Previous research has examined general attitudes towards mental health. These attitudes have tended to be stigmatised, which results in a negative impact upon the individuals who suffer from mental health difficulties. When parents have a child who suffers from a mental health difficulty, they are also affected by these stigmatising views, and there appears to be a culture of blame placed upon parents, particularly mothers. When a child needs psychological therapy, the effects that parents can have upon their child's therapy have been well researched, but the effects that children's mental health and the receipt of psychological therapy has upon the parents has been less researched, and there is a significant lack of research conducted around this area in the UK. This piece of research aimed to address this gap and to explore parents' experiences of having had a child or children receive psychological therapy. Eight mothers were interviewed all of whom had a child or children under the age of sixteen years receive psychological therapy. A semi-structured interview schedule was used, and the data was analysed using Interpretative Phenomenological Analysis. Four master themes emerged from the analysis which highlighted how the mothers made sense of having a child receive psychological therapy; the enhancement of relationships, exploring the meaning of having a child with mental health difficulties, the journey of therapy, and negotiating the role of parenthood. These themes are further discussed, and links are made to relevant previous research and literature. The challenges of conducting this research are discussed, along with the strengths and limitations of the study and the implications for the field of Counselling Psychology and practice. Ideas for future research are also presented.

The publications and critical commentary constitute a body of work spanning the period from 1988 to 2012. This has seen: the professionalisation of the field of counselling and psychotherapy, the development of a wide range of approaches; and an exponential growth of training programmes associated with these changes. The thesis constitutes the response of a systemic psychotherapist and academic engaging with the expanding formal knowledge of the field as it informs intervention with clients and the training of practitioners. This is to be understood as an extended exercise of praxis in the dialectical application of theory to challenges encountered in practice. From this a number of themes have emerged which have made an original contribution to the knowledge base of the subject area. These are: the development of a model for working with process; the application of systemic approaches to intervention with individuals; crosscultural work; a critical response to the ‘post-modern turn’; and a cross-modality approach to training. This response to an unfolding epistemological context opens the way to establishing a cross-modality position; one that argues for a ‘respectful co-existence’ which is appreciative of differences between theories and models but cautious in the face of claims to orthodoxy and supremacy.

The current study investigated the experience of the Yoga Therapy for the Mind (YTFTM) 8-week course, a manualised yoga and mindfulness-based intervention, for mild to moderate depression and anxiety. Eight female students from across four YTFTM courses participated in semi-structured interviews exploring their experiences of the course. Interviews were analysed using an Interpretative Phenomenological Analysis, with thirteen subordinate themes emerging and grouping into four super-ordinate themes: Personal Journey of Change, Ambivalence, Mind/Body Connection and Group Experience. The findings of the study have been interpreted in light of relevant literature from across the fields of psychology, neuroscience and Buddhist and yogic philosophy. The findings echo previous research into comparable mindfulness-based courses, but suggest there may also be additional psychological benefits to the practice of yoga asana. These added benefits include a more holistic and embodied understanding of psychological distress and adaptive coping strategies, as well as enhanced wellbeing. Recommendations have been made with a view to influencing future courses and Counselling Psychologists interested in developing a more holistic approach to therapy.

Despite there being a vast amount of research within the field of bereavement, as well as death and dying, there are still some experiences which are yet to be explored within the literature. One of the aspects seen within the bereaved and medical communities is that of patients and relatives achieving a ‘good death’. The ‘good death’ has transpired as being physically present at the moment of someone’s death. Although there have been a handful of studies which have looked at presence at the moment of death, the current study explored the embodied experiences of bereaved people who were physically present or absent at the moment of death. Nine participants took part in semi-structured interviews, which explored how they made sense of the phenomenon. Interpretative phenomenological analysis (IPA) was used to analyse the transcripts and what emerged were three inter-connective super-ordinate themes of: ‘connecting to the body and emotions’, ‘putting the moment of death into the wider context’ and ‘endings and beginnings’. Participants spoke of their relationship with their bodies, their emotions and the dying person’s body. As the experiences were context bound, participants mentioned the challenges of choice at the moment of death and the connectivity to their wider family and societal networks. Finally, physical presence or absence at the moment of death not only brought about the significance of saying goodbye but also life changes in response to the event. These findings go against the longstanding medicalied view of death to offer a different way of looking at bereavement as well as death and dying. In doing so, they offer application to practice for counselling psychologists, but also those working with the dying as an attempt to incorporate the body into providing holistic care to people.

The World Health Organisation (WHO, 2015) states by the year 2017, the majority of the world’s population will be living in an urban environment. Numerous studies are also highlighting the increasing levels of mental distress for those living in contemporary urban, as opposed to rural, environments. Professionals and academics are arguing that this is partly due to our disconnection from nature, that was brought about by the 19th Century industrial revolution. Finding ways to reconnect with the natural world, may thus go some way towards ameliorating the detrimental effects of urbanisation on mental health. Existent literature has established that nature is therapeutic but does not tell us how people experience and make sense of their experiences and has typically viewed and treated nature as a quantifiable entity. To address this gap, this study used Interpretative Phenomenological Analysis to explore how nine people experienced urban nature as therapeutic. Semi-structured interviews were conducted on allotments, in parks, gardens and in urban forests and produced an in-depth insight into how participants made sense of their experiences. The themes that emerged include, ‘The Intertwining Body’, highlighting our dynamic interaction with the natural world and the body’s importance for wellbeing; ‘Roots and Shoots’, two parts of a cyclical whole with Roots, and, Shoots, each, further sub-dividing into three themes. Roots reflects the more personal, introspective therapeutic experiences and Shoots elucidates how urban nature fosters wellbeing through enabling creativity and social cohesion and action. Finally, the theme of ‘Continuity’, captures how participants made meaning from the continuous cycles of the natural world as well as made sense of their own finiteness. The findings challenge our thinking about the ways in which we view health and conduct therapy and call for counselling psychologists to expand their roles by becoming more involved at a local and global level.

The role and impact of a positive therapeutic alliance on psychotherapy outcome has been vastly documented. However, ruptures in the therapeutic alliance are a common phenomenon posing marked challenges on the work of therapists. Although outcome research indicates that rupture-repair processes contribute to an enhancement of the therapeutic relationship, as well as positive treatment outcome, there is a relative lack of qualitative research on the topic. The aim of the current research project was to address this gap by exploring the ways therapists experience, make sense of and repair therapeutic ruptures. Ten semi-structured interviews with counselling psychologists of various therapeutic orientations were conducted, and subsequently analysed using Interpretative Phenomenological Analysis. Four superordinate themes emerged from the data: ‘The Threat’, ‘The Struggle’, ‘The Meaning-Making’, and ‘The Resolution’. Ruptures were perceived as threatening to the therapeutic endeavour, and experienced in the form of withdrawal, breakage or misattunement. Participants’ accounts also revealed experiences of heightened struggles in the form of power and control issues, personal and professional dilemmas, as well as negative emotionality. Participating counselling psychologists appeared to make sense of ruptures in relation to intense intrapsychic and interpersonal dynamics, personal vulnerabilities, as well as pacing of therapeutic interventions. Unique and idiosyncratic ways of processing ruptures were employed, whilst successful resolution was ultimately experienced as transformational for the therapeutic relationship and outcome, and was perceived as a valuable learning experience for both therapists and clients. Overall, therapeutic ruptures and repairs were conceptualised as fundamentally relational, intersubjective acts, co-created and co-experienced by both members of the therapeutic dyad. The emerged findings are examined in relation to existing literature and, the implications for the research, training, and practice of Counselling Psychology are discussed.

The following portfolio seeks to view counselling psychology and people with learning disabilities from a pluralistic standpoint. The focus of the research is to understand the attitudes of support workers towards counselling psychology and this particular client group. It attempts to investigate through mixed methods the likelihood of support workers considering a referral for counselling and the factors that affect this while understanding the views and opinions of support staff. In addition, the portfolio includes a publishable paper based on this research which focuses on the role of counselling psychology in improving access to counselling for people with learning disabilities. Finally, a case study presents therapeutic work with someone who has a learning disability underpinned by a pluralistic framework.

There is a distinct lack of empirical research pertaining to how UK counselling psychology and its practitioners construct ‘rupture in the therapeutic alliance’, and what the term accomplishes for those that use it. Arguably there is also the potential for discourses of ‘rupture’ to be overlooked within a profession whose regulating and training discourses prioritise the healthy alliance as normative and desirable. Informed by a critical realist constructionist epistemology, this study explores how the profession and individual counselling psychologists construct ‘rupture in the therapeutic alliance’. This exploration is in two parts: (i) a mapping of the contemporary discursive terrain of ‘rupture in the alliance’ through an analysis of the discipline’s expert texts and (ii) an exploration of practitioners’ constructions of ‘rupture’ via analysis of four qualified counselling psychologists’ semi-structured interviews and a focus group with five trainees. These two sites of analysis permit an exploration of the wider discursive resources available to counselling psychologists and an investigation of how participants’ choice (or resistance) of particular discourses and discursive repertoires impact their subjectivities and practices. To explore this interface a synthesis of Foucauldian, discursive and critical discursive analytic approaches was used. Analysis of expert texts indicates a binaried, discursive terrain which draws on medical and relational discourses to position participants as either ‘diagnostician’ or (ideal) ‘relational being’ in relation to ‘rupture in the therapeutic alliance’. In their talk, individuals evade such fixed positions by drawing on alternative discursive repertoires of rupture as ‘inter’ and’ intrapersonal crisis’. These allow practitioners to take up alternative positions (e.g. practitioner as ‘emotional being’, ‘dutiful soldier’) from which to manage issues of accountability in relation to ‘rupture’ within the clinical space. This can lead to fractured professional subjectivities. Interestingly rupture constructed as ‘ending’ belongs to a marginalised discourse within both textual and individual accounts. The consequences of this marginalisation, along with the implications of practitioners’ fractured subjectivities for the profession and practice of counselling psychology are discussed.

Family structures and career paths have changed significantly in the last 50 years, yet women still seem to shoulder the majority of domestic and childcare responsibilities, often alongside pursuing their own career. If women also have a partner who travels regularly overnight for work, research shows that roles and relationships are impacted. Very little UK research has focused on the experience of individuals and families affected by work-related travel (WRT), despite its increased prevalence in recent years. A multi-perspectival Interpretative Phenomenological Analysis was conducted to qualitatively explore a woman’s lived experience of holding the roles of parent, professional, and partner. Six women with preschool-age children, careers and a partner who travels regularly overnight for work participated in the study. Data was collected from semi-structured interviews incorporating open-ended questions and a visual prompt, and journals kept during one period when each participant’s partner was traveling. Three master themes emerged from the analysis, each with two to four subordinate themes describing the women’s experience of ongoing movement between engaging with uncertainties of their context and active choice-making, influenced by and influencing a conflicted self as it interacts with the external world. Findings from the study have been considered alongside literature pertaining to WRT, holding multiple roles (for example Barnett and Hyde’s 2001 expansionist theory), and theories of gender, transition and development. Implications for Counselling Psychology and ready applicability of the findings are also discussed. In the spirit of IPA, my impact on the research has been held in mind reflexively throughout.

Research investigating clients’ internalised representations of their therapists has shown that developed therapist representations can be evoked by clients both within therapy and post-therapy. Clients can use their therapist representations to problem-solve, to self-soothe and to introspect. However, research suggests that clients may experience difficulty in forming representations of their therapists where there is either an absence of a therapeutic alliance or therapy relationship. Given that most therapists have engaged in therapy as clients themselves it is likely they also can potentially form representations of their therapists. From a Counselling Psychology perspective, therapists who can form representations of their therapists may be able to use these for personal and professional development. Considering the implications of therapists possibly using their therapist representations, it would seem relevant to investigate therapists’ experiencing of this phenomenon. Therefore, this qualitative study aims to explore how therapists experience their therapist representations. Semi-structured interviews were conducted with eight participants, -three psychologists and five psychotherapists, - all of whom were therapists and had completed a minimum of one ended year of personal therapy with the same therapist. Using Interpretative Phenomenological Analysis (IPA) the transcripts were analysed which indicated three master themes: 1) letting the therapist in, 2) identifying with the therapist, 3) the changes within. It was found that the participants seemed to have experienced a felt-presence of the representations of their therapists either alongside them or inside of them. They seemed to experience their therapist representations as holding. These representations may have had a reparative function of early object-relations thus improving current interpersonal relationships. The participants experienced imagined dialogue almost as a mentor-mentee style relationship. Interpretations of the participants’ descriptions of their experiences appeared to make the process of internalised representations more explicit. The implications, applications and limitations of this qualitative study are addressed from a Counselling Psychology perspective.