Suggestions on Enhancing the Relevance of Research on Counsellor/Therapist Experiences

Entry for 4 March 2007:

A common topic for MSc dissertations (=masters theses) here in the Counselling Unit is counselor experiences of working with X population (e.g., dissociated clients) or Y counselling situation (e.g., crises). However, these studies often seem unfocused and may not contribute substantially to knowledge. It often seems that counsellors are a sample of convenience here, in the same way that Intro Psychology students are in psychology departments.

However, from the point of view of psychotherapy change process research and also PE-EFT, research on therapist experiences can be very productive as an initial phase of a task analysis. Therapists, especially experienced ones, possess a large amount of implicit knowledge or wisdom. The explication of this information is the first step of doing a task analysis, that is, the construction of a rational model of a particular therapeutic task. And even if one is not working in the PE-EFT approach, there is still a lot of information to be had about two main kinds of things: practice principles and client markers/micro-markers. I think that it is important to do research aimed at explicating this implicit knowledge.

First, therapists can be asked about practice principles:
(a) “What have you learned from working with this kind of client/situation?” “What general guidelines have you found useful?” [=change principles]
(b) “What kinds of things do you generally try to avoid doing or getting into?” [=proscriptions]
(c) “Can you give me an example of these?” “Anything else?” [=generally useful follow-up questions]

Second, the researcher can ask about markers/micro-markers and “when-then” practice principles:
(a) “Based on your experience with this kind of client/situation, what kinds of response do you look for in the client as markers of something important happening that needs your attention?” [=markers/micro-markers]
(b) “And what do you then do, in response to such a marker?” [=when-then practice principles]
(c) “Can you give me an example of this?” “Anything else?” [=follow-up questions]

This can be done as a traditional qualitative interview, particularly as a very first step of mapping therapist process expertise. However, an even more productive approach would be to play videotapes of their sessions back for experienced therapists, and to ask them to comment on what principles they were following and what markers they were responding to and what ways.

Sidenote: I have a hundred significant therapy events from the University of Toledo Depression project with this sort of information. These data have never been analyzed, although Julia von Starck, a grad student from Germany did begin work on these data in 2001-02 before withdrawing from her doctoral studies.