View in EDS HTML Full Text PDF Full Text

Choosing to Be Present with Clients: An Evidence-Based Model for Building Trainees' Counselling Competence

Saved in:
Bibliographic Details
Title: Choosing to Be Present with Clients: An Evidence-Based Model for Building Trainees' Counselling Competence
Language: English
Authors: Tannen, Tina, Daniels, M. Harry, Koro-Ljungberg, Mirka
Source: British Journal of Guidance & Counselling. 2019 47(4):405-419.
Availability: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 15
Publication Date: 2019
Document Type: Journal Articles
Reports - Research
Education Level: Higher Education
Postsecondary Education
Descriptors: Evidence Based Practice, Models, Counselor Client Relationship, Competence, Counselor Training, Metacognition, Student Experience, Therapy, Counseling Effectiveness, Graduate Students, Self Concept
DOI: 10.1080/03069885.2017.1370694
ISSN: 0306-9885
Abstract: Being present with clients has been suggested to be a necessary condition for the therapeutic relationship [Geller & Greenberg, 2012. "Therapeutic presence: A mindfull approach to effective therapy." Washington, DC: American Psychological Association. doi:10.1037/13485-000] and therefore for therapeutic effectiveness. In this article we describe the results of a qualitative investigation of how counsellors in training (CITs) describe their experience of being present and the meaning they make of that experience. The findings suggest that starting students down the pathway to becoming a master counsellor involves more than training in basic counselling skills and theories. Our findings add a new dimension to existing counsellor development models and have implications for counsellor training and supervision.
Abstractor: As Provided
Entry Date: 2019
Accession Number: EJ1224740
Database: ERIC
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
    Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHj0k_4E0hTGH8RJwT4gCJyBsGNe_WN95AvKlDbXJGqwxwFaYsnxflh9GZhR79YQSpqIAAAA4jCB3wYJKoZIhvcNAQcGoIHRMIHOAgEAMIHIBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDGVdN0MaEMXQacWpSAIBEICBmjBp0IpWdCohdebb_mrEOxcEZwOEnSXb-CiVBspVNifsr5zWMntF5Q3ROQGy0wUeKIBbfTqXYBHJl54xNUA1f7iDWLS0TtJC6kGbf5Zh8CqAmmwabp9SLKsISZs1To1TFUoOmFLibnTNUVszQhnhtSp-4B1R1AinaJSxMW6jHUvdFLweIpNY4xPGCg8COL_LUEhLVQaTjU7Thoc=
Text:
  Availability: 1
  Value: <anid>AN0138027035;bjg01aug.19;2019Aug14.02:59;v2.2.500</anid> <title id="AN0138027035-1">Choosing to be present with clients: an evidence – based model for building trainees' counselling competence </title> <p>Being present with clients has been suggested to be a necessary condition for the therapeutic relationship [Geller & Greenberg, 2012. Therapeutic presence: A mindfull approach to effective therapy. Washington, DC: American Psychological Association. doi:] and therefore for therapeutic effectiveness. In this article we describe the results of a qualitative investigation of how counsellors in training (CITs) describe their experience of being present and the meaning they make of that experience. The findings suggest that starting students down the pathway to becoming a master counsellor involves more than training in basic counselling skills and theories. Our findings add a new dimension to existing counsellor development models and have implications for counsellor training and supervision.</p> <p>Keywords: Counsellor education; counsellor development; therapeutic relationship; mindfulness; presence</p> <hd id="AN0138027035-2">Introduction</hd> <p>What makes counsellors effective? Compelling research findings that the therapeutic relationship accounts for a large share of the variation in client outcomes may be slowly shifting emphasis away from the effectiveness of different theoretical orientations and therapeutic interventions and toward the relationship that develops between therapist and client (Horvath, [<reflink idref="bib28" id="ref1">28</reflink>]; Hubble, Duncan, & Miller, [<reflink idref="bib30" id="ref2">30</reflink>]; Lambert, [<reflink idref="bib34" id="ref3">34</reflink>]; Martin, Garske, & Davis, [<reflink idref="bib38" id="ref4">38</reflink>]; Norcross, [<reflink idref="bib42" id="ref5">42</reflink>]; Stevens, Muran, Safran, Gorman, & Winston, [<reflink idref="bib63" id="ref6">63</reflink>]; Watson & Geller, [<reflink idref="bib71" id="ref7">71</reflink>]; Zuroff & Blatt, [<reflink idref="bib74" id="ref8">74</reflink>]). The focus on the therapeutic relationship is not new – Carl Rogers' necessary and sufficient conditions ([<reflink idref="bib55" id="ref9">55</reflink>]) have been foundational for decades. However, as this reorienting of priority occurs, it is important that attention in counsellor training be on how counsellors connect with clients in a way that fosters the therapeutic relationship. This study adds to the exploration of how this capacity may be cultivated, and what impact this process might have on existing counsellor development models.</p> <p>The therapist's presence, or their way of being, as distinguished from the application of knowledge or technique, has been suggested to be a necessary condition for the therapeutic relationship and therefore for therapeutic effectiveness (Geller & Greenberg, [<reflink idref="bib18" id="ref10">18</reflink>]). As noted by Bozarth ([<reflink idref="bib4" id="ref11">4</reflink>]), Rogers described empathy as 'one of the most delicate and powerful ways of using ourselves ... (yet), it is a way of being that is rarely seen in full bloom in a relationship' (Rogers, [<reflink idref="bib54" id="ref12">54</reflink>], p. 137). Presence, as it is used here, is seen as precondition to Rogers's concept of empathy.</p> <p>Systematic exploration of therapist presence has been minimal although therapists through the decades have written passionately about the importance of being present in their work (Buber, [<reflink idref="bib6" id="ref13">6</reflink>]; Bugental, [<reflink idref="bib7" id="ref14">7</reflink>]; May, [<reflink idref="bib39" id="ref15">39</reflink>]; Reik, [<reflink idref="bib47" id="ref16">47</reflink>]; Rogers, [<reflink idref="bib53" id="ref17">53</reflink>]; Perls, [<reflink idref="bib46" id="ref18">46</reflink>]; Welwood, [<reflink idref="bib72" id="ref19">72</reflink>]; Yontef, [<reflink idref="bib73" id="ref20">73</reflink>]). What is understood about being present so far comes from the experience of seasoned therapists who have an interest in and a propensity to be present. The perspective of counsellors in the training phase of development has received far less attention in the professional literature. In this article we describe the results of a qualitative investigation of how counsellors in training (CITs) describe their experience of being present and the meaning they make of that experience. The findings suggest a new dimension to add to existing counsellor development models and have implications for counsellor training and supervision.</p> <hd id="AN0138027035-3">Literature review</hd> <p>Preparing competent counsellors who can provide effective counselling services to clients in all societal settings is one of the hallmarks of counsellor preparation programmes (Association for Counselor Education and Supervision, [<reflink idref="bib2" id="ref21">2</reflink>]; Ridley, Mollen, & Kelly, [<reflink idref="bib50" id="ref22">50</reflink>], [<reflink idref="bib51" id="ref23">51</reflink>]). Over the last half-century, counsellor educators have used a combination of micro-skills training and a required course in counselling theories as the primary means of introducing students to the knowledge and skills that are fundamental to the counselling process and promoting their development as therapists (Ridley & Mollen, [<reflink idref="bib49" id="ref24">49</reflink>]). Historically, this skill-based, developmental approach to professional preparation held considerable value among counsellor educators because it was possible to document the degree to which students could acquire and demonstrate specific micro-skills as well as their understanding of different counselling theories. The efficacy of this approach was supported by research evidence that pointed to an underlying sequence of counsellor development (Hogan, [<reflink idref="bib27" id="ref25">27</reflink>]; Loganbill, Hardy, & Delworth, [<reflink idref="bib37" id="ref26">37</reflink>]; Reising & Daniels, [<reflink idref="bib48" id="ref27">48</reflink>]; Stoltenberg, [<reflink idref="bib65" id="ref28">65</reflink>]; Stoltenberg, McNeill, & Delworth, [<reflink idref="bib67" id="ref29">67</reflink>]). Further, consistent with the core values of the scientist – practitioner orientation that serves to define the counselling profession, the model provided an evidence-based strategy for preparing the next generation of counsellors.</p> <p>Despite its popularity and near universal adoption, the micro-skills approach was not without its critics (Miville, Jorja, & Hernandez, [<reflink idref="bib40" id="ref30">40</reflink>]; Robinson & Halliday, [<reflink idref="bib52" id="ref31">52</reflink>]). As noted by Warnath ([<reflink idref="bib70" id="ref32">70</reflink>]) it was common for students to have a difficult time combining their understanding of micro-skills with their knowledge of counselling theories. Many would struggle to grasp how theory translates into practice and how practice emanates from theory (Ridley & Mollen, [<reflink idref="bib49" id="ref33">49</reflink>]). Frustrated by an inability to use their newly acquired knowledge and skills effectively with their clients, beginning students would become anxious about their work with clients (as well as the evaluations of their peers and supervisors) and resort to method-bound communication behaviours (Hogan, [<reflink idref="bib27" id="ref34">27</reflink>]; Reising & Daniels, [<reflink idref="bib48" id="ref35">48</reflink>]; Stoltenberg et al., [<reflink idref="bib67" id="ref36">67</reflink>]).</p> <p>Beginning counsellors find it difficult to develop and demonstrate the complex set of skills that result in positive therapeutic outcomes (Ridley et al., [<reflink idref="bib50" id="ref37">50</reflink>]), this despite the fact that researchers have documented the effectiveness of psychotherapy for a variety of presenting problems and diagnoses (Asay & Lambert, [<reflink idref="bib1" id="ref38">1</reflink>]; Hubble et al., [<reflink idref="bib30" id="ref39">30</reflink>]). Ridley et al. ([<reflink idref="bib50" id="ref40">50</reflink>]) argue that the lag in the acquisition of the complex skills that define effective counselling can be directly linked to an over emphasis on micro-skills training. They argue that the professional development of beginning students is constrained because they have a limited number of opportunities to establish a basis for making complex clinical judgments, which involves recognising and attending to their feelings, integrating their thoughts and feelings, and using this information to build therapeutic relationships with clients (Ridley et al., [<reflink idref="bib50" id="ref41">50</reflink>]).</p> <p>There is clear and convincing evidence that the counselling relationship is a predictor of therapeutic outcome. Among the four common factors of effective therapy, that is, client, relationship technique, placebo/hope/expectancy factors, (Hubble et al., [<reflink idref="bib30" id="ref42">30</reflink>]; Lambert, [<reflink idref="bib34" id="ref43">34</reflink>]), researchers agree that the relationship is the most critical to achieving a positive therapeutic outcome (Horvath & Greenberg, [<reflink idref="bib29" id="ref44">29</reflink>]; Lambert & Bergin, [<reflink idref="bib35" id="ref45">35</reflink>]; Nuetzel, Larsen, & Prizmic, [<reflink idref="bib43" id="ref46">43</reflink>]). Importantly, the quality of the relationship refers to the counsellor's way of being with the client as opposed to the application of a particular skill, technique, or knowledge set (Geller & Greenberg, [<reflink idref="bib18" id="ref47">18</reflink>]).</p> <p>Rogers ([<reflink idref="bib55" id="ref48">55</reflink>]) may have been the first therapist to stress the importance of attending to and communicating one's thoughts and feelings within the counselling relationship. For Rogers, counsellors are responsible for managing two sets of conditions: therapist offered conditions (TOC), including genuineness, warmth, and empathy; and relationship-oriented conditions (ROC), in which the client and therapist are in contact and in which not only does the therapist offer them but the client <emph>perceives</emph> the therapists' TOC.</p> <p>Typically, Roger's approach is reduced, especially for purposes of research and training, to what are called therapist offered conditions (TOC) and the relationship-oriented conditions (ROC) are not addressed (Bozarth, [<reflink idref="bib4" id="ref49">4</reflink>]). Increasingly, counsellor training has focused on the acquisition and demonstration of specific counselling skills and techniques while missing the essence of the client's state of being. Thus, the micro-skills approach to training focuses primarily on the acquisition of the TOC, and even then often with the 'specificity myth' (Bozarth, [<reflink idref="bib3" id="ref50">3</reflink>]) that one can learn to apply skills only, with the ROC receiving considerably less attention (Tannen, [<reflink idref="bib69" id="ref51">69</reflink>]).</p> <p>The limitations that are inherent to micro-skills approach point to the need to consider alternative frameworks for preparing counsellors. Ridley and colleagues (Ridley & Mollen, [<reflink idref="bib49" id="ref52">49</reflink>]; Ridley et al., [<reflink idref="bib50" id="ref53">50</reflink>], [<reflink idref="bib51" id="ref54">51</reflink>]) have proposed such a model, one that is rooted in the concept of counselling competence. Briefly, for Ridley and associates, counselling competence extends beyond micro-counselling skills to include the integration of cognition and affect and the development of two factors that are known to be essential to counsellors' capacity to make complex clinical judgments; namely, metacognition and continuous self-reflection and self-assessment. The last two characteristics are of particular importance for the current study.</p> <p>Borrowing from Hacker ([<reflink idref="bib25" id="ref55">25</reflink>]), Ridley and associates (Ridley et al., [<reflink idref="bib50" id="ref56">50</reflink>], [<reflink idref="bib51" id="ref57">51</reflink>]; Ridley & Mollen, [<reflink idref="bib49" id="ref58">49</reflink>]) claim that metacognition consists of three parts: metacognitive knowledge (what one knows), metacognitive skill (what one is doing), and metacognitive experience (one's cognitive and affective states). Seen from this perspective, metacognition is an essential component of cognitive complexity, and seems particularly important in promoting clinical expertise.</p> <p>Metacognition also implies the existence of a self-regulatory or executive function that includes the ability to observe one's self in action, evaluate one's performance and/or attitude, and modify one's behaviour so as to refine one's professional identity (Dimmitt & McCormick, [<reflink idref="bib16" id="ref59">16</reflink>]). It is this self-regulatory aspect of metacognition that lends emphasis to the importance of continuous self-reflection and self-assessment as a means of building counsellor competence (Ridley et al., [<reflink idref="bib50" id="ref60">50</reflink>]).</p> <p>The importance of continuous self-reflection and self-assessment as tools for promoting quality therapeutic relationships is well documented in the research literature (cf., Jennings, Sovereign, Bottorff, Mussell, & Vye, [<reflink idref="bib32" id="ref61">32</reflink>]; Skovholt & Jennings, [<reflink idref="bib59" id="ref62">59</reflink>]; Skovholt & Trotter-Mathison, [<reflink idref="bib61" id="ref63">61</reflink>]). These investigators asked 10 experienced, master therapists to identity the qualities that contributed to their success and longevity. The master therapists tended to be experienced therapists who were in private practice and who were identified by professional colleagues as exemplars of clinical expertise. Based on multiple analyses of longitudinal interviews, the researchers created a portrait of the master therapist (Jennings, Goh, Skovholt, Hanson, & Banerjee-Stevens, [<reflink idref="bib31" id="ref64">31</reflink>]; Skovholt, Jennings, & Mullenbach, [<reflink idref="bib60" id="ref65">60</reflink>]), which was organised into four types of characteristics: paradoxical, word, identifying and central. Paradoxical characteristics include 'compelled to mastery coupled with never a sense of having fully arrived,' 'ability to be deeply present with another and yet often preferring solitude,' 'generous in giving of self to others while simultaneously nourishing a private self'. Examples of Word characteristics of master therapists are congruent, intense, open, curious, reflective, and self-aware. Identifying characteristics of master therapists include 'comprehends the complex ambiguities in life', 'experiences reverence for human life and conditions', and 'dismisses simplistic models and theories'. The Central characteristics were organised into cognitive, emotional, and relational domains. In the Cognitive domain, the authors give as examples 'embraces complex ambiguity' and 'profound understanding of the human condition'; under the Emotional domain, 'deep acceptance of self,' and 'intense will to grow,' and finally in the Relational domain, 'piloted by boundaried generosity' and 'able to intensively engage others' (Jennings et al., [<reflink idref="bib31" id="ref66">31</reflink>], p. 66; Skovholt et al., [<reflink idref="bib60" id="ref67">60</reflink>], p. 135).</p> <p>Two features of these analyses are important for this study. First, the qualities, characteristics, and practices of the master therapists contrast sharply with the characterisation of novice counsellors in various models of counsellor development presented earlier. Second, the results point to the importance that the master counsellors place on knowing and understanding their own emotional and physical needs, recognising themselves as change agents while recognising the boundaries of their competence, and realising their own capacity for relationships while grasping a sense of their power in counselling settings (Ridley et al., [<reflink idref="bib50" id="ref68">50</reflink>]). Stated differently, master counsellors' ability to work effectively with clients is linked to their willingness to establish (create) a working relationship with clients and utilise their metacognitive skills and processes to monitor, guide, and promote it.</p> <p>In summary, starting students down the pathway to becoming a master counsellor involves much more than training in the basic counselling skills and theories. One way to approach this goal is to teach students how to be mindful of their thoughts, feelings, and behaviours in the moment without judgment as a guide to being present with – being in relationship with – their clients. Here, therapeutic presence refers to the following components: 'availability and openness to all aspects of the client's experience, openness to one's own experience in being with the client, and the capacity to respond to the client from this experience' (Geller & Greenberg, [<reflink idref="bib17" id="ref69">17</reflink>], p. 72).</p> <p>Educators and trainers from a variety of mental health care professions have incorporated mindfulness training in their preparation programmes, including counselling (Chrisman, Christopher, & Lichtenstein, [<reflink idref="bib12" id="ref70">12</reflink>]; Newsome, Christopher, Dahlen, & Christopher, [<reflink idref="bib41" id="ref71">41</reflink>]; Schure, Christopher, & Christopher, [<reflink idref="bib56" id="ref72">56</reflink>]), medicine (Shapiro, Schwartz, & Bonner, [<reflink idref="bib58" id="ref73">58</reflink>]), psychology (Shapiro, Brown, & Biegel, [<reflink idref="bib57" id="ref74">57</reflink>]), and psychotherapy (Geller, Greenberg, & Watson, [<reflink idref="bib19" id="ref75">19</reflink>]; Grepmair, Mitterlehner, Loew, & Nickel, [<reflink idref="bib24" id="ref76">24</reflink>]). Stauffer and Pehrsson ([<reflink idref="bib62" id="ref77">62</reflink>]) identify three types of research that focus on the efficacy of mindfulness in counselling and psychotherapy. The first is on the therapeutic effects of counselling when counsellors teach their clients to use mindfulness methods on their own. A second is the evaluation of outcomes when therapists and clients practice mindfulness methods together during sessions. The third type centres on encouraging counsellors to identify with and practice therapeutic presence during their counselling sessions with clients, which means to be 'open and available to all aspects of the client's experience, open to one's own experience of being with the client, and the capacity to respond to the client from this experience' (Geller & Greenberg, [<reflink idref="bib17" id="ref78">17</reflink>], p. 72). Independent of the focus of the research, most programmes used the Mindfulness Based Stress Reduction (MBSR) model developed by Kabat-Zinn ([<reflink idref="bib33" id="ref79">33</reflink>]) as the basis for training.</p> <p>The available research evidence points to the general utility and effectiveness of mindfulness-informed counselling (Germer, [<reflink idref="bib20" id="ref80">20</reflink>]). Among other things, the evidence demonstrates that counsellors' awareness and acceptance of themselves and their clients increases over the course of training (Greason & Gashwell, [<reflink idref="bib23" id="ref81">23</reflink>]). Further, the effects of training continue to exert a positive influence on counsellor behaviour years afterward (Christopher et al., [<reflink idref="bib13" id="ref82">13</reflink>]).</p> <p>In contrast, little is known about the manner in which students translate mindfulness training into a personal capacity to be present with their clients. How do students come to understand and internalise the cognitive, emotional, attitudinal and behavioural elements of being present and bringing that sense of presence with their clients? Ridley et al. ([<reflink idref="bib51" id="ref83">51</reflink>]) have suggested that competent counsellors will develop and use mental maps to guide their behaviour. However, if counsellor educators wish to be intentional in our efforts to train competent counsellors, we will benefit by having access to conceptual models that illustrate how counsellors-in-training experience and describe the process of choosing to be present. Our research was designed to provide such a model.</p> <hd id="AN0138027035-4">Methodology</hd> <p>The purpose of the study was to explore the following research questions: How do counsellors in training (CITs) describe their experience of being present? What meaning do they make of being present in counselling? As open-ended and subjective, these questions lend themselves to qualitative inquiry. It was our intention to investigate in-depth the situated experiences of CITs and the meaning they constructed of their experiences of presence in counselling relationship.</p> <p>A constructivist theoretical perspective was used to frame this study. Denzin and Lincoln ([<reflink idref="bib15" id="ref84">15</reflink>]) noted that individual constructions and meaning making may come together with those of other individuals in such a way as to create something of a consensus. A constructivist theoretical perspective assumes that the opinions held by individuals are experiential and created from within (Denzin & Lincoln, [<reflink idref="bib15" id="ref85">15</reflink>]). In addition, the constructivist perspective highlights individuals' unique experiences and realities (Hatch, [<reflink idref="bib26" id="ref86">26</reflink>]). From this perspective, researchers are discouraged from being distant and objective, and rather both researchers and participants engage to construct a subjective and consensual reality (Hatch, [<reflink idref="bib26" id="ref87">26</reflink>]). Participants' individual voices and their personal, historical, and social perspectives and understandings are seen as meaningful and important when investigating counselling processes. We believe that being present takes on meaning as constructed from experience by the counsellors in training and as such we chose a constructivist approach rather than a phenomenological one. Being present has been described in the literature from the perspective of experienced therapists. In this study it was the meaning constructed by beginning counsellors that was of interest.</p> <hd id="AN0138027035-5">Participants</hd> <p>Sampling in qualitative inquiry yields participants who can provide rich data relevant to the research questions (Patton, [<reflink idref="bib45" id="ref88">45</reflink>]) and in this study to probe deeply into the experience and meaning of CITs. Participants were recruited from two graduate programmes in counselling at a large university in the southeastern United States. All participants met established sampling criteria: current graduate students in counsellor education or counselling psychology who had experience counselling clients in clinical placements.</p> <p>Nine participants were recruited, two of whom withdrew following the first interview. The seven participants were assigned pseudonyms to protect their anonymity in reporting the findings. The participants all identified as female and included diversity in race/ethnicity, academic department, degree programme, and, to some extent, theoretical orientation (See Table 1).</p> <p>Table 1. Participant demographics.</p> <p> <ephtml> <table><thead valign="bottom"><tr><td>Name</td><td><sup>a</sup></td><td>Programme</td><td>Student status<sup>c</sup></td><td>Theoretical orientation<sup>b</sup></td><td>Race/Ethnicity<sup>b</sup></td></tr></thead><tbody><tr><td>Andrea</td><td char=".">4</td><td>Counselling Psychology</td><td>4th yr Doctoral</td><td>Integrative (interpersonal, multicultural, CBT, Gestalt, SFT)</td><td>White 1st Generation, Polish American</td></tr><tr><td>Cathy</td><td char=".">4</td><td>Counselling Psychology</td><td>4th yr Doctoral</td><td>Integrative (interpersonal, psychodynamic, feminist/ multicultural, client-centered)</td><td>Biracial Asian American</td></tr><tr><td>Irene</td><td char=".">3</td><td>Counsellor Education</td><td>1st yr Doctoral</td><td>Wellness</td><td>Caucasian American</td></tr><tr><td>Jesse</td><td char=".">4</td><td>Counsellor Education</td><td>4th yr Doctoral</td><td>Feminist, relational-cultural, eclectic</td><td>Arab American</td></tr><tr><td>Jill</td><td char=".">4</td><td>Counselling Psychology</td><td>4th yr Doctoral</td><td>Humanistic/existential</td><td>Caucasian</td></tr><tr><td>Pam</td><td char=".">3</td><td>Counsellor Education</td><td>3rd yr Masters</td><td>Humanistic, person-centered, Gestalt</td><td>White</td></tr><tr><td>Teresa</td><td char=".">4</td><td>Counselling Psychology</td><td>5th yr Doctoral</td><td>Integrative (existential, humanistic, family systems, multicultural, CBT)</td><td>Black and Latina (Panamanian American)</td></tr></tbody></table> </ephtml> </p> <p> <sups>a</sups>Number of Interviews <sups>b</sups>As identified by participants. <sups>c</sups>At the time of the study. Note: CBT: Cognitive behavioural therapy, SFT: Solution-focused therapy.</p> <hd id="AN0138027035-6">Data collection</hd> <p>The first author collected data through semi-structured, formal interviews which created an opportunity for the participant CITs to articulate their experience and its meaning to them. These are not observable phenomena, so lent themselves to interviewing as an appropriate data collection method. Participants were trained in mindfulness meditation as a way to cultivate being present. The 8-week mindfulness meditation training programme was based on Mindfulness-Based Stress Reduction (Kabat-Zinn, [<reflink idref="bib33" id="ref89">33</reflink>]). The group leader was a licensed psychologist who drew on his training in both Buddhist mindfulness meditation and Mindfulness-based Stress Reduction. Four interviews were conducted. The first interview took place prior to the mindfulness meditation training, the second during the seventh week of the training and the third interview took place two weeks following the completion of the training. These three interviews were conducted with each of the seven participants. The final interview was conducted for the purpose of theoretical sampling and saturation was reached after interviews with five of the participants.</p> <p>The first interview used an open-ended interview guide, beginning with the following prompt:</p> <p>During this part of the interview, I would like you to immerse yourself as much as you can in your subjective experience of being present. Being present has been described as being all there (body, mind, emotions, spirit) and aware in the present moment. I am going to ask you to remember a time when you were present, preferably in a counselling session. I am going to ask you to describe this experience as thoroughly and as richly as you can.</p> <p>In the second interview we explored participants' journals from the meditation training. The third interview used the same prompt as in the first. In each interview after the first one we checked meaning and interpretation of the previous interviews with participants, and conducted theoretical sampling. Five participants were interviewed a fourth time four months after the completion of the mindfulness training for member checking and theoretical sampling. Participants gave feedback on the proposed theory and on less developed categories to reach saturation.</p> <hd id="AN0138027035-7">Data analysis</hd> <p>Constructivist grounded theory was chosen to analyse data since it was important for us to generate a theoretical model to explain the findings in relation to the participants' concepts and experiences. Although grounded theory, as created by Glaser and Strauss ([<reflink idref="bib22" id="ref90">22</reflink>]), has its roots in a positivist paradigm, Kathy Charmaz ([<reflink idref="bib8" id="ref91">8</reflink>], [<reflink idref="bib9" id="ref92">9</reflink>], [<reflink idref="bib10" id="ref93">10</reflink>], [<reflink idref="bib11" id="ref94">11</reflink>]) and others (e.g. Bryant, [<reflink idref="bib5" id="ref95">5</reflink>]; Clarke, [<reflink idref="bib14" id="ref96">14</reflink>]) maintain that it may be used from a constructivist theoretical orientation. Constructivist grounded theory researchers acknowledge that participants have a voice in the data and their voices interact with the researcher in the development of theories that are grounded in the data (Charmaz, [<reflink idref="bib10" id="ref97">10</reflink>]). Constructivist grounded theory focuses on actions and processes in various phenomena which makes it an appropriate methodology for the study of being present as experienced and interpreted by CITs (Charmaz, [<reflink idref="bib10" id="ref98">10</reflink>]; Glaser, [<reflink idref="bib21" id="ref99">21</reflink>]).</p> <p>Transcripts of the 26 interviews with participants formed the data to be analysed and interpreted. The process of grounded theory analysis involved data collection, several levels of coding, theory building, and memo writing (Glaser & Strauss, [<reflink idref="bib22" id="ref100">22</reflink>]). During the theory building the researcher moves toward developing progressively more abstract concepts or categories and exploring the relationships among them (Charmaz, [<reflink idref="bib9" id="ref101">9</reflink>]). Additional and potentially ongoing data collection is targeted to answer questions and fill out categories in what is called theoretical sampling (Glaser & Strauss, [<reflink idref="bib22" id="ref102">22</reflink>]).</p> <p>Charmaz has outlined two main phases of grounded theory coding: '1) an initial phase involving naming each word, line, or segment of data followed by 2) a focused, selective phase that uses the most significant or frequent initial codes to sort, synthesise, integrate, and organise large amounts of data' ([<reflink idref="bib10" id="ref103">10</reflink>], p. 46). In coding the data, the first author followed Glaser's ([<reflink idref="bib21" id="ref104">21</reflink>]) questions of the data (what is happening here, what are the processes at work and what accounts for those processes), but from a constructivist perspective not 'discovering' the processes but interpreting what she saw as emerging from the data. Clarke's ([<reflink idref="bib14" id="ref105">14</reflink>]) situational mapping process facilitated the exploration of relationships between the phenomenon under study and contextual factors.</p> <p>The theoretical sampling interviews (interview #4) gathered reactions to and feedback on the theory developed thus far, filled out categories that seemed significant but were not yet well developed, and inquired about rarely mentioned but interesting data. Participants were provided an emerging conceptual model and overview of the categories in its form at the time. The conceptual model was then revised and extended after interpretation from these interviews and after participants' feedback.</p> <hd id="AN0138027035-8">Trustworthiness</hd> <p>Credibility for this study was established using member checking, prolonged engagement, disconfirming evidence, and peer debriefing procedures (Lincoln & Guba, [<reflink idref="bib36" id="ref106">36</reflink>]). Participants were interviewed over a six-month period, and their journals during the eight-week meditation training served as secondary data sources. Throughout the data collection and analysis, both convergent themes and disconfirming evidence were reflected in codes. Theoretical sampling interviews were used to fill out or eliminate categories and refine proposed processes. An audit trail supports the dependability and confirmability of the study's outcomes. Frequent meetings among the authors and a grounded theory research group helped refine coding and the emerging theory.</p> <p>The methodology for this study has been clearly recorded including the theoretical perspective, the data collection and analysis procedures, subjectivity of the researcher, and potential limitations.</p> <hd id="AN0138027035-9">Findings</hd> <p>Grounded theory methods culminate in a theoretical model of processes and relationships interpreted from the data (Charmaz, [<reflink idref="bib10" id="ref107">10</reflink>]; Glaser, [<reflink idref="bib21" id="ref108">21</reflink>]; Strauss & Corbin, [<reflink idref="bib68" id="ref109">68</reflink>]). The theoretical model from this study, Choosing to be Present as Counsellors in Training, is shown graphically in Figure 1. The model maps the processes involved in CITs choosing to be more or less present, how context facilitates or inhibits those choices, and the impact those choices have on counsellor development over time. The seven major elements of the theory, corresponding to the selective codes derived from the data analysis, anchor the model: being present, choosing to be present, awakening to choices, acting to contain anxiety and uncertainty, contexts facilitating or inhibiting being present, experiencing the outcomes of being present, and experiencing the outcomes of containing anxiety and uncertainty.</p> <p>PHOTO (COLOR): Figure 1. Theoretical model: choosing to be present as counsellors in training.</p> <p>The model illustrates how CITs' choices result in their being more or less present along a continuum shown as an open-ended black line at the bottom of the figure. In a continuous, moment-to-moment process, CITs either seek safety by acting to contain their anxiety and uncertainty (signified in Figure 1 by the black arrows moving in the loop to the left) or seek connection by choosing to be more present (signified in Figure 1 by the black arrows moving in the loops to the right). There is a point (in the centre of the figure where the loops join) when CITs become aware of choices to be more present. They move back and forth along a continuum of being present, in a dynamic and idiosyncratic path, illustrated by the black arrows around the various loops in Figure 1. For instance, a CIT may awaken to the choice to be present but then make the choice to move back toward containing anxiety and uncertainty, and then move back again toward being more present, looping through the various processes, based on a variety of factors. All the choices take place in contexts that either inhibit or facilitate being present. And CITs' own experiences of the outcomes of being more or less present or of containing anxiety and uncertainty also influence their choices. The vertical axis at the right of the figure projects that the choices CITs make over time – how much time they spend in any of the loops along the continuum – shape their development as counsellors. These processes are described in more detail below with supportive quotations from the data.</p> <p>CITs face insecurity and uncertainty as they begin their work as counsellors. They may suddenly find themselves alone in a room with a person experiencing significant pain. That person is looking to the new counsellor for help. CITs have choices then about how they work with the uncertainty and the anxiety that arises in them. They make choices not only in the counselling session itself, but also within a broader context that includes their academic departments, family and/or spiritual values, professional standards, and prevailing cultural norms.</p> <p>There are so many other things that we're told that are important, that are not, that have nothing to do with connection and, to a certain extent, some limited thing to do with relationships, but like we don't get reinforced for that stuff. (Cathy)</p> <p>Defaulting to what seems to be the socially acceptable way (referred to in the data as 'the normal way') they take steps to contain their anxiety in order to perform well as new counsellors. 'I don't like feeling uncomfortable so I'm going to do everything I can in my power to avoid feeling uncomfortable, whether it's going shopping, or whatever it may be' (Jesse). Participants described doing this by trying to be in control (planning, researching, and/or adopting a role); by distracting themselves from or avoiding uncomfortable emotions, and by trying to maintain an image of competence.</p> <p>I think at the beginning of counselling I always came in with an agenda, thinking 'OK this person had said this during this session, OK let me look up these things, these are the, this is the list of things that we're going to talk about. (Andrea)</p> <p>But what happens when they do that appears to be that they are less present and less connected with their clients which in turn makes them less effective and less satisfied in their work, ' ... like I have a weight on my head or something ... . It feels like there's like a shade or something that is there' (Pam). Those CITs who are exposed to the experience of being present – in supervision, through mindfulness training, or in spontaneous personal experiences – awaken to an alternative paradigm. This alternative paradigm, the paradigm of being present, seems to enable them to connect with themselves and with their clients and, as a by-product, develop a different relationship with their anxiety.</p> <p>I felt an increased capacity to be effectively responsive to the situation and I wasn't, I was very in the flow, like I was intuitively knowing what to do next rather than being like 'oh, gosh, what do I do next?' (Irene)</p> <p>CITs in this study described the actions of being present as trusting and letting go; accepting what is; being human, staying with what is, beginner's mind, attending inwardly and outwardly, and being aware. In so doing, anxiety is not contained but transcended or transmuted and CITs are more available for therapeutic connection with their clients. While the actions of being present are not initially comfortable and require some courage, the outcome is somehow satisfying and energising.</p> <p>... feeling that true connection with another person I think is like really powerful and I think that's a great, I don't know, I think that's a great reward for me. And with other people, too. When I actually sit with somebody, I'm like 'Wow, we just had something that was true.' That's like so sustaining. And so, I think that's really big. (Cathy)</p> <p>Choosing to be present is not easy for CITs. For them choosing to be present means taking personal and professional risks in navigating conflicting paradigms. It means revising priorities often in a way that contradicts their training, such as entering a session open and without a plan.</p> <p>I can remember, you know, first starting out in my prac and I have all these, you know, things that I've heard professors say of you know 'you have to be intentional with everything you say,' and 'there has to be this, you know, plan,' 'what is your goal here in each of these' and so I came in thinking that and then at the [practicum site] they're saying, just, you know, the most important thing is to be, connect, and be genuine, and this and that and so I'm thinking 'Aaaa, what am I doing?' (Pam)</p> <p>It means heightening awareness of themselves as persons, as well as of their clients, which puts CITs up against previously unacknowledged parts of themselves, often creating new anxiety.</p> <p>I think ultimately I'm probably scared because of what I'm feeling and my emotions ... just being fearful of what I might be feeling. (Jill)</p> <p>What appears to move them to take these risks is their experience of being present. In that experience, they recognise a fit with who they are, their beliefs and values, and their sense of purpose, and they see benefits to the therapeutic relationship and process.</p> <p>Paradoxically, once the risk is taken and the CIT lets go into the present moment, anxiety dissipates, becomes less important, or is transmuted into feeling at peace.</p> <p>But in that moment, we were able to be there together and acknowledge that, I mean there's a lot of unknown in this world ... we're kind of just letting go into the present moment and, and the benefit of that is a sense of peace, and a feeling of release and a feeling of calm, that we had both not been experiencing prior to that moment. (Jesse)</p> <p>The CIT is more available to connect with herself and with her clients. That connection, whether with oneself or with clients, is seen by the participants in this study as fundamentally healing.</p> <p>Using myself at that moment to kind of be a part of that healing process for the client, so, and try to step out of my boundaries and even though it's scary for me to do that, but being able to step out there, too, and in the long run that I know that, that I might help in, in the healing process for the client. (Teresa)</p> <p>Being present, CITs have conscious access to their emotional reactions, their experience, their training, their intuition, their creativity, and their cognitive processing – it is all there in the moment, which allows counselling to be alive in its complexity. This in turn reinforces taking the necessary risks, especially if CITs are supported by contexts that facilitate their taking those risks rather than reinforcing the 'normal way.'</p> <p>Choosing to be present is not a dichotomous choice but rather a continuum from being in 'automatic mode' to 'being fully present.' Choosing to be present means consciously fostering and cultivating being present so that one may move toward being fully present. Each of the actions associated with either containing anxiety or with being present move the CIT along the continuum, e.g. controlling and planning at one end and trusting and letting go on the other. There seems to be a threshold, though, at which CITs identify their experience as being present as opposed to not being present. That threshold is the point of awareness or awakening.</p> <p>Acting to contain anxiety and uncertainty feels safe and familiar but the fallout in counselling is disconnecting, being less available, missing healing opportunities, and not building relationship. 'I'm not available. I'm not totally there, like part of me might be there, but, so there's less of me to connect with or that's attempting to make a connection.' (Irene) Choosing to be present the CIT risks coming to know herself, rejection, loneliness, feeling uncomfortable emotions, and for some, religious censure.</p> <p>The benefits for counselling of choosing to be present weigh in heavily, though: amplifying connection, feeling at peace, being a better instrument of and facilitating the therapeutic process, counselling in the present moment, building tolerance for discomfort, and sustaining counsellors in the work.</p> <p>I don't think I've ever been really present with someone without feeling that natural like interconnectedness, like we're kind of the same, you know, like we're all of the same stuff, and we all have related experiences. We're all in this life together. And I think when I feel that, I truly do care about the other person. (Jill)</p> <p>Choosing to be present is both a moment to moment choice and a broader choice about living one's life. CITs may set the intention to be present and cultivate that ability through various practices and through coaching themselves. Caring for themselves as whole people, not confining themselves to their role as student or as counsellor, enhances their ability to be present. CITs may awaken at moments in life or in counselling when they become aware of their critical thoughts, their efforts to plan and control and other ways they contain their anxiety. At that moment, with that awareness, they become more present. They have awakened to the choices they have to foster presence and connection or to hold on to the familiarity of containing their anxiety. 'I feel like when you start to go in this path of like mindfulness, connection, presence, I think sometimes you start to re-evaluate your relationships in some ways, ways of being in the world.' (Cathy) With awareness comes the inevitability of choice. Choice replaces habit. Avoiding and distancing or being more present can no longer be unconscious acts.</p> <p>Part of containing anxiety involves protecting one's vulnerability. When CITs choose to be more or less present they take into account the context. In some cases the context may not be a conducive or safe one in which to open oneself.</p> <p>There's also a self-protective piece. It is important for therapists to take care of themselves, to not be traumatized. I think you can be present in protecting yourself. And you can be not present in protecting yourself. The difference is awareness. (Jesse)</p> <p>So CITs may at times operate in the loop of safety and protection and other times flow into the loop of opening and letting go. Again, though, even in making a conscious choice to protect themselves, they are more present. The more experience the CIT has being present, the more the choice is about connecting with others and with herself and less about negotiating discomfort.</p> <p>And it's not to say that that doesn't make your life hard ... like we don't get reinforced for that stuff. You know? So it's kind of like I feel like when you connect with another person, truly connect with them, it's a reminder of, of what's important, it's a reminder of, you know, like truth. ... so I think it's completely worth it because it's like every time I do it I feel like I get that great reminder and then I feel like I'm closer to knowing myself. (Cathy)</p> <p>Choosing to be present is going toward something positive where containing anxiety is going away from something uncomfortable or negative. The two loops have a different quality.</p> <p>As moment to moment choices string together over time and the counsellor or person spends more time in one loop or another, she develops and changes. The choosing is part of a developmental process and affects the kind of counsellor or person she becomes. 'I know it's moment to moment but it's also those moments build up. There is a broader change in your being ... ' (Teresa).</p> <p>Participants were interviewed three times. At the first interview, every participant had experienced what they considered being present. Participants were interviewed again after seven and again after eight weeks of practicing mindfulness meditation as a way of cultivating presence. Their descriptions of the experience of being present did not change. What did change was their sense of agency in being present, their awareness of their choices to be more or less present. They became aware of the power they had to approach the therapeutic encounter, and themselves, deliberately with openness, non-judgment, letting go of control, in the present moment. This sense of agency and the identification of the impact of choices made has implications for counsellor development and training.</p> <hd id="AN0138027035-10">Implications</hd> <p>Every human being has the innate ability to be present. The theory derived from the data in this study proposes that CITs can intentionally cultivate being present in their work and that being present enhances therapeutic effectiveness by amplifying connection, heightening empathy, counselling in the present, building tolerance for discomfort, being a better instrument of therapy and facilitating the therapeutic process. Each element of the theoretical model that depicts this process deserves attention for its implications for counsellor education and development. Since they are interrelated they cannot truly be segregated and must be explored with the model as a whole in mind. Here, however, we draw attention to two features of the process – awakening to choices and the impact of those choices on counsellor development over time.</p> <p>Common among models of counsellor development is the characterisation of the beginning CIT as plagued by anxiety and self-consciousness while demonstrating a naïve sense of security, lacking awareness of their blind spots, rigid attachment to techniques or theory, and dependent on outside expertise (Hogan, [<reflink idref="bib27" id="ref110">27</reflink>]; Loganbill et al., [<reflink idref="bib37" id="ref111">37</reflink>]; Orlinsky et al., [<reflink idref="bib44" id="ref112">44</reflink>]; Stoltenberg et al., [<reflink idref="bib67" id="ref113">67</reflink>]; Stoltenberg & Delworth, [<reflink idref="bib66" id="ref114">66</reflink>]). As counsellors develop, according to these models, they move toward greater autonomy, self-awareness, flexibility, acknowledgment of complexity, comfort with ambiguity and uncertainty and ability to focus on the client (Hogan, [<reflink idref="bib27" id="ref115">27</reflink>]; Loganbill et al., [<reflink idref="bib37" id="ref116">37</reflink>]; Orlinsky et al., [<reflink idref="bib44" id="ref117">44</reflink>]; Stoltenberg et al., [<reflink idref="bib67" id="ref118">67</reflink>]; Stoltenberg & Delworth, [<reflink idref="bib66" id="ref119">66</reflink>]). Counsellor development models note that characteristics and behaviours are different in the different stages/phases but not <emph>how</emph> the development occurs. Even one of the main architects of counsellor development and supervision models has said:</p> <p>It is important to have a set of identifiable skills and behaviours that define what competence is for professional psychologists....As important as these specific skills and behaviours are, however, it is imperative that psychologists consider how their supervisees progress on this developmental path and what they can do in a developmentally appropriate manner to encourage this progression. (Stoltenberg, [<reflink idref="bib64" id="ref120">64</reflink>], p. 862).</p> <p>We are proposing that CITs have agency in their development and that awakening to their choices offers powerful and perhaps untapped opportunities to understand how CITs progress in their developmental path and to influence that development.</p> <p>Developmental models of supervision have responded to beginning CITs' desire for security and external guidance by providing it and then weaning students from it as they gain confidence and skill (Stoltenberg et al., [<reflink idref="bib67" id="ref121">67</reflink>]). Looking at the theoretical model (Figure 1) from this study we can see that when CITs seek to contain their anxiety and uncertainty (seek safety) they move toward being less present along the continuum. The data indicate they do this by avoiding, controlling, distracting, and managing their image as counsellors (self-monitoring, wanting to appear competent and putting on a counsellor persona). If they awaken to and make the choice to be more present, they move toward connection and their anxiety becomes less of a focus. This presents a different way of addressing CITs' desire for security; cultivating awareness of the choice to be present rather than acting to contain or diminish anxiety and uncertainty. In turn this seems to move CITs along in their development as counsellors as they have more of a sense of their own agency (autonomy), increased self-awareness, and increased connection to their clients. The phase models of counsellor development are primarily descriptive rather than process oriented (Loganbill et al., [<reflink idref="bib37" id="ref122">37</reflink>]; Stoltenberg & Delworth, [<reflink idref="bib66" id="ref123">66</reflink>]) and the theory from this study proposes processes that appear to facilitate movement in counsellor development. In addition, the choices this model suggests that CITS have in their development are not addressed in existing models (Loganbill et al., [<reflink idref="bib37" id="ref124">37</reflink>]; Stoltenberg et al., [<reflink idref="bib67" id="ref125">67</reflink>]; Stoltenberg & Delworth, [<reflink idref="bib66" id="ref126">66</reflink>]). We propose that introducing students to the processes outlined in the theoretical model and helping them cultivate the awareness of their choices to be more or less present adds an important dimension to their training and facilitates their development and as such has implications for counsellor education and supervision. Future research is needed to test or explore the theory proposed here and perhaps expand their generalisability, exploring the relationship between CITs' agency in their own development, choosing to be present, and the previously identified stages and phases of counsellor development.</p> <p>CITs are in a developmental process. According to the theory proposed here, they take in their experiences in context, moment by moment and day by day making choices in how to be. And in those choices, CITs construct their personal developmental path. If they choose the path of becoming more present they reap the benefits of being present. These benefits are identified in this study as amplifying connection, being a better instrument of the therapeutic process, facilitating the therapeutic process, building tolerance for discomfort, counselling in the present moment, the counsellor feeling at peace, and sustaining counsellors in their work. Cultivating being present was seen by participants as a path toward being the therapist they wanted to be. And the portrait of master therapists from the work of Jennings et al. ([<reflink idref="bib31" id="ref127">31</reflink>]) and Skovholt et al. ([<reflink idref="bib60" id="ref128">60</reflink>]) validates those desires as master therapists are portrayed in the above studies as open, curious, reflective, self-aware, deeply accepting of self, embracing complex ambiguity, and able to intensively engage others. These qualities are consistent with descriptions of being present. Despite the experienced benefits of being present, choosing to be more present involved risking vulnerability, going against the 'normal way,' and active fostering of being present through mindfulness meditation practice, slowing down, and engaging in self-care. The participants in this study indicated that often their academic contexts either did not encourage or actively discouraged taking the risks to be more present. Hence, additional exploration is needed of the impact of counsellor training programmes in academic settings on CITs choosing to be present. What is the role of counsellor educators and supervisors in creating contexts that facilitate the awakening to choices and then making the choice to be more present? What if, when CITs request structure, direction, or plan or adopt a somewhat rigid or naïve confidence, they were asked by a supervisor or professor to nonjudgmentally sit with the anxiety inherent in those behaviours, open to what is present, practice tolerating uncertainty? What if supervisors and professors were to give permission to CITs to be where they are, directing the CITs' attention to their present moment experience, encouraging awareness rather than trying to fix or improve? What questions by supervisors facilitate the CIT's 'awakening to choices' to be present? These are all questions for future research to explore and illuminate.</p> <p>And closer to home, these processes have implications for counsellor educators and supervisors themselves. How might the focus on and awareness of CIT choices to be more present or to contain their anxiety change the role of the supervisor? It certainly points to a parallel process for supervisors. The supervisor also makes choices along the continuum of being present with the supervisee moment to moment. Supervisors may contain their own anxiety and uncertainty by taking on the role of expert or by having a plan for supervision or may move toward being more present which may challenge their own need for safety but amplify their connection with their supervisees. Being more present, the supervisor relinquishes some control. This may be confrontive in different ways for beginning supervisors and experienced supervisors but would be true for both. Future research is needed to explore these processes.</p> <p>Research into the above questions is needed to continue to improve counsellor effectiveness through training that facilitates counsellor presence and connection and by advancing our understanding of the process of counsellor development.</p> <hd id="AN0138027035-11">Limitations</hd> <p>All the participants who volunteered for the study identified as females situating the findings within gendered experiences. Although findings are somewhat limited by having no data from male-identified participants, females make up a larger percentage of CIT populations than males in the two counselling programmes from which participants were recruited. Future research involving male-identified participants could enlarge and enhance understanding of being present from the point of view of male CITs. In addition, all study participants came from the same university and findings of this study are generalisable within this population. Having participants from both counselling psychology and counsellor education, different programmes and disciplines of counselling, also diversified data and offered multiple perspectives. The sample did include diversity in socioeconomic, cultural, and racial characteristics which strengthened the theory. People who agreed to be in the study knew they would be learning mindfulness meditation which also may have attracted a particular segment of the CIT population.</p> <hd id="AN0138027035-12">Disclosure statement</hd> <p>No potential conflict of interest was reported by the authors.</p> <p>Notes on contributors</p> <p> <bold> <emph>Tina Tannen</emph> </bold>, Ph.D., is a Clinical Assistant Professor at the University of Florida Counselling and Wellness Center where she integrates mindfulness, Gestalt and developmental approaches in therapy with university students and in counsellor training. She holds a Ph.D. in Counsellor Education from the University of Florida, USA.</p> <p> <bold> <emph>M. Harry Daniels</emph> </bold>, Ph.D., is an Emeritus Professor in the School of Human Development and Organizational Studies in Education at the University of Florida, USA. Dr. Daniels was actively involved in the training and supervision of counsellor educators, school counsellors and marriage and family therapists for over 35 years.</p> <p> <bold> <emph>Mirka Koro-Ljungberg</emph> </bold> (Ph.D., University of Helsinki) is a Professor of qualitative research at the Arizona State University, USA. Her scholarship operates in the intersection of methodology, philosophy, and socio-cultural critique and her work aims to contribute to methodological knowledge, experimentation, and theoretical development across various traditions associated with qualitative research. She has published in various qualitative and educational journals and is the author of Reconceptualizing qualitative research: Methodologies without methodology (2016) published by SAGE.</p> <ref id="AN0138027035-13"> <title> References </title> <blist> <bibl id="bib1" idref="ref38" type="bt">1</bibl> <bibtext> Asay, T. P., & Lambert, M. J. (1999). The empirical case for the common factors in therapy: Quantitative findings. In M. A. Hubble, B. L. Duncan, & S. D. Miller (Eds.), The heart and soul of change: What works in therapy (pp. 33 – 56). Washington, DC : American Psychological Association.</bibtext> </blist> <blist> <bibl id="bib2" idref="ref21" type="bt">2</bibl> <bibtext> Association for Counselor Education and Supervision. (2011). Best practices in clinical supervision. Alexandria, VA : Author.</bibtext> </blist> <blist> <bibl id="bib3" idref="ref50" type="bt">3</bibl> <bibtext> Bozarth, J. D. (1998). Person –centered therapy: A revolutionary paradigm. Ross-on-Wye : PCCS Books. pp. 163 – 173.</bibtext> </blist> <blist> <bibl id="bib4" idref="ref11" type="bt">4</bibl> <bibtext> Bozarth, J. D. (2001). Person centered counseling: The culture within. Journal of Counseling and Development, 79 (2). doi: 10.1002/j.1556-6676.2001.tb01953.x</bibtext> </blist> <blist> <bibl id="bib5" idref="ref95" type="bt">5</bibl> <bibtext> Bryant, A. (2002). Regrounding grounded theory. Journal of Information Technology Theory and Application, 4, 25 – 42.</bibtext> </blist> <blist> <bibl id="bib6" idref="ref13" type="bt">6</bibl> <bibtext> Buber, M. (1970). I and thou (W. Kaufman, Trans.). New York : Charles Scribner's Sons.</bibtext> </blist> <blist> <bibl id="bib7" idref="ref14" type="bt">7</bibl> <bibtext> Bugental, J. F. T. (1987). The art of the psychotherapist. New York : W. W. Norton & Company.</bibtext> </blist> <blist> <bibl id="bib8" idref="ref91" type="bt">8</bibl> <bibtext> Charmaz, K. (2000). Grounded theory: Objectivist and constructivist methods. In N. K. Denzin, & Y. S. Lincoln (Eds.), Handbook of qualitative research (2nd ed., pp. 509 – 535). Thousand Oaks, CA : SAGE Publications.</bibtext> </blist> <blist> <bibl id="bib9" idref="ref92" type="bt">9</bibl> <bibtext> Charmaz, K. (2005). Grounded theory in the 21st century: Applications for advancing social justice studies. In N. K. Denzin, & Y. S. Lincoln (Eds.), SAGE handbook of qualitative research (pp. 507 – 535). Thousand Oaks, CA : SAGE Publications.</bibtext> </blist> <blist> <bibtext> Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. Thousand Oaks, CA : SAGE Publications.</bibtext> </blist> <blist> <bibtext> Charmaz, K. (2008). Grounded theory as an emergent method. In S. N. Hesse-Biber, & P. Leavy (Eds.), Handbook of emergent methods (pp. 155 – 170). New York, NY : Guilford Press.</bibtext> </blist> <blist> <bibtext> Chrisman, J. A., Christopher, J. C., & Lichtenstein, S. J. (2009). Qigong as a mindfulness practice for counselling students: A qualitative study. Journal of Humanistic Psychology, 49, 236 – 257. doi: 10.1177/0022167808327750</bibtext> </blist> <blist> <bibtext> Christopher, C., Chrisman, J., Trotter-Mathison, M., Schure, M., Dahlen, P., & Christopher, S. (2011). Perceptions of the long-term influence of mindfulness training on counsellors and psychotherapists: A qualitative inquiry. Journal of Humanistic Psychology, 51, 318 – 349. doi: 10.1177/0022167810381471</bibtext> </blist> <blist> <bibtext> Clarke, A. E. (2003). Situational analyses: Grounded theory mapping after the postmodern turn. Symbolic Interaction, 26, 553 – 576. doi: 10.1525/si.2003.26.4.553</bibtext> </blist> <blist> <bibtext> Denzin, N. K., & Lincoln, Y. S. (Eds.). (2005). The SAGE handbook of qualitative research (3rd ed.). Thousand Oaks, CA : Sage Publications.</bibtext> </blist> <blist> <bibtext> Dimmitt, C., & McCormick, G. M. (2012). Metacognition in education. In R. Karen, S. Graham, T. Urdan, C. B. McCormick, G. M. Sinatra, & J. Sweller (Eds.), APA educational psychology handbook, Vol 1: Theories, constructs, and critical issues (pp. 157 – 187). Washington, DC : American Psychological Association.</bibtext> </blist> <blist> <bibtext> Geller, S. M., & Greenberg, L. S. (2002). Therapists' experience of presence in the psychotherapy encounter. Person-centered and Experiential Psychotherapies, 1 (1&2), 71 – 86. doi: 10.1080/14779757.2002.9688279</bibtext> </blist> <blist> <bibtext> Geller, S. M., & Greenberg, L. S. (2012). Therapeutic presence: A mindfull approach to effective therapy. Washington, DC : American Psychological Association. doi: 10.1037/13485-000</bibtext> </blist> <blist> <bibtext> Geller, S. M., Greenberg, L. S., & Watson, J. C. (2010). Therapist and client perceptions of therapeutic presence: The development of a measure. Psychotherapy Research, 20, 599 – 610. doi: 10.1080/10503307.2010.495957</bibtext> </blist> <blist> <bibtext> Germer, C. (2005). Mindfulness: What is it? What does it matter? In C. K. Germer, R. D. Siegel, & P. R. Fulton (Eds.), Mindfulness and psychotherapy (pp. 3 – 27). New York, NY : Guilford Press.</bibtext> </blist> <blist> <bibtext> Glaser, B. G. (1978). Theoretical sensitivity. Mill Valley, CA : The Sociology Press.</bibtext> </blist> <blist> <bibtext> Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory. Chicago, IL : Aldine Publishing Company.</bibtext> </blist> <blist> <bibtext> Greason, P. B., & Gashwell, G. S. (2009). Mindfulness and counselling self-efficacy: The mediating role of attention and empathy. Counsellor Education & Supervision, 49, 2 – 19. doi: 10.1002/j.1556-6978.2009.tb00083.x</bibtext> </blist> <blist> <bibtext> Grepmair, L., Mitterlehner, F., Loew, T., & Nickel, M. (2007). Promotion of mindfulness in psychotherapists in training: Preliminary study. European Psychiatry, 22, 485 – 489. doi: 10.1016/j.eurpsy.2007.02.004</bibtext> </blist> <blist> <bibtext> Hacker, D. J. (1998). Definitions and empirical foundations. In D. J. Hacker, J. Dunlosky, & A. C. Graesser (Eds.), Metacognition in educational theory and practice (pp. 1 – 23). Mahwah, NJ : Lawrence Erlbaum.</bibtext> </blist> <blist> <bibtext> Hatch, J. A. (2002). Doing qualitative research in educational settings. Albany : State University of New York Press.</bibtext> </blist> <blist> <bibtext> Hogan, R. A. (1964). Issues and approaches in supervision. Psychotherapy: Theory, Research, and Practice, 1, 139 – 141. doi: 10.1037/h0088589</bibtext> </blist> <blist> <bibtext> Horvath, A. O. (2005). The therapeutic relationship: Research and theory. Introduction to the special issue. Psychotherapy Research, 15, 3 – 7. doi: 10.1080/10503300512331339143</bibtext> </blist> <blist> <bibtext> Horvath, A. O., & Greenberg, L. S. (1989). Development and validation of the working alliance inventory. Journal of Counseling Psychology, 36, 223 – 233. doi: 10.1037/0022-0167.36.2.223</bibtext> </blist> <blist> <bibtext> Hubble, M. A., Duncan, B. I., & Miller, S. D. (1999). The heart and soul of change: What works in therapy. Washington, DC : American Psychological Association.</bibtext> </blist> <blist> <bibtext> Jennings, L., Goh, M., Skovholt, T. M., Hanson, M., & Banerjee-Stevens, D. (2003). Multiple factors in the development of the expert counsellor and therapist. Journal of Career Development, 30, 59 – 72.</bibtext> </blist> <blist> <bibtext> Jennings, L., Sovereign, A., Bottorff, N., Mussell, M. P., & Vye, C. (2005). Nine ethical values of master therapists. Journal of Mental Health Counseling, 27, 32 – 47. doi: 10.17744/mehc.27.1.lmm8vmdujgev2qhp</bibtext> </blist> <blist> <bibtext> Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York : Dell Publishing.</bibtext> </blist> <blist> <bibtext> Lambert, M. J. (1992). Implications of outcome research for psychotherapy integration. In J. C. Norcross, & M. R. Goldfried (Eds.), Handbook of psychotherapy integration (pp. 94 – 129). New York : Basic Books.</bibtext> </blist> <blist> <bibtext> Lambert, M. J., & Bergin, A. E. (1994). The effectiveness of psychotherapy. In A. E. Bergin, & S. L. Garfield (Eds.), Handbook Of psychotherapy And behavior change (pp. 143 – 189). New York : John Wiley & Sons.</bibtext> </blist> <blist> <bibtext> Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Beverly Hills, CA : SAGE Publications.</bibtext> </blist> <blist> <bibtext> Loganbill, C., Hardy, E., & Delworth, U. (1982). Supervision: A conceptual model. The Counseling Psychologist, 10, 3 – 42. doi: 10.1177/0011000082101002</bibtext> </blist> <blist> <bibtext> Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical Psychology, 68, 438 – 450. doi: 10.1037/0022-006X.68.3.438</bibtext> </blist> <blist> <bibtext> May, R. (1958). Contributions of existential psychotherapy. In R. May, E. Angel, & H. F. Ellenberger (Eds.), Existence: A new dimension in psychiatry and psychology (pp. 37 – 91). New York : Basic Books.</bibtext> </blist> <blist> <bibtext> Miville1, M. L., Jorja, A. K. R., & Hernandez, E. (2011). Microskills, trainee competence, and therapy outcomes: Learning to work in circles. The Counseling Psychologist, 39, 897 – 907. doi: 10.1177/0011000011404438</bibtext> </blist> <blist> <bibtext> Newsome, S., Christopher, J. C., Dahlen, P., & Christopher, S. (2006). Teaching counsellors selfcare through mindfulness practices. Teachers College Record, 108, 1881 – 1900. doi: 10.1111/ J.1467-9620.2006.00766.X doi: 10.1111/j.1467-9620.2006.00766.x</bibtext> </blist> <blist> <bibtext> Norcross, J. C. (Ed.). (2002). Psychotherapy relationships that work: Therapist contributions and responsiveness to patients. New York : Oxford University Press.</bibtext> </blist> <blist> <bibtext> Nuetzel, E. J., Larsen, R. J., & Prizmic, Z. (2007). The dynamics of empirically derived factors in the therapeutic relationship. Journal of the American Psychoanalytic Association, 55, 1321 – 1353. doi: 10.1177/000306510705500411</bibtext> </blist> <blist> <bibtext> Orlinsky, D., Ambuhl, H., Botermans, J., Davis, J., Ronnestad, M. H., Willutski, U., ...  Davis, M. (1999). Psychotherapists' assessments of their development at different career levels. Psychotherapy: Theory, Research, Practice, Training, 36, 203 – 215. doi: 10.1037/h0087772</bibtext> </blist> <blist> <bibtext> Patton, M. Q. (1990). Qualitative research and evaluation methods. Thousand Oaks, CA : SAGE Publications.</bibtext> </blist> <blist> <bibtext> Perls, L. (1978). Concepts and misconceptions of gestalt therapy. Voices: The Art and Science of Psychotherapy, 14/3. Reprinted in Journal of Humanistic Psychology, 32, 50 – 56.</bibtext> </blist> <blist> <bibtext> Reik, T. (1948). Listening with the third ear. New York : Farrar, Straus and Company.</bibtext> </blist> <blist> <bibtext> Reising, G. N., & Daniels, M. H. (1983). A study of hogan's model of counsellor development and supervision. Journal of Counseling Psychology, 30, 235 – 244. doi: 10.1037/0022-0167.30.2.235</bibtext> </blist> <blist> <bibtext> Ridley, C. R., & Mollen, D. (2010). Training in counselling psychology: An Introduction to the Major contribution. The Counseling Psychologist, 39, 793 – 799. doi: 10.1177/0011000010377664</bibtext> </blist> <blist> <bibtext> Ridley, C. R., Mollen, D., & Kelly, S. M. (2011a). Beyond microskills: Toward a model of counseling competence. The Counseling Psychologist, 39, 825 – 864. doi: 10.1177/0011000010378440</bibtext> </blist> <blist> <bibtext> Ridley, C. R., Mollen, D., & Kelly, S. M. (2011b). Counseling competence: Application and implications of a model. The Counseling Psychologist, 39, 865 – 886. doi: 10.1177/0011000010378443</bibtext> </blist> <blist> <bibtext> Robinson, V., & Halliday, J. (1987). A critique of the microskills approach to problem understanding. British Journal of Guidance and Counselling, 15 (2), 113 – 124. doi: 10.1080/03069888700760151</bibtext> </blist> <blist> <bibtext> Rogers, C. R. (1961). On becoming a person. Boston : Houghton-Mifflin.</bibtext> </blist> <blist> <bibtext> Rogers, C. R. (1980). A way of being. New York: Houghton Mifflin.</bibtext> </blist> <blist> <bibtext> Rogers, C. R. (2007). The necessary and sufficient conditions of therapeutic personality change. Psychotherapy: Theory, Research, Practice, Training, 44 (3), 240 – 248. doi: 10.1037/0033-3204.44.3.240</bibtext> </blist> <blist> <bibtext> Schure, M. B., Christopher, J. C., & Christopher, S. E. (2008). Mind-body medicine and the art of self-care: Teaching mindfulness to counselling students through yoga, meditation, and qigong. Journal of Counseling & Development, 86, 47 – 56. doi: 10.1002/j.1556-6678.2008.tb00625.x</bibtext> </blist> <blist> <bibtext> Shapiro, S., Brown, K. W., & Biegel, G. M. (2007). Teaching self-care to caregivers: Effects of mindfulness-based stress reduction on the mental health of therapists in training. Training and Education in Professional Psychology, 1, 105 – 115. doi: 10.1037/1931-3918.1.2.105</bibtext> </blist> <blist> <bibtext> Shapiro, S. L., Schwartz, G. E., & Bonner, G. (1998). Effects of mindfulness-based stress reduction on medical and premedical students. Journal of Behavioral Medicine, 21, 581 – 599. doi: 10.1023/A:1018700829825</bibtext> </blist> <blist> <bibtext> Skovholt, T. M., & Jennings, L. (2005). Mastery and expertise in counseling. Journal of Mental Health Counseling, 27, 13 – 18. doi: 10.17744/mehc.27.1.gnblmy6g3dbqduq4</bibtext> </blist> <blist> <bibtext> Skovholt, T. M., Jennings, L., & Mullenbach, M. (2004). Portrait of the master therapist: Developmental model of the highly-functioning self. In T. M. Skovholt, & L. Jennings (Eds.), Master therapist: Exploring expertise in therapy and counselling. Needham Heights, MA : Allyn & Bacon.</bibtext> </blist> <blist> <bibtext> Skovholt, T. M., & Trotter-Mathison, M. (2011). The resilient practitioner: Burnout prevention and self-care strategies for counsellors, therapists, teachers, and health professionals (2nd ed.). New York, NY : Routledge.</bibtext> </blist> <blist> <bibtext> Stauffer, M. D., & Pehrsson, D. (2012). Mindfulness competencies for counsellors and psychotherapists. Journal of Mental Health Counseling, 34, 227 – 239. doi: 10.17744/mehc.34.3.208547m4p2010308</bibtext> </blist> <blist> <bibtext> Stevens, C. L., Muran, J. C., Safran, J. D., Gorman, B. S., & Winston, A. (2007). Levels and patterns of the therapeutic alliance in brief psychotherapy. American Journal of Psychotherapy, 61, 109 – 129. doi: 10.1176/appi.psychotherapy.2007.61.2.109</bibtext> </blist> <blist> <bibtext> Stoltenberg, C. (2005). Enhancing professional competence through developmental approaches to supervision. American Psychologist, 60, 857 – 864. doi: 10.1037/0003-066X.60.8.85</bibtext> </blist> <blist> <bibtext> Stoltenberg, C. D. (1981). Approaching supervision from a developmental perspective: The counsellor complexity model. Journal of Counseling Psychology, 28, 59 – 65. doi: 10.1037/0022-0167.28.1.59</bibtext> </blist> <blist> <bibtext> Stoltenberg, C. D., & Delworth, U. (1985). Supervisees' perceptions of their development: A test of the counsellor complexity model. Journal of Counseling Psychology, 32, 630 – 633. doi: 10.1037/0022-0167.32.4.630</bibtext> </blist> <blist> <bibtext> Stoltenberg, C. D., McNeill, B., & Delworth, U. (1998). IDM supervision: An integrated developmental model for supervising counsellors and therapists. San Francisco : Jossey-Bass Publishers.</bibtext> </blist> <blist> <bibtext> Strauss, A., & Corbin, J. (1998). Basics of qualitative research. Thousand Oaks, CA : SAGE Publications.</bibtext> </blist> <blist> <bibtext> Tannen, C. (2009). Choosing to be present as counsellors in training: A grounded theory (Unpublished doctoral dissertation). University of Florida, Gainesville, FL.</bibtext> </blist> <blist> <bibtext> Warnath, C. F. (1979). Counsellor burnout: Existential crisis or a problem for the profession? The Personnel and Guidance Journal, 57, 325 – 328. doi: 10.1002/j.2164-4918.1979.tb05403.x</bibtext> </blist> <blist> <bibtext> Watson, J. C., & Geller, S. M. (2005). The relation among relationship conditions, working alliance, and outcome in both process-experiential and cognitive-behavioral psychotherapy. Psychotherapy Research, 15, 25 – 33. doi: 10.1080/10503300512331327010</bibtext> </blist> <blist> <bibtext> Welwood, J. (2000). Toward a psychology of awakening: Buddhism, psychotherapy, and the path of personal and spiritual transformation. Boston : Shambhala.</bibtext> </blist> <blist> <bibtext> Yontef, G. (2007). The power of the immediate moment in gestalt therapy. Journal of Contemporary Psychotherapy, 37, 17 – 23. doi: 10.1007/s10879-006-9030-0</bibtext> </blist> <blist> <bibtext> Zuroff, D. C., & Blatt, S. J. (2006). The therapeutic relationship in brief treatment of depression: Contributions to clinical improvement and enhanced adaptive capacities. Journal of Consulting and Clinical Psychology, 74, 130 – 140. doi: 10.1037/0022-006X.74.1.130</bibtext> </blist> </ref> <aug> <p>By Tina Tannen; M. Harry Daniels and Mirka Koro-Ljungberg</p> <p>Reported by Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib28" firstref="ref1"></nolink> <nolink nlid="nl2" bibid="bib30" firstref="ref2"></nolink> <nolink nlid="nl3" bibid="bib34" firstref="ref3"></nolink> <nolink nlid="nl4" bibid="bib38" firstref="ref4"></nolink> <nolink nlid="nl5" bibid="bib42" firstref="ref5"></nolink> <nolink nlid="nl6" bibid="bib63" firstref="ref6"></nolink> <nolink nlid="nl7" bibid="bib71" firstref="ref7"></nolink> <nolink nlid="nl8" bibid="bib74" firstref="ref8"></nolink> <nolink nlid="nl9" bibid="bib55" firstref="ref9"></nolink> <nolink nlid="nl10" bibid="bib18" firstref="ref10"></nolink> <nolink nlid="nl11" bibid="bib54" firstref="ref12"></nolink> <nolink nlid="nl12" bibid="bib39" firstref="ref15"></nolink> <nolink nlid="nl13" bibid="bib47" firstref="ref16"></nolink> <nolink nlid="nl14" bibid="bib53" firstref="ref17"></nolink> <nolink nlid="nl15" bibid="bib46" firstref="ref18"></nolink> <nolink nlid="nl16" bibid="bib72" firstref="ref19"></nolink> <nolink nlid="nl17" bibid="bib73" firstref="ref20"></nolink> <nolink nlid="nl18" bibid="bib50" firstref="ref22"></nolink> <nolink nlid="nl19" bibid="bib51" firstref="ref23"></nolink> <nolink nlid="nl20" bibid="bib49" firstref="ref24"></nolink> <nolink nlid="nl21" bibid="bib27" firstref="ref25"></nolink> <nolink nlid="nl22" bibid="bib37" firstref="ref26"></nolink> <nolink nlid="nl23" bibid="bib48" firstref="ref27"></nolink> <nolink nlid="nl24" bibid="bib65" firstref="ref28"></nolink> <nolink nlid="nl25" bibid="bib67" firstref="ref29"></nolink> <nolink nlid="nl26" bibid="bib40" firstref="ref30"></nolink> <nolink nlid="nl27" bibid="bib52" firstref="ref31"></nolink> <nolink nlid="nl28" bibid="bib70" firstref="ref32"></nolink> <nolink nlid="nl29" bibid="bib29" firstref="ref44"></nolink> <nolink nlid="nl30" bibid="bib35" firstref="ref45"></nolink> <nolink nlid="nl31" bibid="bib43" firstref="ref46"></nolink> <nolink nlid="nl32" bibid="bib69" firstref="ref51"></nolink> <nolink nlid="nl33" bibid="bib25" firstref="ref55"></nolink> <nolink nlid="nl34" bibid="bib16" firstref="ref59"></nolink> <nolink nlid="nl35" bibid="bib32" firstref="ref61"></nolink> <nolink nlid="nl36" bibid="bib59" firstref="ref62"></nolink> <nolink nlid="nl37" bibid="bib61" firstref="ref63"></nolink> <nolink nlid="nl38" bibid="bib31" firstref="ref64"></nolink> <nolink nlid="nl39" bibid="bib60" firstref="ref65"></nolink> <nolink nlid="nl40" bibid="bib17" firstref="ref69"></nolink> <nolink nlid="nl41" bibid="bib12" firstref="ref70"></nolink> <nolink nlid="nl42" bibid="bib41" firstref="ref71"></nolink> <nolink nlid="nl43" bibid="bib56" firstref="ref72"></nolink> <nolink nlid="nl44" bibid="bib58" firstref="ref73"></nolink> <nolink nlid="nl45" bibid="bib57" firstref="ref74"></nolink> <nolink nlid="nl46" bibid="bib19" firstref="ref75"></nolink> <nolink nlid="nl47" bibid="bib24" firstref="ref76"></nolink> <nolink nlid="nl48" bibid="bib62" firstref="ref77"></nolink> <nolink nlid="nl49" bibid="bib33" firstref="ref79"></nolink> <nolink nlid="nl50" bibid="bib20" firstref="ref80"></nolink> <nolink nlid="nl51" bibid="bib23" firstref="ref81"></nolink> <nolink nlid="nl52" bibid="bib13" firstref="ref82"></nolink> <nolink nlid="nl53" bibid="bib15" firstref="ref84"></nolink> <nolink nlid="nl54" bibid="bib26" firstref="ref86"></nolink> <nolink nlid="nl55" bibid="bib45" firstref="ref88"></nolink> <nolink nlid="nl56" bibid="bib22" firstref="ref90"></nolink> <nolink nlid="nl57" bibid="bib10" firstref="ref93"></nolink> <nolink nlid="nl58" bibid="bib11" firstref="ref94"></nolink> <nolink nlid="nl59" bibid="bib14" firstref="ref96"></nolink> <nolink nlid="nl60" bibid="bib21" firstref="ref99"></nolink> <nolink nlid="nl61" bibid="bib36" firstref="ref106"></nolink> <nolink nlid="nl62" bibid="bib68" firstref="ref109"></nolink> <nolink nlid="nl63" bibid="bib44" firstref="ref112"></nolink> <nolink nlid="nl64" bibid="bib66" firstref="ref114"></nolink> <nolink nlid="nl65" bibid="bib64" firstref="ref120"></nolink>
Header DbId: eric
DbLabel: ERIC
An: EJ1224740
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Choosing to Be Present with Clients: An Evidence-Based Model for Building Trainees' Counselling Competence
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Tannen%2C+Tina%22">Tannen, Tina</searchLink><br /><searchLink fieldCode="AR" term="%22Daniels%2C+M%2E+Harry%22">Daniels, M. Harry</searchLink><br /><searchLink fieldCode="AR" term="%22Koro-Ljungberg%2C+Mirka%22">Koro-Ljungberg, Mirka</searchLink>
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22British+Journal+of+Guidance+%26+Counselling%22"><i>British Journal of Guidance & Counselling</i></searchLink>. 2019 47(4):405-419.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 15
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2019
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Audience
  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Evidence+Based+Practice%22">Evidence Based Practice</searchLink><br /><searchLink fieldCode="DE" term="%22Models%22">Models</searchLink><br /><searchLink fieldCode="DE" term="%22Counselor+Client+Relationship%22">Counselor Client Relationship</searchLink><br /><searchLink fieldCode="DE" term="%22Competence%22">Competence</searchLink><br /><searchLink fieldCode="DE" term="%22Counselor+Training%22">Counselor Training</searchLink><br /><searchLink fieldCode="DE" term="%22Metacognition%22">Metacognition</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Experience%22">Student Experience</searchLink><br /><searchLink fieldCode="DE" term="%22Therapy%22">Therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Counseling+Effectiveness%22">Counseling Effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Graduate+Students%22">Graduate Students</searchLink><br /><searchLink fieldCode="DE" term="%22Self+Concept%22">Self Concept</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1080/03069885.2017.1370694
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0306-9885
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Being present with clients has been suggested to be a necessary condition for the therapeutic relationship [Geller & Greenberg, 2012. "Therapeutic presence: A mindfull approach to effective therapy." Washington, DC: American Psychological Association. doi:10.1037/13485-000] and therefore for therapeutic effectiveness. In this article we describe the results of a qualitative investigation of how counsellors in training (CITs) describe their experience of being present and the meaning they make of that experience. The findings suggest that starting students down the pathway to becoming a master counsellor involves more than training in basic counselling skills and theories. Our findings add a new dimension to existing counsellor development models and have implications for counsellor training and supervision.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2019
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1224740
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1224740
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/03069885.2017.1370694
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 15
        StartPage: 405
    Subjects:
      – SubjectFull: Evidence Based Practice
        Type: general
      – SubjectFull: Models
        Type: general
      – SubjectFull: Counselor Client Relationship
        Type: general
      – SubjectFull: Competence
        Type: general
      – SubjectFull: Counselor Training
        Type: general
      – SubjectFull: Metacognition
        Type: general
      – SubjectFull: Student Experience
        Type: general
      – SubjectFull: Therapy
        Type: general
      – SubjectFull: Counseling Effectiveness
        Type: general
      – SubjectFull: Graduate Students
        Type: general
      – SubjectFull: Self Concept
        Type: general
    Titles:
      – TitleFull: Choosing to Be Present with Clients: An Evidence-Based Model for Building Trainees' Counselling Competence
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Tannen, Tina
      – PersonEntity:
          Name:
            NameFull: Daniels, M. Harry
      – PersonEntity:
          Name:
            NameFull: Koro-Ljungberg, Mirka
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2019
          Identifiers:
            – Type: issn-print
              Value: 0306-9885
          Numbering:
            – Type: volume
              Value: 47
            – Type: issue
              Value: 4
          Titles:
            – TitleFull: British Journal of Guidance & Counselling
              Type: main
ResultId 1