An exploration of the perception of practitioners of the strengths and limitations of psychosynthesis psychotherapy in application
An exploration of the perception of practitioners of the strengths and limitations of psychosynthesis psychotherapy in application
This chapter, which highlights the study's aims, includes a critical discussion of the theoretical framework adopted for this enquiry. It offers an explanation of how the research was planned, and how the method of data collection and instrument used, were chosen. The chapter also explains how the data was analysed and the study conducted to ensure rigor and ethical standards. It concludes with statements that link it with the following chapter on the findings of this study.
This enquiry aimed to elicit the views and experiences of psychotherapeutic and counselling practitioners' application of the psychosynthesis model of counselling and psychotherapy.
A qualitative research approach was most appropriate for this study, because the aim was to capture meanings and significances rather than measuring or quantifying aspects of counsellors' practice (Banister et al. 1994, McLeod 1996). The qualitative paradigm was based on the use of the researching participants' experiences and subjective interpretations. This was in contrast to the quantitative paradigm's approach, where all trace of researching participants and the "contamination of their human touch" (Sanders & Liptrot 1994, p.3), was removed. The fundamental distinction between the two paradigms was essentially a philosophical difference, a contrast of epistemological as well as methodological positions (Denzin & Lincoln 1994, Guba & Lincoln 1994, Schwandt 1994).The interpretative phenomenological approach was the particular qualitative research design used in this study. It was based on the philosophical position that knowledge was to be acquired by means of a co-creative relationship between subject and object, between the enquirer and the object of his enquiry (Hammersley & Atkinson 1997). It included the study of "the emotions, actions and perceptions of things and relationships" (McLeod 2001 p.37). The interpretative phenomenological research approach also relied on the philosophy of Husserl (1859-1938), who was concerned with human experience and a quest for the essentials, the certitude, and the truth about phenomena. Husserl's philosophical position was that understanding and new knowledge required more than rationality, logic and empirical evidence, the bedrock of the positivist and natural sciences' position. He argued that, "aiming with radical consistency at absolute knowledge, he (the phenomenological enquirer) refuses to let himself accept anything as existent unless it is secured against every conceivable possibility of becoming doubtful" (Husserl 1999, p.3). This statement contained not only a description of the attitude required of a researcher using the phenomenological approach but also one of the basic principles of how knowledge was acquired in this methodological stance, namely by a radical laying aside of all preconceptions and everything that was known, in order to uncover the essence(s) of what was being studied (Giorgi 1997).
The use of the phenomenological approach was based on the assumption that human experience was a valid source of knowledge. This was because the human person reflected on their experiences of phenomena and retained the resulting insights gained, in memories and emotions (Becker 1992). In the study reported here, it was important to have a theoretical perspective for the research that validated human experiences, memories, emotions and other attributes, as a legitimate arena for, and means of, scientific enquiry. Thus, the author also understood himself to be interpreting, as well as describing and reporting in the whole process of enquiry, into the participants' experiences.
Phenomenology, as a philosophy, inspired the phenomenological approach, which was based on Husserl's (1999) work. Taking an overview, the whole process using the phenomenological approach in this study, was inevitably protracted, cyclical and iterative (Figure 3). It began with the author's own understanding of the subject of the enquiry, progressing through the interviewing and transcribing stages, and into the phase of discernment of meanings, continuing through the write up of findings, and returning to each of the previous steps as was necessary.
The phenomenological approach was used throughout the whole process of investigation and it consisted of the following elements: Fig 3.
1. Epoche - the process of bracketing: Fig 3.
This originates in Husserl's (1999) concept of 'epoche'. It involved suspending and bracketing existing ways of interpreting experiences, thus creating an openness, in order to receive them as original phenomena, and consequently, developing an opportunity to establish authentic meaning, as offered by the essence of the lived experience. Acknowledging each of the assumptions in turn and maintaining openness with the purpose of revealing essences, was a process which Husserl (1999 p.21) termed "transcendental-phenomenological reduction". In effect, bracketing meant this researcher was trying consistently, to lay aside his own preconceptions about psychosynthesis and its effects in practice, and acquire the meanings offered by the participants. It was particularly pertinent in conducting the interviews and when analysing the resulting data.
2. Acquiring meanings and being reflexive: Fig 3.
In the context of the process of reduction, the researcher analysed the data and attempted to grasp meanings, sometimes guessing and suspending conclusions about what was meant. In being reflexive, he considered the interpretations of meanings as a process that included his use of the wider body of knowledge in all fields, but particularly in the fields of counselling, psychotherapy and psychology (Hammersley & Atkinson 1997). Thus, and perhaps most importantly, regarding reflexivity as a post-modern enquirer, this researcher considered his "being implicated in the construction of [the] knowledge" acquired in this study (Bryman 2001, p.470). In the whole process of the enquiry he saw himself to be a co-creator of meanings rather than a neutral communicator of the participants' experiences. The implications of this were that the findings were rather more the researcher's understanding of the participants' meanings, than an objective version, and needed to be interpreted as such.
3. Writing: Fig 3.
Writing was integral to the processes of discernment of meanings and reflexivity. It enabled the researcher to acknowledge his preconceptions, and prompted insights into and the realisation of possible new meanings. Being a reflexive activity "at the heart of the ethnographic exercise" (Bryman, 2001, p.471), writing was considered to be more than an extrinsic process. In "re-presenting" and not simply mirroring the participants' contributions (Hammersley & Atkinson 1997 p.239), something new was being formed, resulting in the narrative that emerged. This literary style, which closely reflected the way in which the participants had made their contributions, was deemed to be the most appropriate for conveying the participants' experiences. The resulting text needed to be understood as the product of the researcher's work that incorporated the participants' presentations in a narrative different to the original types offered, and to a certain extent, other than their original meanings. In other words, this researcher's writing in this study had produced a particular emphasis and analysis. For example, the researcher's 'voice' was more apparent than the participants' (Denzin & Lincoln 1994), and he employed stylistic devices such as use of language and quotations from participants, to authenticate and enhance the credibility of the study. Thus, the text produced as a result of the process of data analysis, which included bracketing, was one in a range of other possible interpretative accounts of the data offered by the participants (Hammersley & Atkinson 1997, Bryman 2001).
4. Categorising the data
The analysis included categorising, typological and sorting activities (Sanders & Liptrot 1994). Taking account of this researcher's postmodernist position as a contributing enquirer, it was nevertheless important, in order to be consistent with the phenomenological approach, to identify as far as was possible, self evident, inherent categories in the data gathered. It was thus essential to attempt to receive those categories that arose out of the page, as it were, and corresponded to the authentic original sources of meaning. So, eliciting these categories was meant to expose the practitioners' understanding of the strengths and limitations of the psychosynthesis model in practice (Coolican 1992 and Sanders & Liptrot 1994). The coding system used, consisted of upper case letters referring to individual research participants, and numbers identifying sections of meaning in the original transcriptions of the taped interviews, for example, T13. A matrix was utilised to offer a framework for the themes identified across the transcriptions, and to rank them in order of prevalence.
5. Using protocols
Various protocols for analysing the data were considered including Becker (1992), Giorgi (1997), and McLeod (2001). The one that was utilised in this study was an amalgamation of these. Giorgi's (1997) suggestion that the analytic procedure be conducted at two levels was observed. In effect this meant that first, precise transcriptions of the original recordings of the interviews, consisting of the participants' original and spontaneous descriptions, were made (Giorgi 1997). Second, using the elements of the phenomenological approach previously discussed, the tapes and original pristine transcriptions were repeatedly revisited and analysed in order to clarify, as far as possible, essential meanings (Husserl 1999), and a comprehensive summary of each interview was created, identifying major and minor themes. This was followed by a macro level summary, which was an attempt to organise and integrate the meanings identified across all the transcriptions. The summaries were inclusive of as much original material from the participants' contributions to arrive at, as closely as possible, the equivalent of condensed individual and collective narratives (Giorgi 1997).
In addition to acknowledging the way in which he made interpretations of the participants' meanings, and developed a narrative that reflected his own as well as the participants' perspectives, this researcher attended to his other experiences of reflexivity and being a creator of knowledge, throughout the enquiry (Bryman 2001). Creating the instrument, namely the questions used, allowed this researcher to conduct the interviews with a particular emphasis. The questions were aimed at achieving the purposes of the study, namely to acquire knowledge about the participants' experiences of the strengths and limitations of psychosynthesis in psychotherapy practice. However, the researcher recognised on reflection that an aspect of the stance he adopted when using the questions, was to seek a coherent objective evaluation of the model in practice, even though it was not an evaluative study. It was hard to determine the specific effects of this but it was deemed relevant that sometimes the participants reflected at an objective, theoretical level and needed to be invited, in addition to pre-interview prompting to prepare evidence from practice experience, to re-enter their practice experiences, when offering their responses. As a consequence, the raw data was considered to include the participants' own positive prejudices about psychosynthesis in practice without sufficient substantiating evidence from their experiences in working with clients.
The researcher also considered how he was inclined to adopt a contradictory naturalist stance, trying to facilitate the participants to "tell it like it is", and similarly portray the data received (Hammersley and Atkinson 1997 p.206). As a result, at the stage of analysing the transcriptions, the researcher constrained himself to interpreting the meanings to an understanding of how they had been given verbatim, without giving sufficient consideration to other possible meanings. For example, those that could have arisen from seeing meaning units in the context of the participant's wider contribution in the interview as a whole, their professional practice more broadly and indeed from the researcher's knowledge of the fields of psychosynthesis and psychotherapy. This more comprehensive analysis of the data was considered to have had the potential of offering the possibility of enhancing the already rich contributions of participants.
The method of data collection selected was the semi-structured interview. It was judged to be appropriate to the phenomenological approach being used because it provided a means by which individuals could tell their stories, in their own terms (Bryman 2001).
An advantage of the semi-structured interview was that it allowed for the tailoring of questions to the position and comments of the practitioners. This was conducive to the aim of this study, as well as the methodology chosen. Referring to unstructured interviewing, Fontana & Frey (1994 p.365) suggested that it "provides a greater breadth than the other types", and even though the potential for breadth of information was not as available in semi-structured interviewing, it had the advantage of allowing the interviewer greater control over the flow of information, (Sanders & Liptrot 1994). Thus this researcher found the inherent flexibility in the semi-structured interview format, useful in, for example, being able to pursue new and potentially creative lines of enquiry which were prompted by what the participants had disclosed.
An interview schedule (McLeod 1994), was devised, which in a first draft consisted of a list of potential questions arranged into groups relevant to the themes within the subject of the enquiry: one group was used to explore the strengths of psychosynthesis in practice, the other to focus on its limitations. This researcher argued it to be important to ask preliminary questions about how the participants came to use psychosynthesis in their practice, followed by those particularly pertinent to the study, in order to facilitate a relaxed climate for the participants; to share their experiences and enhance their processes of reflection. It also seemed advisable to follow Sanders & Liptrot (1994 p.103), who suggested that, "the interview schedule is a mixture of aide-memoirs to help you if you dry up and instructions so that you know what to do next in order to get all the information you need". Thus, a framework including the questions, together with reminders and instructions for the author to use to determine the course to follow, depending on the responses of the practitioners, was what constituted the first draft of the interview schedule. The instrument in this form was piloted with students and colleagues, and through an iterative process was simplified (Appendix 4) in order for it to assist in creating a less formal and more chatty form of interview.
The participants were interviewed over the telephone whilst in their own homes and the exchange was recorded using an adapter for recording telephone conversations, and a tape recording machine. The telephone interview was chosen after taking into account the dispersed locations of the participants, restrictions on their availability and the researcher's limited resources, and because, given the circumstances, it was considered to be the most efficient for the purpose when compared with the alternatives.
It was acknowledged that interviewing, and telephone interviewing in particular was as Banister et al (1994 p.49) said, "a complex, labour-intensive and uncertain business, fraught with tricky issues". What was especially important was preparing for, as well as conducting the interviews with the participants on a one to one basis, because this afforded the opportunity to develop a relationship which enhanced the process of enquiry. Accessing the participants' experiences required a trusting environment which was developed in the context of the relationship. Becker (1992 p.40) was particularly instructive in this respect in arguing that, "a successful research interview is one in which the interviewee can take the research relationship for granted, can sink into the descriptive details of his or her experience of the phenomenon, and can give details and nuances that bring the researcher into their lifeworld."
Anticipating that the restrictions in using telephone contact for establishing and conducting the interviews could reduce the extent to which it was possible to develop the qualitative experience of the relationship with participants, this researcher attempted to compensate for this by utilising as fully as possible, a whole array of interpersonal skills considered to be pertinent to enhancing the interview, and communication by telephone. Cues, prompts, other paralinguistic skills, and the skills of mirroring and paraphrasing were used together with a dialogic conversational style, to compensate for the absence of body language, and to generally enhance the interview over the phone (Rungapadiachy 2001). Nevertheless it had to be accepted that there were important restrictions. Nuances detectable by facial and bodily expressions, which may have been important indications for further exploration, were not available. The absence of body language was particularly significant because the study aimed to examine phenomenon by accessing the inner psychological resources of individuals where the results of their encounters and experiences of the phenomenon were recorded (Becker 1992). The information portrayed through body language was that which, as Feldman & Rime (1991 p.vii) indicated, was founded upon "principal psychological processes that underlie non-verbal behaviour."
On the other hand, aspects of the participants' physical absence were not so important because gaze or eye contact was not so crucial in this context where a particular quality of self disclosure was sought, which did not depend upon consistent eye contact. Thus it was argued that participants' being in their own environments, without the physical presence of the researcher, enhanced the opportunity for them to connect with and expose the essence of their experiences.
Significant preparation, use of the insights into the restrictions and how to compensate for them, together with pilot interviews, all helped to ensure that the limitations of telephone interviewing were minimised as much as possible.
In this qualitative study, the criteria of credibility, transferability, dependability, and confirmability were used to enable the establishment of its trustworthiness (Koch 1994). With these principles, associated data and activities, this researcher facilitated the evaluation of the rigor of this study. Thus, the preceding discussion about the method used and its application in the study was produced as evidence of the process which occurred and was conducted by the researcher. In addition, all the data and documents used as listed in Table 1 were made available for scrutiny, in order to demonstrate the researcher's decisions during the course of the study.
Both these sets of information enabled the researcher to facilitate an evaluation of the study's credibility, namely its feasibility (Bryman 2001). The researcher maintained that his was one of a number of plausible interpretations of the participants' experiences of the strengths and weaknesses of psychosynthesis in practice. Given this, establishing credibility meant evaluating whether or not his interpretation could justifiably 'fit' within the range of acceptable interpretations. Also, in scrutinising the procedures followed whilst conducting the process of the study according to the chosen method, and comparing these with established and authenticated research practice, a judgement about the study's credibility could be made. Finally, credibility was also enhanced by submitting the findings to the research participants for confirmation that they had been correctly understood (Koch 1994).
To establish the study's transferability, it was important to provide an explanation of the context in which the data was generated (Guba & Lincoln 1994, Koch 1994). Table 2 shows the information supplied to make an evaluation of transferability. With this contextual information the researcher enabled an evaluation of the extent to which the findings were applicable for psychosynthesis practice in "other milieu" Bryman (2001 p.273).
The information provided in the description of the research process, and study's documents, contained evidence of the researcher's decisions in conducting this enquiry. These were all important for evaluating the dependability of this study. The equivalent of an audit (Koch 1994) of this information and the decision-making processes was conducted, in order to make it possible to establish whether or not another researcher could make the same or similar but not different conclusions, using this researcher's data, theoretical standpoint and context in conducting the enquiry (Sandelowski 1986).
Though Guba & Lincoln (1994) suggested that confirmability was the result of the previous criteria having been achieved, Koch (1994) exposed it specifically as an evaluation of the way in which interpretations of meanings had been arrived at in the whole process of the enquiry. In scrutinising the transcriptions and researcher's notes associated with his interpretation of meanings, it was argued that it was possible to make a judgement about the plausibility of these interpretations. The judgement would need to revolve around the coherence of the researcher's 'argument' for the interpretation chosen, and how it corresponded with the data and context from which the latter was acquired (Denzin & Lincoln 1998).
The researcher recruited participants after acquiring information about 146 psychosynthesis practitioners from the United Kingdom Council for Psychotherapy (UKCP). Using an iterative process determined by practitioners having an email address, 50 were contacted electronically with brief details and an invitation to take part in the study. The researcher received 27 responses, and in an initial telephone conversation, arranged for a more lengthy discussion with interested parties, and their receipt of a written description of the study (Appendix 1), and a consent form (Appendix 2). In the second telephone conversation, the researcher discussed information about the study, and the conditions under which the eventual participants would be involved, including assurances that they would remain anonymous, and that their contribution would be dealt with confidentially. The 27 respondents chose either to be or not be involved during this second telephone conversation. Thus, out of the 27 respondents, twelve psychosynthesis practitioners became the participants in this study. These participants had all confirmed that they had completed a minimum of two years training in psychosynthesis psychotherapy and were experienced in practice, as was required for registration by the United Kingdom Council for Psychotherapy (UKCP). These criteria were adopted because in order to achieve a substantive and credible body of knowledge "a good informant is one who has the knowledge and experience the researcher requires" (Morse 1994 p.228). Thus this study required that the participants were conversant with the model, and had significant experience of applying it in practice.
The participants were interviewed during a subsequent arrangement for telephone contact, after having signed and returned the consent form (Appendix 2), which had been posted to them. The final group of 4 men and 8 women, ranging in age from early thirties to mid seventies, lived across the South of England. All were in private practice and their work with clients was almost exclusively in longer term therapeutic contracts, that is, more than 6 sessions. The participants varied in their use of the terms 'counsellor' and 'psychotherapist'. For the purpose of this study, it was decided that both terms were to be used interchangeably. Thus, it was considered that irrespective of what the participants called themselves, they were referring to the same professional roles and activities, when referring to their use of psychosynthesis.
Punch, M. (1994) suggested that in counselling research, most concern revolved around the issues of harm, consent, deception, privacy and confidentiality of data. In using the corresponding ethical principles of autonomy, beneficence, nonmaleficence and justice (Beauchamp & Childress 2001), this researcher ensured that his research was conducted ethically. The author understood that the participants were utilising an ethical framework in their practice, as determined by the professional body with whom they were registered, in order to protect their clients (UKCP).
In seeking to respect the autonomy of the participants, the author attempted to develop a relationship with them as persons, and ensured that they received detailed and complete information about the study (Appendix 1). Developing a relationship, the nature of which was determined by the purpose of the encounter, involved the researcher in professional self disclosures, and openness to enquiry (Beauchamp & Childress 2001). There were restrictions on this process, given that the contact was limited to written correspondence and telephone conversations. Nevertheless, the essential actions in relation to upholding the participants' autonomy were that the researcher provided them with comprehensive information about the study, and opportunities to discuss issues arising for them (Appendix 5). They were free to consider their decision about involvement after the initial contact by email, and the subsequent two telephone conversations. It was only after these three communications that they were asked to make a decision, and if it was to participate, sign the consent form (Appendix 2).
The study's purposes, the processes involved and what contributions they were expected to make, were outlined in explanatory documentation (Appendix 1) submitted to them, as well as in discussions with participants individually. The information supplied, which was aimed at facilitating informed consent (Bryman 2001), also included explanations about how the data offered by the participants would be made anonymous, and, in a collective summary, used by the researcher to gain a postgraduate qualification. The researcher also informed the participants about the intention to publish the findings for consideration by interested parties in the fields of psychosynthesis and psychotherapy generally. He avoided influencing the participants in any coercive manner and encouraged them to take time outside all discussions with himself, to consider their choices regarding involvement.
In the written information provided about the study (Appendix 1) and subsequent discussions, the terms and conditions of maintaining the participants' privacy and confidentiality were explained. This was one of the means of ensuring non-maleficence in conducting the study. The process of seeking their consent, described above, and the provision of a consent form which they needed to sign, were other means of upholding non-maleficence. Clear boundaries were also agreed for contacting participants, namely to limit this to the purposes of the study. Times for contact were determined by the participants and agreement achieved as to the means, namely corresponding by mail and email, and using telephone communication. With regard to confidentiality, the researcher undertook to safeguard all the information offered by the participants "within the constraints of the law" Beauchamp & Childress (2001 p.419). The relevant legislation included the Prevention of Terrorism Act 1999, and the Data Protection Act 1998. Participants' anonymity was maintained by ensuring that all identifying information was removed from recordings, transcriptions and other forms of data, including individual and collective summaries the participants had provided. The coding used for the purpose of data analysis, was designed to ensure that anonymity was secured, and in effect the researcher was the only person with the means of being able to, for example, trace back and identify references in the summary of findings, with the contributing participant.
In a similar vein, of ensuring no harm came to the participants, the researcher submitted a proposal for his study, with supporting documentation, to the University of Central England Research Ethics Committee. Approval for conducting the investigation was duly received (Appendix 3). The researcher also considered it to be his responsibility to do all that was possible within the confines of telephone contact, to minimise undue challenge for participants particularly whilst being interviewed, and so avoid the potential of their experiencing embarrassment, stress, loss of self-esteem or personal dignity (Shillito-Clarke 1996).
The principle of beneficence was upheld in this research by helping the participants to further their "important and legitimate interests" (Beauchamp & Childress 2001 p.260). In the context of this study, this meant furthering their understanding of psychosynthesis, its practice, and the potential of enhancing their service to clients, and their own personal development. Also, by ensuring that the findings of this study were disseminated within the fields of psychosynthesis and psychotherapy, with the intention that researchers and educators, as well as practitioners, would benefit from them personally, and be enabled to enhance the development of others in their respective practices. With a similar intention, the participants were provided with a copy of the summary of findings. Several participants expressed how they had benefited from the process of involvement, in having had an opportunity to reflect on their practice, and a smaller number of them explained that they appreciated having used the experience to prepare themselves for re-accreditation with their professional body (UKCP).
To serve the principle of justice in this enquiry, the process of arriving at the self selecting sample allowed all the psychosynthesis practitioners when first contacted about being involved in the study, the freedom to opt in and out of the research. This strategy was intended to make the study inclusive. Once the participants had given their consent to being involved, the researcher offered the same facilities, including information, support and other opportunities, to all the participants. In this way, he tried to be as equitable as possible.
This brings the presentation of the methodological considerations that were taken into account whilst preparing, conducting and writing up this study, to a conclusion. The following chapter presents the findings of this enquiry, and discusses them in relation to the body of knowledge in the fields of counselling and psychotherapy, and psychosynthesis in particular.
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