Undergraduate BA (Hons) Psychology Empirical Project

Support Workers Perspectives on Counselling for those
Diagnosed with Autism Spectrum Disorder
Jordan Purcell
Matriculation: S1108777
PSYCHOLOGY EMPIRICAL PROJECT
MHC821090
Supervisor: Rosemarie Lynass
2014/15
Word Count: 9596 An empirical project submitted in part
fulfilment of the requirements for the award of the BA Social
Sciences (Honours) Degree.

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Contents
Acknowledgements 2
Abstract 3
Introduction 5
Methodology 20
Design 20
Participants 20
Materials 21
Apparatus 22
Procedure 22
The Interview 25
Approach to Analysis 26
Reflexivity 29
Ethical Issues 30
Analysis/Discussion 33
References 46

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Acknowledgements
Firstly, I would like to say thank you to my empirical project supervisor Rosemarie Lynass.
Without your support and encouragement this year, I would most definitely not have been
able to complete my project and I am so grateful to you for allowing me to focus on a topic
that means so much to me.
I would also like to say thank you to my family, most importantly my Mum and Dad, my
sister Robyn and my boyfriend Martin. I know that you have all been on the receiving end of
my tantrums and moaning throughout my four years at university so I feel you all deserve a
special thanks for putting up with me. Thanks for encouraging me to try my hardest and for
having faith in me when I didn’t have faith in myself. Hopefully it has all paid off!
Dylan, thank you for being there for the past fifteen years and letting me cuddle you
whenever I was stressed or upset throughout my time at primary school, high school, college
and university.
Also, to my cousin Rebecca, I don’t think I could have gotten through this year at university
without having you to freak out to and listen to my moaning. Thank you! And to my cousin
Lauren, thank you for offering to help me when I was stressing out and listening to my
greetin’. You’re the best!
I would like to say thank you to my friends Jenna, Emma and Lauren, with a special mention
to Chanelle and Karly. The past five years have flown in and I couldn’t imagine going
through college and university without you both. Can’t wait to celebrate!
Lastly, to my Uncle Colin. You inspired me to do this more than you’ll ever know x

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Abstract
Autism Spectrum Disorder is a neurodevelopmental disorder that is increasing in diagnoses
rapidly (Happe, Ronald & Plommin, 2006; Kazdin, 2000). Counselling is used as a method
of treatment and intervention for those with Autism Spectrum Disorder, focusing on adopting
a person-centred approach in order to shape the counselling session to suit the client. Despite
the prevalence of Autism and the ever growing popularity of ‘talking therapies’ such as
counselling, there has been very limited research into the areas of counselling and Autism.
This study sought to analyse support workers’ perspectives on counselling for those
diagnosed with Autism Spectrum Disorder, recruiting five participants from Strathclyde
Autistic Society who are employed as Home Support workers and Play Scheme workers.
This qualitative research used semi structured interviews and an inductive approach and
thematically analysed participant responses’ in order to identify support workers perspectives
on counselling for those with ASD and identifying perceived barriers in counselling,
determining whether counselling is viewed as a beneficial approach to helping those with
ASD and looking into awareness and accessibility to counselling. The data collected from
the semi-structured interviews was analysed thematically, with the researches identifying
codes and emerging themes in participant responses’. The study successfully identified
perceived barriers in counselling for those with ASD such as communication and social
interaction, and gauged that support workers’ have a generally positive view of counselling
for those with ASD, believing that it could be beneficial in helping clients’ deal with social
situations and coping mechanisms. The research also identified that there is a significant lack
of accessibility and awareness of counselling as an approach to helping those with ASD. The
research questions were successfully supported in their exploration of counselling as an
approach for those with ASD from the perspectives of support workers, however the research

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is determined to have limitations as it used an exclusively female sample and the sample size
is relatively small. These findings are discussed in relation to relevant literature and theory.

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Introduction
Autism Spectrum Disorder (ASD) is a term which medical professionals and psychologists
have had difficulty in applying a definition to due to the broad spectrum of symptoms,
behaviours, mental processes and perspectives (Happe, Ronald & Plomin, 2006). According
to the American Psychiatric Association (APA), ASD can be defined as a
neurodevelopmental condition which is diagnosed on the basis of three behavioural
impairments: impaired social interaction, impaired communication and restricted and
repetitive interests and activities (APA, 1994). More recently, Kazdin (2000) has defined
ASD as a social impairment which can affect the ability to interpret social situations, the
feelings of others and having a significant effect on the individuals’ verbal and non-verbal
communication. Significant changes have been made in the fifth edition of the Diagnostic
and Statistical Manual of Mental Disorders (DSM-IV) in relation to the diagnosis criteria for
ASD. The DSM-IV has combined Autism, Asperger’s Syndrome (AS), Childhood
Disintegrative Disorder and Pervasive Developmental Disorder one diagnostic category
referred to as Autism Spectrum Disorder. These diagnoses are now grouped under the
heading of Neurodevelopmental Disorders (Buser, 2015).
Prevalence of Autism Spectrum Disorder
Statistics collaborated by the National Autistic Society (2014) show that one in every
hundredth individuals in the United Kingdom will be diagnosed with ASD (NHS, 2014). In
the United States of America, data collected by California’s Department of Developmental
Services (1999) reported a two hundred and seventy three percent increase in the number of

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children entering treatment centres for ASD within the region over the course of eleven years.
This saw the prediction of one in two thousand five hundred individuals being diagnosed with
ASD prior to the 1990s increase sharply to one in every one hundred and ten (Bernier &
Gerdts, 2010). The American Academy of Pediatrics (2008) offer a number of factors in the
increase in diagnosis, such as the increasing number of behaviours and disorders which are
currently being considered in the definition of ASD in comparison to previous years and the
increasing awareness of ASD in both the medical profession and society (Oller & Oller,
2010).
Autism Epidemic
Many psychologists declare that society is currently experiencing a worldwide autism
epidemic (Eyal, Hart, Onculer, Oren & Rossi, 2010; Bock & Stauth, 2008). An epidemic is
defined as a widespread occurrence of a disease in a community at a particular time
(Stevenson, 2009). Eyal et al (2010) states that the reason for this epidemic is due to the
visibility of autism in modern society and not the epidemic highlighting the prevalence of
ASD diagnosis. Eyal et al believe that the frequency in diagnosis is due to the change in
diagnostic criteria in the DSM IV, greater awareness of ASD as a disorder and the behaviours
and disorders associated with ASD, and better detection services in the medical environment.
However, Kirby (2007) refutes the ideology of an autism epidemic and discusses the
controversial argument focusing on the possibility of children’s exposure to mercury through
vaccinations playing a key role in the surge of autism diagnoses. Jepson & Johnson (2007)
also argue that the changes made to the diagnostic criteria for ASD in the DSM-IV are not

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significant enough to encourage such a dramatic increase in in the diagnosis of ASD in recent
years, focusing on the increased awareness of the disorder in recent years and social
ignorance towards the disorder in years when the disorder was less common.
Person-Centred Therapy
Rogers’ (1950) concept of person-centred therapy is pivotal in relation to the discussion of
counselling for those diagnosed with Autism Spectrum Disorder (Chalk, 2012). Person-
centred therapy involves the process of clients assessing their perception of self, in
comparison to similar approaches such as psychodynamic psychotherapy, which is more
dependent on the counsellor’s ability to interpret the client’s unconscious thoughts and ideas
(Tudor & Worrall, 2006). The person-centred approach is an effective method of counselling
for individuals diagnosed with ASD as it provides clients with a social environment which
encourages their communication and engagement with the counsellor. Joseph et al. state that
the appropriate social environment encourages the development of emotional growth and the
actualisation of their inherent optimal nature. This provides clients with the ability to
communicate, which aides in the positive outcome of the therapy.
Robertson, Emmerson, Hatton, Elliot, McIntosh, Swift, Krijnen-Kemp, Towers, Romeo,
Knapp, Sanderson, Routledge, Oakes and Joyce (2005) conducted a study which explored the
effectiveness of person-centred therapy and provides evidence of how it is beneficial to those

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on the autistic spectrum. Robertson et al study used twenty-five participants who had been
diagnosed with learning disabilities such as ASD and Asperger Syndrome (AS) and took
place over a period of two and a half years, measuring the positive effects of person-centred
therapy. The study was conducted over four locations in England on the basis that person-
centred therapy was to be implemented with the aim of benefitting the client and having a
positive outcome for the client’s life experience, as opposed to seeking to meet organisational
obligations and requirements. These locations also had a diverse community, ranging from a
wide variety in ethnicity, affluence and urban/rural locations. The data collected in this
qualitative study was thematically analysed with the aim of identifying the effect that the
implementation of person-centred therapy can have on a participant with a learning disability
such as ASD or AS and the costs of such implementation. The results of the research showed
that clients’ participation in person-centred therapies were positively correlated with clients
increased involvement within the community, increased interaction with family and friends
and an increase in social activity. Furthermore, the results showed that person-centred
therapy had a negative effect on areas such as employment and physical health. This was
considered to be a negative consequence of the increased activity in social involvement.
However, it could be considered that those who qualified to participate in the person-centred
therapy could generally be of ill health which would have a significant effect on employment
and physical health, which is a possibility that has been explored in Emmerson’s later
research.
Emmerson and Baines (2010) carried out a study which sought to assess health inequalities of
those diagnosed with learning disabilities in Britain. Emmerson et al state that people
diagnosed with learning disabilities are proven to be more poorly in health than their non-

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disabled peers. Statistics provided in the research paper have indicated that people with
learning disabilities who reside in the Britain are evidenced to have earlier mortality rates and
are 2.5-4.5 times more likely to have poorer general health than their non-disabled peers.
These results could conflict with Emmerson’s earlier suggestions that person-centred therapy
has a negative effect on physical health and employment, as more recent research suggests
that individuals with learning disabilities generally have poor health which could therefore
have a negative effect on their likelihood to find stable employment.
Prouty’s theory of Pre-Therapy & Social Autism Pre-Therapy
Prouty’s theory of pre-therapy and social autism pre-therapy, also referred to as ‘contact
work’, is a method that is used to bring individuals diagnosed with learning disabilities, such
as Autism Spectrum Disorder, to a state of ‘psychological contact’. This theory is heavily
influenced by Rogers’ concept of person-centred therapy and is implemented with the aim of
bringing those who are regularly in a state of agitation or upset to a state in which they can
communicate (Cooper, O’Hara, Schmid & Bohart, 2013). As those with Autism Spectrum
Disorder are often in states of high stress regardless of their environment, Prouty’s concept of
pre-therapy allows for therapists and their clients to establish a means of communication and
therefore allows for emotional expression to take place (Prouty, 1994). Pre-therapy is the
concept and process of psychological contact, which is defined as a process where two
individuals are effected by and respond to one another. This forms the basis of a reciprocal
relationship (Rogers, 1957). When individuals’ who are participating in pre-therapy start to
engage meaningfully on a daily basis, they are determined as to be fully functioning. In order

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to become fully functioning, clients must experience three processes which are known as
reality contact function, affective contact function and communication contact function.
Reality contact function refers to the clients’ awareness of what is realistically happening in
their environment. Affective contact function refers to the clients’ ability and willingness to
experience feelings and emotions. Communication contact function refers to the clients’
ability and willingness to verbally communicate their thoughts, feelings, moods and emotions
to others in their environment in a socially acceptable manner which allows others to
understand them. The aim of pre-therapy is for every client to achieve psychological contact
with others. However, this is not always a realistic possibility as this is dependent on the
individuals’ abilities. Therefore, it can be determined that individuals’ diagnosed with low
functioning ASD might not have the ability to achieve the three contact functions. This can
sometimes result in pre-expressive behaviour, of which a consequence is people isolating
themselves, becoming withdrawn and expressing odd physical behaviours. Pre-therapy is
determined to be a positive process as it provides clients’ with the ability to function in
everyday life, to their full potential (Wilkins, 2009).
Sommerbeck (2001) suggests that pre-therapy could possibly be damaging to patients as the
processes could be perceived as patronising and condescending. This is because the process
require practitioners to mimic the behaviour of clients’, which could have a detrimental effect
on the client akin to the issues of ableism.

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Labelling Theory
The labelling theory is a sociological theory which was developed by Becker in 1963. The
labelling theory focuses mainly on two questions; why are some people chosen for labelling
rather than others? And what is the effect of official labelling on future behaviour?
(Farrington & Murray, 2013). Labelling refers to society’s tendency to assume that an
individual will adopt certain behaviours or attitudes which are stereotypically associated with,
in this case, those who have a mental illness or learning disability. This can often lead to
self-acceptance of being of a particular label and can often result in influencing an individual
to behave in a certain way and embracing this as their personal identity (Brain, 2001). Scheff
(1966) constructed the first labelling theory in relation to mental health, which focused on
both informal labelling and official labelling processes Informal labelling refers to the
labelling from a spouse or friend, whilst formal labelling refers to the label which is applied
to a person through treatment contact, such as their participation in counselling (Aneshensel,
Phelan & Bierman, 2012). Pilgirm (2014) states that primary deviance arises from biological,
psychological and social sources but that the ultimate fate of the individual exhibiting the
behaviour is determined by contingent social-psychological factors. Secondary deviance is
therefore shaped by these social-psychological factors; namely the extent to which the
behaviour is tolerated or labelled and controlled. According to Pilgrim, these processes
amplify the role of the labelled individual.
Hodge (2012) conducted a study which focused on clients diagnosed with Asperger’s
Syndrome, and aimed to highlight how the processes of labelling can have a negative effect
on clients’ participation in counselling. Hodge’s findings showed that during their

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participation in counselling, clients’ diagnosed with AS may consciously make an effort to
appear neurotypical and exhibit behaviours they deem to be socially normal rather than give
in to AS tendencies, whilst other individuals are accepting of the label. This can often result
in problems between the counsellor and client establishing a relationship as those on the
spectrum are less likely to have the ability to honestly express their thoughts and feelings.
This can also be a problem as it makes it impossible to address issues which are required to
be discussed for a positive outcome of counselling.
Barriers
Barriers in social interaction and communication are a significant source of difficulty for
individuals diagnosed with ASD and can have a debilitating effect on their ability to tell
others how they are feeling, interpret social situations and empathise with others (NAS,
2015).
Ableism is defined as prejudice against individuals who are not able-bodied or have been
diagnosed with a disability (Colman, 2009). According to Rose (2010) ableism determines
ASD to be a disability and reinforces this negative affliction throughout society, through the
media and medical system and is significantly apparent in the education system.

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Hodge (2012) carried out various research which aimed to identify the barriers that are faced
by those on the Autism spectrum during their participation in counselling. Hodge’s initial
study which was carried out in 2012, and sought to explore the notion of ableism and
determined that experiencing the effects of ableism can have a significantly negative impact
on the process of counselling. Hodge assesses how ableism can have a detrimental effect on
an individuals’ ability to express any means of empathy they may feel, and explores how this
can make counselling a negative experience. Hodge uses the example of his client, a young
boy diagnosed with ASD and his experience of counselling. Hodge aimed to support
counsellors in assessing and discussing how individuals with ASD are likely to process and
interpret a counselling session, and how the prevalence and experience of ableism can effect
clients’ ability to feel comfortable enough in their environment to engage with the counsellor,
resulting in a positive perspective of counselling. Hodge suggested that in order to encourage
the positivity of counselling, counsellors should deem every counselling session to be an
organic process. Hodge also suggests that the counsellor approach every session with a fresh
mind set and clear perspective and should be prepared to view issues from the clients’ point
of view. This will encourage counsellor to establish a relationship with the client and aims to
result in a positive outcome.
Emotional Awareness
Autism Spectrum Disorder is one of the principal disorders which involve deficits of
empathy, with social communication considered to be the overarching core deficit amongst
those diagnosed with ASD. Although some people who have been diagnosed with ASD are

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less functionally impaired and still have normal vocabulary and sentence construction, in
childhood their praxis differs significantly from typically developing children. Individuals
diagnosed with ASD exhibit early deficits in social interaction and communication,
particularly difficulties in the ability to differentiate emotional facial expressions, basic
imitation abilities and empathy (Benson & Haith, 2010).
Silani, Bird, Brindley, Singer, Frith and Frith (2008) conducted research which sought to
explore those with Autisms’ inability to identify and define their own feelings. The research
used fifteen participants diagnosed with ASD, consisting of thirteen males and two females,
and a control group which was made up of thirteen participants with no known disorders
which effect emotional awareness, consisting of thirteen males and two females. Silani et al
measured this inability through the use of alexithymia and empathy questionnaires, assisted
by the use of fMRI in order to investigate participants’ brain activity whilst introspecting on
emotion. Participants were required to rate stimuli from the International Affective Picture
System twice, one according to a degree of un/pleasantness that the pictures induced, and the
second according to colour balance. The results of the study showed a significant difference
between the two groups in the alexithymia and empathy questionnaires, with a significant
correlation between the alexithymia and lack of empathy highlighting a link between
understanding one’s own emotions and the emotions of others. A significant difference
between both groups was also found in self-reporting, with the study showing that those with
ASD showed a reduced activation in self-reflection and mentalizing regions. Overall, the
results of the study showed that individuals diagnosed with ASD lack of emotional awareness

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is related to hypo activity, and that particular difficulties in emotional awareness are not
related to their impairments in self-reflection.
Research conducted by Baron-Cohen and Wheelwright (2004) questioned the self-reporting
methods used to measure levels of empathy of those diagnosed with ASD and proposed the
use of the Empathy Quotient (EQ), providing evidence of its reliability in determining a
difference in degrees of empathy between individuals with Autism and a control group. The
study used ninety participants consisting of sixty-five males and twenty-five females who had
been diagnosed with Autism and Asperger’s Syndrome (AS) and a control group which
consisted of an equal number of male and female participants. The results of study one
showed that the participant group consisting of those diagnosed with Autism and AS scored
significantly lower on the EQ than the age matched control group. Specifically, of the ASD
and AS group, eighty one percent of participants scored equal to or fewer than thirty points in
comparison to the control group of which only twelve percent scored equal to or less than
thirty points. The results of the study therefore confirmed that there is a significant deficit in
empathy between those with Autism and AS.
Deficits in Communication
The lack in communication skills and lingual abilities are unique to those diagnosed with
Autism. According to Frith (1989), all the impairments that are unique to autism are
concerned with the deficit of language for the purpose of communication. Frith states that

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this inability to achieve satisfactory communication can be identified with a limitation in the
computing of relevance and as a lack of taking account of mental states. This is determined
to be a consequence of a cognitive dysfunction, which leads to impairments in social
relationships and imaginative play.
Lord, Risi, Lambrecht, Cook, Leventhal, DiLavore, Pickles and Rutter (2000) conducted a
study which sought to measure social and communicative deficits associated with the Autism
spectrum. The two hundred and twenty three participants were made up of both adults and
children, all of whom had been diagnosed with Autism Spectrum Disorder or Pervasive
Development Disorder Not Otherwise Specified (PDDNOS). The information was measured
through the use of the Autism Diagnostic Observation Schedule- Generic (ADOS-G), which
is a semi-structured, standardized assessment of social interaction, communication, play and
imaginative use of materials. The observational schedule was comprised of four modules
which lasted for a period of thirty minutes, with each module differing in design according to
the participants’ individual level of expressive language. The findings of the study showed
that those diagnosed with ASD expressed significantly less communicational skills both
physically and verbally throughout all four modules in comparison to the participants
diagnosed with PDDNOS, therefore supporting the general consensus that ASD has a
debilitating effect on an individuals’ social interaction and communication. This is evidence
of the struggles faced by those diagnosed with ASD and can also offer an explanation for the
difficulties experienced by individuals with ASD when participating in face to face
approaches such as counselling.

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Accessibility to Counselling
Research into the commonality of those with ASD participating in counselling or being
offered counselling is extremely limited, as is the literature. Reeve (2000) cited in Hodge
(2012) states that a key factor in the lack of research into counselling for those on the autism
spectrum is the dependency on the clients’ financial situation. Reeve and Hodge offer their
perspective which suggests that the likelihood of non-disabled people being more financially
comfortable is increasingly higher than those who have been diagnosed with a learning
difficulty or disability, such as ASD as they are less likely to be in stable employment. Reeve
et al believe that this has a significant effect on the number of individuals on the spectrum
who participate in counselling. Most treatments offered to those with Autism by the National
Health Service in Britain are offered in early childhood upon diagnosis. Amongst these
common approaches are Applied Behavioural Analysis (ABA), dietary approaches and
medicinal approaches such as the prescription of antipsychotics, antiepileptic drugs and blood
pressure medication which aim to alleviate the behavioural symptoms of ASD (Turkington
and Anan, 2007). Hodge also states that there is a negative perception of counselling in
relation to autism and Asperger Syndrome as these conditions are often linked to anxiety and
depression which can steer professionals away from recommending counselling. As
counselling does not appear to be a typically common approach to autism treatment, this
could account for the lack of research in this area.

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Aims & Objectives of Research
Based on previous research and literature, this research aims to explore support workers
perspectives’ on counselling for those diagnosed with Autism Spectrum Disorder. The
research questions if there are any perceived barriers that support workers consider inhibiting
to those diagnosed with ASD during their participation in counselling and aims to identify
these barriers. The research also seeks to determine if counselling is a commonly discussed
and easily accessible source of treatment for individuals with ASD, questioning if support
workers determine that it is likely for individuals with ASD to actively seek counselling, and
if support workers think that counselling would be a beneficial source of help to those with
ASD. The research also explores support workers’ perspectives on how counselling could be
made more accessible to those with ASD.

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Methodology
Design
The research project used a qualitative, semi-structured face to face interview design. The
study aimed to analyse the perspectives of support workers who have worked alongside
individuals diagnosed with Autism Spectrum Disorder, exploring the benefits of those with
ASD participating in counselling and the perceived barriers that may have an effect on the
process and outcome of their participation in counselling. The study aimed to determine
whether support workers felt that counselling would be beneficial or unbeneficial to those
with ASD and aimed to identify support workers reasons pertaining to the ineffectiveness of
counselling for those diagnosed with Autism. For example, do support workers feel that
there are barriers that may have a significant effect on individuals diagnosed with ASD’s
ability to participate in counselling? An example of these issues could be communicative
issues or difficulties engaging effectively in social interaction.
Participants
A total of five participants were used in this study, which consisted of five females who are
currently or have previously been employed in the position of home support worker or play
scheme worker by Strathclyde Autistic Society. The researcher did not consciously recruit
five female participants, this was the result of a majority female populated workforce. The
principal investigator of the research project is also a current employee of Strathclyde

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Autistic Society so measures were taken to ensure that colleagues known to the investigator
were not recruited as participants for the study. An e-mail was sent to the chairwoman of the
charity giving a brief summary of the aims of the study and requesting the charity’s
permission to use employees of Strathclyde Autistic Society as participants in the research
study (Appendix A). Permission was granted from the chairwoman of the charity to
interview employees’ willing to take part in the research project (Appendix B). Participants
were recruited through the use of a recruitment e-mail (Appendix C) sent to their work e-mail
addresses which were provided by Strathclyde Autistic Society. The e-mail gave a brief
summary of the research, the length of time that was required for participation (estimated to
be between thirty and forty-five minutes) and contact details of both the principal investigator
and the supervisor should the participants require any further information and to inform the
researcher if the wished to confirm or decline their participation in the study.
Materials
Five consent forms (Appendix D) and five information sheets (Appendix E) were printed and
one was given to each of the participants upon arrival to the location of the research study.
Participants were also provided with pens to sign the consent forms. The researcher printed
five copies of the interview schedule (Appendix F), one for each interview. The interview
schedule was blank at one side in order for the researcher to take notes during the interview if
need be, using the pens provided. Five debrief sheets (Appendix G) were printed off to be
given to each participant at the end of the study.

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Apparatus
The interviews were recorded using the voice note recorder on an Apple iPhone 6 and were
then uploaded onto a password protected laptop and encrypted using 7zip encryption software
in order to protect the data collected.
Procedure
The current study obtained ethical approval from the Glasgow Caledonian Ethics Committee.
The information sheets and consent forms provided in the study met ethical guidelines and
were deemed to be sufficiently informative. A risk assessment form (Appendix H) was
completed by the researcher due to the study being conducted outside of university grounds
and to address ethical concerns raised by the researcher interviewing colleagues from
Strathclyde Autistic Society. The risk assessment form was analysed by the Glasgow
Caledonian Ethics Committee and approved. The debriefing material provided all necessary
information as it gave participants a brief summary of the purpose of the study and provided
contact details of the principal researcher and supervisor should the participant require any
further information regarding the study, have any questions about their participation or wish
to request their responses be withdrawn. The approved ethical application form is available,
see Appendix I.

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The participants who responded to the e-mail and granted their consent to participate in the
research were each contacted individually to arrange a date and time for the interviews to
take place. The interviews were conducted in a ground floor IT room within Centre 81, a
local community centre where the Strathclyde Autistic Society’s secondary office is also
based. The interviews were all conducted in the evening time, after the Strathclyde Autistic
Society’s office closed in order to prevent contact with other employees or bosses, in order to
minimise the chance of the possible encounters influencing the participants’ responses to the
interview questions. Other business’ bases and community classes continued to take place as
usual during the time of the interviews and the care takers remained in the building until the
centre closed which was before the end of the interviews. Participants were interviewed
separately.
Participants were directed to take a seat at the table in the room and were handed the
information sheet and consent form and were asked to read over these sheets and sign with
the pen provided should they wish to continue. The researcher advised the participants that
they would not be required to participate in the study for any longer than forty-five minutes.
The researcher then collected in the consent sheet and informed each participant that they
could keep the information sheet should they wish to. The participants were also informed
that whilst their contribution and participation in the study would be anonymous, it would not
be appropriate for them to refer to a specific client and they were asked to answer all
questions with a general perspective without focusing on one particular experience or
referring to one particular person. The participants were also advised that no information

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would be discussed with the chairwoman, managers or other employees of Strathclyde
Autistic Society. However, should any participant communicate any information to the
researcher which gives the researcher cause for concern for the welfare of any individual,
employee or client, the researcher has a moral obligation to let the appropriate people know.
The researcher then advised each participant that the interview would be recorded using the
voice note recorder on an Apple iPhone 6 and requested their permission to do so. After
permission was granted from each participant, the researcher sat in a seat directly across from
the participant.
The researcher activated the voice recorder and asked each participant the five open ended
interview questions on the interview schedule. Whilst the participants provided their answers,
the researcher would occasionally write down notes on the blank spaces on the interview
schedule when necessary.
After all interview questions were asked by the researcher and answered by the participants,
the participants were debriefed using the standardised debriefing form. The participants were
thanked for their participation in the study verbally and any questions asked were addressed.
Participants were also informed of the aims and objectives of the study and were reminded to
take their information sheet which provided contact details for the researcher and research
supervisor. Participants were also informed of their right to withdraw from the study at any

25
time until the data is written up in the final report, however they were assured that they would
remain anonymous.
The information gathered through the interviews were transcribed verbatim and saved to a
word document using pseudonyms (Appendix J). The word document was then encrypted
using 7zip encryption software and saved onto a password protected laptop.
The Interview
The research used semi-structured interviews as a method of data collection. This was
determined to be the most suitable method of data collection for this study as this method
permits the researcher to request more information from a participant regarding the answering
of a question. This therefore allows the researcher to obtain sufficient information at a depth
that the researcher deems necessary, in order to make a reliable conclusion of the data
collected (Craighead & Nemeroff, 2002).
This was determined to be the most appropriate and effective method of data collection for
this study due to the nature of the study, as the main focus is exploring the perspectives of
support workers in relation to counselling for those on the Autism Spectrum. The questions

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asked by the researcher require more than a yes or no answer and using a semi-structured
interviews allows the researcher to ask for further information pertaining to a participants’
answer, if necessary. The researcher consciously chose not to use other methods of data
collection such as questionnaires or structured interviews as these methods do not allow for
flexibility when asking questions and when receiving participant responses’ (Hersen, 2011).
Approach to Analysis
An inductive approach was adopted in the analysis of the data collected from the interviews.
An inductive approach is often used within qualitative analysis as this approach allows for the
data to lead to the emergence of concepts, which has been demonstrated within this research
through the identification of emerging patterns in participant response regarding the
perception of barriers in counselling, labelling and recurring themes in relation to the
exposure to counselling (Yin, 2011).
This was determined to be an appropriate approach to data analysis for this study as inductive
research begins with observations and proceeds with a search for patterns in what has been
observed. The researcher plays a key role when adopting an inductive approach to data
analysis, as it requires the analyst to have a strong reserve of insight and reflection in order to
successfully identify crucial patterns embedded within the observations (Babbie, 2009).
The principal researcher of this study was actively involved in conducting the experiment,
through the participation in face to face interviews with recruited participants and analysing
data through observation and identification of trends and patterns, rather than deciphering the

27
data with the aide of computer software analysis. The inductive approach was therefore an
effective method to use within this study as it was key in highlighting recurring issues and
trends in participant responses.
Thematic analysis is defined as a qualitative analytical method of “identifying, analysing and
reporting patterns and themes within data”. This method of analysis organises and describes
the data collected in significant detail and interprets various aspects within the topic of
research (Braun & Clarke, 2006).
The researcher followed the six step process of coding in order to identify, organise and
interpret the significant patterns which emerged throughout participant responses. The six
stages of coding that were followed were: familiarization with data, generating initial codes,
detecting themes amongst the codes, reviewing themes, defining and naming themes, and
writing up the final report (Saldana, 2008).
Following the process of coding, the researcher transcribed the recording of the interview
verbatim to separate word documents. The researcher read over the transcripts from each
interview several times in order to become familiar with the participant responses. The

28
researcher then highlighted specific areas of each transcript that were of interest, such as
similar responses from a number of participants, which is referred to as codes. The
researcher then sought to identify relationships or similarities between these codes and
grouped similar codes together. In thematic analysis this is referred to as a theme. These
themes were then labelled in relation to the group they belong to, such as the emerging theme
of barriers, with the codes being discussed under the heading of barriers. The codes were
grouped together and split into categories: ‘barriers’, ‘counselling: beneficial or
unbeneficial?’ and ‘exposure’. The category of ‘barriers’ consisted of three subcategories
which were labelled as social interaction, communication deficits and understanding emotion.
The category of ‘counselling: beneficial or unbeneficial?’ was considered as one theme. The
category of ‘exposure’ was subdivided into awareness and accessibility and awareness and
responsibility.
This was decided as an appropriate method of analysis for this research as it allowed the
researcher to highlight the recurring themes in the participant responses and allowed for the
researcher to discuss information collected through the interviews which supported the basis
for this study, such as identifying which barriers are perceived in counselling for those with
ASD.

29
Reflexivity
Finley (2003) defines reflexivity in qualitative research can as the researchers’ engagement in
self-aware meta-analysis, and awareness of the researchers’ role in the practice, process and
outcomes of qualitative research (Klenke, 2008). Reflexivity requires the acknowledgement
of the impossibility of researchers’ remaining ‘outside’ of one’s subject area during the
research process, and encourages the consideration of the ways in which a researcher’s
involvement with a specific study influences, acts upon and informs such research
(Nightingale & Cromby, 1999).
Willig (2001) identified two types of reflexivity in relation to research, termed personal and
epistemological reflexivity. Personal reflexivity considers the effect that the research process
has on researchers, and considers how this influence shapes researchers’ thoughts and beliefs
(Major & Savin-Baden, 2012). Epistemological reflexivity requires the critical interrogation
of how researchers have conducted research through aspects such as the design of the study,
the questions asked and the analysis of the results (Macfarlane, 2010).
Alvesson and Skoldberg (2009) suggest that there are two basic characteristics of reflexive
research, which are referred to as interpretation and reflection. Alvesson et al state that
interpretation fails to reflect any sense of reality, but instead is influenced by the assumptions,
political position, language and values. Reflection refers to the process of researches taking

30
into consideration the influence of themselves, their community and their traditions, effecting
the research. Reflection therefore becomes a form of interpretation and so is termed as being
reflexive.
Ethical Issues
The research faced a number of substantial ethical issues, however these ethical issues were
reported onto a risk assessment form and analysed and approved by the Glasgow Caledonian
University Ethics committee.
The first ethical issue that was considered was the interviews taking place off campus and in
a local community centre. The principal researcher and participants’ were all aware of the
location of fire exits and health and safety regulations within the building as they had all
completed the necessary training to work in the community centre due to the location of the
Strathclyde Autistic Society office being based within the centre.
The second ethical issue that was considered is the possible effect of the principal
investigator being a fellow employee of the company that the participants’ are also employed
by. However, an effort was made to recruit participants who were not familiar with the

31
researcher and had never worked alongside the researcher. Due to this, none of the five
participants were known to the researcher and so this minimised the effect that this could
have on participant responses.
The third ethical issue that was considered was the possibility of participants referring to a
particular client or colleague in their response to an interview question. The participants’
were asked in advance to only answer the questions with a general perspective of the issue
within the question. The participants were also informed that if they did refer to a specific
person, that information could not be used within the study and would be destroyed
immediately.
The fourth ethical issue that was considered by the researcher was the possibility of
participants attempting to discuss with the researcher any issues that they may have with their
employer, colleagues or job role due to them being employed by the same company.
However, participants were asked to remain professional in their responses and only provide
general information regarding the questions being asked in an effort to avoid this happening.

32
The fifth ethical issue that was considered by the researcher was the possibility of participants
providing information which may give the researcher cause for concern. For example, if a
participant admits to not following protocol which may put a client, the participant or other
employee’s in danger. Participants were informed before participating in the study that any
information provided that gives the researcher a cause for concern for the welfare of the
colleague or client, would have to be reported to the appropriate person at Strathclyde
Autistic Society.

33
Analysis/Discussion
This section of the report will analyse the themes and codes which were identified through
the thematic analysis of the interviews’. This will provide an in-depth analysis of the
results/findings and will analyse the relationship between these codes. Establishing themes
and patterns was a consequence of the thematic analysis that was conducted and so these
themes will be identified in this section of the report. The emergent theme of the interviews
will be discussed in relation to the literature and theory aforementioned in the paper.
Barriers
When participants were asked if they perceive there to be any barriers in counselling for
those with ASD, every participant identified a barrier that they considered would have a
negative impact on the process of counselling for clients’ with ASD. These barriers have
been split into three sub-categories:
Social Interaction
“In my experience it takes an awful lot, a considerable amount of time for both children and
adults with Autism to warm to you and build a trustworthy relationship so I’d imagine that
being questioned by someone they don’t know might make them feel quite intense, like they
are being interrogated and prodded to communicate feelings that they are uncomfortable
with. Quite a lot of clients I’ve worked with would be taken aback by it.” [Participant 1]
“…Some of them might struggle to settle in to the environment.” [Participant 2]

34
The issue of the difficulty in building a relationship was highlighted through participant
responses’. The participants also spoke of how being in the environment of a counsellors
office may be a significant barrier due to most individuals with ASD having issues with
physical proximity and feeling uncomfortable in social situations. As participants stated,
being in a room with a stranger in an environment which encourages communication and
interaction, may be a considerable issue. This issue with social interaction plays a pivotal
role in the effectiveness of counselling, for both the counsellor and the client (Hodge 2012;
Hodge 2012).
Communication Deficits
“I think there would be an initial barrier with communication. Like I said, a lot of clients I’ve
worked with who have been diagnosed with Autism have very limited communication or are
non-verbal, so there would be problems with their actual ability to communicate”
[Participant 1]
I think that communication is a very obvious barrier but in my opinion, I feel like it all comes
down to having appropriately trained staff who know the best ways to approach certain issues
without making the client feel uncomfortable and using methods that will encourage
communication.” [Participant 3]
“Most of the people that I work with just now communicatethrough idiosyncratic formsof sign
language so that would be a clear barrier for the counsellor. How would they be able to
communicate because a lot of people with Autism are maybe. Even if they aren’t non-verbal,
they’ve got severe verbal limitations in terms of communication so I think that would be a
definite barrier.” [Participant 5]

35
Every participant stated that communication is a significant barrier in counselling, however
one issue that was highlighted by participants one and five was the difficulty in
communication with clients with ASD that are non-verbal.
Participant five stated that a method of communication used by many with ASD is
idiosyncratic forms of sign language, and stated that this as a definite barrier for both the
counsellor and the client, when attempting to deliver effective counselling. This significant
deficit in communication highlighted by participants is supported by the research of Lord,
Risi, Lambrecht, Cook, Leventhal, DiLavore, Pickles and Rutter (2000), whose insight into
communication deficit and issues with expressive language for those with ASD evidenced
that there is a significant barrier in this area.
Understanding Emotion
“Understanding tone. Facial Expressions. They might not convey what the counsellor’s
trying to get across.” [Participant 5]
“It can be hard for them to communicate how they’re feeling and their emotions, because a
lot of the time they don’t understand the emotion that they’re feeling. So I don’t really know
how they could tell a counsellor if they don’t know themselves.” [Participant 1]
Another significant issue that was recurrent in participant responses, was the issue of ASD
clients understanding of emotions. Participant five explained that through her experience of

36
work as a support worker she has become aware of how difficult it can be for those with ASD
to perceive the tone of someone’s voice and the significant problem in relating someone’s
facial expression to their emotions.
Participant one highlighted the issue of emotional awareness and remarked on the service
users’ inability to understand the complexity of emotion, not just in the case of interpreting
another person’s emotion, but understanding how they are feeling themselves, which is a
concept supported by the previous research of Silani, Bird, Brindley, Singer, Frith and Frith
(2008) and Baron-Cohen and Wheelwright (2004). The support worker expresses their
concern over the clients’ ability to effectively participate in a counselling session, which is
effectively a talking therapy, if they are unable to express themselves.
Counselling: Beneficial or Unbeneficial?
Assessing the results of the data analysis, it can be determined that support workers generally
do have a positive view of counselling for those with ASD and do feel that it could be
beneficial to those with ASD for a number of reasons:
“I think counselling could be helpful to people with Autism, cause I think it could address
different issues that they might be having in their life. For example, people with Autism can
struggle a lot with education and work, and counselling could actually provide them with
coping mechanisms for this. It might also be helpful for behavioural issues that people with
ASD might have. It could maybe provide them with calming methods if they suffer with anxiety
or anger issues that causes them to lash out.” [Participant 3]

37
“Definitely, I would say that it varies to each child or adult and it’s very context dependant,
according to that person’s personal circumstances. Like, for example, if they come from a
deprived background then I feel that counselling could help greatly with their communication
and social interaction skills. I definitely think that people diagnosed with Autism could
benefit from counselling. Even if it’s one to one counselling or group sessions, I think it could
help with their social interaction and stuff. Like, it might encourage them, if you know what I
mean?” [Participant 1]
“I think it would make people with Autism better equipped to deal with certain situations
better. They could have help in learning how to approach certain social situations and
learning appropriate ways to communicate and behave. That could be a great help in like
educational and social and work environments. (Pause) I think it could be especially helpful
for people with Autism that are in school or university, cause it would help them socialise
and would help them make friends. And that’s a key part of being a student and a pupil. I
think a lot of people with Autism find social situations like school and university really
difficult because of communication issues that people with Autism have. I think they’d find it
hard to make friends and feel accepted if they’re not able to express certain feelings and
interpret certain situations. So, I think if these issues were addressed in counselling it could
actually be a great help to them.” [Participant 4]
“I think it would depend on the persons circumstances, I think it would have different effects
on different people. So if someone had a bad background in the sense that they weren’t
mentally stimulated as they should’ve been and because of that they had issues with verbal or
physical communication, they would probably benefit from counselling cause it would
address their issues with communication and then hopefully help them learn to communicate

38
in a way that’s comfortable to them. I think that the type of counselling that people with
Autism receive would have an effect on whether it would be helpful or not.” [Participant 2]
The support workers determined that counselling could be beneficial in addressing
behavioural problems which are often experienced by those with ASD. A recurrent aspect
which the participants touched upon was how counselling could help those with ASD learn
how to cope during life experiences and social situations, such as going to school or
university or gaining employment. The participants also take into consideration how
counselling can be shaped to the individual, emphasising the benefits of a person-centred
approach (Rogers, 1950). These considerations of the benefits of a counselling session which
revolves around the needs of the client have been supported through the research of
Robertson et al (2005), whose exploration into the benefits of person-centred therapy for an
individual diagnosed with ASD, showed that participation in counselling benefitted
participants through an increase in community involvement and increased positive interaction
between the individual with ASD and their family and friends. This study gives evidence that
counselling can be beneficial to those with ASD, and lends support to the findings of the
research, that support workers feel that a person-centred counselling approach could be
beneficial to those with ASD.
Exposure
The analysis of the interviews highlighted the concerning issue of lack of exposure to
counselling as an option for those with ASD. This exhibited how there is a significant lack of
information available for those who have an interest in treatments and interventions for those

39
with Autism, whether that be an individual with Autism seeking counselling or relations or
Autism services seeking treatments on their behalf.
Awareness & Accessibility
When participants were asked how common they thought it would be for counselling to be
offered to those with ASD, four out of the five participants said that they determine it to be
uncommon for counselling to be offered to those with ASD:
“I don’t think it’s very common at all… I think people often maybe don’t realise the need for
people with Autism to be counselled and there’s maybe not enough experts in the field of
Autism to recognise their needs.” [Participant 3]
“I definitely don’t think there’s enough awareness that counselling is actually an option. It’s
rarely been discussed with clients that I’ve worked with over the last three years. I actually
know very little about it considering I’ve worked in this job for quite a while now, so I
definitely think that awareness must play a role in the reason why it’s not a common option.”
[Participant 4]
Two participants touched upon the lack of awareness of Autism as a disorder and of
counselling as a helpful resource for those diagnosed. This lack of awareness of counselling
for those diagnosed with ASD is concurrent with the lack of research in this area, however
the perception that there is not enough awareness of contradicts the previously discussed
theory of an autism epidemic (Eyal, Hart, Onculer, Oren & Rossi, 2010; Bock & Stauth,
2008). When answering question one, relating to the commonality of counselling being

40
offered to those with ASD, participants three and five both referred to being aware of service
users participating in the well-known approach of Applied Behavioural Analysis but both
have never experienced work with a client who has participated in or has been offered
counselling. This concern has been echoed in the literature of Reeve (2000) and Turkington
and Anan (2007) whose research into the lack of awareness of counselling for those with
ASD exposed factors such as financial problems and lack of availability or options from
doctors or Autism services, as predominant factors for such little research being conducted in
this area.
Accessibility & Responsibility
In relation to awareness, another emerging trend identified in data analysis was participants’
responses to the last interview question, which enquired about the accessibility of counselling
for those with Autism and asked participants how counselling could be made more readily
accessible to those with ASD (interview question five). All participant responses indicated
that counselling should be advertised in government funded sectors by teachers of pre-
schools, specialist schools and mainstream schools, doctors, support workers, counsellors
themselves, psychologists and social work departments:
With the indication that there is a significant lack of awareness of counselling as an active
resource which can be used to aide those with ASD, the question of responsibility arises.
Who should be responsible for making the public more aware of counselling for those with
ASD? :

41
“I think it’s about identifying people who are in need of counselling with Autism early on. I
think doctors and support workers who are appropriately trained should have the
responsibility of letting people know that counselling is actually an option for people with
Autism. Even letting parents of children diagnosed with Autism know that there are different
types of counselling available that could suit their child’s needs and encouraging them to
explore their options. I suppose it’s important to empower people with Autism to know that
counselling is an option. I think that would let them know when and how to seek it and what
benefits they might get from it. Again ,I think that it would fall down to appropriately trained
counselling staff to let people know that counselling is available and to be able to sit down
with people with autism or their parent or guardian and explain the process to them to allow
them to decide if it’s a resource that they want to use. I think it’s really important to let
people know that there are a variety of techniques that are available, cause there are
different people who have different needs, and some counselling methods might be appealing
to some but not to others. Autism’s a wide spectrum, I think every person with Autism is
unique. So it’s important to let people know that there are a number of different counselling
approaches available, it’s not a one size fits all approach.” [Participant 3]
Every participant delegated responsibility to one of these areas without being asked, in
answer to the question of accessibility. This therefore highlighted the importance of
encouraging awareness and helped in identifying that there is an issue with limited awareness
and access to counselling in recent years.

42
Each of these themes are relative to the labelling theory (Becker, 1963; Scheff 1966; Hodge
2012) and it must be questioned if these perceived barriers in counselling could be a matter of
applying a general label to those on the Autism spectrum. Despite numerous participants
acknowledging how broad the spectrum is and how unique every person diagnosed with ASD
is, there does seem to be a general consensus that those with ASD do not have the ability or
coping mechanisms in order to participate in counselling.
The issue of lack of awareness and accessibility to counselling for those with ASD is also a
significant issue in terms of generalization, as both the literature and participant responses
have indicated that there is a concerning lack of awareness of counselling resources available
to those on the spectrum. This comes from a number of areas which have the responsibility
of offering therapies, interventions and treatments for those with ASD. Therefore, it could be
questioned if the labelling of those with ASD is effecting their accessibility to counselling
due to preconceived notions that those with ASD simply cannot communicate. Whilst a clear
lack in communication and social skills is evidenced throughout literature and research, it is
also necessary to maintain that every person on the spectrum is unique and giving them
access to a person-centred approach could be of great benefit to the population who have
been diagnosed with ASD.
The findings obtained from the thematic analysis of the interviewers has indicated an
emergence of patterns in participant responses regarding; awareness of counselling, barriers
faced by those with ASD during their participation in counselling, generally positive
perceptions of counselling for those with ASD from support workers’ perspectives and the

43
accessibility to counselling. This therefore supported the aims of the study which were to
identify these perceived barriers in counselling and determine if support workers’ determined
that counselling would be beneficial to those diagnosed with ASD.
Limitations & Future Research
The research being discussed can be criticised as it failed to recruit any male participants to
take part in the study. However, this sample was representative of the employees of
Strathclyde Autistic Society as the workforce is predominantly made up of females. Future
research would benefit from recruiting both male and female participants in order to
eliminate the possibility of gender bias effecting the results of the study. Future research
should aim to recruit an equal number of male and female participants in order to ensure a
fair representation of both sexes and ensuring that the study accounts for both male and
female perspectives.
A limitation of this study is the relatively small sample size of five participants. Whilst this
sample size was limited as the research was conducted in order to fulfil the requirements of a
BA Social Sciences (Hons) undergraduate empirical project, the word count was therefore
limited to eleven thousand words and the sample size was appropriate for the method of
thematic analysis. However, it can be argued that the responses of this small sample that
were collected and analysed, cannot be generalized to the population of support workers.
Future research in this area would benefit from using a larger sample size in order to benefit
from a larger volume of responses and significantly more data to analyse in order to support
or dispute the research question.

44
Future research would benefit greatly from recruiting participants who work in the role of a
support worker, employed over multiple companies. This would be of significant benefit to
the study as it is a possibility that different companies have more or less exposure to certain
treatments for autism or may work with a different client group which could have an
important effect on the results. Strathclyde Autistic Society service users are predominantly
children and young adults who range from three years old to eighteen years old, both male
and female. Therefore, those employed by SAS do not work alongside adults over the age of
eighteen and may not be aware of counselling approaches which may be offered more
regularly to individuals on the spectrum that are over the age of eighteen. This may also have
had a significant effect on responses to the question of the likelihood of those with ASD
actively seeking counselling themselves. Five out of five participants determined that it
would not be likely for an individual with ASD to seek counselling with all suggesting that it
would be more likely for the service users’ parent or guardian to seek counselling on their
behalf. However, having only worked with clients up to the age of eighteen, it can be argued
that these clients are likely to still be living at home and will therefore remain under the
supervision of their parents. These service users may be less independent than those who live
themselves or with a partner, in residential care or in sheltered accommodation, and therefore
it would be beneficial to future research to recruit participants from companies that have
service users’ who range in age.
Thematic analysis calls for the researcher to be critically appraised throughout the research
report, as this method of analysis emphasises the key role of the researcher throughout the

45
research process (Braun & Clarke, 2006). This is also referred to as the process of
reflexivity, which can be determined to have played a significant role within this study.
Despite efforts being made by the researcher to eliminate the influence of both the researcher
and participants being employed by Strathclyde Autistic Society, this possibility must be
considered. Also, despite the researcher ensuring that they never worked alongside the
participants recruited for the study, the researcher is unable to determine if the participant has
possibly been exposed to conversation or information regarding the researcher. If the
participant has been exposed to information about the researcher before the interview, this
could have a significant effect on the validity and reliability of the answers provided by the
participants’. Future research could benefit from ensuring that the principal investigator of
the study is completely unfamiliar to the participants’ of the study in order to preserve the
validity of the information collected and analysed.
In conclusion, the research can be praised as it succeeded in exploring the area of counselling
for those with ASD from the perspectives of support workers, and also successfully identified
perceived barriers in counselling and raised significant concerns over the issue of lack of
awareness of counselling and a lack of accessibility to counselling despite a general
agreement in perspectives of the support workers’ and supporting literature evidencing that
counselling could be of significant help to those on the spectrum. However, future research
within this area should take into consideration the limitations and suggestions for future
research in order to improve upon this current study.

46
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Towers, C. Romeo, R. Knapp, M. Sanderson, H. Routledge, M. Oakes, P. Joyce, T (2005).
The Impact of Person-Centred Planning. Lancaster: Institute for Health Research. 1-5.
Rose, R. (2010). Confronting the Obstacles to Inclusion: International Responses to
Developing Inclusive Education. Oxon: Routledge. 23-27.
Saldana, J. (2008). The Coding Manual for Qualitative Researchers. London: Sage
Publications. 1-15.
Silani, G. Bird, G. Brindley, R. Singer, T. Frith, C. Frith, U. (2008). Levels of emotional
awareness and autism: an fMRI study. Social Neuroscience. 3 (2), 97-112.
Sommerbeck, L. (2011). An Introduction to Pre-therapy. Psychosis: Psychological, Social
and Integrative Approaches. 3 (3), 235-241.
Stevenson, A. (2009). Oxford Dictionary of English. 3rd ed. Oxford: Oxford University
Press. 589.
Tudor, K. Worrall, M. (2006). Person-Centred Therapy: A Clinical Philosophy. 3rd ed.
London: Routledge. 123.
Turkington, C. Annan, R. (2007). The Encyclopedia of Autism. New York: Infobase
Publishing. 111-114.
Wilkins, P. (2009). Person-Centred Therapy: 100 Key Points. East Sussex: Routledge. 107-
110.

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Yin, R.K. (2011). Qualitative Research from Start to Finish. New York: Guilford Press. 193-
195.

52
Appendix A
Request for Permission
06/02/2015
Sent to: strathclyde81@yahoo.com
Sent from: jordanpurcell92@yahoo.co.uk
Subject: FAO Susan Dolan
Hi Susan,
I’m currently doing an empirical project for my last year on my BA Social Sciences course at Glasgow
Caledonian University and the main focus of my study is support workers’ perspectives on counselling
therapies for people with Autism Spectrum Disorder. The study is aiming to analyse any issues which
may be identified by the participants such as communicational issues and will discuss if counselling
therapies are beneficial or not for clients with Autism Spectrum Disorder. I am looking for your
permission to use five home support and play scheme staff from Strathclyde Autistic Society as
participants for my project. They will be asked to take part in an audio recorded interview which will
last for thirty minutes at the most and will consist of five questions which will ask general questions
about their perspectives of counselling for those with Autism Spectrum Disorder and will not ask any
questions about any clients in particular. The interview will take place in an IT room in Centre 81 and
participants will be recruited via e-mail to their employee e-mail address, if I have your permission. I
will be the main researcher and will be overseen by Rosemarie Lynass from the psychology
department at Glasgow Caledonian University. If you have any further questions before you make
your decision please e-mail me at this e-mail address and I will get back to you as soon as possible.
If you decide to give permission or wish to refuse, please e-mail me at this e-mail address also.
Thanks,
Jordan Purcell

54
Appendix C
Recruitment Email
I am a student on the BA Social Sciences program at Glasgow Caledonian University, and I am
conducting a study to fulfil the requirements of a Psychology Empirical Project. The study concerns
perceptions of counselling for individuals with Autism Spectrum Disorder, and involves assessing
whether support workers feel that counselling is beneficial or not to those with Autism Spectrum
Disorder and why. I am looking for participants who have been employed as support workers by
Strathclyde Autistic Society for home support and play scheme work. I would be very grateful if you
would be willing to take part in my study. If you are interested, please contact me at the address
below. If you do so, you will have the chance to find out more about the study before coming to any
decision. You would be under no obligation to take part.
My study is supervised by Rosemarie Lynass, and she can be contacted on R.Lynass@gcu.ac.uk.
The use of email to recruit participants for this study has been approved by the Psychology Ethics
Subcommittee.
Jordan Purcell
Jpurce200@caledonian.ac.uk

55
Appendix D
PSYCHOLOGY EMPIRICAL PROJECT
JORDAN PURCELL
CONSENT FORM
Please initial box
1. I confirm that I have read and understood the information sheet dated 20/02/2015 for the
above study and have had the opportunity to ask questions and have had these
answered satisfactorily.
2. I understand that my participation is voluntary and that I am free to withdraw at any time
without giving any reason without my medical care or legal rights being affected.
3. I agree to take part in the above study.
4. I understand that my participation will be recorded and analysed, anonymised
quotes may be used in publications about the research however it will not be
possible to identify me from this information. I give my permission for this.
5. I understand that the results from this work may be published however it will not be
possible to identify any participant from this
___________________________ ____________ ___________________________
Name or initials of participant Date Signature or initials
___________________________ ____________ __________________________
Name of person taking consent Date Signature
(if different from researcher)

56
Appendix E
Appendix 5
Participant Information Sheet: Support Workers’ Perspectives on Counselling for those with
Autism Spectrum Disorder
Introduction and study purpose
You are invited to take part in a study about the issues and benefits for those with Autism Spectrum
Disorder when participating in counselling therapies in Glasgow. The aim of the study is to analyse
whether support workers feel that clients with Autism Spectrum Disorder might benefit from
counselling. The research is being carried out by Jordan Purcell at Glasgow Caledonian University
under the supervision of Dr Rosemarie Lynass of Glasgow Caledonian University’s psychology
department.
Your contribution to the study will help us to understand more about how support workers think and
feel about the benefit of counselling for those with Autism Spectrum Disorder. Before you decide
whether or not to take part, it is important for you to understand what participation in the study will
involve for you. Please take time to read the following information carefully and discuss it with others if
you wish. Please contact us at the address below if you would like more information.
What will I have to do if I take part?
If you are interested in taking part, you are asked to participate in an interview which will require you to
answer approximately five questions which will be asked by the researcher. It may take approximately
30 minutes to complete. You will be asked to complete the consent form and read the information
sheet before you participate in the study should you choose to do so.
Do I have to take part?
No. It is up to you to decide whether or not to take part. You can stop taking part in the study at any
time, without giving a reason. This will not affect any medical care you might receive.
What are the possible disadvantages and risks of taking part?
You will be interviewed by a colleague of Strathclyde Autistic Society. Although there will be no
personal questions regarding work ethos, if this does make you feel uncomfortable then you are free
to refuse participation or to withdraw from the study at any time. None of the questions asked will be
personally intrusive to the participant and will only ask for information regarding experience and
perspectives, not personal feelings, e.g. “How common do you think it is for people with Autism
Spectrum Disorder to be offered counselling? Why do you think this is?”. You should not give any

57
personal information about yourself, the clients or the organisation at any point throughout the
interview process. No individual information will be reported back to the manager, however
information gathered across all of the interviews will be included in the final report.
What are the possible benefits of taking part?
We can’t promise that the study will help you personally. However, the results should help our
understanding of support workers perspectives on the experience of counselling therapies for those
with Autism Spectrum Disorder.
What happens when the research study stops?
Written reports of the study findings will be available from May 2015. However, if you wish, a copy of
the report can be requested from Jordan Purcell at the e-mail address given at the end.
What if there is a problem?
If you are concerned about your participation in the study and would like to speak with someone out
with the research team, please contact Rosemarie Lynass on the e-mail address given below.
What will happen to the information that you give?
The data will be collected through an iPhone. The data will then be stored onto the researcher’s
laptop using an encryption program in order to ensure complete confidentiality. The data will then be
transcribed by the researcher and put into the empirical project. The encrypted data will then be
destroyed and all information wiped from the hard drive of the laptop.
Will my taking part in this study be kept confidential?
Yes. Ethical and legal practice will be followed, and all of your information will be handled in
confidence. . Names and addresses are stored securely, and will be destroyed after the study has
been completed. The responses that you provide will be treated in confidence. Your rights are
protected under the Data Protection Act and any information that might identify you will not be shared
outside of the research team. No identifying information will appear in any documents or in the final
report.
What will happen to the results of the research study?
The data will be analysed and will be available to a range of people, including the research team,
health professionals and researchers through written reports, established website reports, the media,
presentations and journal publications. However, it will not be possible to identify any individual
participant from these reports or publications.

58
Who has reviewed the study?
Ethical Approval has been granted by HLS committee.
Further information and contact details
You can get more study information or discuss the project with the research team at: Jordan Purcell,
Glasgow Caledonian University, jpurce200@caledonian.ac.uk, 07736346053 or from the supervisor:
Rosemarie Lynass, Glasgow Caledonian University, R.Lynass@gcu.ac.uk.
What happens next?
If you decide you are interested in participating in the study after reading this information sheet, please
e-mail the researcher Jordan Purcell and arrange a time for the interview. You will be given the
consent sheet and information sheet upon arrival at the interview. If you would like to find out more
about the research before participating please do not hesitate to contact Jordan Purcell. Thank you for
taking the time to read this study information sheet.

59
Appendix F
APPENDIX 6
Question 1.
How common do you think itis for people with
Autism Spectrum Disorder to be offered
counselling?
Why do you think this is?
Question 2.
How common do you think itis for people with ASD
to seek counselling?
Why do you think this is?

60
Question 3.
Do you think that counsellingcould behelpful if it
was offered to people with Autism Spectrum
Disorder? Why?
Question 4.
Are there any barriers thatyou think would be faced
by people with Autism Spectrum Disorder if they
were to participatein counselling? Whatdo you
think these barriers mightbe?

61
Question 5.
Are there any ways in which you think counselling
could be made more accessibleto those with ASD?

62
Appendix G
Debrief
Thank you for your participation in the study, it is greatly appreciated. The aim of the study was to
discuss whether counselling therapies are beneficial to those with Autism Spectrum Disorder from the
perspectives of support workers. Please remember that any information you provided will remain
confidential and will not be discussed with the head of the company or any employees unless it gives
the researcher cause for concern that anyone is in danger. The main researcher and supervisor can
be contacted via the contact details given to you in the information sheet and recruitment e-mail.
Thank you again,
Jordan Purcell
Principal Researcher
Glasgow Caledonian University

63
Appendix H
Research-related Risk Assessment
Name of Interviewer/Researcher Miss Jordan Purcell
Name of Supervisor/Principal
Investigator
Dr Rosemarie Lynass
Name of Study Support Workers Perspectives on Counselling
for those with Autism Spectrum Disorder
Number of respondents 5
Date study start 20/02/2015
Date (approx) study ends 01/05//2015
Give a brief description of the study:-
The study aims to gather information on support workers perspectives on counselling for those with
Autism Spectrum Disorder. The study aims to recruit five participants who will take part in an
interview which will take place in an IT room at Centre 81, where the Strathclyde Autistic Society’s
main office is based. The participants will be recruited via e-mail using the e-mail addresses which
they use to contact Strathclyde Autistic Society and receive their time sheets and work information.
The participants will be given the consent forms and information sheets to sign before they participate
in the study should they choose to do so. The participants will then be asked five open ended
questions regarding their experience in working with those with ASD and their experience and
perspectives of counselling for those with ASD. Each interview should not take any longer than thirty
minutes to complete. The participants will then be debriefed and thanked for their participation in the
study. The data recorded will then be encrypted onto the researchers laptop and data will be
transcribed and findings written into the final report.

64
If you do not feel a risk assessment is necessary, please provide a rationale for this decision:

65
Identifications of hazards
Please indicate in the table below hazards identified as pertinent to your research project and rate
them and indicate your rating of the likelihood of the identified hazard causing actual harm. Please
refer to research related risk assessment guidelines (Forms A & B).
Level of Risk = severity of harmful event x likelihood of event occurring
Risk Assessment and Response Matrix
Likelihood of Occurrence
⇓
High 4 Tolerate/
Treat
7 Treat/
Transfer
9 Treat/Transfer/
Terminate
Medium 2 Tolerate/
Treat
5 Treat/
Transfer
8 Treat/Transfer/
Terminate
Low 1 Tolerate 3 Tolerate/
Treat
6 Treat/Transfer
Impact of Risk ⇒ Low Medium High
e.g. Hazard 1 medium likelihood of occurrence x low impact = tolerable or treat
Hazard 2 high likelihood of occurrence x high impact = treat, transfer or STOP
Hazard Severity Likelihood Treatment of
Risk

66
1. Participants and researchers
being colleagues
Low high tolerable
2. Not guaranteed anonymity Low high tolerable
3. Interviews off campus Medium high treat
4. Participants divulging
information of a personal
nature or information which
the researcher feels may put
others in danger.
medium low Treat
Devising and implementing safe working practice
Describe below what measures will be taken to minimize the risks identified above and promote safe
working practice:-
The participants of the study will be colleagues of the researcher. However, the researcher will not
ask anyone who they have worked with closely or regularly on a one to one basis to participate in
order not to jeopardize the studies ethical authenticity. The main researcher does not work alongside
any other colleague at the moment during home support and has not for the past two years and has
minimal contact with other employees as the only time they are required to see each other is at staff
training or staff meetings which do not occur often.
As the participants are employees of the same company as the main researcher, the questions will be
clearly relating to the participants general perspectives and not their perspectives or experience with
any client in particular. Participants will be told before the interview not to divulge any personal
information about themselves, clients or the organisation. If a participant says anything regarding
their work which the researcher feels may put clients or other staff in danger, the researcher will have
a duty of care to report this to Susan Dolan, the manager of Strathclyde Autistic Society.
Due to the researcher being a colleague, anonymity is not guaranteed as the researcher is able to
identify the person whom they know as a colleague. However, the participant will be guaranteed
complete confidentiality.
The interviews will take place off campus which is also a risk. However, the interviews have been
arranged to take place in an IT room in centre 81, which is the community centre where the west
Dunbartonshire office of Strathclyde Autistic Society is based. This means that this is a familiar
environment for the participant and the participant and researcher are also aware of all health and
safety and fire safety procedures. The interviews will take place in the evening, after the Strathclyde
Autistic Society office has closed in order to prevent participants from feeling uncomfortable or being
distracted by other employees of the charity. This will also prevent participants from discussing the
interview beforehand. The leisure centre will still be open and there will be community classes taking
place until 9pm, when the care taker will lock the building. The interviews will finish before the centre
closes. This is normal practice, the Strathclyde Autistic Society office closes at 5pm every weekday.

68
Appendix I
EC1 - Version5- August2014
School of Health & Life Sciences
Application and Guidance notes for Ethical Approval
for Research
The School of Healthand Life Sciences has three departmental ethics
committee. Please tick whichcommittee youwishtosubmit your
applicationto (please indicate withanX)
Nursing and Community Health (Chair: Dr NicolaRoberts)
Psychology, Social Work and AlliedHealthSciences (Chair:Dr Phil
Dalgarno)
X

69
Life Sciences (Chair: Dr Les Wood)
Category of principal applicant (please indicate withanX)
Staff: Research student (PhD/Prof D/DPsych):
Taught postgraduatestudent: Undergraduatestudent:
Locationof researchwork (please indicate withanX)
On campus: Off campus:
One copy of all of the paperwork for an ethics application shouldbe
submittedelectronically toHLSEthics@gcu.ac.uk
X
X

70
School of Health & Life Sciences Ethics Committee Application Form
Project Title: Support Workers’ Perspectives on Counselling for those with Autism
Spectrum Disorder
Principal Investigator (s): Jordan
Purcell
Email address:jpurce200@caledonian.ac.uk
Supervisor: Rosemarie Lynass
Other academic staff involved:
Project start date: October 2014 Project Duration: 8 months, May 2015
Date application Submitted:
20/02/2015
Is this a clinical trial: No
YOU MUST ANSWER ALL QUESTIONS YES NO N/A
1 Will you provide participants with a written information sheet in
advance of the study describing the main procedures so that they are
informed about what to expect in your study?
2 Will you tell participants that their participation is voluntary?
3 Will your participants be able to read and understand the participant
information sheet?
4 Will you obtain written informed consent for participation?
(consent is implied for questionnaire studies)
5 Will you tell participants that they may withdraw from the research
at any time without penalty and for any reason?
6 With questionnaires/interviews, will you give participants the option
of omitting questions they do not want to answer?
7 Will you tell participants that their data will be treated with full
confidentiality and that, if published, it will not be identifiable as
theirs?
X
X
X
X
X
X
X

71
8 Will you give participants a brief explanation of the purpose of the
study at the beginning of their participation in it, and answer any
questions?
9a Will your project involve deliberately misleading participants in any
way?
If YES, go to question 9b. Please note you must provide a
justification in the research proposal.
9b If YES, will an explanation be offered following participation?
10 Is there a realistic risk of the participant/researcher experiencing
either physical or psychological distress or discomfort?
If YES, give details in the research proposal and state how you will
address these risks (e.g. who they can contact for help).
11 Do the participants fall into any of the following special groups? If
the answer is YES, indicate which group(s) by ticking the
appropriate box(es):
Children (under 18 years of age)
Children (under 5 years of age)
People with a disability such as learning and
communication difficulties.
Please specify:
Pregnant women
People studied with respect to mental or sexual health
People in custody
People engaged in illegal activities (e.g. drug-taking)
Non-human animals
Patients/service users
X
X
X
X
X

72
NOTE:You may also need to obtain clearance from Protection of
Vulnerable Groups (PVG) or an equivalent authority.
You must tick either Box A or Box B below and provide all relevant information in support
of your application. If you answered NO to any questions 1 – 3, 5-8, or YES to any questions
9 – 11, then you must check Box B.
A I consider that this project has no significant ethical implications to be brought to the
attention of the University Research Ethics Committee.
Please provide a short study protocol in a separate attachment of no more than 2 sides of A4 (Arial
font size 10). The accompanying notes give additional information about how to write the protocol.
Your proposal must include the following sections:
1. Project title (with student name or staff member name clearly stated)
2. Version number.
3. Background information.
4. Aims and objectives of the study.
5. Brief description of participants and recruitment methods (sample, numbers, access,
recruitment and inclusion and exclusion criteria)
6. Brief description of the research methods and measurements. Include details on how the
data will be securely stored and disposed of.
7. Consent, confidentiality and anonymity
8. Risks to participants/self
Arrangements for debriefing. You must also provide the intended (1) Participant Information
Sheet(s), (2) Consent Form(s), (3) copies of any non-validated or validated tools/questionnaire(s),
(4) details of interview questions you plan to use, (5) notices advertising the study, (6) draft letter(s)
for gatekeeper accesspermission to recruit participants and (7) replies/proof of gatekeepers
approval for access to recruit participants
B I consider that this project may have significant ethical implications that should be
brought to the attention of the University Research Ethics Committee.
Please provide a short study protocol in a separate attachment of no more than 4 sides of A4 (Arial
font size 10). The accompanying notes give additional information about how to write the protocol.
Your protocol must include the following sections:
1. Project title (with student name or staff member name clearly stated)
2. Version number.
3. Background information.
4. Aims and objectives of the study.
X

73
5. Brief description of participants and recruitment methods (sample, numbers, access,
recruitment and inclusion and exclusion criteria)
6. Brief description of the research methods and measurements. Include details on how the
data will be securely stored and disposed of.
7. Consent, confidentiality and anonymity.
8. Risks to participants/self (include a risk assessment form).
9. Arrangements for debriefing.
10. A clear statement of the ethical considerations raised by the project and how you intend to
deal with them.
You must also provide the intended (1) Participant Information Sheet(s), (2) Consent Form(s), (3)
copies of any non validated or validated questionnaire(s), (4) details of interview questions you
plan to use, (5) notices advertising the study, (6) Risk Assessment form, (7) draft letter(s) for
gatekeeper access permission to recruit participants and (8) Replies/proof of gatekeepers approval
for access to recruit participants
Declaration
I am familiar with the Declaration of Helsinki and professional body code of human research
ethics (e.g. BPS), and have discussed them with the other researchers involved in the project.
I confirm that my research abides within these guidelines.
Signature
Date
Principal Investigator Jordan Purcell 20/02/2015
Supervisor Rosemarie Lynass 20/02/2015
There is an obligation on the Principal Researcher and/or the Supervisor to bring to the
attention of the Ethics Committee any issues with ethical implications not covered by
the above checklists.

74
Please complete the checklist withdetails of the documents whichare
includedin your submission (where applicable)*
EC1 form X
2 page protocol (forthose with no significant
risks) or 4 page protocol (forthose WITH
significantrisks)
X
Participantinformationsheet(s) X
Consentform(s) X
Non-validated orvalidated tools/questionnaires n/a
Interviewguide/schedule X
Advert/noticesforstudy n/a
Riskassessmentform (if applicableforthose WITH
significantrisk))
X
Your letter(s) whichrequest accesspermissionto
recruitparticipants
X
Gatekeepersapprovalsforaccesspermissionto
recruitparticipant
X
*Paperwork associated with your application does not need to be anonymised. Only
one set of these documents are needed. These can be sent as one large word document,
please do not send a combined PDF document.

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