Fortalezas y debilidades. Propuestas de actuación

Before determining the relationship between personal aspects and effective practice, it was necessary to determine the representativeness of the yoked respondent sample (n =37) as compared with the full respondent sample (n = 42). Accordingly, this initial section focuses on this comparison.

Analyses were carried out in a manner similar to those conducted in Study I in order to ascertain the psychometric properties of personal aspects in the yoked practitioner sample.

Association between personal aspects 4.5.1

Figure 4.1 displays histograms of practitioner personal aspect scores between the yoked respondent sample (n = 37) and the full respondent sample (n = 42). .

Figure 4.1: Histograms of yoked and full respondent scores on a) resilience, b) empathy, and c) mindfulness (n = 37) and (n = 42)

4.1a Resilience (CD-RISC scores)

(n = 37) (n = 42)

111 4.1b Empathy (BES-A scores)

(n = 37) (n = 42)

4.1c Mindfulness (MAAS scores)

(n = 37) (n = 42)

Distributions of scores for the n = 37 practitioners on personal aspects were tested for

normality based on visual examination of histograms and distributions’ skewness statistic. Consistent with distributions on scores n = 42, practitioners scores were normally distributed: resilience

skewness coefficient = -0.19 (SE = 0.39); empathy skewness coefficient = -0.35 (SE = 0.39); and mindfulness skewness coefficient = -0.54 (SE = 0.39). Resilience scores continued to show

significant positive kurtosis; kurtosis coefficient = 1.93 (SE = 0.76) compared to empathy scores 0.32

112 (SE = 0.76) and mindfulness scores .51 (SE = 0.76), although, the degree of kurtosis has reduced as shown by the reduced pointedness of the left compared to the right graphs in Figure 4.1a.

Histograms on all practitioner personal aspect scores including empathy subscales are shown in Appendix VIII.

Figure 4.2 displays scatterplot graphs each containing a line of best fit for the different

possible combination of pairs of practitioner personal aspects. Scatterplots are presented on the yoked (n = 37) and the full (n = 42) respondent samples to enable visual comparisons. Based on visual inspection the yoked sample (n = 37) was found to be consistent with the full respondent sample (n = 42). For all scatterplots across practitioner personal aspects, see Appendix IX. Pearson correlational analysis was conducted examining the relationship between resilience, empathy and mindfulness for the yoked sample of respondent practitioners. A significant positive correlation was identified between resilience and mindfulness r= .41, p = .01, 95% CI [.10, .65], consistent with the same significant association identified in the full respondent sample r= .40, p = .01, 95% CI [.11, .63]. No significant correlations were found between resilience and empathy r= -.08, p = .65 and mindfulness and empathy r= -.01, p = .95.

Figure 4.2: Scatterplots of combinations of yoked respondent scores on measures of resilience, empathy, and mindfulness (n = 37) and (n = 42)

4.2a Resilience by Mindfulness

(n = 37) (n = 42)

113 4.2b Resilience by Empathy

(n = 37) (n = 42)

4.2c) Mindfulness by Empathy

(n = 37) (n = 42)

Correlational analyses were conducted across each practitioner grouping comprising

practitioner roles (i.e., PWPs, CBT therapists and counsellors), treatment intensity (i.e., low intensity treatment provided by PWPs and high treatment intensity provided by CBT therapists and

counsellors), and theoretical association (i.e., counselling and CBT-oriented treatment approaches).

There was a total of five correlational analyses (i.e., three between practitioner roles, one between treatment intensity and one between theoretical orientation).

114 Pearson correlational analyses conducted across practitioners’ professional roles as PWPs (n

= 8), CBT therapists (n = 12) and counsellors (n = 17) identified one statistically significant

correlation between resilience and mindfulness among the yoked counsellors only r = .61, p = .009, 95% CI [.19, .85]. This finding was similar to that of Study 1 where a one statistically significant positive correlation was identified involving all counsellor respondents (n = 19), r= .61, p = .005, 95% CI [.22, .83]. Amongst the yoked counsellors, no significant relationship was found between resilience and empathy, r = .18, p = .50; and mindfulness and empathy, r = .15, p = .57. Correlational analysis of responses by PWPs showed no significant relationship between resilience and

mindfulness, r = .14, p = .75; resilience and empathy, r = -.18, p = .67; and mindfulness and empathy, r = -.42, p = .30. Correlational analysis of CBT therapist responses yielded no significant associations between resilience and mindfulness, r = .07, p = .82; resilience and empathy, r = -.31, p = .33; and mindfulness and empathy, r = .11, p = .73.

Pearson correlational analysis between personal aspects across treatment intensity provided by low intensity practitioners (i.e., PWPs, n = 8) and high intensity practitioners (i.e., CBT therapists and counsellors, n = 29) found no significant relationships. Responses by low intensity practitioners showed no significant relationships between resilience and mindfulness, r = .14, p = .75; resilience and empathy, r = -.18, p = .67; mindfulness and empathy, r = -.42, p = .30. High intensity practitioner responses showed one significant association between resilience and mindfulness, r = .41, p = .03, with no significant associations between, resilience and empathy, r = .001, p = .998, and mindfulness and empathy, r = .17, p = .39. The significant positive association between resilience and

mindfulness for yoked respondent high intensity practitioners (n = 29) is consistent with that of the full respondent high intensity practitioner sample (n = 31), r= .41, p = .02.

Correlational analysis of personal aspects given practitioner groups based on theoretical orientation comprised practitioners who provided CBT-oriented treatment (i.e., PWPs and CBT therapists, n = 20) and practitioners who provided counselling (n = 17). A significant positive relationship between resilience and mindfulness was found for counselling only, r = .61, p = .009, 95% CI [.19, .85]. No significant relationship was found between resilience and mindfulness for

115 CBT-oriented practice, r = .21, p = .37. Associations between the other personal aspect combinations of practitioners’ theoretical orientation showed no significant findings: counselling practice resilience and empathy, r = .18, p = .50; counselling practice mindfulness and empathy, r = .15, p = .57; CBT-oriented practice resilience and empathy, r = -.31, p = .19; and CBT-CBT-oriented practice mindfulness and empathy, r = -.17, p = .47. Correlational tables are displayed in Appendix XIII.

Distribution and differences between personal aspect scores 4.5.2

Table 4.5 presents the mean and standard deviation values of the personal aspects across the practitioner groupings for n = 37 and n = 42. Analysis of differences for the full respondent sample (n

= 42) is reported in Study I. As raw score are scale dependent, bar graphs on standardised scores are presented to enable a visual display of all personal aspects in each figure. Bold bars reflect

differences found to occur at a lower probability (i.e., p <.05) – that is, less likely to be due to chance alone. Figures 4.3a – 4.3c display the mean and SD of personal aspect scores across all practitioner groupings for both the yoked respondent sample (n = 37) and the full respondent sample (n = 42) to enable comparisons of the two samples. Direct comparisons between the yoked sample (n = 37) and the unyoked sample (n = 5) were not conducted due to the discrepant and insufficient sample size.

A total of 12 comparisons were conducted. For each of the four personal aspect variables, a one-way independent ANOVA examined differences between the three practitioners groups (i.e., PWPs, CBT therapists, and counsellors) followed by two independent samples t-tests for comparisons between treatment intensity (i.e., low versus high intensity of treatment) and theoretical orientation (i.e., CBT-oriented versus counselling treatment).

116 Table 4.5: Descriptive statistics (Mean and SD) of personal aspects across practitioner grouping comparing all respondents sample data (n = 42) with all yoked respondents sample data (n = 37)

Comparisons between treatment approaches using a one-way independent AVONA identified no statistically significant differences for resilience, F(2, 34) = 2.60, p = .09; and empathy, F(2, 34) = 0.60, p = .55. Significant differences were identified for mindfulness, F(2, 34) = 3.35, p = .047; and R+M, F(2, 34) = 4.36, p = .02. The bold bars in Figure 4.3a display how the findings of the n=37 yoked respondent sample identified that differences between practitioner groups in mindfulness and

Sample size

Resilience (R) Empathy (E) Mindfulness (M) Resilience &

Mindfulness (R+M)

117 R+M as occurring less likely due to chance alone. The same finding was obtained in the full n = 42 respondent sample.

Figure 4.3: Bar graphs displaying distributions of personal aspect variables (resilience, empathy, mindfulness and combined resilience and mindfulness)

Figure 4.3a: Between PWPs, CBT therapists, and counsellors

(n = 37) (n = 42)

Figure 4.3b: Between practitioners who deliver low intensity (i.e., PWPs) and high intensity interventions (i.e., CBT therapists and counsellors)

(n = 37) (n = 42)

Figure 4.3 c: Between practitioners who deliver CBT-oriented intervention (i.e., PWPs and CBT therapists) and practitioners who deliver counselling

(n = 37) (n = 42)

PWPs

CBT therapists Counsellors

Low intensity treatment High intensity treatment

CBT-orientated approach Counselling approach

118 Independent samples t-tests were used to compare personal aspect scores between treatment intensity practitioner groups. Low intensity PWP intervention (n = 8) and high intensity CBT therapy and counselling (n = 29) did not statistically differ in empathy, t (35) = 0.67, p = .51, effect size r = .11, 95% CI[-.22, .42], however, significantly differed in resilience, t (35) = -2.29, p = .03, effect size r = .36, 95% CI[.04, .61]; mindfulness, t (35) = -2.27, p = .03, effect size r = .36, 95% CI[.04, .61];

and R+M, t (35) = -2.80, p = .01, effect size r = .43, 95% CI[.12, .66]. This finding in the yoked respondent sample (n = 37) is consistent with that of the full respondent sample (n = 42) – indicated by the bolded bars in Figure 4.3b.

In respect to practitioners’ theoretical orientation, independent samples t-tests were conducted on personal aspect scores between practitioners of counselling orientation (n = 17) and those of CBT-orientations (i.e., PWPs and CBT therapists, n = 20). No statistically significant differences were identified on practitioners’ resilience, t (35) = 1.31, p = .20, effect size r = .22, 95%

CI[-.12, .51]; and empathy, t (35) = 0.44, p = .67, effect size r = .07, 95% CI[-.26, .38]. Significant differences were identified on practitioners’ mindfulness, t (35) = 2.14, p = .04, effect size r = .34, 95% CI[.02, .60]; and R+M, t (35) = 2.10, p = .04, effect size r = .33, 95% CI[.01, .59]. This finding is consistent with the full respondent sample (n = 42) where significant differences were identified in personal aspects of mindfulness (p = .02), and R+M (p = .03). See Fig 4.3c.

Summary of comparison between full (n = 42) and yoked (n = 37) respondent samples 4.5.3

In summary, the yoked practitioner sample is representative of the full respondent sample.

Practitioners in the subsample display the same characteristics, associations and group differences between practitioner personal aspects as identified in the full respondent sample. Key similarities comprised i) significant age differences between the practitioner treatment groups, ii) a significant positive association between resilience and mindfulness across all practitioners that was found to be specific amongst counsellors and iii) a consistent finding of differences beyond chance alone in mindfulness and combined resilience and mindfulness across all practitioner groupings (i.e., across practitioner treatments, treatment intensity levels and theoretical-orientation). Relatively higher levels of mindfulness and combined resilience and mindfulness were indicated amongst counsellors,

119 practitioners of high-intensity treatment and practitioners of counselling as compared to

CBT-orientation.

Results II: Personal aspects unique to more effective practice