ADEOLU AMOS ADEYEMO D240 EMA X246808X
QUESTION: (A) Summarise the research article ‘An exploration of the therapeutic process while using computerised cognitive behaviour therapy’ (D240, 2010 The Open University). (B) Discuss the strengths and weaknesses of the approach to research contained in the article. (C) Conclude by discussing which understanding of the counselling relationship you feel most drawn to and why. Word Count. 2000.
PART A SUMMARY
The purpose of this qualitative study on the use computerised cognitive behaviour therapy is to investigate the experience of clients when using computerised cognitive behavioural therapy and also to identify if it has the same effect as it would in face to face cognitive-behaviour therapy; given that high value have been placed on client-therapist relationships in success or failure of a therapy. The other purpose of the study is to explore the process by which clients are able to make use of unsupported computerised Cognitive-Behavioural therapy self-help therapy to aide their recovery (Davd G. Purves & Dutton, Janet, 2013). In order to carry out this qualitative study, seven participants were recruited, six female and one male between ages 30 to 57 years on voluntary basis through newspaper advertisement; those recruited have had mild depression with some self-help experience in the past. Those recruited were screened with the use of questionnaire to make sure they were appropriate for the research. For the purpose of this research Blues Begone Computerised Cognitive Behavioural therapy program which was designed as self-help to fight the symptoms of fear and anxiety was used. Each participant was sent one in form of CD to be downloaded into their computers, each has thirty episodes. It offers assessment and personalised program of therapy as contained in CBT framework, with no interference from the researchers, though they were available for assistance ((Davd G. Purves & Dutton, Janet, 2013). After completion of the programme, data were collected from the participant through semi-structured interview, the transcript of the interviews were analysed by the use of Interpretative Phenomenological Analysis method. Inter-rater reliability was used to reduce any bias that may impact interpretation of the data; the data was also checked by two autonomous raters but were familiar with conducting and analysing interview data ((Davd G. Purves & Dutton, Janet, 2013).
At the end of data analysis the research result shows four main areas of interest were discovered while carrying out the process of computerised Cognitive Behavioural Therapy activity.
There was development of some reasonable relationship with self-help materials provided which was confirmed by five of the seven participants, the design of the program which cartoon provides warmth, humour and enthusiasm. It encourages them to form ‘relationship’ just as in real live therapeutic bond. However the computer was unable to provide immediate response to difficulty, and specificity as in human encounter therefore the users were unable to address their problems at a deeper psychological level. Also five participants expressed that they feel empowered because the program provided them information that altered their perspective on a specific issue, they were able to take information that are relevant they are to their situation and how that information can be used to address their situation without any assistance from a therapist. The third point raised was that the participants were stimulated with the way the program were presented in different colours, music, images and humorous cartoon, all these boost their engagement and helped some to think, this was seen as a form of interaction. The last finding was that the participants found how the structured of the Blues Begone helped them to break down their issues and handle them in a convenient way thereby regaining both sense of direction and individual control in the process ((Davd G. Purves & Dutton, Janet, 2013).
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While the researcher was discussing the research it was suggested the environment created by therapist with warmth and empathy that enhance therapeutic change can be converted into self-help media to the extent that the user became engaged in the self-help process and motivated to undertake the work of change. Even with the participants not being able to experience the reaction and depth of face-to-face rapport, it did not reduce the worth of the cCBT intervention. And what the cCBT experience lacked in depth was made up for in participants involved with different features of the program to experience changes in thinking and develop new explanations to their problems. It was also suggested that while cCBT has the prospective of stimulating and facilitating individual process, as the responsibility of the work of therapy lies with the client. It also confirms the idea that in self-help effort the client is indeed the main cause of change. It also suggested that the implication for practice was talking therapy services are to offer self-help or guided self-help intervention before receiving face-to-face therapy.
Discuss the strength and weakness of the approach to research (qualitative) contained in the article.
Qualitative research can be defined as organised study that involves gathering and evaluating non-numerical data (D240, 2010 p.309). It is about the study of people in specific circumstances and usually in their own normal environment, Qualitative research usually aim to give support to the development of understanding, by arriving at a report and or interpretation of specific aspect of human experience. Qualitative research is different from quantitative research; quantitative research is mainly about gathering numerical (numbers) data usually through questionnaires, surveys to give explanation to a specific phenomenon and in most cases it involves larger group; hypothesis is usually given at the beginning of the research unlike qualitative research (D240, 2010).
There are different means of collecting qualitative data, among which are interviews, open-ended questionnaires, diaries and recordings made during counselling therapy sessions (D240, 2010 p. 309). The style of qualitative research used dictates the method that will be used to construct meanings, for instance there are different guidelines that can be used to analyse interview data which includes empirical phenomenology, grounded theory and interpretative phenomenological analysis. However another school of thought believed that meaning is made up between people through their use of language; in view of this idea analysis of dialogue and everyday talk is taken as sources of meaning (D240, 2010 p. 309). In this type of qualitative research approach, there are different methods of analysing different aspects of language. Discourse analysis, conversation analysis and narrative analysis. The discourse analysis for example focuses on how an individual position herself or himself within wide-ranging culturally based ways of talking while conversation analysis is on the way meaning is created in the moment by moment interaction between talkers. Narrative on the hand emphasises the stories someone tell about his or her lives as vital elements of meaning (D240, 2010 p. 310).
However whatever way of conducting qualitative is chosen there are sets of standard procedures to follow. It starts with researcher identifying question or issue to explore; this is followed with the creation of text which can be in for of diary, interview transcript or a recording session of a therapy to represent the phenomenon. The researcher will now have to deeply involve himself or herself for its meaning to come out, after which the act of interpretation will be transferred to appropriate audiences in a report format (D240, 2010 p.310).
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One of the strengths of qualitative research approach is in its ability to provide a thoughtful and description of people’s understandings of a phenomenon which cannot be understood in terms of numbers; example can be taken from the article, most of the participants felt empowered during the course of cCBT program, this type of feeling cannot be quantified in numbers. Also qualitative research approaches permits some amount of flexibility in the conduct of a certain study which indicates that the researcher do not have to use a definite type of data collection method towards the investigation but can be flexible in using a variety of methods to collect data.; it helps the investigation of complex or difficult topics if a bond of trust develops between the investigator and the participants; and aided investigators to make connections between diverse facets of people’s life, like domestic issues, work and leisure. Another good thing about qualitative research approach is that as a researcher you have the capability to interact with participants in the language they understand and most importantly on their positions.
After identifying the process involved in conducting qualitative research and how good it can be to unearth the hidden fact that quantitative research cannot give answer to, some weaknesses have also been noticed. One of these weaknesses is in the focused group which are always small which means the results are most likely to be valid for that specific focused group. In that wise generalisation cannot be made as will do with quantitative research results. Another point is because qualitative researches pay more attentions on depth, it may mean that collection and the analysis of data materials can take a long time, and if that is case the economic and human resources costs may be high. Also there could be doubt in accuracy of the interpretation of the investigator; the investigator/researcher as a human-being just like participants may have their own biases to consider when carrying out the research process. And again because qualitative research involves small group of participants, other academic researchers might not take the outcome of the research seriously.
COUNSELLING RELATIONSHIP I FEEL DRAWN TO AND WHY. The relationship that develops between a client and therapist has been described as a very vital aspect of counselling process; therefore sustaining a good therapeutic relationship is essential. A good therapeutic relationship between the counsellor and client across all therapeutic approach to counselling has been suggested to be one of the best factors that lead to successful therapeutic results (D240, 2010 p.259). The counselling relationship I feel drawn to is from therapeutic alliance perspective, it involves all essentials of the relationship needed with the bonding between therapist and client (D240, 2010 p. 261). I believed that collaboration between the client and the therapist, with full focus on the clients and their essentials needs and set goals will help the clients to improve their coping strategies and be able to help themselves, while enabling positive therapeutic environment to help in exploring their past and present issues without passing judgement. Among the factors identified as necessary for development of therapeutic alliance is empathy; it is defined as the capability of the counsellor to have thoughtful of the world of the client and be sensitive to their experience in a moment-by-moment manner (D240, 2010 p. 262). It was suggested that there is prove that empathy is effective in bringing about positive therapeutic change more than individual technique (Bohart, Elliott, Greenberg and Watson, 2002 cited in D240, 2010 p. 262). It is about going into client’s world and sees things from their own perspective. Partnership between the client and therapist in some counselling approach start with shared goals and expectations that are deliberated and agreed upon for the therapeutic work they are working towards, recognition of tasks to be performed by each person can hold the relationship together. I believed that therapeutic alliance should start from the time initial contacts were made with the client by showing attributes of respect, candidness, understanding and it is stated in the client-therapist contract.
The contract usually sets out boundaries, roles, responsibilities and expectations on both sides. Other characteristics of therapeutic alliance are active listening to clients and make them know that they are being heard and understood, therapist to be aware of verbal and non-verbal communication. I do believe in given objective feedback either positive or negative; both are believed to be important in improving outcomes (D240, 2010 p. 264). Although at the same time I will be mindful of any negative feedback I give so that it will not create more problems for the client having realised that people process information in a different way. Also on my role, I prefer to work together with client on equal levels that is adult-adult/friend-friend type of relationship to deal with presenting issues (D240, 2010 p. 267).
Barker, M. Vossler, A. and Langdridge, D. (2010) D240: ‘Understanding counselling and psychotherapy’, London, Sage for The Open University.
David G. Purves and Dutton J, (2013) An exploration of the therapeutic process while using computerised cognitive behaviour therapy: Linking research with practice, DOI: 10.1080/14733145,2012.761259
SELF-REFLECTION The area I found interesting is the counselling relationship, understanding it makes me confident on how to engage with clients The areas I found difficult was research summary and I struggled a bit with discussion on strength and weakness of qualitative research method.
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