The nature and effectiveness of therapies provided in counselling centres at the Princess Nourah Bint Abdulrahman University

Student thesis: Doctoral Thesis

Abstract

Interest in counselling and guidance in Saudi Arabia has grown in recent years. Evidence about how it is delivered and by whom, as well as its effectiveness, is limited. What does psychotherapy/counselling look like in practical terms in Saudi Arabia? How have western mental health approaches and procedures fared in an Arabic/Islamic cultural milieu? What has been assimilated and what has been accommodated or adapted? In this research I aimed to explore the nature and effectiveness of the counselling services provided at Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia. This dissertation presents two studies using complementary research methods, carried out within a pluralist, broadly critical-realistic framework. The first study was a constructivist/descriptive qualitative counselling service research study, which aimed to map the nature of the therapists’ perceptions of the counselling services, asking three broad questions: First, what kinds of services do therapists see themselves as providing to their clients? This included kinds of ‘therapies’, ‘techniques’,and ‘measures’. Second, what kinds of professional experiences have therapists report, including ‘years of experience’, ‘personal development’ and ‘improvement in providing counselling’? Third, what kinds of practice difficulties and challenges do therapists perceive, including ‘in-session challenges’ and ‘external difficulties’? The study sample consisted of thirteen (out of a total of sixteen) female therapists at the counselling centre in Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia. A semi-structured interview was developed and piloted in order to collect the study data, which was then analysed from the viewpoints of both a version of grounded theory and Braun & Clarke’s thematic analysis.The findings showed that therapists used different kinds of predominantly western forms of psychotherapy, both positivist-realist (e.g. CBT) and humanistic-phenomenological (Person-centred Therapy) as well as mostly positivist-realist therapeutic techniques (e.g.they most commonly used homework, behavioural therapy, and behavioural activation) and assessments/measures (e.g. the Beck Depression Inventory and Beck Anxiety Inventory). Furthermore, therapists generally reported that they had improved in their performance and were interested in developing their skills and providing better services, although some complained of limited opportunities to do so. Finally, therapists indicated that they faced both external difficulties (e.g. lack of privacy and conflict with co-workers) and in-session challenges with their clients (e.g. lack of client commitment to counselling and client silence) that affected their performance and work satisfaction. The second study was a quantitative client practice-based outcome study, using what can be described as both a mental health services research design and a practice-based therapy effectiveness study of the outcomes of counselling practiced at Princess Nourah bint Abdulrahman University. It aimed to document amount of client-reported personality change in the counselling centre at the Princess Nourah bint Abdulrahman University over the course of therapy. To do this, I used a western psychotherapy outcome measure that had been developed to assess -in a non-pathologising manner- the outcome of humanist, phenomenological approaches to psychotherapy.This assessment measure, the Strathclyde Inventory (developed by Elliott, Rodgers, Freire, & Stephen, 2016), was chosen to avoid cultural sensitivities that might have been activated by more commonly-used pathology distress measures such as the CORE-OM. Therefore, an Arabic translation of the Strathclyde Inventory was prepared, using standard practices including parallel and back translation. The result was the 20-item Arabic translation (the SI-20-A) that measures two
Date of Award10 Jun 2019
Original languageEnglish
Awarding Institution
  • University Of Strathclyde
SupervisorRobert Elliott (Supervisor) & Marc Obonsawin (Supervisor)

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