedback: He says that he has found that I am more effective when I do very simple presentations, and that the one I have just given was hard to follow because I have tried to do too much. I realize that if Ken is having trouble following it, then I am in trouble, because it he is really sharp. I protest that it would have taken twice as long to make the talk simple, but this seems a bit feeble as an excuse. Then I wake up.

Emotion scheme analysis:
I. Emotion scheme nucleus (felt emotion): Embarrassment, frustration,

II. Perceptual-memory elements (also: intentionality; associations):
-Sensations: Conference venue; moving from chair environment to open lobby-type space; I don’t get a clear visual image of Ken, but I somehow knows him.
-Current life situation: I keep getting asked to do major addresses, such as keynotes, at conferences; these presentations tend to be long & complicated, quick overviews of big areas.
-Associations/references: How long has Ken been dead now? He died in October 2000, more that 6 1/2 years ago. It doesn’t seem that long. I had a dream in which Hans Strupp came to me in a dream last October shortly after he died. These are important scientific icons for me, but they were both people who I respected and liked as friends and colleagues.
III. Bodily/expressive elements:
-Likely facial expression: I imagine a rueful smile and slightly whiny tone of voice.
-Bodily sensations: I feel smaller, like I’m shrinking down or hunching over.
IV. Cognitive/symbolic elements (e.g., metaphors, propositions, identities)
-Propositions: I’m not as good as I want to believe about myself. I always try to cover too much. I’m the flavor of the month; soon they’ll get tired of hearing me say the same thing over and over.
-Metaphors: ??
-Identity: Fake
-Action tendency/wish (also lessons, directions for action):
-BodilyAction/Action tendency: To defend myself against a perceived criticism; to leave, go away by myself.
-Wish/fear: To gain Ken’s respect and praise by doing better in the future; afraid I won’t have time to do a good job in the future.

Saturday, May 26, 2007

May in Glasgow

Entry for 26 May 2007:

Once again, May is slipping by. May is my favorite month, largely because my birthday is at the end of it. I always think that I should take the time and savor it, but then it turns out to be busy with end of term work and conferences, and so it slips away, like sand between my fingers.

The streets were wet with rain this morning when I got up. Clouds mixed with sun throughout the day. It was cool and breezy but not cold, perfect weather for a long run along the canal. The canal waters were clear and only slightly rippled in the wind. I noticed how much the trees have leafed out along either side of the canal. It’s hard to keep a good running schedule when I’m so busy with conferences, so I’ve lost distance over the past month and now have to build back up again, carefully, because of my knee problems. So I was pleased to be able to do 7 miles this morning without any difficulty.

Diane has gone back to America to provide company and support for Kenneth, who has now finished his first year at university. I’m here finishing up the term, with piles of papers to grade and ever-mounting email, feeling a bit jealous at not being able to have a bit of vacation and hang out with my kids. But the solitude isn't bad either...

After I finished my run and ate a late breakfast, I took a bit of personal time to read the climax of Vernor Vinge’s Rainbows End, a near-future science fiction novel about the next 15 years of computer/internet development, which has some quite challenging ideas about the continuing pace of extreme technological, social, medical, and personal change. If he is correct, the new Jordanhill Building being planned right now here for 2010 will be obsolete before it’s even finished! Very thought provoking; it convinces me that my strategy of trying to stay on top of new technology is vital.

So life is basically good here: With each passing month, I understand more about the system and the culture, and my students and colleagues, and I feel more on top of things and able to function here. There are many challenges, but they feel like stretching and growing rather wearing away or draining. The work is meaningful, I enjoy my colleagues and students. Every week is full of new things. At this point, I’m feeling more grounded and effective in my teaching with students at various levels.

Yesterday, for example, the students in my supervsion group and I weathered a crisis that we were able to get through by doing our best to be open, caring, and self-reflective. It was an emotionally draining experience, but afterwards I felt proud that we had gotten through it in a productive, helpful manner, and realized that I am going to miss my intrepid band of supervisees when the course is over in a couple of weeks.

And so, as May winds down toward my birthday and June, I am happy and feel myself growing and moving on in my life and work. I feel pleased and grateful to have this chance. And May is a lovely time to be in Glasgow!

Thursday, May 24, 2007

Rennie’s Meta-Methodological Framework for Qualitative Research

Entry for 24 May 2007:

I have been following David Rennie’s investigation of key philosophical issues underlying qualitative research for many years, and always enjoy going along with him on his latest adventures exploring different philosophers. This past March he gave a really interesting paper at the British Psychological Society Conference in York. In this paper, I could finally see the outlines of a complete philosophical framework emerging, and I found this so exciting that I volunteered to do a presentation on it for the MSc course. Tonight the time for this presentation finally arrived. My lecture notes follow. Disclaimer: This is my version of what I understood David to be saying; if you want to really be sure you’ve got it right, it’s a good idea to read him in the original.

1. “Methodology” = a set of methods, rules and rationales those methods; also, the study of methods
•not the Method section of an scientific report!
“Meta-Methodology”: a set of methods for evaluating methodologies

2. Rennie argues that qualitative research has not reached the status of quantitative research because it lacks a compelling, coherent meta-methodology comparable to positivism

3. Following Kvale (and the Odyssey), Rennie warns of twin dangers:
•Scylla (=scary monster with claws): Rigid metholatry (“all method”)
•Charbdis (=giant whirlpool in the ocean): Relativism, post-modernism (“no method”)
•Instead, Rennie advocates taking the dangerous middle passage between these two, which he refers to as Methodical Hermeneutics
•A meta-methodology that he believes is suitable as a elegant foundation for qualitative research

4. Hermeneutics
•The activity of interpreting the meaning of text
•Hermes = Greek messenger god, carried messages: Scroll sealed in a tube = metaphor for interpretation
•Originally referred to Bible scholarship; broadened by Dilthey
•Central concept: Hermeneutic Circle: Understanding any part of a text requires understanding to whole text, and vice versa
•Distinguishes between
•Philosophic Hermeneutics (Gadamer)
•Methodical Hermeneutics (relevant to research)

5. Four Main Elements of Rennie’s Methodical Hermeneutics
•Critical Realism
•Abduction & Induction
•Disclosed Reflexivity

6. Element 1: Rhetoric
•Rhetoric = the art of persuasion (figures of speech, lines of argument)
•Hermeneutics requires rhetoric:
•Multiple interpretations possible; how to persuade audience of your version?
•Anti-rhetoric prejudice since the Enlightenment (=modernism)
•But science always uses rhetorical devices, disguised as methods
•Incorporate sets of scientific good practice into sets of scientific canons or standard
•E.g.,: Elliott, R., Fischer, C., & Rennie, D. (1999). Evolving guidelines for publication of qualitative research studies in psychology and related fields. British Journal of Clinical Psychology, 38, 215-229.

7. Element 2: Critical Realism
•Realism says that that entities really exist outside of us and that we can know them
•Critical Realism says that our knowledge of these entities is always imperfect/ approximate
•Through the lense of our pre-understandings, expectations, methods, and language
•Understandings are both representations of reality and constructions
•Equivalent to Dialectic Constructivism (Piaget, Pascual-Leone)
•Emphasizes that knowledge and understanding emerges out of the dialog between dialectically opposing perspectives

8. Element 3: Abduction
•C.S. Peirce (American logician, founder of semiotics)
•Deduction = deriving a logical conclusion from a set of propositions
•Based on logical relationships (tautology)
•Therefore, can’t use to discover anything new about the world
•Induction = generalizing from a sample of similar observation to a whole class of observations
•Can never be certain that the inference is valid
•Abduction = imagining the most likely explanation/hypothesis for a novel observation
•Peirce argued that scientists go back and forward between Induction and Abduction, using each to support and correct the other
•Application to qualitative research:
•Abduction: empathic/imaginative understanding of a piece of text in terms of proposed category
=> Leads to hypothesis that category will be relevant to rest of the text/corpus of texts
•Induction: careful search for additional examples to support or refute the generalizability of the category
•Another version of the Hermeneutic Circle?

9. Element 4: Disclosed Reflexivity
•Providing the audience with relevant information about the researcher/interpreter’s values and expectations
•A form of rhetoric
•Missing from Modernism/positivist science
This part of Rennie’s framework not well-worked out yet

10. Rennie’s Larger Philosohical Meta-Methodological Framework:
A. Ontology (philosophy of being): Multi-Level and Entity Pluralism, Complexity Theory, Dialectics
Description: An account of what kinds of things exist; e.g., Self organizing systems give rise to qualitatively different higher-order processes as emergent properties: e.g., biology => embodied experience => language

B. Epistemology (philosophy of knowing, i.e., Meta-methodology): Critical Realism, Dialectical Constructivism, Philosophical Hermeneutics, Multiple Truth Criteria
Description: An account of whether and how knowledge is possible, including how we know if something is true. (Criteria and psychological processes); e.g., reality can be known, but only imperfectly, thus requiring multiple converging criteria and processes.

C. Methodology (system of methods): Methodical Hermeneutics, Methodological Pluralism, Converging Operations
Description: A system of general methodological principles; e.g., involving abduction; induction; rhetoric; disclosed subjectivity

D. Method (set of procedures): e.g., Grounded Theory Analysis, Empirical Phenomenology
Description: Detailed description of general strategies used in the method, e.g, theoretical sensitivity; bracketing

E. Procedure (sequence of activities): e.g., Constant Comparison, Meaning Units
Description: Detailed description of specific procedure in terms of actual activities, e.g., compare meaning unit to existing categories, then…

Tuesday, May 22, 2007

Twenty Three Research Topics In Person-Centred Therapy

Entry for 19 May 2007; completed 22 May:

Offered by participants at “Research as a Growing Edge for the Person-Centred Approach: Issues and Opportunities”, Workshop given at PCT Scotland Twentieth Anniversary Conference, May 2007. Used by permission.

Topics identified by focusing on areas of curiosity. The person’s emotional reactions to the topic are provided in brackets. Some participants produced multiple topics. My commentary is given under each topic in italics.

Note to participants: I have tried to set the topic descriptions as accurately as my notes and memory allows; if I have got yours wrong, please let me know so I can correct the description. Also, please take a look at the commentary and suggestions I have added beneath your topic. Feel free to post comments!

1. Time-limited counselling is a reality, for example, in EAP work. What’s the evidence for how much & how often is effective?
Robert: See dose-effect research, e.g., Howard, K.I., Kopta, M., Krause, M.S., & Orlinsky, D.E. (1986). The dose-effect relationship in psychotherapy. American Psychologist, 41, 159-164.

2. Critical appraisal of the development of PCA in Britain. Any radical political impact? [Emotional reaction to topic: guilty, self-indulgent]
Robert: It might be useful to try to open up this question: What are the political and social effects, if any, of the development of the PCA in Britain? This might need to be investigated using sociological methods.

3. Is PCT the long-term most cost effective for government funders [burning]
Robert: In order to assess cost effectiveness, you have to determine the economic (monetary cost) of achieving specific effects (e.g., people returning to work or improving by a .5 mean scale points on the CORE). “Long-term” would mean tracking these effects over time (e.g., for 5 years after therapy).

4. Fragile process & culture: What is the relation between fragile process and culture? What are the implications of culture for training in working with fragile process (vs. western, middle class)? Change cultural context in which training occurs: What are the effects of this on work with fragile process?
Robert: I think I’d want to start with the first part of this: What does fragile process look like in different cultures? How do different cultures regard & treat fragile process?

5. Who do we miss? Who are the people who we don’t reach, or who don’t reach out to us (e.g., men). Also, how we miss people (cultural/social) in the moment through sexism etc. Being on the edge, don’t want to go. What factors? What is the role of referrers in this?
Robert: Maybe identify people who were/are clinically distressed but who don’t seek therapy (community surveys always identify a large number of people like this). Interview them about what keeps them from seeking help.

6. What things enable therapy to be more accessible (e.g., for attracting higher percentage of men)?
Robert: This is the complementary question to no. 5. Maybe interview men whose profile suggests that they would be unlikely too seek help, and ask them how/why they got there.

7. What helps us be OK with difference as therapists?
Robert: I assume this means something like, how do therapists cope with working with clients who are very different from them in various ways, e.g., culturally or in terms of gender, sexual orientation, social class, or disability.

8. What do my clients think of me? [emotional reaction: self-centred, guilty]
Robert: You could use the Helpful Aspects of Therapy Form after each session; the Change Interview after part or all of therapy. See

9. What do my clients make of being in therapy? What do they think is happening to them?
Robert: See topic no. 8, especially the Change Interview.

10. Supervision: What is effect of supervision? How does it work? What is the evidence?
Robert: This is an active Research Front. I’m particularly fond of the program of research by Nick Ladany and others, which has adapted research methods from qualitative research on client therapy experiences for studying supervision. For example, see a recent book: Critical Events in Psychotherapy Supervision: An Interpersonal Approach, by Nicholas Ladany, Myrna L. Friedlander, & Mary Lee Nelson. Washington, DC: American Psychological Association, 2005.
As for the last question above, see: Handbook of Psychotherapy Supervision, edited by C. E. Watkins, Jr., 1997.

11. How clients experience me? [difficult to stay with curiosity]
Robert: See topics 9 & 10.

12. I find it difficult to contemplate how to go about doing research. Who is tere available to help? What about funding? How do I start?
Robert: These are important questions about the research process and bridging the research-practice gap. Linking with some kind of community is important, I believe. Banding together with other like-minded practitioners is one strategy; another is connecting to a research centre on a volunteer basis.

13. Ways of coming at the world: Some clients come to therapy looking for practical solutions, while others come interested in exploring ideas for their own sake. I am interested in the the interaction between the therapist’s way of coming at the world and the client’s expectations and experience of world. [In this processm, nothing came, I felt like an interloper. It’s hard to describe]
Robert: The topic of the interplay between client and therapist views of the world is often tackled using discourse analysis of therapy texts. That is, the researcher collects transcripts of qualitative interviews or therapy sessions in which there is some revealing of ways of coming at experience and seeing the world, especially points of clash or discrepancy in world-view/approach. Then one looks closely at the text to see what is revealed and other client and therapist manage to negotiate the discrepancy. Issues around clients who expect and want the therapist to act as an expert and person-centred therapists who eschew such as role would a be particularly rich environment to study this.

14. Clients who come looking for practical solutions; how they understand my offer might change over the course of therapy. How can I present my offer to clients more effectively?
Robert: See topic 13. In addition, your interest in the practical aspect of handling this situation makes this appropriate for Task Analysis of how PCT therapists handle this situation more vs. less effectively.

15. I work in a GP setting alongside CBT pilot project. We are supposed to devise an outcome questionnaire. [This feels like a head bit; emotionally, I have a flat response to this; it is something to do out of necessity.]
Robert: Necessity is important, too, but then I always wonder if there is some way of making it more interesting. Perhaps an individualized change measure, such as the Personal Questionnaire, or a qualitative approach to outcome, such as the Change Interview? Or some kind of change that you think is particularly important to look at? On the other hand, maybe what’s needed is some simple way of measuring outcome, such as with the CORE, which could leave you free to go on this something that you find more interesting, like topic 16.

16. What is it that I do, what happens in the room that the client finds helpful? [I felt surprised to be asked about my curiosity. This topic feels like it has energy, gives me enthusiasm, is doable, nonacademic, and personalized; even I could do that! This topic is more about curiosity than necessity.]
Robert: See topics 8 & 9. You can see that this is a really a key issue of therapists.

17. What do my clients make of being in therapy? Also, what do they make of my perspective, which could be quite different? How do these two perspectives match & differ?
Robert: See topics 8, 9 & 16 regarding what clients find helpful. Also topics 13 & 14 regarding how clients come at therapy and the therapist and how client-therapist differences in approach and worldview get played out in therapy. Qualitative interviewing can be useful here, as can discourse analysis of points of reveal discrepancy in view and approach.

18. Therapist use of language that has invitational sensitivity to client experiencing.
Robert: I assume that you are interested what this kind of invitationally sensitive language sounds like in therapy sessions. This is a great topic for discourse analysis or conversation analysis, in which you collect and transcribe examples of this kind of talk, probably from early sessions of PCT and study it.

19. The client’s experience of the process between client and therapist: I’m interested in surprising feedback, where the client’s experience is far more than I realize.
Robert: One approach to this would be to collect examples of sessions in which striking discrepancies can be detected, such as when client and therapist ratings or reports of therapeutic alliance in the session or the effects of the session on the client are quite discrepant. Then, using various qualitative and quantitative methods, one could study these sessions to try to figure out what was going on.

20. What am I worth financially as a therapist? What do people (clients, service providers) think I worth? What criteria do clients and GPs use to decide how much counselling is worth? This is a market/costing issue. What is my comparative worth relative to other mental health staff? [This feels like a burning issue]
Robert: See also topic 3. There are various costing methods, and the issue is very current, as a Google search of the terms “cost effectiveness psychotherapy” will reveal. You will notice that one approach is to try to figure out the cost of untreated psychological problems in terms of lost work productivity and reduced quality of life; then it becomes possible to show that therapy can pay for itself by reducing other costs, both monetary and psychological.

21. How can we build social capital in order to make therapy redundant and unnecessary? How can we change society so there is less need for therapy, throught outreach, prevention, education, improvements in parenting practices and so on? [This feels like a slow burn of interest]
Robert: This is a large part of the focus of the community psychology movement, where there is a strong emphasis on reducing the causes of poor mental health (=primary prevention) and early detection and treatment before problems get worse (=secondary prevention). A key idea in contemporary community psychology is psychological sense of community; see Wikipedia article: ttp://, which has various components such as membership, influence, integration and fulfillment of needs, and shared emotional connection. Sense of community is like therapeutic alliance, but at the level of the person’s relationship with their community. For an overview of ideas about social capital, see Wikipedia article: ttp:// I think that community psychology has rich collection of theory and interventions that speak to this topic.

22. I am interested in the young counselor just starting in training, and the use of basic, extended residential encounter groups in training. What new methods are there for studying these?
Robert: Old methods for studying the outcomes and change processes of encounter and large group experiences would also be useful to apply: Pre-post designs with psychometrically-sound, theoretically appropriate measurement instruments such as the Strathclyde Inventory are still needed. Qualitative interview methods such as the Change Interview and Helpful Aspects of Therapy Form could also be easily adapted for this purpose. Of course, research on the effects and change processes in psychotherapy and counselling training courses is also very much needed.

23. Classical and experiential approaches to PCT: How do advocates of classical/nondirective and experiential/process-guiding approaches to PCT experience each other, and themselves in relation to each other? What do they want from each other? How do they experience conflicts with each other? What do they feel would be needed in order to reduce these conflicts? [Emotional reaction: sadness, fear, moving toward hope-
Robert: This was my unexpected topic. I think it would be really interesting to interview advocates on both sides about this. I’ve elaborated the research questions a bit further, moving them toward interview questions.

Research as a Growing Edge: Presentation to PCT Scotland Conference

Research as a Growing Edge for the Person-Centred Approach: Issues and Opportunities
Presented May 19, 2007, PCT Scotland Twentieth Anniversary Event)

Two Paths to Person-Centred Research: Experiential & Programmatic:

I. First Path: An Experiential Approach to PCT Research
A. An exercise:
1. Preliminary steps: Get comfortable. Approach your research hopes and fears gently
2. Ask yourself: What is something am I curious to research about Person-Centred Therapy?
3. Wait… Take your time… See what comes to you… See what else is there that wants research…
4. Write down 1 or 2 research topics that symbolize your curiosity
•Check each research topic to make sure it fits at least part of your curiosity
B. Summary of the First Path:
•Start with your natural curiosity, derived from experience with self and others
•Describe your curiosity in words, as a research topic
•Translate your topic(s) into research questions to express this curiosity
•Find research methods to help answer the questions
•Not the other way around!
•Stays close to experience
•Leads to use of a wide variety of methods
II. The Second Path to PCT Research:
A. Dialogue:
•Hold onto your curiosity while considering programmatic possibilities
•Look at the available possibilities for collaboration in research communities
•Host an internal dialogue between your curiosity and the available possibilities
B. Possibilities for PCT Research: Current Research Fronts
•Research Front = research topic being actively pursued by a variety of researchers
•A scientific growing edge
•Can use research politically for empowering PCT therapists & their clients
•Opportunities for collaboration
•Research in community
1. Person-Centred Outcome with specific types of clients
•Serving the present moment: a political necessity
•Young people (school counselling)
•Social Anxiety
•Group studies in centres or by therapist research networks
•Single case research in one’s practice
2. Relational processes: Deepening PCT
•Contemporary understandings of person-centred relational processes
•Relational depth
•Measurement (e.g., Therapeutic Relationship Scale)
•Micro-process research (e.g., understanding the dance of empathy between client and therapist)
3. Client Experiences: Listening to the Client
•Significant events research
•Clients’ experiences of helpful and hindering processes
•Use to improve therapy
4. Task analysis: Tapping Therapist wisdom
•Markers, indicators & micro-processes: What do experienced, skilled therapists look out for in client in-session process? What do they pick up on?
•Therapist responsiveness: What do experienced, skilled therapists do when they pick up client markers?
•Therapeutic tasks How do experienced, skilled therapists help their clients accomplish things in sessions?
5. Emerging front: Effects and Change Processes in Person-Centred Training
•Effects/outcomes (e.g., personal & professional functioning; therapy process & outcome
•Helpful and unhelpful processes
•Justify/improve training; accountability

III. The Dialogue between Experiential and Research Front Paths to PCT Research
•Use your curiosity to reflect on the programmatic possibilities
•Questions to facilitate reflection:
•Is there space for my curiosity in this?
•Is there something here that captures my curiosity more strongly?
•Or is my curiosity a burning passion that needs to follow its own path?

Sunday, May 13, 2007

BACP Research Conference in York

Entry for 10 – 12 May (Written 13 May):

The British Association of Counselling and Psychotherapy (BACP) is the main professional organization for counsellors in the UK, with something over 29,000 members. Some years back they established a Research Office to, naturally, encourage counsellors to get more engaged in research. Under the leadership of John McLeod at the University of Abertay, they created a journal, Counselling and Psychotherapy Research (CPR), and then somehow engineered things so that all members of BACP automatically get the journal as a benefit. This makes CPR the largest-circulation scientific journal in the world devoted to publishing psychotherapy/counselling research. By contrast, Psychotherapy Research, the journal that I used to edit, has 1000 – 1200 subscribers, and the top journal in the field, Journal of Consulting and Clinical Psychology, has about 4100 subscribers! (Whether BACP readers actually read CPR is a different story, but the same can be said for Psychotherapy Research or practically any other scientific journal.)

As part of this process of increasing the profile of research within the BACP and also to increase research awareness and skills in counsellors, the BACP also holds an annual Research Conference. So when Nancy Rowland and other BACP research office folks heard that I was moving to Scotland, they asked me to give one of the keynote speeches at this year's conference. I sent in my IPEPPT research framework talk, and that suited their needs, so we were on.

Diane and I got up very early and took the train down to York on Thursday, so I could go to the CPR Editors’ Board meeting, which I definitely enjoyed more than the last time I went, last October. It’s a nice little journal, by which I mean, it publishes short articles, mostly on qualitative research, and is still finding its feet and educating readers, authors and reviewers. It reminds me a lot of the early days of Psychotherapy Research, when I when editor there. At any rate, I enjoyed myself at the meeting, and we covered a lot of ground.

I have presented once before to the BACP Research Conference, in 2002, when Dave Mearns brought me over to the give the Mary Kilborn lecture. On this previous occasion, in London, I presented an HSCED study of the treatment of the client with borderline processes, which I didn’t feel went over very well. On that occasion, some of the psychodynamic members of the audience interpreted the mostly positive outcome data as not credible, and then complained that I had brought in a treatment failure to show them. I found this particular take on the case rather annoying, and I was left with ambivalent feelings about presenting to this audience again. I was also more nervous than usual when I got up to present last Friday morning.

However, the presentation when well and seemed to have been better received than the one I did 5 years ago. Furthermore, since my talk was the first regular scientific presentation of the conference (after the usual opening speeches), I could then relax and enjoy the rest of the conference.

Compared to UK-SPR (which I went to in March), the BACP Research Conference was larger (150 vs. 40 attendees), busier and more intense, more formal, and better organized. (On the downside, the hotel wasn’t great, and the view of the York Race Track could not compare to the stunning cliffs of Ravenscar.) As a result, by the time we got home late last night, we were pretty much wiped out, and have been taking it easy today. All in all, though, it was an interesting and successful experience, and I learned a lot and met a lot of people. It’s all part of the process!

Saturday, May 12, 2007

Social Anxiety Research Protocol Approved

Entry for 8 May 2007 (written 12 May):

After all my concerns about the Social Anxiety research project ethics proposal being put off until June or turned down, it turns out to have pretty much sailed through the University Ethics Committee, with only minor revisions needed. This startled me with its suddenness; now, we will be ready to start recruiting clients at least 6 weeks sooner than anticipated. Brian Rodgers has now been hired into the Researcher position for the Research Clinic, so he and met for a while last Wednesday, readying the next protocol for submission (the Practice-Based Research Protocol), and planning our next steps to get the Social Anxiety study off the ground.

The Social Anxiety Study Group was very pleased to hear this news, and it appears that we have entered a new phase of our work: preparing to start recruiting and screening clients. Suddenly, we are immersed in the ADIS and the PDQ-4, bastions of psychiatric/mainstream psychological research. I keep waiting for my intrepid band of co-researchers to rise up in rebellion at the horror of this much medical model/positivist discourse, but we keep bravely soldiering on, in the Heart of Darkness (or is it the Dark Side of the Force?). I myself have marched this far into Enemy territory before and returned with my soul, but few of them have, so they have to take it on faith that I am not Leading Them Astray.

Every so often, Tracey or someone will say, “Now, this is so our research will be able to stand up under scrutiny from the powers that be, right?”, so that I can reassure her that, yes, there is a Very Good Reason for learning about DSM-IV and diagnostic interviewing. I keep telling them that they will not fully appreciate just how bad psychiatric diagnostic practices are and how much the whole thing is a political/social construction until they have had the lived experience of learning to use one of these structured diagnostic interviews. Of course, it also true that these diagnostic interview schedules are as good as psychiatric diagnosis gets; ordinary diagnostic practice is generally much worse, in terms of being done hastily and without due consideration of the full range of possibilities.

But in the meantime, there is much to be done!

Sunday, May 06, 2007

PE-EFT Training in Norwich

Entry for 5 May 2007:

Arrival. We flew down to Norwich on Friday morning for one of my standard lecture plus day-long workshop format PE-EFT training. We arrived around noon at Norwich’s tiny 5-gate airport, to find spring significantly more advanced there than in Glasgow: Almost all the trees were out, many – chestnut, whitebeam – in full bloom, visible even from the air. Ivy and other vines already had a good start in their attempt to cloth the buildings in leafy green. The campus of the University of East Anglia is a 1960’s cement construction, distinguished by its extensive network of elevated walkways connecting the buildings to each other and giving the feeling of being in one of the Myst worlds. (A computer game; I kept expecting to have to solve some sort of complicated puzzle…)

Research Consultation. That afternoon, I spent an hour and a half with a group of research students talking with them about some of their research projects and about the need for both quantitative and qualitative research in counselling. One or two were unhappy with my advocacy of what they saw as positivist research methods. I did my Render Unto Caesar number (quantitative research for the government, our Caesar; qualitative research to enlarge the human spirit, which is God-for-us). One of the students, Richard I think, is has collected a bunch of significant therapy events from his work with clients and is interested in their “poetic intensity”, so I talked about my own interest in significant events and how it was sparked by my love for T.S. Eliot’s Four Quartets.

Evening Theory Lecture. Before the Friday evening theory lecture, we had supper in Judy’s room in the Counselling Centre. Brian Thorne (with Dave Mearns the co-founder of the Person-Centred Approach in the UK) joined us, and we discussed this week’s elections. Like Judy, Brian is very English: very polite, cordial but a bit reserved, the kind of person around whom I always feel somewhat awkward in my Americanness. I had actually never spent much time with him and very much enjoyed the chance to get to know him a bit better. After dinner, he kept Diane company while Judy and I were preoccupied sorting out the technical arrangements for the evening, and she was charmed by him.

The lecture was well attended, but I was nervous to be presenting to another new type of audience in a new social-ideological context I didn’t know. The audience didn’t seem very responsive. I tend to feel more comfortable when I have more interaction with the audience, so the lack of obvious responsiveness gave my Critic some scope for imagining disapproval or lack of interest. Judy, on the other hand, later told us that the she had noticed that the audience was unusually rapt and attentive, without the restlessness or stirrings she usually notices at this lecture series! It appears that English Person-Centred/Experiential therapists are less expressive than Scottish or American ones. To quote Kate Fox, “Typical!” (This, we are told, is how English people express disapproval or disappointment … but only privately.)

After a full night’s sleep (unusual for me, especially under these circumstances), I was ready and eager to run the day-long workshop. Judy had chosen a short day schedule, 1000 – 1600, so the trick was going to be getting two tasks into such a short time.

Systematic Evocative Unfolding. I opened by reviewing a bit of the basic theory for those who had missed the previous night’s lecture, and described the System Evocative Unfolding (SEU) task. I don’t have a classic example of SEU on video, but have been showing client PE-111’s bridge phobia unfolding that turns into gestalt enactment/body-work and then into traumawork. It’s a nice piece of therapeutic work, very interesting in its own right, but doesn’t really do justice to the more typical SEU work of using the client’s external-perceptual experiences as a way of helping them access and differentiate emotional reactions.

To make matters more confusing, my audience was packed with students and graduates from Campbell Purton and Judy Moore’s postgraduate course in Focusing-Oriented Therapy (FOT), who were ready to assimiliate everything into Focusing (in the same way that I assimilate everything into tasks and Les assimilates everything into emotion etc, etc). When I broke them into small groups to practice (in little rooms tucked into obscure corners down tangled hallways throughout the building), most of them ended up reverting to Focusing after they found that an external focus interfered with their currently-experienced, internally-oriented Problematic Reaction Points.

What’s the difference between Focusing and the kind of internally-oriented Unfolding work you’ve just shown us?, they wanted to know after we got back together. A good question, I said: Not much really when you’re working with a current internal reaction. So we have a limiting case where Focusing and SEU overlap. But, I said, it’s still really useful to have a task to use with clients who have an externalizing process or who present with externally-focused behavioral (rather than emotional) reactions. I love it when I learn something from trying to teach a task!

Two Chair Work. After lunch in the Sainsbury Centre, a large art museum on the U of East Anglia campus, it was time to Two Chair work, a daunting prospect, given that we now had a bit less than two hours. I rushed through Dialectic Constructivism, which I’ve started teaching as the theory input for Two Chair Work, and described the markers and main steps of the task. I showed them bits of client PE-111 doing Two Chair Work over whether to try to cross a bridge. I’d been debating about whether to do a live demonstration, but decided on the spot that the process needed something more live, and a volunteer was forthcoming.

Live demonstrations are somewhat controversial; they were a point of severe conflict at my last job, where other faculty claimed that they amounted to doing therapy on my students, in violation of the new American Psychological Association Ethics Code. Also, they have a frequent tendency to “go sideways”, i.e., to veer off into something entirely different, as happened to me last year in the Netherlands when a Space Clearing demonstration ended up going into Self Soothing work. For this reason, Les Greenberg doesn’t do live demonstrations in workshops. (He makes commercial video demonstrations instead, something that would totally terrify me!) However, I am learning that the Two Chair Process is strong enough and the markers robust enough that this task seems to be less likely to go off unpredictably (so far at least…). Nevertheless, we now had only about an hour of workshop time left, so I was feeling the time pressure. The Two-Chair demonstration I did in Heusden last month was much more comfortable, in part because there wasn’t the time pressure. Fortunately, in spite of the time pressure, the client and I made the best of the situation, and it worked out pretty well.

After a bit of processing, however, we were left with only half an hour for small group practice. I told them to back to the same groups and rooms as this morning. The first two groups I visited felt paralyzed by the lack of time (I had also dispensed with the marker work, which didn’t help). I raced back and forth among the groups, usually providing helpful suggestions, but in one case just making things worse (fortunately, Campbell was present in that group to help contain the client).

Suddenly, it was over; the clock had run out. A few of us hung around for a bit; I put away my equipment; several people came over to thank me. Judy had had a really good experience of Two Chair Work in the client role, so she was very excited about the day and declared herself “a convert”. She wanted to know if I could come down again to do another workshop, perhaps even a four-day Level 1 training.

Evening in Norwich. After a bit of downtime, Judy picked us up and took us into the Norwich town centre. Diane had already had a nice wander around, so I was the newby. We tried to get into the Cathedral, but it had closed early for some reason, so I will have to visit it next time I am in Norwich. There is a seven-circuit Cretan Labyrinth in the cathedral cloister which I am very eager to experience next time! (This is the same kind of labyrinth as at my parents’ place in Murray Creek, but it is highly unusual for a church to have this as its only labyrinth; the more complicated Chartres is much more common.) We wandered down to the river, then back along the narrow, winding medieval streets, past many, many old churches (Our friend John Riches from St. Mary’s claims that Norwich has the highest per kilometer proportion of churches of any place in the UK), past the market, which its colourful stripe-roofed market stalls, and finally to the Forum, a large, new building that houses the Norwich Library, the local BBC centre, and various restaurants and shops. There, at the Pizza express, Campbell, Judy, Diane and sat overlooking the market, and another local church, with Norwich Castle and the Cathedreal in the distance. We sat there reviewing the workshop, talking about our lives and children, beginning to make tentative plans for the future, as the evening gradually darkened around us. The doors of the church below us opened, and people came spilling out into the night from some concert in the Norfolk Arts Festival. Finally, we said goodnight and goodbye (for now), and Judy took us back to the our hotel, the end of a satisfying and successful training.

University Day Ceremony at Barony Hall

Entry for 4 May 2007:

New professors are invited to attend the yearly University Day ceremony, held this past Wednesday, 2 May, during which they and the new administrators (“senior officers”) are publicly recognized and get to shake hands with the mysterious Chancellor of the university. The Chancellor is the official head of the university, although it is actually run by the Principal, whom I have mentioned in previous entries. He is David Hope, Baron Hope of Craighead PC (i.e., he is life peer and therefore a member of the House of Lords and a member of the Queen's Privy Council). In fact, he is a nice, friendly, unassuming chap.

However, the new professors (all 4 of us who could make it) were not the Main Event for this ceremony, but rather a brief opening ritual. What the University Day ceremony is really about is recognizing donors, reciting the history of the university, recognizing a member of staff for their outstanding contributions, and awarding honorary degrees. This year the honorary degrees went to a minister (current Moderator, or head, of the Church of Scotland), the Advocate General of Scotland (basically the Attorney General), an entrepreneur who pioneered the manufacture of inexpensive contact lenses, and Eddi Reader, a well-known Scottish singer-songwriter. This made for a lot of long speeches, which proved to be bit difficult for those of us sitting on hard chairs in heavy, hot academic robes. Near the end, however, the long process was largely redeemed when Eddi Reader was prevailed upon to sing one of her versions of a Burns song, “John Anderson My Jo”, an appropriate and obvious choice given that the University of Strathclyde was founded by a John Anderson (albeit a different one).

At receptions before and afterwards, we variously snacked on buffet food, toasted to the health of the University, and talked to folk whom we encountered, including several people from our church, such as Jill, who entertained Diane and kept her company during the long process. We have been reading Observing the English by Kate Fox (see Oban entry), so we amused ourselves by testing her observations on the eclectic mix of native Scots and transplanted English people. So far, we are finding her descriptions to be uncannily accurate of the English people we meet, but thankfully less so of the Scottish people, who seem to be generally free-er and less inhibited.

Wednesday, May 02, 2007

Oban Adventure

Entry from 28 April 2007 (completed 2 May):

For this week’s Saturday Adventure, we took the train to Oban, with Mick and his 3 daughters. Helen was out of town hanging out with some of her friends, and Mick contacted us earlier this week to see if we might want to do something with him. We had been trying to figure out what to do with regard to the West of Scotland, so this seemed like a good opportunity.

So Diane, Cristina and I got up early and walked down to the Hyndland train station about 8 in the morning. Diane was skeptical that Mick would actually be able to get his kids organized to make it there, but there he was waiting for us on the platform, big smile, looking wide awake and with all three kids in tow. As usual Shula began screaming as soon as she saw me, so Mick decided to take bets on how long she would continue to cry under conditions of prolonged exposure to the Feared Stimulus (i.e., me). Much to our surprise, it turned out that Maia’s estimate of 5 minutes was the correct prediction, and I had a fine time interacting with her throughout the day!

The Oban train originates at Glasgow Queen Street Station, but we saved ourselves time by taking the train west from Hyndland to Dumbarton Central (one stop past where we had gone on our Dumbarton Castle adventure with Beth last September). There we picked up the Oban train, and continued west along the north bank of the Clyde until the route turned north up into the Highlands, high above Loch Long. From there we went along the west side of Loch Lomond for awhile. At Crianlarich, the train split (we had to move ourselves and the stroller), and the front half went west toward Oban.

The day was sunny, with a bit of cloud, as we progressed through fairly wild glens and lochs, with unexpected vistas opening out every so often, forests newly leafing out, below craggy, rocky heights, almost mind-numbingly beautiful, as we passed through stations with names like Tyndrum and Dalmaly, all with their original Scots Gaelic names given right below the English. After Helensburgh, we had gone onto a single line track, often proceeding slowly up hills and over somewhat uneven railroad bed, with an old-fashioned rocking, clickety-clack effect. (It appears that oncoming trains on the line must pass each other at stations, something we saw as Crianlarich.)

The girls variously played cards, drew pictures, ate snacks, allowed themselves to be entertained by Mick, Diane, Cristina or me, or teased each other. The journey seemed both interminable (with the kids frequently asking if we were almost there yet), and all too quick, because we were passing rapidly from one beautiful place to another.

We arrived in Oban a little after 11am, to a bright sunny day in this smallish seaside town. The ferry to Mull was just about to leave; so we watched it go from the docks. The tide was out, and seagulls and swans were working the rocky shore looking for food or waiting for Maia and Ruby to throw them the rest of Shula’s sandwich.

Actually, there isn’t that much to do in Oban: The Ferry, a line of shops several blocks long, the Museum of War and Peace, churches… and McCaig’s Tower, a folly that looms over of the town. Oban is a working harbor, lots of boats, some being worked on, and a place that you pass through on your way to the island of Mull and Iona, or on your way north up the jagged west coast of Scotland.

We wandered up the esplanade, past the Woolworth’s (I still can’t over seeing Woolworth’s in Scotland…), the WH Smiths, finally reaching the kids’ Mecca, the most important attraction, the magnet that Mick had used to get them to agree to the day-long excursion: Sweetie’s, billed as “the best candy store in the world”. And it was impressive, row upon row of large, old-fashioned jars of candy of all imaginable types, and then some, overwhelming the visitor with an enormous range of choices. You buy the candy in wee batches of 50 or 100 grams, really only a small number of pieces each, watching the shop assistants stuff the candy in little white paper bags. Afterwards, we continued walking along the esplanade, sampling the candy, while Maia immediately began worrying that she had chosen badly. This led to a discussion of the Existential Burden Of Choice… and eventually to a promise to return later to try again (so much for the EBOC!).

We wandered up the esplanade to a large grey granite church, the Roman Catholic Cathedral of St. Columba’s. Some weeks ago, on Palm Sunday, we had visited St. Columba’s in Glasgow (with its memorable mural of St. Columba and the Loch Ness monster). Rather plain and uncluttered on the inside, two things particularly struck me about this St. Columba's: First, over the door in back there is a large, rather dark painting, which when examined closely in the somewhat dim light, revealed itself to be … a depiction of the druids driving St. Columba out of Scotland (an inversion of St. Patrick and the snakes?): There they are high on the cliff waving their arms, dark expressions on their faces, cursing him; for his part, the saint stands in the prow of a small boat, halo over his head, looking beatific (appropriate since he's a saint), heading out to sea, while his followers row, work with the sails and look unhappy. A very curious painting, which induced in me with an image of Scotland left to cranky pagans.

Second, reading the various notices about the church, as one does in these situations, in order to learn more about the place, we came upon a description of a celebration from several years back, marking the installation of the two great bells of the church, named… Brendan and Kenneth! Obviously, this church has some synchronistic connection to our family, since its great bells are named after our two children. We went out and down the stairs to the rocky beach, where we sat for awhile, until one of those bells struck the hour of one. I wonder which one it was…

We had a bit of time before lunch, so Diane, Cristina, and I left left Mick to hang out with the kids on the beach and walked up to McCaig’s Tower. This sits on a hill overlooking the town and resembles a great inverse stone circle: that is, it is a large circular wall, 9 to 14 meters tall, with regularly spaced cut-out arches where standing stones would be in a traditional stone circle. Apparently, this resonance with the nearby bronze age stone circles in Kilmartin and the Islands was not intended, as the tower is reported to have been inspired by the Colliseum in Rome as a late Victorian project to keep local stone masons in work during the winter. Diane and I both had distant memories of visiting it on our trip through Scotland in 1985, but I was surprised to find a lovely garden full of spring flowers within its walls. The view out over Oban and the surrounding bay and islands is spectacular.

We ate lunch at a fine seafood restaurant that is a personal favorite of Mick’s: Ee-Usk (phonetic Scots Gaelic for “fish”). The girls had chips, but the rest of us greatly enjoyed our salmon, fish cakes, angostinos, and haddock, while looking out over the bay. After lunch, we wandered for awhile, past the docks, ferry terminal, train station, until we started to run out of town, then turned back, stopping at the bookstore while Mick went on with the girls back to the beach. I found Kate Fox’s Observing the English, which was recommended to me by my friends Chris and Nancy some time ago and which we have been finding quite illuminating since picking it up.

The train journey home turned out to be memorable for an unfortunate event. Diane picks up the story from here (quoting from a recent email to her mom):
I had a strange experience on the train coming back from Oban on Saturday which I found rather disturbing. … A man fell twice coming down the aisle trying to get to the restroom on the train. Mick removed his 3 girls to their seats and away from the area where they were playing and where the man fell. As he lay on the floor I looked around and everyone was taking care not to look at him. I guess they all assumed that he was drunk and possibly violent as there is a lot of drinking done on the trains.

I got up right away to see if I could help and asked him what was happening. He said he had just finished running a 53 mile race [Robert: this is called ultra-distance running; this distance is twice the length of the marathon] and was trying to return to Glasgow--hurrying to try not to miss the last train and his blood sugar dropped (the race lasted 12 1/2 hours and he had had little to drink and nothing to eat. I brought him some water and Robert found both an apple and another piece of fruit. I thought he would be OK after eating and drinking something.

Finally, after I made an attempt to talk to him, other people suddenly become concerned and one of the train officials offered to call an ambulance to meet us at the next city. He refused and I didn't think he needed it. He did say that he wouldn't do another of those long races without having a support team or person to meet him at regular check points and assist him home for future races. I really don't know if he made it home or not and I felt a bit guilty at not following up better with him but the most disturbing part of the whole experience was how everyone just looked away when he fell. A bit more of the dark side of Glasgow.
I can only say after this that we returned home Saturday night, exhausted, our heads full of the adventure of the day. Since then, the week has been so busy that I’ve only now finished entry!

Scottish Local Area Group of the SPR Initiated

With the support of the UK-SPR Steering Group, a Scottish Local Area Group of SPR has been formed, with regular meetings to begin this September. Modelled after the long-running Chicago Local Area Group, the Scottish group will meet on Thursday evenings in the Glasgow City Centre, roughly every three weeks, from September 20th, 2007. A call for proposals for the 2007-08 series has been issued, with a May 15 deadline. In addition, a day-long inaugural event on Pluralism in Psychotherapy is being organized for September 3rd, 2007, at the University of Abertay, with another one-day event on research on Relational Depth to be scheduled in February 2008. The Scottish SPR Local Area Group is coordinated by Scottish Psychotherapy and Counselling Research Consortium (ScotCon), currently represented by researchers from University of Abertay, University of Strathclyde, Glasgow Caledonian University, and University of Aberdeen. For more information and to be added to the Scottish SPR email list, please contact Robert Elliott at