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1.Person Centred Approach
2.Risk and Resilience
3. Social Exclusion

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Themes: person-centred, social exclusion, rejection, loss and identity issues, safeguarding, fear, trust, exclusion

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Themes identified
Person centred  approach ,  data protection,/ confidentiality , equal opportunities ,  social exclusion  , identity , power dynamics , counselling

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Theme 1: Counsellor Role:
person centered counseling, Therapeutic relationship building
Non judgmental
Safe space
Active listening
Openness

Theme 2: Referred persons Experiences
Fear, Grief, Loss
Safety, vulnerability,
Expectations, Self image, Resilience

Theme 3: Social implications and prospects
Family
Friends
Isolation
Community
Support
Opportunities

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THEME ONE
Person centered practice ,unconditional positive regard

THEME TWO
Mental health and the consequences of  loss.

THEME THREE
Isolation and exclusion

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Themes:

1. Person centred counselling: freedom for the client, quality relationship between the counsellor and the client, no to agenda and pathologising.

2. Coming out issues: relationships, fear of rejection and feeling of loss.

3. Social part of life and mental wellbeing: safety vs abuse, isolation vs finding people who share similar experiences.

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RUKE UDOSEN                                Themes identified                     Person centred practice,  Confidentiality, Power Issues, Loss and rejection, Safeguarding and neglect, Family and ecological systems theory

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RUKE UDOSEN                                Themes identified                     Person centred practice,  Confidentiality, Power Issues, Loss and rejection, Safeguarding and neglect, Family and ecological systems theory

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Theme 1: Person Centred Approach to Practice
Theme 2: Therapeutic Intra-Relationship Based Practice.
Theme 3: Statutory requirements to access services and the impact on Person Centred Approach.
Theme 4: Impact of Social Policy requirements on the Service User's Mental Health and Wellbeing.
Theme 5: Systems Theory and the impact of personal support networks on accessing Services.

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1. person centred/non-judgemental
2.mental wellbeing
3.social isolation

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1. Person centred counselling, non-judgemental, no agenda.
2. Rejection-  family, socially, emotional, fear.
3. Loss- sense of loss, grief

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Themes
1.  Person centred working: non judgement, relationship building, client at centre and leading
2. Power dynamics of NHS to client - how it makes people feel due to mandatory nature of the counselling. - counsellor as gatekeeper to service. - medicalisation of gender identity
3.  Grief and loss - loss of family or friends/fear of loss of these/loss of self identity.
4. risk and resilience - risk posed by others, risk to self for some people.
5. Support networks
6. Importance of experience sharing.

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Theme 1- Gender Identity and person-centred approach
Theme 2- Mental Health and social isolation
Theme 3- Community support and social networks

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Theme 1 - Person centred counselling – Building Rapport - Opportunity

Theme 2 – Social Exclusion – Social Progression – Social Isolation

Theme 3 – Networking – Mental Health

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Theme 1 - Person centred counselling

Non-judgemental / No
set agenda

Theme 2 – Mental
health

Suicide
Exposure
Grief and loss
Identity

Theme 3 - Barriers

Social exclusion

Isolation
Experience
Personal

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1: person centred counselling
Relationship building
Grief and loss
Individual choices
2:identity
Denial
Grief and loss
Exposure
Fearful
3:
Barriers
Social exclusion
Isolation
Experience
Personal
4: social support networks and community
Mental health wellbeing
Acceptance

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1. Person-centered counselling
2. Social exclusion and loss
3. Safety and resilience

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Theme 1- Person centred: describing core conditions to counselling,  non-judgemental, there for the client, not reporting back to referrer
Theme 2- Organisational agenda/constraints: service provision due to NHS criteria, "sent with an agenda", lack of choice to attend due to criteria
Theme 3- Loss and rejection: experience of loss multi-dimensional including loss of family, loss of life and identity living in with a different identity,
Theme 4- Safety both physically and mentally: physical safety compromised and at danger, mental health suffered from isolation and living with different identity

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Theme 1: Gender Identity:
The rejection that societal institutions lead people to feel, purely as a result of how they define their gender. Also, the online and physical communities that pop up around this, and the shared experience that engenders.

Theme 2: Mental Health:
The consequences of the rejection mentioned above - Depression, self-harm and isolation from important relationships.

Theme 3: Institutional Responses, Good and Bad:
The medicalisation of the condition, and how this process can be narrow or incomplete for people, and how person-centred counselling seeks to redress this by putting someone and their identity first, and reflexively acknowledging the possible effects of therapy and 'treatment'.

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Theme 1
Person centred
Counselling
Appreciating individuality
Developing relationship

Theme 2
Gender identity
Fear
Rejection / Isolation

Theme 3
Depression
Social Exclusion

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Theme 1: Gender re-assignment
Living in a wrong body evokes sense of loss.
Counselling is crucial to jumping through the steps.
Counselling enables interviewees to explore their situation.

Theme 2: Person Centred Approach
Therapeutic relationship
No set agenda, exploratory

Theme 3: Social Exclusion
Loss of relationship
Rejection
Depression
Self-harm

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Theme 1- Person centred
-Client speaks about what is important to them, not a checklist approach
- client leading the conversation; deciding what what they want to talk about
-'present as whoever they want to be'
-building rapports with clients through 6 sessions

Theme 2- power dynamics
- No advice or solutions offered by the counsellor
- abuse (verbally) in public places
-loss of family relationships
'don't ever speak to me again'
-social isolation 'not in my world'

Theme 2- disclosure of gender
-self denial
-fear of rejection
-loss
- time period- waiting until teenage years to change

Theme 4- support networks
-Focus on close friends and some forums
- 'online community'
-Shared experience through online sites

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Theme 1- Gender re-assignment as a 'journey':
'Sense of loss for part of life spent living in wrong body.
Counselling as part of mandatory process "All these steps or hoops to jump through".
Service users usually at a stage of feeingl confident to talk once they are referred.
Interviewee sees counselling as an exploration/no set agenda

Theme 2- Bureaucratic/Medicalisation:
Mandatory sessions as part of process
Old paradigm of seeing transsexualism as starting journey of medicalised process including hospitalisation.
(Societal) Connotations of having a 'condition'.

Theme 3 - Importance of person-centred counselling:
Significance on establishing good relationship. Freedom to talk about any subject.
Encouraging complete freedom of expression.

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Theme 1
Person centred approach
Counselling
Individual choices
Therapeutic relationship

Theme 2
Identity
Socially excluded
Abuse
Image of self in the society

Isolated

Theme 3
Mental health
Depression

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Theme 1
Individual choices:
Client can choose topic of discussion in counselling.
Client can wear what they like and be addressed what name they prefer.
Client can choose whether or not they discuss their gender identity with family and friends.
Clients have the choice of using online support groups

Theme 2
State requirements:
The NHS dictate that clients must attend the sessions.
NHS dictates the duration of the sessions (6).
Gender identity highly medicalised in treatment.

Theme 3
Societal barriers:
Clients often suffer abuse and isolation
Clients often feel isolated from friends and family and their communities.
Clients fear they cannot express themselves fully as may be unsafe.

Theme 4
Mental Health issues:
Loss of identity is very real
Loss of close relationships is also a real risk
Isolation and depression are common
Fear of rejection feeds into this

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Theme 1: Person-centred counselling
This theme explains the approach of the counselling, what it means to be person-centred and helps the client understand what can be expected.  It also considers the therapeutic relationship.

Theme 2: Disclosure of Gender Identity.  This theme discusses emotions individuals experience when accessing professional support and that of friends of family.

Theme 3: Living with Gender Identity.
This theme discusses the difficulties experienced when trying to live out  identity in society and the standards that must be met by the professionals in order to be who they are

Theme 4: Social Support.  This theme discusses the importance of social support and networks, including social media, for the wellbeing of a group of people who can often be socially excluded.

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Themes are highlighted green & codes below. Hope I have done this right.

Theme 1 Feelings
Emotions - Transgender
Moving On
Relationships  - Family
Double Life
Wrong Body

Theme 2 Socially Excluded
Abuse - Safety
Depression
Self - Harm

Theme 3 Person Centred Approach
Counselling
Rapport
Shared - Experiences
Individualisation
Freedom

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| Themes  1.    The clients understanding of why they have been sent for person-centred counselling.  2.    The interviewer acknowledges the role of the counsellor.  3.    The clients lived experience.   4.    The emotional and physical impact on client’s wellbeing.     5.    The client’s social and supportive networks.    6.    The benefits of counselling for the client.           |  |  | WAYNE MARTIN Sub Theme 1  Clients understanding of the process, 8 -14.  Clients expectations of the process 11-13,   Interviewer empathising with counsellors role, 36 - 40,    Counsellor’s stories of clients experiences, 56-62, 69-71.   Counsellors account of abuse suffered by clients, 92, 93.  Counsellors account of self harm, 103, 104.   Counsellors understanding of the benefits of social and supportive networks for clients,    Counsellors understanding of the benefits of counselling to clients, 116-122.      | Sub Theme 2  Interviewers understanding of what person centred counselling is, 15, 19, 23    Interviewer empathising with clients, 45 - 48    Client’s stories of loss and rejection, 76, 77.   Interviewers accounts of the emotional impact on clients, 94-98.      Interviewer’s appreciation of the link between social media and client wellbeing, 113-115.