The purpose of this piece of work is to examine what is meant by research and how it informs and supports counselling work.
What is research?
Research is a lot of different things depending on the context. Pure research is more like exploring and finding out more information about something. Applied research is directed by a hypothesis or the desire to complete a goal in a narrower subject area. Both are systematic and careful studies of a subject in order to further understand it, and both types require keen observation of small details as well as recognition of overarching patterns. Quantitative research is used to answer questions that are more open-ended and are based on experiences. Qualitative research is used to answer “why?” questions, and can be very useful in collecting the amounts or totals of things.
Research is essentially the quest to provide evidence and remove mystery.
What is the purpose of research?
We research things to increase and solidify our knowledge, and to discover explanations for things that exist in our world. We research things in order to improve or optimise our performance in life, or to predict outcomes of the events that occur on our plane of reality. The things that we research range from how long you have to cook an egg until it’s edible to how many people will vote for a certain politician, and from the mating habits of Peruvian alpacas to how that client felt when a counsellor asked him “why” he did something.
A lot of the research we do in life is unconscious – biases, preferences and stereotypes are formed to help us deal with situations and make choices quickly. Other times our research is conscious, for example when we survey our friends to find out which videogame we should buy next.
In counselling, the British Association of Counselling and Psychotherapy (the BACP) believes that research provides evidence for the range of issues where therapy can be effective as well as the positive outcomes for clients that undertake therapy. The BACP are also committed to encouraging the best possible research for the benefit of their clients and the widening range of counselling professions, including coaching, mentoring and pastoral care.
What are different types of research methods?
Sometimes research is carried out by a researcher asking questions and comparing answers, sometimes it is carried out with physical experiments, with the results being compared. Sometimes research involves collecting data from multiple sources and comparing the outcomes, whereas sometimes it can involve collecting data from the same source multiple times, but changing a variable each time to monitor the effects of the changes.
How does research show what works for the client in counselling practise?
Research findings in counselling informs counsellors on what works and what doesn’t work, in terms of things like approaches and theories, questions to ask, and the length of counselling sessions. It could be that an hour is the ideal time for a session, and this was found by researching lots of different lengths of session, then determining which helped the client make the most improvement.
I would imagine that research is why therapists stopped asking clients “why?” in their open questions. Ask a client how they felt after they had been asked a “why” question and they could answer that they felt interrogated, or that they were being judged for the choices they made, both of which undermine the core condition of unconditional positive regard. Also, a counsellor could feed their thoughts and feelings back to the researcher after a session – they could say that the client clammed up after being asked the “why” question, or that they got very defensive and the therapeutic process stalled. Other times they might say that nothing of note happened, and that the conversation carried on flowing as normal, which is also a very valid and important observation. It’s important to note what does and doesn’t work; it’s important to record the entire spectrum of findings, not just those that reinforce a certain outcome.
Research could also help counsellors determine which theories are best for certain presenting problems. Some presenting problems are just better suited to being treated with certain theories, and large scale feedback from clients would be massively useful in determining this. Correlating a wide range of problems with a variety of different counselling theories and then measuring the amount of positive change could achieve this. I know that CBT is popular with the NHS because it is measurable in such a way.
I feel like Sigmund Freud, Carl Jung and the early psychotherapists were pioneers in their fields, conducting field research as they went along, seeing what worked and what didn’t in real-time. I also feel that Carl Rogers, after reading one of his books, had a very experimental approach when he was developing his theories, using personal research to figure out the best ways to help people. In this way, personal research into what does and doesn’t work for you as a counsellor is important for your personal and professional development. You may not gel with a particular theory, or upon talking to other counsellors, realise that something you do doesn’t work for them.
The counselling process is difficult to quantify, as clients, counsellors and their relationships are full of variables and wildcards. Things like the “effectiveness” of counselling and the “skill” of the counsellor are personal and subjective, and can often only be measured in relation to that particular relationship between that particular counsellor and that particular client. But research is nonetheless important, as it sets baselines for certain aspects of the therapeutic process.
As a case study, I will be referring to an article about research for the rest of this piece of work. The article, POSTNATAL DEPRESSION: NHS IS FAILING NEW MOTHERS, SAY RESEARCHERS, was originally published in the Guardian in October 2011, and can be found at the end of this essay.
What was the aim of the research?
The aim of the research was to find out what sort of treatment was being received by new mothers that suffer from postnatal depression.
Does the research focus on a particular client group?
According to a widely accepted figure, one in ten new mothers suffers from postnatal depression, and this research focuses on them.
Is the research located within a particular theoretical orientation?
Cognitive behavioural therapy and counselling are mentioned specifically in the article as potential treatment methods, but the research is not located within a particular theoretical orientation, but rather based on “talking therapies” as a whole.
Does it inform the development of any theory?
This research does not inform the development of any particular theory, but it does promote counselling and talking therapies as being more suited to postnatal depression in mothers as it has been proven to be more effective than medication.
How did they undertake the research?
Researchers from the charity 4Children surveyed all health trusts in England and Wales. They probably did this with a questionnaire that asked new mothers questions like whether they felt they suffered from postnatal depression, if their symptoms were recognised by their GPs, and what treatment they received, if any.
What were the findings of the research?
The research found that, of those new mothers whose symptoms were recognised at all by their GPs, the vast majority were being prescribed antidepressants, which is against guidance from the National Institute for Clinical Excellence (NICE). They recommend talking therapies, such as counselling and cognitive behavioural therapy for mild and moderate cases of postnatal depression, also known as the “baby blues”.
What are the implications of the findings for the counsellor?
The implications of the findings for the counsellor are that they could expect more mothers coming to therapy to help with their postnatal depression if GPs more accurately follow the NICE guidelines, rather than being issued antidepressants.
Do the research findings have wider implications?
The findings of the research state that of the 2,000 mothers questioned, 70% were given prescriptions for antidepressants rather than access to a talking therapy. It is not known how many of the remaining 30% were directed to counselling. The wider implications are that more funding is needed in the NHS for talking therapies. It should also be noted that the Department of Health holds no statistics at all, so an accurate system of record keeping would need to be installed as well.
Do you think the research is reliable or opens up further questions?
I think the research is reliable, in terms of getting an idea of how many new mothers are prescribed antidepressants rather than given access to a talking therapy. In this case the research is more reliable than any actual statistics held by a government agency. I think all research should be the basis for more questions, and it would be good to cast the net further and ask more new mothers of their experiences.
In what way was the research useful?
The research was useful because it highlighted not only the issues around GPs not being empathic or understanding, but the issues around the Department of Health not tackling this issue with the seriousness it deserves, and not adhering to the guidelines published by NICE.
POSTNATAL DEPRESSION: NHS IS FAILING NEW MOTHERS, SAY RESEARCHERS
Doctors are prescribing antidepressants rather than providing counselling and other treatments
Mothers with postnatal depression are being failed by the National Health Service, which is ignoring international guidelines on the condition.
Researchers from the charity 4Children surveyed all health trusts in England and Wales to find out what sort of treatment was being received by the one in 10 new mothers who suffers from the condition. They found that, of those whose symptoms were recognised at all by their GPs, the vast majority were being prescribed antidepressants, against guidance from the National Institute for Clinical Excellence, which recommends “talking therapies” – counselling and cognitive behavioural treatments – for mild and moderate cases of the so-called “baby blues”.
The survey, by parenting club Bounty on behalf of 4Children, also found that few health authorities were collecting information on the prevalence or severity of postnatal depression, while others seemed to have only a patchy understanding of the issue. There were vast disparities between those who did hold information – two primary care trusts claimed they had had only one case in the past year, while another reported 1,350 cases. Only 9% of health trusts were keeping track of the condition in their area.
“That’s pretty unlikely given the one in 10 figure that is widely accepted for postnatal depression,” said Anne Longfield, chief executive of 4Children. “This is not a rare condition. You’d think it might have rung an alarm bell with them, but what is perhaps more astonishing is that the Department of Health holds no statistics at all.” Longfield said that the results of the report were shocking and showed that postnatal depression was not being taken seriously: “It just reveals so much in terms of lack of empathy and sympathy for these people. It’s a complete disregard for their health and wellbeing. “It seems that, from the Department of Health’s point of view, it’s not an issue; they don’t even ask the questions or collect the information. It’s seen as an everyday little personal issue and GPs, I’m afraid, are not proving very sympathetic to those mothers that are coming through their door. At the end of the day, no one is taking it seriously.”
Of more than 2,000 mothers questioned, 70% were given antidepressants when they approached their doctor. The NICE guidelines recommend early diagnosis and quick access to treatment to limit the damaging effect postnatal depression has on the baby, the partner and other children in the family. The international health body states that psychological therapies should be offered as an alternative to antidepressants. “The NICE guidelines are clear, just as it’s clear they are being flouted. This report shows a massive default towards antidepressants when proper care is within the gift of health professionals,” said Longfield.
This article was originally posted here: https://www.theguardian.com/society/2011/oct/01/nhs-failing-postnatal-depression-women
