A Synthesis of the Reflective and Scientific 
                     Counselling Psychologist Practitioner: 
                  Dynamics in Research, Practice, and Clinical 
                                   Supervision 
               
               
               
                                         
                                         
                           Portfolio for the Professional 
                            Doctorate in Counselling 
                              Psychology (DPsych) 
                                         
                                         
                                 Alison E Walne 
                                         
                                         
                                 City University 
                                         
                            Department of Psychology 
                                         
                              Submitted July 2015 
               
               
               
               
               
               
                                        1 
               
     THE FOLLOWING PARTS OF THIS THESIS HAVE BEEN 
     REDACTED FOR DATA PROTECTION REASONS: 
     pp 171-172: 
     Appendix 4. Letter authorising research. 
     pp 248-270: 
     Section C: Case Study. The emotional effects of Anxiety: an Integrative 
     Therapeutic approach.  
     THE FOLLOWING PART OF THIS THESIS HAS BEEN 
     REDACTED FOR COPYRIGHT REASONS: 
     p247:   
     Appendix 27: AMSTAR Criteria 
     http://www.nccmt.ca/registry/view/eng/97.html 
                                                                                          Table of Contents 
                                                                                                                                                                                       
                                                     Acknowledgements....................................................................................................8             
                                                     City University Declaration......................................................................................9                
                                                                                                                                                                                       
                                       PART A: PREFACE..............................................................................................................10                 
                                                     References.................................................................................................................14     
                                                                                                                                                                                       
                                       PART B: THE RESEARCH.................................................................................................16                         
                                                     Abstract....................................................................................................................17    
                                                                                                                                                                                       
                                       1.            Chapter 1: Literature Review................................................................................18                    
                                       1.1           Introduction...............................................................................................................18     
                                       1.2           The Therapeutic Relationship...................................................................................20                 
                                       1.3           Conceptualisation of the Therapeutic Alliance.........................................................23                                                                                         
                                       1.4           Therapeutic Alliance and Outcome...........................................................................24                                                                                    
                                       1.5           Therapeutic Alliance Scales and Factors Currently Involved...................................29                                   
                                       1.6           Rating the Therapeutic Alliance................................................................................34                 
                                       1.7           Therapist Characteristics and Relational Factors in the Therapeutic Alliance.........42                                           
                                       1.8           Evolution of the Therapeutic Alliance......................................................................45                     
                                       1.9           Do We Need the Therapeutic Alliance and Therapeutic Alliance Measurement?...47                                                    
                                       1.10          Summary of the Literature Review...........................................................................47                     
                                       1.2.1         Rationale for the Study..............................................................................................49           
                                       1.2.2         Relevance to Counselling Psychology......................................................................54                       
                                       1.2 3         Ethical Considerations..............................................................................................55            
                                       1.2.4         Reflexivity.................................................................................................................56    
                                       1.2.5         Personal Reflexivity..................................................................................................57          
                                       1.2.6         Epistemological Reflexivity......................................................................................59               
                                                                                                                                                                                       
                                       1.3.1         Research Aims..........................................................................................................60         
                                       1.3.2         Research Objectives..................................................................................................60           
                                       1.3.3         Research Questions...................................................................................................60           
                                       1.3.4         Pilot Study.................................................................................................................60    
                                                                                                                                                                                       
                                       2.            Chapter 2: Methodology.........................................................................................61                 
                                       2.1           Research Design........................................................................................................61         
                                       2.1.2         Phase One Overview: Focus Group..........................................................................61                       
                                       2.1.3         Phase Two Overview: Panel Judges.........................................................................62                       
                                       2.1.4         Phase Three Overview: Online Survey.....................................................................62                        
                                                                                                                                                                                       
                                       2.2           Participants................................................................................................................63    
                                                     Demographics Focus Group (Table 1)......................................................................63                        
                                                     Demographics Panel Judges (Table 2)......................................................................64                       
                                       2.2 1         Inclusion Criteria: Phase One and Two - Focus Group and Panel Judges................65                                            
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                                                  2.2.2             Exclusion Criteria: Phase One and Two - Focus Group and Panel Judges...............65   
                                                  2.2.3             Inclusion Criteria: Phase Three - Online Survey......................................................65                                                                
                                                  2.2.4             Exclusion Criteria: Phase Three - Online Survey.....................................................65                                                                 
                                                  2.2.5             Recruitment...............................................................................................................65                                           
                                                  2.2.6             Sample Size...............................................................................................................66                                           
                                                  2.2.7             Procedure...................................................................................................................66                                         
                                                  2.2.8             Materials....................................................................................................................70                                        
                                                                                                                                                                                                                                           
                                                  2.3               Data Analysis............................................................................................................71                                            
                                                  2.3.1             Analysis Overview....................................................................................................71                                                
                                                  2.3.2             Phase One: Rationale for a Focus Group Interview..................................................73                                                                   
                                                  2.3.3             Phase One: Rationale for a Focus Group – Use of Two Measures...........................73                                                                              
                                                  2.3.4             Phase One: Rationale for a Focus Group Manual Analysis .....................................74                                                                         
                                                  2.3.5             Phase One: Rationale for a Focus Group Computer Qualitative Content Analysis..74   
                                                  2.3.6             Phase One: Rationale for a Focus Group NVivo 10: Computer Coding Analysis...75                                                                                         
                                                  2.3.7             Phase One: Focus Group Transcript Analysis: Initial Statements............................75                                                                           
                                                  2.3.8             Phase Two: Rationale for a Hybrid Thurstone-Likert Model...................................77                                                                          
                                                  2.3.9             Phase Two: Rationale for Thurstone Scaling and Panel Judges...............................77                                                                           
                                                  2.3.10            Phase Two: Thurstone Scaling: Analysis Process....................................................78                                                                   
                                                  2.3.11            Phase Three-Part A: Rationale for Likert-Type Scaling: Online Survey                                                                                                   
                                                                    Respondents..............................................................................................................79 
                                                  2.3.12            Phase Three-Part A: Likert-Type Scaling: Analysis Process....................................79                                                                        
                                                  2.3.13            Phase Three-Part B: Exploratory Factor Analysis: Analysis Process.......................79    
                                                                                                                                                                                                                                           
                                                  3.            C   h  a  p   t e  r    3  :   R   e  s u  l t  s ..  . . . . . . . . . . . . .....................................................................................80      
                                                  3.1               Results Overview.....................................................................................................80                                                
                                                  3.1.1             Qualitative Content Analysis Focus Group Manual Coding.....................................81                                                                          
                                                  3.1.2             What Is The Therapeutic Alliance?...........................................................................82                                                         
                                                  3.1.3             When Does The Therapeutic Alliance Start?............................................................83                                                                
                                                  3.1.4             How Do Therapists Develop The Therapeutic Alliance?.........................................83                                                                         
                                                  3.1.5             How Do Therapists Maintain The Therapeutic Alliance?........................................84                                                                         
                                                  3.1.6             Is The Therapeutic Alliance Measurable?.................................................................85                                                             
                                                  3.1.7             Qualitative Content Analysis – Focus Group: NVivo 10 Coding.............................86                                                                             
                                                  3.1.8             Word Frequency Count Process: NVivo 10..............................................................88                                                                 
                                                  3.2               Panel Judges..............................................................................................................89                                           
                                                  3.3               Quantitative Results Overview..............................................................................92                                                          
                                                  3.3.1             Exploratory Factor Analysis Overview.....................................................................94                                                            
                                                  3.3.2             Descriptive Statistics.................................................................................................95                                              
                                                  3.3.3             Exploratory Factor Analysis Results: Q1-22............................................................97                                                               
                                                  3.3.4             Varimax Orthogonal Rotation.................................................................................102                                                        
                                                  3.3.5             Direct Oblimin Rotation..........................................................................................106                                                   
                                                  3.3.6             Exploratory Factor Analysis Results: Q23-27........................................................109                                                                 
                                                  3.3.7             Reliability................................................................................................................112                                         
                                                                                                                                                                                                                                           
                                                  4.                Chapter 4: Discussion...........................................................................................114                                                    
                                                  4.1               Study Overview.......................................................................................................114                                               
                                                  4.2               Participant Demographics.......................................................................................116                                                     
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