Graham Westwell, Robert Elliott & Beth Freire University of Strathclyde

1. Developing the Person Centred & Experiential Psychotherapy Scale (PCEPS) – A heuristic, collaborative process. Graham Westwell, Robert Elliott & Beth Freire University of Strathclyde

2. Heuristics“The root meaning of heuristic comes from the Greek word heuriskein, meaning to discover or to find. It refers to a process of internal search through which one discovers the nature and meaning of experience and develops methods and procedures for further investigation and analysis.”(Moustakas, 1990)

3. What the PCEPS is: • Passionate about the underlying principles and values of the Person Centred/Experiential Approach • Concerned with clarifying what we mean by ‘person centred’ and ‘experiential’ work • Dedicated to promoting best practice in person-centred therapy • Interested in seeing what ‘common ground’ there is between ‘person-centred’ and ‘experiential’ work • An opportunity to ‘test in reality’ key theoretical points.

4. What the PCEPS isn’t: • A tick box list of how to ‘do’ person-centred therapy • A reductionist approach to a complex process • Closed to the art of therapy and the beauty of human encounter • Aligned to a medical model of understanding emotional distress • Complacent about the difficulty of creating such a scale

5. Heuristic process in the pilot phase • The research team group process followed these stages of heuristic enquiry: engagement, immersion, incubation, illumination, explication and creative synthesis (Braud and Anderson, 1998) in order to refine and evolve the instrument. • A certain amount of ‘Groping around in the dark’ – seeing what worked and what didn’t. • “The goals emerge along with the methods. New problems emerge as others are dealt with, and later problems are solved differently from earlier ones.” (Stiles, 1993)

6. Engagement, Immersion, Incubation • This was the 'discovery-orientated' and 'theory-building' phase (Stiles, 1993). • This involved systematically playing 10-15 minute audio segments of therapy from the archive of the Strathclyde Therapy Research Centre, using the instrument to rate the segments, analysing resultsand incorporating findings and experience into revised versions of the scale • Mapped against Humanistic therapy competencies developed by Hill, Roth, Pilling, et al (2009) and revised to represent them. • Developed up to version 10.1 before end of pilot phase.

7. Illumination, Explication and Creative Synthesis • Resulting data analysis enabled clarification of purpose and focus of the scale: • Differentiated concepts leading to two therapeutic modality subscales. • Changed item measure from frequency to quality. • Focused on relational qualities of therapist. • Focusing on the therapists experience of the client • 6 anchor points for each item. • Repeated testing of the instrument scrutinised its theoretical validity and usefulness (Cronbach and Meer, 1955).

8. Eureka!“The cousin word of heuristic is eureka, exemplified by the Greek mathematician Archimedes’ discovery of a principle of buoyancy. While taking a bath, he experienced a sudden, striking realization – the “aha” phenomenon – and ran naked through the streets shouting “eureka”. The process of discovery leads investigators to new images and meanings regarding human phenomena, but also to realizations relevant to their own experiences and lives.”(Moustakas, 1990)

9. Collaborative process • We played a 10 minute segment video of therapy at the PCEPS workshops presented at WAPCEPC conference in Rome, July 2010 and COSCA conference in Stirling, November 2010. and invited those present to use the PCEPS to rate the therapy and discuss results. The elicited feedback was incorporated into design. • In the rater-training phase, the team used the PCEPS to rate 10-15 minute audio segments of therapy. We processed results and experiences in group discussions. Feedback elicited was again used to revise scale. • Raters scoring 60 segments of therapy each in the testing phase using the PCEPS are seen as co-researchers.

10. PCEPS design features • A behaviourally anchored rating scale. • Six point anchor scale is the common structure within the instrument: • 1 is always total absence of the quality/skill • 4 is always adequate presence of the quality/skill • 6 is always excellent presence of the quality/skill • High degree of specificity and differentiation within the instrument. • Highly descriptive – giving examples of poor practice and best practice. • Differentiated subscales accommodates theoretic modalities and allows comparisons between the two.

11. PCEPS subscales • Differentiated 2 subscales. • Person-centred processes: • 10 items – focused on therapist’s ‘way of being’ • Experiential processes: • 5 items – focused on process facilitation of emotional exploration and differentiation

12. Person Centred processes subscale • PC1 - Client frame of reference/track • PC2 - Core meaning • PC3 – Client flow • PC4 – Warmth • PC5 – Clarity of language • PC6 – Content directiveness • PC7 – Accepting presence • PC8 – Genuineness • PC9 – Psychological holding • PC10 – Dominant or overpowering presence

13. Experiential processes subscale • E1 – Collaboration • E2 – Experiential specificity • E3 – Emotion focus • E4 – Client self-development • E5 – Emotion regulation sensitivity

14. Testingreliability • 2 Protocols sampled: • Social Anxiety protocol • Practice Based protocol • 10 therapists sampled: • 6 from Social Anxiety protocol (3 PCA, 3 EFT) • 4 from Practice Based protocol • 20 Clients sampled: • 3 sessions per client • 2 segments per session • 6 independent raters rated a total of 120 segments (60 x 10 minute and 60 x 15 minute audio segments of therapy). • Inter-rater reliability is being measured.

15. Reliabilitystudy design • 10 Therapists sampled in each protocol • 6 Social Anxiety: • 3 EFT • 3 PCA • 4 Practice Based 2 clients per therapist sampled (20 total) 3 Sessions per client sampled (60 total) 2 segments per session sampled (120 total)

16. Analysing convergent validity • Audio segments have been specifically chosen from the Research Unit archive to correspond with available ‘relational assessment’ data: • Therapeutic Relationship Scale (Client) • Therapeutic Relationship Scale (Therapist) • Working Alliance Inventory • Revised Sessions Reaction Scale • Client Post Session Questionnaire • Inter-rater reliability analysis and rater scores will be correlated against ‘relational assessment’ data to measure convergent validity.

17. Other uses for the PCEPS • Person centred/experiential training experiences: • Used as a feedback tool in clinical placement supervision sessions. • Field testing with Year 2 Advanced Diploma in Counselling Studentsdeveloped into Action Research study. • Supervision: • As an aid for self-reflection and to monitor own practice

18. Widerresearch • Institute for Learning Bursary award: • Pilot project using the PCEPS as a self-assessment instrument and as a focal tool for trainee counsellors giving feedback to peers in supervision of clinical placement. • Exploring the impact of using the PCEPS as an aid for developing and enhancing therapeutic practice. • An abridged composite version of the PCEPS (called the ‘Therapy Adherence Scale) has been used in BACP’s Counselling for Depression (CfD) project. • A qualitative analysis of raters self-reports on their experiences of the PCEPS project is in progress.

19. Contact Robert Elliott: fac0029@gmail.com Beth Freire: elizabeth.freire@strath.ac.uk Graham Westwell: gramw@tiscali.co.uk