Saturday, December 20, 2008

Sleepless in Glasgow

Entry for 20 December 2008 (en route to USA):

I don’t usually have trouble sleeping, and I’ve been needing extra sleep for the past month as I recovered from the bug that laid me low. Even now, every time I end up a bit short on my sleep, the cough kicks in again, just to remind me that I’m still not completely well. So it was that as I got into bed last night after a very full and exhausting week, the last week in the run-up to my Christmas holiday, I fully expected to fall asleep without much effort.

Unfortunately, as soon as I turned off the light, I found myself wide awake. I tossed and turned for a good half an hour, then, remembering the standard advice, got up and read for an hour before trying again, finally falling asleep at 2am.

As I lay there, and even this morning, as I wait for our flight to Amsterdam, the first leg of our voyage back to Ohio, I am still puzzled by what happened last night. It can be looked at as a Problematic Reaction Point, so I could try to unpack my puzzling sleeplessness using Systematic Evocation Unfolding. However, last night it felt more like an Unclear Felt Sense, and I tried to Focus on it, with limited success. I suppose that Ann Weiser Cornell would say that I wasn’t able to be fully in presence with it, because I found myself feeling impatient with it: “For once you’re ready before a trip: you’ve done your essential email, you’re all packed, why can’t you sleep!” In retrospect, the Focusing was at least a partial success; it just didn’t help me fall asleep… and of course the impatience got in the way of sleeping also.

I did make some headway with the felt sense, though: It felt a bit like a caffeine-induced unsleepiness, but not exactly. Hmm… there was something like the feeling of excitement I used to get on Christmas eve, waiting for the next day to arrive, wishing I would just fall asleep to make the time go faster but being prevented from doing so by the very excitement to arrive there. So I was clearly excited to get out of the dark, big-city, still-after-2-and-a-half years-somewhat alien life here and back to the two-hours-of-light-more-a-day, suburban, easy familiarity of Toledo (and from there North California). And my kids and the rest of my family… and Christmas.

“Ridiculous!”, said something adult and impatient in me. “You’re not 7 years old, and you don’t really even want anything for Christmas this year. You’re going back a home that isn’t really a home anymore. Sure, you’re looking forward to seeing your kids and larger family again, but that’s not something to lose sleep over!” So I lay there tossing and turning, until I finally gave in to the sleeplessness and got up again. As I said, I was having difficulty being patient with myself, but the getting up was in a way a way of at least acknowledging the validity of the sleeplessness.

This morning I still find myself wondering about, and Unfolding, in a Focusing sort of way, the episode a bit: Some things that felt connected:

First, it has been an intense week, including two different intense processing sessions that revealed deep truths about my relationships with others and left me both drained and more fully appreciative of these situations and their sources. At some level, this feels quite important, although the implications need time to play out. But I’m left with a sense of excitement somewhere in me, about possibilities for new ways of being with others.

Second, there is sense of intellectual excitement over a new possible collaboration with a very diverse collection of colleagues from all over the University, around work on practical applications of Complexity Theory, something I’d looked into years earlier. Ernesto Estrada, recently arrived (about the same time as Lucia, but from Spain instead of Italy) to take up a new Chair of Complexity Science (cross-appointed in Math and Physics), is leading this effort. The developing project is helping me to think about the connection between significant therapy events and complexity theory, using Ernesto’s framework: internal structure (the person’s internal complexity of multiple voices or emotion schemes and modes of engagement); and external forces (the therapeutic framework, which provides a context that changes the equilibrium of the person’s internal organization). This has stimulated my scientific imagination, leaving me with a sense of excitement about the possibilities, not the least of which is the chance to interact with some of the best minds in this science-and-technology-oriented university, which I am coming to realize has a lot in common with Case Western Reserve University (Cleveland, Ohio), where my kids have gone to school.

Third, there is something bubbling away here about the RAE, or Research Assessment Exercise, the initial report for which was reported two days ago. The RAE happens every 7 years in British universities, and is a Big Deal. In addition to status, universities get more money from the government if they get higher RAE scores. I’ve got tons of publications (about 110 at last count), but they only look at the past 7 years, and it hasn’t really been clear exactly what the review panels have been looking for, so I don’t know if my individual submission will meet expectations or not (the individual results apparently will not be available for some time). I’ve been fairly nervous about this, because I was hired as part of an effort to improve the Education Faculty’s RAE ratings, and the Powers That Be will not be happy with me if I don’t do well. In fact, a couple of hours before I went to bed, I’d read our Vice Dean’s pessimistic assessment of our overall results, so that was definitely percolating in the background as I lay awake, a source of indeterminate worry.

Fourth, I realized that my body had a kind of unexercised untiredness, like it hadn’t been used enough. I’ve done very little running in the past two months; now with my energy coming back, it begins to feel like I’m missing the tiredness that comes from having run 3, 5, 6 or even 8 miles. So the unsleepiness also felt a bit like my body saying that it hadn’t been used enough. This didn’t help me sleep, so the impatient part that wanted sleep didn’t appreciate it at the time, but it’s an important message to hear and to do something about.

So no wonder I was having trouble sleeping… and one more thing: This morning, getting up on 5 hours of sleep, felt familiar in itself, comfortable, as if one is supposed to start one’s Christmas vacation tired, dozing on the plane, relieved just to be away from it all. It is the proper mode for travel, especially when you are going to be packed into a large tin can for many, many hours, waiting, suspended between here and there, now and then, waiting to arrive. Instead of Dramamine or alcohol, I have my tiredness to keep me company and temper the journey into a bearable, even enjoyable, time between.

Saturday, December 06, 2008

New Diploma Course Director Arrives

Entry for 5 December 2008:

As I’ve mentioned before, since Tracey Sander left last July, I’ve been Acting Course Director for our three Postgraduate Counselling Diploma courses, along with all my other duties. I’ve been able to survive this by virtue of a lot of help various people: Rachel in the Counselling Unit Office reminded me when things needed to be done, and nagged me when I forgot about them or when the email got buried in the 700 emails in my in-box. Alison Cumming picked up Tracey’s Personal and Professional Development group on the Monday Part-time course. Terry Daly helped the overseas students find placements and took on the monthly Deferrer’s group (for students from the last year or two who are still working on completing their requirements). Various members of the part-time teaching staff continued the pattern initiated by Tracey, of helping out with administrative tasks such as course timetabling and room booking.

For the past five months, some things got forgotten or left aside, while other things were not done with the style or grace with which they had been done before, but somehow we have managed to muddle through.

This week, however, to our great relief, our new course director, Lucia Berdondini, arrived. Lucia is highly focused, enthusiastic Italian woman with an easy smile and a direct but friendly manner. She was trained in Gestalt and Person-Centred therapies and lived in England for 13 years before going back to Florence 3 years ago. She found contemporary Italian politics and life no longer to her liking, and has been eager to return to the UK. She says that she has always wanted to live in Scotland. Although she is just beginning to learn what the job entails, it is a great relief to have her join us, and I for one am looking forward to having a new colleague to bounce ideas off of.

When she saw the ad for the course director position, she says she learned about the Counselling Unit not only from our regular website but also from this blog. I can only hope that the reality doesn’t prove to be too far off the mark from her experience. I don’t make any claims that my perceptions of reality, as represented here, match those of other people!

We invited her to come along to a large group session on the Monday Part-time course on her very first day at work, and she was very impressed with the quality of the interaction among the students she observed. It was a process she recognized entirely from the course she trained on and has taught on, and so I think it helped her feel at home here. And it is a great relief for me to have the company. Even though the early December days are short and the nights long (and this week cold and icy) we are doing our best to help her feel welcome. Welcome, Lucia!

Monday, December 01, 2008

Bracketing in Psychotherapy Research

Entry for 30 November 2008:

In the midst of the run-up to Thanksgiving, my old friend Connie Fischer contacted me for some help with a manuscript on “Bracketing” she was writing for Psychotherapy Research. Clara Hill was asking her for an example from therapy research. Since Connie’s area is psychological testing, she was a bit a stumped and wanted to know if I could provide her with an example. (Connie does wonderful stuff on humanistic approaches to psychological assessment, among other things.)

This was an interesting question for me, because of the short pieces I’ve written recently for the Applied Educational Research course website, on the Hermeneutic Circle and Sensitizing Categories (also posted on this blog). Bracketing is an interesting linguistic metaphor (brackets are what Americans call parentheses), and yet another take on issues of researchers’ prior understandings and what to do with these. While I don’t think that complete bracketing is possible, I do firmly believe that the attempt to bracket expectations and preferences for one’s data is an essential aspect of a responsible scientific process, because it helps open us up to what are informants are trying to tell us. In this sense, bracketing is close to my heart.

Accordingly, I sat right down and wrote the following example of bracketing in psychotherapy research for Connie:
For example, in their study of significant insight events in psychodynamic and cogntive-behavioral therapies, Elliott et al. (1994) attempted to bracket their expectations for what they would find: At the beginning of their study, the members of the research team wrote down what they thought they might find. They then literally stuck these expectations away during the conduct of the study, attempting to hear as clearly as possible what the data were telling them. In addition, at the end of the study, in order to capture their emergent expectations, they repeated this process, finally rating all the categories they had obtained for the extent to which they now realized they had expected these. They thus accomplished the double movement of both reflecting on their pre-understandings while also consciously striving to be open to their data. Beyond this, they were able to demonstrate the success of their bracketing, by showing that their actual findings differed from their expectations: that is, they had found things they hadn't expected and also failed to find other things that they had expected.
As for Connie’s take on bracketing and what she did with the example I sent her, we’ll all just have to wait for her paper, which will be coming out in Psychotherapy Research in 2009, as part of a special issued on research methods. Look for it!

Reference:

Elliott, R., Shapiro, D.A., Firth-Cozens, J., Stiles, W.B., Hardy, G., Llewelyn, S.P, & Margison, F. (1994). Comprehensive process analysis of insight events in cognitive-behavioral and psychodynamic-interpersonal therapies. Journal of Counseling Psychology, 41, 449-463.

Sunday, November 30, 2008

Glasgow Thanksgiving 2008

Entry for 29 November 2008:

For several years, I missed Thanksgiving from travelling, twice to Belgium and once to Rome. For this reason, it was important not to miss out this year. We collected some fellow ex-patriot American friends from church, Melissa and her three daughters, plus Franny and Robert (a native of New Zealand and a Brit) and put on a regular American Thanksgiving feast, complete with turkey, green beans, green and fruit salads, bread, vegetarian entre’, as well as special dishes: cranberry-orange relish (ours) and southern sweet potato mash in hollowed out oranges topped with melted marshmallows (Melissa’s). And to top it off: pumpkin pie made from pumpkin we’d cooked ourselves (with a little help from a some canned pumpkin that my friend Jo had found for me at a store in Edinburgh). It was all great, but the pumpkin pie was a particular hit with the kids and adults alike.

Franny questioned us about Thanksgiving, as she tried to find the cultural equivalent in the UK, but the best she could come up with was Christmas dinner. Do we have any rituals associated with Thanksgiving, like the Queen’s Speech or Christmas crackers? Not really, unless you count watching (American) football (which none of us do). No, it’s really all about the food and the gathering of family. By the end, we were all quite full from eating so much, had had lovely conversation, and felt quite satisfied with our own slightly-delayed Scottish version of Thanksgiving.

Of course, Thanksgiving is also a time to give thanks, although this too is not really part of any particular ritual. I like to think about things to be thankful for:

1. I was finally feeling well enough today to go out for a run. I took it easy, since it’s been 5 weeks since I ran last and I still have a bit of the cough left. Even though it was a cold morning, it felt great to get out on the road again. It’s great to be feeling better, too.

2. I’ve finally begun making progress on my adjudicated HSCED paper, which I’ve been sitting on for 5(!) years. It needs a lot of work to deal with the 10 pages of editorial feedback, but really needs to be done soon. So I’ve been working on it for 15 minutes each morning. It may take me months to finish the revisions at this rate, but if I had done this 5 years ago, the thing would have been finished at least 4 and a half years ago…

3. Lucia, our new diploma course director, has arrived in Glasgow full of enthusiasm, and I had a good visit with my colleague Lorna, so it’s clear that Help Is On The Way.

4. With my friend Antonio Pascual-Leone, an EFT researcher and ex-student of Les Greenberg’s, and one of Les’ current students, Susan Wnuk, we have put together a nice little panel for the SPR meeting next June in Santiago, Chile, on research advances in EFT.

5. Relatedly, data are really beginning emerge from our Social Anxiety study in the research clinic, and the outcome results in particular so far are looking very promising. It’s really good to see this moving forward, and we are following up various leads for funding the next stage of this research.

6. Our families are doing well, including our kids, who have managed to find themselves surrogate families to celebrate Thanksgiving with. I'm really looking forward to seeing them, along with our US friends and family in a few weeks.

Saturday, November 22, 2008

Workload and EPS Retirement Event

Entry for 21 November 2008:

I’ve been essentially working three jobs for the past couple of months, covering for Tracey, our former course director, who left in July, and for Lorna, one of our lecturers and our finance person, who has been off on extended medical leave since September. Fortunately, I’ve had some help from various people, for which I’m very grateful, but it’s actually been fairly stressful. I haven’t done as well as I would have liked at these various duties, most of which I didn’t really understand when I took them over. It’s been an education, and I must say that I now understand the system much better than I did previously.

However, all the extra teaching and admin has finally taken its toll, and I came down with a very bad cold about 2 weeks ago. I’m now left with a lingering cough and am still feeling somewhat run down. Holing up at home for the past two weekends has helped, as has getting extra rest, but meanwhile the email has continued to mount ever upwards and important tasks have not always been done in a timely manner.

One of the people who has really helped me get through this difficult time has been Mike Hough, whose department retirement function was yesterday. Mike and another Educational and Professional Studies colleague, David Cornwell, were treated to a thoughtful and well-attended retirement party, complete with 1960’s music and a wide variety of snacks.

These leaving functions have become a regular feature of life on the Jordanhill campus of the University of Strathclyde. In addition to the general aging of the faculty and staff, the frequency of these events also reflects the fact that life in the Education Faculty has become more difficult for most people, including faculty, staff and sometimes students as well. Between strong pressure to increase research productivity and a serious budget shortfall for the Education Faculty (=college of education in American terms), there is more pressure being brought to bear on everyone here, much of it the result of criticism and directives from the upper administration. Staff who leave or go on medical leave aren’t replaced, budgets have been cut, and those of us who remain are asked to do more and more. Some of this trickles down to the student level, as Terry and I learned this week when we spoke to a group of angry overseas students from the fulltime diploma course, who complained that they are not receiving adequate support and are therefore being short-changed.

I had been asked to say a few words at Mike’s retirement event, but was not prepared for what turned out to be a more formal, involved process than I had expected. Mike and his colleague have each been at Jordanhill for more than 30 years, and about 60 people showed up to see them off and hear the speeches. I’d jotted down a few notes, but hastily added to them once saw what was expected. Mike has been a good colleague to me, caring, wise and passionate (as I said in my remarks), and has really provided a bridge for me to connect me to the rest of the EPS department. As a result I have met new colleagues whom I respect and to whom I enjoy speaking. As I gave my little speech, I looked out over the assemblage of people gathered to say goodbye to two well-loved colleagues. A powerful sense of community came over me. This is a group of people who care about one another, who have history with this place and each other. Afterwards quite a few people, including Mike, thanked me for my brief but heart-felt words. As a result, I myself now feel more connected to and part of this community.

It is a crazy time for all of us, but it’s clear that most of us care deeply about our students and the work, and that this commitment unites us in the face of the difficulties. I’m pleased to be part of it. And I’m very much looking forward to the arrival of the new course director, Lucia Berdondini, next week, and the return of Lorna in January.

Tuesday, November 18, 2008

Sensitizing Categories

Entry for 17 November 2008:

Here is another little methods piece I did for the University’s research methods website, which I think is of more general interest.

Sensitizing categories, as proposed by Glaser & Strauss (1967), are concepts brought by researchers to aid qualitative analyses, but which do not unduly affect the results the emerge from the data. In addition to being potentially useful tools, the concept of whether or not to consciously employ sensitizing categories in one’s research raises important general issues for qualitative researchers to consider.

1. Before starting a qualitative study, should I avoid reading the literature, in order to keep an open mind?

In 1980’s, at the beginning of the qualitative revolution in social science research, many researchers were convinced that the only way to escape the narrowness of previous quantitative social science research was to avoid reading about your topic until after collecting and analyzing your data. In this way, by keeping your mind in a pristine condition, you would be able to maintain an unbiased view of the data. You wouldn’t have to “bracket” your assumptions (a favourite metaphor of phenomenologists), because you wouldn’t have any assumptions.

This view is attributed to Glaser and Strauss (1967), founders of the Grounded Theory approach to qualitative research, and Glaser (1978; as opposed to Strauss, 1998) does in fact advocate avoiding doing pre-research literature reviews. This has a certain appeal, and also justifies jumping right into one’s research without lengthy, boring sitting around in libraries reading books and articles. You could go directly, “back to the things themselves” (to quote the famous dictum of the phenomenologist Husserl, 1913/1982).
Questions for reflection:
•Why is this no longer the dominant view of qualitative researchers?
•Whose interests might be served by a return to a more traditional view of “literature review first”?
•Under what conditions might “literature-free” research be justified?
•How can qualitative research retain its openness and freedom, while still grounding itself in the relevant scientific literature?

The inevitability of “bias”


Whether the belief in assumption-free qualitative research can be best understand as misplaced optimism about the openness of the human mind, as an expression of laziness, or as dangerous naiveté leading to unconscious, unchecked bias, it is not the dominant view of qualitative researchers today. In fact, it’s not clear that this “eternal sunshine of the spotless mind” was ever really subscribed by more than a few qualitative zealots. For example, an important early text (Bogdan & Taylor, 1975) urges readers preparing to do qualitative observational studies to read the literature in preparation for entering the field, so as to avoid committing faux pas with informants. Clearly, it is necessary to know something about what you are studying before starting to collect data; the question is, what and how much? There is also the question of how to use what one does know.

Philosophers since Kant have generally understood that it is impossible to know anything without bringing some prior knowledge, or forestructure, along. Not only is it impossible not to drag one’s prior knowledge along, but this prior knowledge is what makes the knowing possible. Without prior assumptions, categories, and words, we would be faced with what the American psychologist-philosopher William James (1890) referred to as a “buzzing, blooming confusion”, in other words, chaos. We wouldn’t even know there was something there to be known; everything would sound like noise, that is, meaningless, random stuff. For example, even something as seemingly straightforwardly obvious as an impression of the colour red is only made possible by the fact that our sensory system is biologically tuned to certain light frequencies and culturally programmed to divide the light spectrum into certain major categories. Awareness of these prior knowledge structures has led to whole fields of study into the nature and content of the human knowledge system, including perceptual and cognitive psychology, depth psychology (psychoanalytic and Jungian), cultural anthropology, and ethnomethology (Garfinkel, 1967), among others.

Even worse, failure to acknowledge the role, influence, or aid of prior knowledge means that we cannot therefore know the extent to which we are being limited or influenced by that knowledge, thus blinding us to our biases, whether these are biological, psychological or cultural in origin.
Exercise: Take a blank piece of printer paper. Fold it half the short way, top to bottom. Run your finger along the fold, looking carefully at how the paper has taken the fold. Now unfold the paper, and fold it the long way, right to left. Once again, take a close look at the fold, at how bumpy or not the fold is. Note that that one of the two folds you made is much more smooth while the other is more bumpy. The bumpy fold was done against or across what is referred to as the bias or grain of the paper, while the smooth fold was done with the bias or grain.
Finally, find a good dictionary and look up the meaning and origin of the word “bias”. Why is there bias in paper? What other things have bias? Is it possible or even desirable to make “unbiased” paper? What implications does this parable have for research in general, and qualitative research in particular? What does this have to do with the concept of “sensitizing categories”?

Using Sensitizing Categories

In retrospect, Glaser’s (1978) argument against pre-research literature reviews appears to have been misunderstood. First, he doesn’t say you should read nothing. Rather, his view is that the researcher should read books on qualitative method, especially his books, to help you develop an open, creative approach to your data. He also says you shouldn’t record your interviews or talk to anybody about your emerging theory (Wikipedia, 2008); fortunately, nobody today listens to those methodological guidelines either! Second, the reason Glaser says it’s a bad idea to read the research literature before doing your research is that it will desensitize you, that is, make it more difficult for you to hear what your data are trying to tell you. He doesn’t want you to read right past your data, saying to yourself, “Oh, of course that’s an example of X”, rather than stopping to really listen to what a participant is trying to tell you. So the real point is that anything that interferes with hearing your data with a fresh, curious ear is bad and should be minimized.

But Glaser (1978) also argues in favour of “theoretical sensitivity”, the use of sensitizing concepts that help you hear what is going on in your data. How is this possible?

Glaser (1978) and Strauss (Strauss & Corbin, 1998) famously disagreed on how to do this. While Glaser favours a more open-ended, creative, unstructured use of prior concepts, Strauss and Corbin put forward a “paradigm” of organizing categories, which is the basis of what they refer to as “axial coding” (i.e., organizing your data within a set of broad headings or domains). Exactly what this means is subject to varying interpretation. On the one hand, it can be understood as a general social theory that can be applied to a wide range of social phenomena, as Strauss & Corbin appear to imply. On the other hand, others (e.g., Elliott & Timulak, 2005) argue that the axial coding or domain structure of a topic emerges over the course of analyzing the first 3 to 5 interview protocols, and reflecting the interaction between the researcher’s interests and what participants are interested in telling about the topic. For example, it is appears to be common for informants to want to say much more about the background or context of the phenomenon than the researcher is interested in studying(e.g., Rhodes et al., 1994).

Sensitizing categories as research topic domains. In this latter view, then, the most useful sensitizing categories are broad headings that remind the researcher to listen for particular aspects of experiences, without constraining the specific nature of those aspects. For example, it is generally useful to organize one’s topic into a set of domains or subtopics such as:
• Context: What led up the targeted experience (e.g., realizing one’s ordinary way of seeing something was wrong; struggling and feeling confused; considering different possibilities; etc)
• Experience: What happened during the targeted experience (e.g., understanding a scientific concept such as gravity)
• Effects: What happened afterward, or flowed out of the targeted experience (e.g., feeling clarity and relief; applying the concept to other situations)
While such a framework of sensitizing categories or research domains seems obvious and straightforward, it often turns out need further adaptation. For example, participants may have little to say about the effects of an experience, but may make an important distinction between the immediate context or situation in which the experience occurs and its deeper context or background earlier in person’s studies or life. Thus, it seems important for the researcher to hold these sensitizing categories lightly and to be ready to adapt them to fit the particular research topic and data.

At the same time, even a primitive set of sensitizing domains will alert the researcher to listen for a broad range of aspects relevant to their topic. It will tell them where to look, but not what they should see there. Sensitizing categories organize the phenomenon being studied, without constraining it. Organizing the data into domains reduces the complexity of the analysis into more workable subsets of data that can be handled one at a time. This means that the researcher is less likely to be overwhelmed by the “buzzing, blooming confusion” of their data.
Exercise: Spend half an hour thinking about a research topic you are interested in. What specifically do you want to know about it? What are its aspects or phases? Is it something that happens in a single moment, or does it unfold gradually over time? Does it have a beginning, middle and an end? See if you can produce an initial set of headings to organize your topic. Try to write one or two interview questions for each heading.

References

Bogdan, R., & Taylor, S.J. (1975). Introduction to qualitative research methods. New York: Wiley.

Elliott, R. & Timulak, L. (2005). Descriptive and interpretive approaches to qualitative research. In J. Miles & P. Gilbert (eds.), A Handbook of Research Methods in Clinical and Health Psychology (147-159). Oxford, UK: Oxford University Press.

Garfinkel, H. (1967). Studies in ethnomethodology. Englewood Cliffs, NJ: Prentice-Hall.

Glaser, B. G. (1978). Theoretical sensitivity. Mill Valley, CA: Sociology Press.

Glaser, B. G. & Strauss, A. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine.

Husserl, E. (1913/1982). Ideas pertaining to a pure phenomenology and to a phenomenological philosophy: General introduction to a pure phenomenology (trans. F. Kersten). Boston: Kluwer.

James, W. (1890/1981). Principles of psychology. Cambridge, MA: Harvard University Press, 1981.

Rhodes, R.H., Hill, C.E., Thompson, B.J., & Elliott, R. (1994). Client retrospective recall of resolved and unresolved misunderstanding events. Journal of Counseling Psychology, 41, 473-483.

Wikipedia. Grounded theory (Glaser). Retrieved on 12 Nov 2008 at: http://en.wikipedia.org/wiki/Grounded_theory_(Glaser)

Saturday, November 08, 2008

HPCE Expert Reference Group – Part 6

Entry for 7 November 2008:

In the continuing saga of the Humanistic-Person-Centred-Experiential (HPCE) therapy competences expert reference group (ERG), we have now reached our sixth meeting. The framework is now being worked on primarily by Andy Hill and Tony Roth, with input from various of the rest of us on the ERG, plus a working group at UKCP (UK Council for Psychotherapy). We have worked and reworked the “Generic Therapeutic Competences”. These run across different theoretical orientations with relatively minor variations in language and nuance, such that parallel versions exist for CBT, psychodynamic and family-systemic therapies. These are these are now in fairly good shape, so they got very little of our time today.

Basic Therapeutic Competences. Today’s main agenda item was to review the work that Andy and Tony had done on the next domain in the framework: “Basic Therapeutic Competences”, defined as foundational competences shared and constitutive of HPCE practice. These are really the heart of the HPCE framework. We had done quite a bit of work on these last time, and now had to review and try to finalize them, plus deal with various version control issues stemming from folks having worked off of different evolving version.

At this point, the Basic HPCE Competences are divided into the following outline (this is still not the final version, but should give the flavour):

A. Knowledge of the rationale for HPCE therapy
A1. Knowledge of humanistic principles that inform the therapeutic approach
A2. Knowledge of HPCE theories of human growth and development and the origins of psychological distress
A3. Knowledge of the HPCE conditions for and goals of therapeutic change
B. Ability to initiate therapeutic relationships
B1. Ability to explain and demonstrate the rationale for HPCE to the client
B2. Ability to work with the client to establish a therapeutic aim
C. Ability to maintain and develop therapeutic relationships
C1. Ability to experience and communicate empathy
C2. Ability to experience and to communicate unconditional positive regard for clients
C3. Ability to maintain congruence in the therapeutic relationship
D. Ability to conclude the therapeutic relationship

Under each of these headings are 5 to 20 subheadings, extending up to 3 outline levels deeper, presented in indented boxes, for example, under empathy, Box C1c, currently reads, “An ability to sense and understand those feelings and perceptions of which the client is aware, as well as those which [sic] have not yet entered the client’s awareness.”

A working group of the Humanistic and Integrative Psychotherapies (HIPS) section of UKCP had put a considerable effort into doing up a revision of the Basic Competences; the nature and extent of these proposals was such that several of us had gone into the meeting today worried about the potential for this to derail the whole process. Our fears proved unfounded, however, as Steve, Tony, Janet Tolan (the representative from the British Association for the Person-Centred Approach), and others were able to make creative use of many of these suggestions to improve the emerging product, while remaining true to the evidence base and training manual corpus. Thus, we were able to work efficiently (for us) through the latest version of this domain, and at the end were quite pleased for the progress on this part of the framework.

Metacompetences. One of the thing that came out strongly from the day was the importance of what Tony and Steve are calling “Meta-competences,” that is, competences about how to apply the competences. This is where things like clinical judgment, responsiveness, critical self-reflection, effective use of therapist own experiences, and issues of directivity and nondirectivity all come into play. Many of the really tricky bits fall under this rubric. For example, the key overarching principle in PE-EFT is actually a meta-competence: Balancing relational and task processes, a general issue that appeared in several forms over the course of the day. In fact, much of the input from UKCP about critical reflection and personal integration really speaks to issues that can be nicely handled as metacompetences. Furthermore, it has become clear that there are specific metacompetences distinctive of HPCE, which will be important defining criteria. So this turns out to be a very useful conceptual tool indeed, in a way analogous to regulatory DNA in the genetic code, which is turning out to be at least as important as the traditional kind of DNA, in that it turns the latter on and off.

Onward to the Specific HPCE Methods Domain. Before finishing up, we turned briefly to the next domain, Specific HPCE Methods, more to scope out the next steps than anything else. After some discussion, we clarified that this domain should address therapeutic methods common to many but not all (or even most) HPCE therapists. This means that there can be things here that various folks never use and might not even approve of, which allows the framework the capture important variations in practice, without their being imposed on those who don't want them.

Much of this section as it currently stands is derived from the two PE-EFT texts we’re using, Learning emotion-focused therapy (Elliott et al., 2004) and Emotion-focused therapy for depression (Greenberg & Watson, 2006). What isn’t clear yet is whether this will be the realm of the experiential branch of HPCE family only, or whether we will be able to find something useful in it for therapists from the classical/relational person-centred branch.

This section is also particularly important for the HIPS folks from UKCP, many but not all of whom belong to the experiential branch of the HPCE family. This is where their use of enactments (chairwork), re-experiencing, and focusing/awareness methods will be able to find a place. Fortunately, PE-EFF is an instance of an integrative humanistic therapy that has a systematic theoretical and practice framework, but also has the RCT evidence and detailed therapy manuals needed for the competence development process. This allows much of HIPS a road into the HPCE competence framework.

The issue of how to bring into this the classical-relational branch of HPCE is a more difficult question. After some discussion, we decided to see if we could broaden the entries in this domain, to make at least some of it more relevant to a wider range HPCE therapists of classical and nonclassical persuasions.

Translating PE-EFT into Classical PCT. This is actually something close to my heart at the moment, as I have recently been trying find ways to talk about PE-EFT concepts to more traditional students and colleagues. For example, I want to talk with classical-relational person-centred therapists about how they understand and work with conflict splits in a more traditional way, using empathic exploration rather than chair enactments. This is because for me working on the right task (for this client at this moment) more important than the particular methods used to work on that task. If you’re working on the wrong task (that doesn’t fit where the client is at the moment), then it doesn’t matter what you do; you’re still going to be at cross purposes with the client. But if you are at least going in the same direction as the client, it means that you are less likely to get in their way!

The result of our discussion today was that we appointed me to work with Andy and Tony to put in some further effort on the working with emotion section of the Specific Methods domain. This should be an interesting challenge…

Dialectical constructivist reflections. As the meeting broke up, it was 4pm on a Friday afternoon in London, darkening already in the early November dusk, but also I felt darkened by the deepening economic recession (I wondered if that was why the train to London was surprisingly empty). Mick and I stayed and chatted with Tony and Steve for a few minutes before heading off. I think it’s been a good journey so far, and the dialogue with them and with Vanja representing something of the humanistic-integrative position was been both educational and useful for all of us. I think we’ve all learned from each other, and over the months I think I’ve detected a rising respect for all this humanistic therapy stuff from Steve and Tony, or at least less bemusement and scepticism. At the same time, I’ve come to respect what they’re about on this project of developing all these different competence frameworks. What looked like it might turn out to be a cookie cutter process has turned into something much more subtle. In piagetian terms, there has been both accommodation and assimilation: We have changed and so have they, their views and even the general competence framework itself evolving out of the process. I was reminded of my friend Bill Stiles’ theory-developing case study research on the Assimilation Model, morphing and adapting as it encounters new data and new problems. In PE-EFT and Gestalt therapy terms, we’d say it has been a dialectically constructive process in which different processes were differentiated or separated, then brought back into contact, something that we believe is fundamental to the process of change, producing newness that is never predictable in advance, but which makes logical sense afterwards.