Course:::: Inferential stats in decision making:::1.QUALITATIVE Journal Article Review2.QUANTITATIVE Journal Article ReviewFor the above two questions please use the below formatreview both quantitati

ABSTRACT REVIEW #2: Qualitative

By

STUDENT, B.S, M.S., M.A.

September 2018

Introduction/Background

De Stefano, Atkins, Noble, & Heath, (2012) conducted a qualitative study to examine the experiences of counselors-in-training (CIT) who worked with clients that engaged in non-suicidal self-injury (NSSI) in order to understand how counseling interns “react to and resolve the challenges presented” (p. 289) by complex clients. NSSI in clients poses potential ethical and legal concerns which may be amplified when the clinician is a CIT. De Stefano et al. highlight that NSSI may increase unexpected and unwanted reactions in the CIT which may negatively impact the therapeutic relationship. Additionally, since CIT are being supervised, understanding how the CIT’s work is impacted by the supervisory process may be beneficial.

Methodology

De Stefano et al. (2012) identify that the study was oriented toward discovery and exploration and intended to gain insight into: “(1) How do trainees describe and understand their experiences of working with these challenging clients? and (2) What can these experiences tell us about their evolving clinical development and learning?” (p. 291). They identified and tracked potential research biases as (1) CIT would experience emotional reactivity from working with NSSI clients, (2) these experiences would lead to substantial learning professionally and personally, and (3) provide insight into the supervisory process.

The 12 participants were a sample of convenience in the second-year of their MA program in counseling psychology. The criterion required for participation was that the CIT had counseled with one or more clients within the past 9 months who had engaged in some form of NSSI. The participants were all female and of Anglo-European background, ranging in age from 23 to 37 years. They were recruited from the entire MA cohort during a class session in which the researcher was not the course instructor. The intent of the study was explained and those meeting the criterion were invited to participate. Data was gathered through 45 to 60 minute, semi-structured interviews utilizing questions about the CIT “reactions, thoughts, and feelings when working with these clients” (De Stefano et al., 2013, p. 292). The sessions were recorded and transcribed and then analyzed using consensual qualitative research (CQR; Hill et al., 2005; Hill, Thompson, & Nutt-Williams, 1997; as cited in De Stefano et al., 2013); CQR uses a constant comparison method with a team of researchers, in order to reach a consensus on domains, open codes, and cross-case analysis.

Study Findings and Limitations

The study identified three general themes: (1) CIT formulate a basic model of NSSI even though they lack previous experience and knowledge; (2) NSSI clients are challenging on many levels for CIT; and (3) working with NSSI offers new but incomplete learning. Additionally, the investigation highlighted that the supervisory process had mixed benefits and was disappointing for many of the CIT (De Stefano et al., 2013). Limitations of the study include the reality that the findings are suggestive and it is not generalizable to all CIT. Furthermore, interviewing participants several times and with access to client notes may have enhanced and strengthened recall. Finally, the study did not address diversity which De Stefano et al., highlight may have impacted the CIT experiences.

Conclusions

This study is significant in that despite the exploratory aspect of this investigation, it reveals that when CIT openly acknowledge feelings of incompetency “it was accompanied by vigilance and a self-observational quality typical of self-monitoring and reflexivity that are hallmarks of good practice” (De Stefano et al., 2013, p. 303). While not part of the intent of the study, it is worthwhile insight. The article could have been enhanced by using bar graphs or tables to present the findings and this would have highlighted the identified themes more clearly. Considering the ethical dilemma faced by CIT who work with NSSI clients, this study provides foundational insight which can inform future research.

References

De Stefano, J., Atkins, S., Noble, R. N., & Heath, N. (2012). Am I competent enough to be doing this?: A qualitative study of trainees’ experiences working with clients who self-injure. Counselling Psychology Quarterly, 25(3), 289–305. doi:10.1080/09515070.2012.698981