Book Review: Reflective Practice in Counselling and Psychotherapy

The earliest of the four texts I am surveying, Reflective Practice in Counselling and Psychotherapy, appeared in 2010. I use the term 'surveying' as I have made a contribution to all but the most recent of these four texts, and so I cannot claim to have the disinterested objectivity (if such a stance can ever be said to fully exist) of an independent reviewer. I might think of myself, using research-terms, as an 'insider-researcher'. It is not a book about research per se, since its focus is on reflective practice and how this can help us to become more aware of the ways in which we interact with our clients. Much of the text, then, is concerned with making links between theory and everyday practice. It raises a number of fundamental questions such as: Do we really work with our clients in ways that are consistent with our theoretical and personal beliefs? Do we really understand ourselves? Could reflective self-awareness help us to become more aware of how our own biases and individual backgrounds impact on how we relate to our clients? Will critical reflexivity show us how we and the wider world are linked together? Given the central role of the researcher as prime researcher in qualitative inquiry, we can see how these questions have relevance for us as researchers. Indeed, if we replace the word 'client' with 'research participant', it will be evident that reflective self-awareness is as important for qualitative research as it is for clinical practice. A chapter by Biljana van Rijn shows how evidence-based practice and reflective practice are complementary, while another that I contributed turns the relationship around to look at the relevance of therapy research to everyday therapeutic practice.

I outlined a case in the pages of Existential Analysis way back in 2004 for re-thinking the notion of research, and its place in training programmes. I argued then that, in important respects, the whole of training could usefully be regarded as a training in research, and I continue to hold this view today. It is a mistake to think of research as a hurdle in the form of a post-graduate dissertation to be 'got over'. If we take this view, then for many – probably the majority – it will be got over like a nasty dose of influenza, an unpleasant experience to be avoided ever after. Instead, we need to take more seriously the idea of research as a personal journey of discovery, a continual transformative process rather than a discrete event, or something you do just once or twice in your life to gain a qualification. Research must not, of course, remain only of personal significance if it is to have any impact on professional practice – it must be disseminated and evaluated by our peers, colleagues and clients.

There is a tension which I have noticed in my work as an external examiner over the years between a tendency for students on humanistic trainings to believe that their internal locus of evaluation is paramount, and students on broadly psychodynamic trainings to feel answerable (though they may not use the language) to an external locus of evaluation. Meanwhile, there is a tendency among existential trainees to fall back on a few 'standard' methodologies – those of Colaizzi or Moustakas and, increasingly in the last decade, on Jonathan Smith's Interpretative Phenomenological Analysis.

This tendency can lead to an approach which is every bit as mechanical as the unthinking application of a quantitative research tool. There is a danger that the underlying philosophical notion of the co-created world could be lost in this 'leap to the known'. I have often been invited to assess dissertations that do not include the researcher's self-analysis or any attempt at imaginative variation, or, for that matter, a return to the co-researchers toward the end of the process to check the validity of an exhaustive description. Either the self of the researcher disappears or they are present in the guise of 'expert'. And concomitantly our sense of the self of the research participants is also reduced. More prosaically, when research is reduced to a pre-determined number of specific steps it is surprisingly easy to miss a few out. It is like missing out an ingredient when you bake a cake – the result may still resemble a cake but it will not taste very good.

Good research seems to me to be a living thing; it should leap off the page to revitalise some aspect of our way of being as therapists. In doing so it mirrors the characteristic of good therapy, that there is a genuine connection between the meaning worlds of client and therapist and, in the meeting, some sharing of experience. Research that is dead on the page cannot be resuscitated to invigorate practice. At best, like Frankenstein's creature, it will only be a poor clumsy attempt to mirror living vitality. One test of this is our reaction when we read a research report: do we recognise some 'truth' about the human condition? Do we say to ourselves, "That reminds me of what happens in my own clinical practice?" Do we feel inspired to, perhaps, look more closely at some aspect of the way we work? Does it speak to us? Is it capable of moving us?

The second text that I want to mention, Making Research Matter, was distinctive when it was published in 2016 in consciously moving away from the 'how-to-do-research' approach of which numerous examples exist to present a range of successful real-world research projects, in order to show how they made a difference to theory and practice, and how they came about. It explicitly discusses and illustrates how practitioner-researchers can develop research tools and carry out investigations with rigour in ways that are congruent with their training and practice. In doing so, it aimed to take seriously the injunction that, if it is to impact on professional practice, research should be disseminated to the most relevant audiences, and should be evaluated by our peers, colleagues and clients. The book actively sets out to challenge the much talked-of practice-research gap by demonstrating ways in which it can be bridged through practitioner research. The contributors – all experienced, senior professionals – share their knowledge and insight about research that makes a difference, and what the process of producing it really involved, including its impact on themselves. Their reflexive voices are included in the texts as integral to the process, providing vivid insight into the lived experience of their research journey.

If we set out to inspire practitioners to engage in qualitative research, and to do so not just in the course of their training but regularly throughout their subsequent careers, there is evidence that such encouragement continues to be needed. In a recent paper, Dr. Sofie Bager-Charleson, Dr. Alistair McBeath and I (2020) undertook a comprehensive literature review which highlighted how often published studies have describe therapists' research activity as 'limited' and their research knowledge as 'unstructured' or 'patchy'. This paper evidenced that therapists, historically, have rarely initiated research. Rather, we discovered:

• Therapists rely more on discussions with colleagues than on research.
• Therapists' knowledge around research tends to be 'patchy' and in-depth knowledge is associated with topics of personal interest.
• Therapists are, for instance, more informed by clinical experience, supervision, personal therapy and literature than by research findings.
• Therapists' research also often stems from an unstructured integration of knowledge gained from workshops, books and theoretical articles.
• Therapists do read research but not as often as researchers in other fields do.
• Therapists tend to be critical of the clinical relevance of much research and also about the clarity of presentation.
• Therapists and researchers are developing disconnected bodies of knowledge.

It is to be hoped that the demand which has led to a second edition of Bager-Charleson's 2010 Reflective Practice in Counselling and Psychotherapy indicates to some extent an increasing interest on the part of practitioners to embark on qualitative research. The revised 2020 text, Reflective Practice and Personal Development in Counselling and Psychotherapy, published by Sage, includes an invaluable chapter, 'Reflecting on practice with research', which provides a highly accessible way of increasing interest on the part of practitioners to embark on qualitative research.

The most recent addition to the stable of texts from Metanoia is Bager-Charleson & McBeath's Enjoying Research in Counselling and Psychotherapy: Qualitative, quantitative and mixed methods research (2021). This book sets out to make a significant contribution to continuing the development of a rigorous and creative research-supported practice for practitioners, researchers and students of counselling and psychotherapy. With an emphasis on critical thinking and 'research mindedness', it introduces practical research skills and links them to self-awareness and critical reflection. Bager-Charleson, McBeath and their authors outline the use of a broad range of research methods, embracing arts as well as RCT-based research, and cover qualitative, quantitative, pluralistic and mixed methods approaches.

In doing so, they aim to support anyone looking for a book that combines self-awareness with analytical and practical skills.

The opening chapter explores some of the differences and similarities between quantitative and qualitative research, and distinguishes between qualitative, quantitative and mixed methods research, establishing the issue of research supported practice as an underlying theme. This chapter aims to support a research-based practice, aided by considering the multiple routes into research. A particular strength of the book is its comprehensive discussion of qualitatively-driven mixed methods, and chapters on doing quantitative research using statistics, surveys and outcome measures. The authors make a convincing case that an understanding of these tools is vital if therapists are to be able to engage with, and critique, evidence-based practice and studies of therapeutic efficacy. Readers are encouraged to familiarise themselves with approaches ranging from phenomenological experiences to more nomothetic, generalising and comparing foci like outcome measuring and RCTs. The book introduces us to a range of research, informed throughout by an interest in both separate approaches and also inductive-deductive combinations, as in Grounded Theory, together with pluralistic and mixed methods approaches. The driver here appears to be a shared aim of providing support in the field of mental health and emotional wellbeing. Subsequent chapters on phenomenological research, IPA, narrative inquiry, grounded research and more, illustrate ways therapists can build an evidence base born out of clinical practice, and emphasise the value for practitioners to continue to engage with research and question our daily practice.

The arc which these four texts describe takes us on a journey in which confidence in reflective practice lays the foundation for rigorous real-world research where the reflexivity of the practitioner-researcher is harnessed and their unique insights are fully recognised. This, in turn, acts as a feedback loop showing not only that practitioners are motivated to undertake qualitative research, but that when they do their work can enrich both how we understand what it means to do research, and how we think about therapeutic practice. Finally, this arc seems to recognise how practitioner-researchers are increasingly moving out of their traditional qualitative research methodology, to work confidently with quantitative and mixed methods.

I would like to suggest that, collectively, these texts provide both a valuable response to the 'theory-practice' divide, and offer an invitation and stimulus to practitioners to really recognise the value of their individual and unique contributions as practitioner-researchers to changing and improving therapeutic practice.

Simon du Plock